Skip to main content
SpringerLink
Log in

Posttraumatic Responses to Childhood Abuse and Implications for Treatment

  • Chapter
Handbook of Dissociation

Abstract

In July 1993, the National Research Council (1993) published a comprehensive volume entitled Understanding Child Abuse and Neglect. In this volume, statistics from the US Department of Health and Human Services documented reports of child maltreatment in 1990 involving more than 2.7 million children. Not surprisingly, childhood trauma, usually in the form of childhood physical, sexual, or emotional abuse, or profound neglect, is a common feature in psychiatric patients. In recent years, clinical observations concerning childhood abuse and research studies have found that childhood physical and/or sexual abuse is reported in the histories of nearly two thirds of adult female psychiatric patients (Bryer, Nelson, Miller, & Krol, 1987; Chu & Dill, 1990; Surrey, Swett, Michaels, & Levin, 1990). Through clinical observations and recent research, the impact of both severe childhood abuse and the dysfunctional environments in which abuse occurs have increasingly become more clearly defined.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders ( 3rd ed. ). Washington, DC: Author.

    Google Scholar 

  • Bernstein, E. M., & Putnam, F. W. (1986). Development, reliability, and validity of a dissociation scale. Journal of Nervous and Mental Disease, 174, 727–734.

    Article  PubMed  Google Scholar 

  • Braun, B. G. (1986). Issues in the psychotherapy of multiple personality disorder. In B. G. Braun (Ed.), Treatment of multiple personality disorder (pp. 1–28 ). Washington, DC: American Psychiatric Press.

    Google Scholar 

  • Braun, B. G. (1990). Dissociative disorders as sequelae to incest. In R. P. Kluft (Ed.), Incest-relatedsyndromes of adult psychopathology (pp. 227–246 ).

    Google Scholar 

  • Washington, DC: American Psychiatric Press. Briere, J., & Conte, J. (1993). Self-reported amnesia in adults molested as children. Journal of Traumatic Stress, 6,21–31.

    Google Scholar 

  • Bryer, J. B., Nelson, B. A., Miller, J. B., & Krol, P. A. (1987). Childhood sexual and physical abuse as factors in adult psychiatric illness. American Journal of Psychiatry, 144, 1426–1430.

    PubMed  Google Scholar 

  • Chu, J. A. (1988). Ten traps for therapists in the treatment of trauma survivors. Dissociation, 1(4), 24–32.

    Google Scholar 

  • Chu, J. A. (1991a). The repetition compulsion revisited: Reliving dissociated trauma. Psychotherapy, 28, 327–332.

    Article  Google Scholar 

  • Chu, J. A. (1991b). On the misdiagnosis of multiple personality disorder. Dissociation, 4, 200–204.

    Google Scholar 

  • Chu, J. A. (1992a). The therapeutic roller coaster: Dilemmas in the treatment of childhood abuse survivors. Journal of Psychotherapy Practice and Research, 1, 351–370.

    PubMed  Google Scholar 

  • Chu, J. A. (1992b). The revictimization of adult women with histories of childhood abuse. Journal of Psychotherapy Practice and Research, 1, 259–269.

    PubMed  Google Scholar 

  • Chu, J. A. (in submission). Depressive and post-traumatic symptomatology in adults with histories of childhood abuse. Unpublished manuscript. Available through Dr. Chu, 115 Mill St., Belmont, MA 21–78.

    Google Scholar 

  • Chu, J. A., and Dill, D. L. (1990). Dissociative symptoms in relation to childhood physical and sexual abuse. American Journal of Psychiatry, 149, 887–893.

    Google Scholar 

  • Courtois, C. (1979). The incest experience and its aftermath. Victimology, 4, 337–347.

    Google Scholar 

  • Donaldson, M. A., & Gardner, R. (1985). Diagnosis and treatment of traumatic stress among women after childhood incest. In C. Figley (Ed.), Trauma and its wake (pp. 356–377 ). New York: Brunner/ Mazel.

    Google Scholar 

  • Finkelhor, D. (1984). Child sexual abuse: New theory and research. New York: Free Press.

    Google Scholar 

  • Foa, E. B., Steketee, G., & Rothbaum, B. O. (1989) Behavioral/cognitive conceptualizations of post-traumatic stress disorder. Behavior Therapy, 20, 155–176.

