Severity of post-traumatic stress disorder and childhood abuse in adult crime victims as mediated by low resilience and dysfunctional coping strategies

Abstract

Background: Experience of childhood abuse has been suggested to increase the severity of posttraumatic stress disorder (PTSD) in adulthood. We hypothesized that resilience and coping strategies, which could be altered by experiencing childhood abuse, may mediate the effects of childhood abuse on PTSD severity in adulthood. Methods: Crime victims with PTSD (n = 212, 38 men, aged 20-65 years) were recruited from South Korea. PTSD severity, a history of childhood abuse, resilience level, and use of coping strategies were assessed using structured clinical interviews and self-report questionnaires. Upon identifying the key factors that were associated with childhood abuse and PTSD severity, mediating roles of these key factors were examined using structural equation modeling and bootstrapping in simple and multiple mediation analyses. Results: Resilience and dysfunctional coping strategies mediated the association between childhood abuse and lifetime PTSD severity in the adulthood, after covarying for the number of repeated trauma exposure (total effect: beta = 0.44, P = 0.01, 95% CI [0.10, 0.77]; direct effect: beta = 0.02, P = 0.90, 95% CI [-0.34, 0.38]; indirect effect: beta = 0.42, P = 0.003, 95% CI [0.14, 0.69]). Limitations: Recall of childhood abuse experience and lifetime PTSD severity can be biased in crime victims. Conclusions: These findings may suggest that resilience and coping strategies mediate the detrimental effects of childhood abuse on lifetime PTSD severity. Targeted treatments that are designed to enhance resilience as well as deter the use of dysfunctional coping strategies may be of help in crime victims with a history of childhood abuse.