Sex-Abuse Trauma?
Or Trauma from Other Sources?

Protocols for Making the Differentiation In Legal and Therapeutic Evaluations

How to Make Critical Assessments for Trauma When Sex Abuse Has Occurred

• Which symptoms, if any, are the direct result of the sexual abuse?
• Which symptoms have other sources and what are they?
• Vital for the treatment of sexually abused children
• Crucial for determining damages in lawsuits

Children who have been sexually abused may react along the whole range from no reactions at all, to psychosis, and all points in between. Accordingly, there is no such entity as a "sex-abuse syndrome." There are, however, symptoms that are more commonly seen than others. The problem of identifying symptoms that are the direct result of sexual abuse is often complicated by the presence of symptoms that may have antedated the abuse and symptoms that have other sources--such as family difficulties. Furthermore, when the abused child becomes involved in the legal process there may be an exacerbation of the symptoms that were the direct result of the sexual abuse or the introduction of new symptoms sometimes introduced by overzealous examiners. But the problem does not stop there. Children in treatment with poorly trained therapists may also suffer with an intensification of symptomatology and the introduction of new symptoms that might not have otherwise arisen.

Sorting out the various sources of the sexually abused child's symptoms presents a formidable task for the evaluator. However, such identification is extremely important for the therapist in order to select the proper therapeutic approach(es). And evaluators working within the legal framework do well to make these important distinctions in order to provide the court with the most accurate information regarding which symptoms are the direct result of the sexual abuse and which have other sources. These discriminations can be particularly important when one is providing findings that can be useful in determining legal damages, both compensatory and punitive.

The protocol consists of 50 areas of inquiry from four different categories. The Sexual Effects Group (#1 - #7), The Posttraumatic Stress Disorder Group (#8 - #21), The Nonspecific Effects Group (#22 - #32), and The Projectives Group (#33 - #50). Each item can be scored in one of six ways: (1) No Psychological Trauma (NPT),(2) Psychological Trauma Resulting from Sexual Abuse (PTSA), (3) Legal Process/"Therapy" Trauma (LPTT), (4) Psychopathology Unrelated to the Sex-Abuse Accusation (PUSAA), (5) Equivocal (Eq), and (6) Not Scorable(NS).