Identification and Prevention of PTSD in Adolescents - Essay Sample

Introduction

Sexual child abuse causes great harm to the victims to the point of the victims losing focus in terms of prospects for a good future. Some of the results of sexual child abuse include MDD (Major Depressive Disorder), PTD (Post-Traumatic Disorder), and Risky Behaviors. It is crucial to determine ways of identifying PTSD in children and charting rehabilitation criteria to prevent permanent social damage to the victims. The methodology of the study will be explorative with a concerted focus on past literature. Arguably, post-traumatic social disorder exposes the victims to a sorry social state that renders them unable to accept themselves, hence, developing risky behaviors that see a good number of them resort to committing suicide.

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The design will follow the five stages of Whittemore and Knafl (2005) in the review of past literature on child sexual abuse. Furthermore, the CINAH database will be searched to review all publications relating to the topic and published between 2013 and 2017. Relevant study publications will be downloaded and saved for the purpose of repeated reviewing to assess their validity for use in this study. The study will carry out an in-depth review of the past literature and extracting data from the sources for subsequent interpretation, analysis, and presentation. Later, the results will be submitted to Ana G Mendez University System Institutional Review Board for ratification purposes. The ratification is crucial as it will validate the findings of this study by relating them with known facts. Distinctly, no human being or animal will participate in the study. The study is based on past literature and the research materials and final documents will be released to the public for research purposes.

Identification of Eligible Resources

All the studies included in this study gave empirical view of the Erickson's theory of psychosocial development and assessed a given group of adolescents' relationship with peers. The studies, further, had to be available, published in English, and had to address the main issue of this study. Studies that presented only theories based on gender, race or ethnicity were excluded from the study because the study is concerned about empirical assessment and not a mere theoretical review. The studies, also, had to clearly define dependability coefficients of the apparatus that were used to arrive at the conclusions. Finally, the results of the studies had to be clearly presented.

The resources used, also, included clinical studies conducted on sexual child abuse involving children of between 2 to 18 years of age. The eligibility of the materials was upheld if the materials contained children that belonged to the age bracket mentioned. Apart from the age bracket, the study materials picked would have a strong research back up. For instance, the sample size used in the publications and the selection criteria of the sample were taken into account. Research materials that did not satisfy the sample size and selection criteria were avoided. The studies, also, had to report the data that allowed for easy determination of DSM and MDD. The authors of the resource materials were contacted to explain the validity of the data. The information in the resources was compared with the already available literature on PTSD.

The Hypothesis of the Study

The null hypothesis assessed by the study was that sexually abused children are at a very high risk for a wide range of medical, psychological, behavioral, and sexual disorders that can persist into and throughout childhood and adulthood (Forman-Hoffman et al., 2016). The study was based on two aspects. First, the study aimed at identifying the risky behaviors and, secondly, the study focused on prevention criteria of the risky behaviors. The objectives of the study, also, focused on assessing the null hypothesis. The main objective was, therefore, to assess the indicators of post-sex abuse trauma in order to reduce risky behaviors in children. The hypothesis was assessed through assessing a variety of literature resources and comparing them with known facts for an amicable solution to be drawn.

Study Variables

The variables in the study included the age of the participants and the risky behaviors of the subjects included in the study. The age variable averaged less than 18 years and the behavioral variables included suicide, suicidal ideation, suicidal planning, and suicidal attempts. Similarly, the study included other variables relating to the authors. For instance, the name of the authors and the year the study was conducted and published was recorded as a variable; the place where the study took place was also recorded as a variable; the number of participants in the study was also recorded as one of the variables, the sex of the participants was also treated as a variable, together with prevalence and type of sexual abuse. The key words for searching the variables included the following: sexual abuse, post-traumatic stress disorder, suicidal ideation, behavioral changes, and suicidal attempts.

The resource materials were studied independently with a concerted focus on identifying the variables of interest. The variables were recorded in a table to make their interpretation easy during analysis. The table was divided into four columns with the author and year column, the country of sample, the size of the sample, and the age range. Resources with variables bearing a similar trend were then grouped for easy analysis. The table is as shown below.

