Posttraumatic Stress Disorder (PTSD) was first used to describe a set of symptoms experienced by combat veterans and individuals who survived a natural disaster. The trauma initiating this disorder would be one that is outside the normal range of experience for a human being that results in fear, terror, and helplessness. The grouping of symptoms includes categories related to:
- Reexperiencing the event
- Avoiding anything that is associated to the event
- Numbing of general responses
- Increased arousal
The effects of child sexual abuse fit within the PTSD model. Finkelhor (1988) provided an explanation that outlined symptoms of sexual abuse and placed them in the PTSD framework.
- Childhood sexual abuse is a stressor that initiates distress symptoms
- Victims reexperience the trauma through intrusive memories, dreams, and nightmares
- Victims experience numbing and become less involved in activities
- Victims feel isolated from others
- Victims experience a restricted range of emotions
- Victims experience hyper-arousal, sleep problems, problems with concentration
- Victims avoid reminders of the trauma
PTSD is not a universal reaction to childhood sexual abuse; however, many victims meet criteria for PTSD. Children sometimes do not demonstrate the symptoms, but instead move the developmental process and repress memories. Dissociation is closely associated to PTSD, and in a dissociated state, the victim avoids the reality of the abuse. Sometimes symptoms may not arise until adolescence or adulthood at which time other consequences are demonstrated.These may include compulsive behaviors (eating disorders, alcohol and drug use, sexual activity), cutting, suicidal thoughts and attempts, relationship difficulties, and poor school and work performance. The victim's symptoms may be exacerbated by betrayal issues resulting from the abuse and are worsened if the abuser was the father or another close family member.
Testa et al. (1992) outlined other factors that influence the development of PTSD and increased severity of symptoms following sexual abuse:
- Having experienced intercourse
- Abuse by a parent
- Severe abuse occurring over a long period of time
- Sexual abuse accompanied by physical abuse
- Bizarre sexual events during the abuse
- Multiple perpetrators
- Negative repsonse when sexual abuse is disclosed