An analysis of the association between posttraumatic stress disorder and depression with post-trauma negative cognitions, peri-trauma distress, emotion regulation and behavioral avoidance

This study investigates various demographic, mental and abuse-related characteristics of adolescent female survivors of sexual trauma in need of institutional care. The predictive role of the severity of peri-trauma emotional reactions, post-trauma behavioural avoidance, emotion regulation strategies and the post-traumatic negative cognitions in posttraumatic stress disorder (PTSD) and depression were examined in two regression models. Participants consisted of 109 girls between the ages of 12 and 18 who were under care and protection because of their sexual abuse experience. They were recruited from a Child Support Center (ÇODEM) affiliated to the Istanbul Provincial Directorate of the Ministry of Family, Labor and Social Services. Results showed that 60% of the participants had probable PTSD, 43% had depression, and 69% of those with PTSD had comorbid depression. Age, sexual abuse features, and experience of physical and / or emotional abuse did not predict PTSD and depression; the severity of emotions experienced during sexual abuse, post-trauma behavioral avoidance and the use of dysfunctional emotion regulation strategies predicted both PTSD and depression. Post-trauma negative cognitions did predict PTSD, and only negative cognitions about self was weakly associated with depression severity. These findings suggest that successful treatment of female sexual abuse survivors requires development of emotion regulation skills and reduction of behavioural avoidance in order to help survivors cope with emotions like fear, anger, helplessness and sadness that may arise upon confrontation with trauma memory and traumatic triggers. Implications of these findings were discussed for institutional care of female adolescents of sexual abuse.