Diversity of Adaptation Profiles in Youth Victims of Child Sexual Abuse

Objective: Child sexual abuse (CSA) is associated with long-term negative consequences in adolescents, but some survivors display resilience. The purpose of this study was to delineate profiles of adaptation in adolescent victims of CSA and to examine their associations with individual and environmental-systemic protective factors. Method: As part of a population-based survey, 8,230 high school students were questioned about CSA and completed measures assessing a host of protective factors and indicators of positive adaptation across 5 domains: self-perception, academic success, mental health, health risk behaviors and romantic relationships. Results: Using a latent class analysis, a best fitting model of 4 classes was identified. This model included a reference group of nonsexually abused teenagers and 3 classes characterizing survivors of CSA: Resilient profile (33% of youth), Externalized profile (34% of youth) and Internalized profile (33% of youth). Sexually abused youth assigned to the Resilient profile were similar to nonsexually abused youth in terms of self-esteem, academic performance, absence of clinical levels of psychological distress and dating violence. Despite experiencing CSA of comparable severity, youth in the Resilient profile reported more optimism and were less likely to rely on avoidant or emotional strategies to cope with difficulties and more likely to report high maternal and paternal support. Conclusions: Findings highlight the utility of a person-oriented approach to enhance our understanding of the diversity of adaptation profiles in youth victims of CSA. Results also underscore the importance of tailoring intervention efforts to efficiently tackle the diverse needs of teen victims of CSA. Clinical Impact Statement Child sexual abuse is associated with a host of negative repercussions. Yet, our results reveal that 1 out of 3 survivors appears to be resilient and report positive self-esteem, academic success, low levels of psychological distress and health-risk behaviors and romantic relationships free of violence. These teenagers appear to display optimism, are less likely to rely on avoidance when dealing with stressors and benefit from maternal and paternal support. Our findings suggest a diversity in outcomes following child sexual abuse and the need to offer tailored-approaches to address the diverse needs of teenagers with a history of child sexual abuse.