Date Published: June 21, 2018
Publisher: Public Library of Science
Author(s): Seung Min Bae, Jae Myeong Kang, Hyoung Yoon Chang, Woori Han, So Hee Lee, Soraya Seedat.
Somatization is a major post-traumatic symptom in sexually abused children. Thus, the present study aimed to determine the relationship between post-traumatic stress disorder (PTSD) symptoms and somatization, and between intelligence and somatization in child sexual abuse victims and to elucidate whether type of abuse had an effect on the relationship between PTSD symptoms and somatization.
This study evaluated the somatizations (Child Behavioral Checklist/6–18 [CBCL]), PTSD symptoms (Trauma Symptom Checklist for Children [TSCC]), and intelligence levels of 63 sexually abused children. Correlation and regression analyses were performed to predict somatization based on PTSD symptoms, intelligence, age, and type of sexual abuse, and to find moderating effect of type of abuse on the effect of PTSD symptom on somatization.
PTSD symptoms (β = 0.471, p = 0.001) and intelligence (β = 0.327, p = 0.021) were associated with somatization. Type of abuse was not, by itself, correlated with somatization (β = 0.158, p = 0.281), but it did have a moderating effect on the effect of PTSD symptoms on somatization (Type of abuse*PTSD symptoms, β = -0.299, p = 0.047). PTSD symptoms were associated with somatization only among those who experienced the molestation type of abuse.
Somatization in sexually abused children was influenced by the severity of PTSD symptoms and intelligence, and the effect of the PTSD symptoms on somatization was moderated by type of abuse. Specifically, the rape type of abuse may attenuate the effect of post-traumatic symptoms on somatization.
Child sexual abuse is a widespread and major public health problem . The definition of sexual abuse ranges from no contact (exhibitionism) to sexual intercourse, and victims can experience a variety of physical and emotional consequences. For example, psychiatric disorders such as major depressive disorder, generalized anxiety disorder, panic disorder, phobias, substance abuse, eating disorders, somatic symptom disorder, and post-traumatic stress disorder (PTSD) are correlated with child sexual abuse . PTSD is one of the most common sequelae of child sexual abuse . Among those who have experienced trauma, sexual abuse victims are the most vulnerable to the development of PTSD; indeed, 48% of this group develop PTSD as adolescents, whereas only 3% of those experiencing natural/other disasters meet criteria for PTSD . Somatizations often follow child sexual abuse . Specific and functional somatizations without a medical cause, such as chronic pelvic pain , irritable bowel syndrome, non-epileptic attacks , and back pain  have been reported to be associated with sexual abuse. Somatization is important in regarding that it can be an adaptive response to psychological distress  and accidental disclosure by post-traumatic somatization can initiate the intervention process and minimize the damage of the sexual abuse.
In the present study, PTSD symptoms correlated with somatization in sexually abused children. More specifically, intelligence and PTSD symptoms were associated with somatization, whereas age and type of abuse were not. Type of abuse alone had no effect on somatization, but it had moderating influence on the effect of PTSD symptoms on somatization.