Description of the Variables

The variables outlined above were crucial in studying the post-traumatic sexual disorders. Age refers to the age of the participants in the study when the respondents were sexually abused (Homma et al., 2012). The age was restricted to 18 years because the study focused on assessing the post traumatic experience of sexually abused children and adolescents. The other variable was suicide ideation and planning (Perez-Gonzalez & Pereda, 2015). Suicide is one of the most dangerous sexual behaviors portrayed by sexually abused adolescents. The variable helped to paint a picture on the extent to which victims of sexual abuse were traumatized and helped to formulate a prevention criteria. The study restricted the involvement of harms to the subjects who had MDD diagnosis (Odhayani, Watson, W. & Watson, L, 2013). Diagnosed subjects have a proof of sexual abuse and, therefore, their responses are more reliable than subjects without MDD diagnosis.

The age of the respondents when they were sexually harassed was also a considerable factor. Respondents who were abused at a very tender age were likely to suffer more than respondents abused at a more mature stage (McLean et al., 2014). The study was, thus, so much focused on finding out the variation in behavioral change in respondents based on the time when they experienced sexual abuse. The age of respondents at sexual abuse or harassment is assumed to contribute to internalization or externalization of post-trauma social disorders too since older subjects may feel ashamed to share their experience with professionals for help (Jones et al., 2013).

The publications used in the study were also treated as variables. The number of resources that had similar information of post-traumatic data offered a more reliable information that the publications that differed greatly from other publications. As such, the screening of the sources was thorough to ensure that they provided reliable information (Yuce et al., 2015). In total, 15 publications met the criteria set forth for selection. They contained reliable data that shed light on the true condition of the sexually abused adolescents. Sources that were left out of the study did not meet proper reference criteria, had inaccurate screening test, small size of the sample used to draw conclusions, and improper criteria of choosing patients. The treatment efficacy chosen by the study met the following conditions. First, the study used had to record minimum attrition rate ranging between 15% and 20% (Rageliene, 2016). Secondly, the studies had to show a great deal of attention to key confounders (Perez-Gonzalez & Pereda, 2015). Generally, sources that were deemed to have unreliable information were left out of the study.

Methods of Data Collection

In most of the studies that met the selection criteria of this study, questionnaires were used to collect data from the sample. McLean et al. (2014) used suicidal ideation questionnaire to gather information about suicide ideation and planning from their sample. On their side, Yuce et al. (2015) used the KSADS-PL and WISC-R to assess the post-traumatic stress disorder in their subjects. Law et al. (2017) used PHQ-9 Scores to assess the PTSD in sexually abused children. PHQ-9 has a variety of advantages over other information collection criteria. For instance, PHQ-9 is easy to administer to the respondents, easy to analyze the data, easy to fill by respondents, and it is available in all languages. As such, the methodology used by Law et al. (2017) is highly reliable for extension of results to this study. In the PHQ-9 scale, a score of less than 9 indicates that the respondent is not at a high risk of getting depressed. Despite the variety of methods used in data collection, most studies' results converged at the same conclusion regarding the post-traumatic state of stress of sexually abused children.

On their side, Jones et al. (2013) conducted interviews to ascertain the post-traumatic behavioral shifts in young adolescents aged between 2 and 12 years. The coding methodology of Jones et al. (2013), that included LONGSCAN and Child Behavior Checklist, offered a reliable view of behavioral changes that occur to sexually abused children and adolescents aged between 2 and 18 years. The CBLC was duly filled by primary caregivers who have experience in observing behavioral changes in young children and adolescents. Jones, also, used the CBLC criterion to assess the extent to what subjects (children and adolescents) internalize their behavioral changes. Further, the score assessed caregivers' propensity of externalizing behavioral change issues among children and adolescents.

A-CASI was also used by Jones et al. (2013) to assess whether the respondents were sexually abused. The A-CASI interview offers a reliable approach to identifying PTSD in children and adolescents and, thus, it enabled the researchers to deliver reliable results. Jones et al. (2013) also made use of a 'yes or no' question to assess if the respondents had had sex. In their assumption, sex below the age of 18 was considered to be initiation stage and it was as risky as sex at the age of 5 or less. The publication was, thus, considered very appropriate for this study and the results presented therein were considered enough be used in this PTSD study.

On their side, Henninger and Welman (1998) used the Trauma Symptom Checklist and Beck Depression Inventory to assess the extent to which the respondents were affected by sexual abuse in their lives. The Trauma Symptoms Checklist is five-point scale with depression and post-sex abuse behavioral changes as some of the points in the scale. On the other side, Beck Depression Inventory is a questionnaire that assesses the extent to what sex abuse affected the abused victims. The study conducted by Henninger and Welman is, thus, a powerful tool to shine light into the PTSD...