    Article  Google Scholar 

  • Freud, S. (1920). Beyond the pleasure principle. In The Complete Works of Sigmund Freud (vol. 18, pp. 7–64 ). London: Hogarth Press, 1955.

    Google Scholar 

  • Gelinas, D. J. (1983). The persisting negative effects of incest. Psychiatry, 46, 312–332.

    PubMed  Google Scholar 

  • Goldman, S. J., D’Angelo, E. J., DeMaso, D. R., & Mezzacappa, E. (1992). Physical and sexual abuse among

    Google Scholar 

  • children with borderline personality disorder. American Journal of Psychiatry, 149,1723–1726.

    Google Scholar 

  • Gunderson, J. G., & Chu, J. A. (1993) Treatment implications of past trauma in borderline personality disorder. Harvard Review of Psychiatry, 1, 75–81.

    Article  PubMed  Google Scholar 

  • Hall, R. C., Tice, L., Beresford, T. P., Wooley, B., & Hall, A. K. (1989). Sexual abuse patients with anorexia nervosa and bulimia. Psychosomatics, 30, 73–79.

    Article  PubMed  Google Scholar 

  • Herman, J. (1981). Father-daughter incest. Cambridge, MA: Harvard University Press. Herman, J. L. (1992). Trauma and recovery. New York: Basic Books.

    Google Scholar 

  • Herman, J. L., & Schatzow, E. (1987). Recovery and verification of memories of childhood sexual trauma. Psychoanalytic Psychology, 4, 1–4.

    Article  Google Scholar 

  • Herman, J. L., & Kolk, B. A. (1987). Traumatic antecedents of borderline personality disorder. In B. A. Kolk (Ed.), Psychological trauma (pp. 111–127 ). Washington, DC: American Psychiatric Press.

    Google Scholar 

  • Herman, J., Russell, D., & Trocki, K. E. (1986). Long-term effects of incestuous abuse in childhood. American Journal of Psychiatry, 143, 1293–1296.

    PubMed  Google Scholar 

  • Herman, J. L., Perry, J. C., & Kolk, B. A. (1989). Childhood trauma in borderline personality disorder. American Journal of Psychiatry, 146, 490–495.

    PubMed  Google Scholar 

  • Horowitz, M. J. (1976). Stress response syndromes. New York: Jason Aronson.

    Google Scholar 

  • Keane, T. M., Fairbank, J. A., Caddell, J. M., & Zimering, R. T (1989) Implosive (flooding) therapy reduces symptoms of PTSD in Vietnam combat veterans. Behavior Therapy, 20, 245–260.

    Article  Google Scholar 

  • Kernberg, O. F. (1967). Borderline personality organization. Journal of the American Psychoanalytic Association, 15, 641–685.

    Article  PubMed  Google Scholar 

  • Kernberg, O. F. (1968). The treatment of patients with borderline personality organization. International Journal of Psychoanalysis, 49, 600–619.

    PubMed  Google Scholar 

  • Kernberg, O. F. (1970). A psychoanalytic classification of character pathology. Journal of the American Psychoanalytic Association, 18, 800–822.

    Article  PubMed  Google Scholar 

  • Kirby, J. S., Chu, J. A., & Dill, D. L. (1993). Severity, frequency, and age of onset of physical and sexual abuse as factors in the development of dissociative symptoms. Comprehensive Psychiatry, 34, 258–263.

    Article  PubMed  Google Scholar 

  • Kluft, R. P. (1987). First rank symptoms as a clue to multiple personality disorder. American Journal of Psychiatry, 144, 293–298.

    PubMed  Google Scholar 

  • Kluft, R. P. (1989). The rehabilitation of therapists overwhelmed by their work with multiple personality disorder patients. Dissociation, 2, 244–250.

    Google Scholar 

  • Lindemann, E. (1944). Symptomatology and management of acute grief. American Journal of Psychiatry, 101, 141–148.

    Google Scholar 

  • Ludolph, P. S., Westen, D., Misle, B., Jackson, A., Wixon, J., & Wiss, E C. (1990). The borderline diagnosis in adolescents: Symptoms and developmental history. American Journal of Psychiatry, 147, 470–476.

    PubMed  Google Scholar 

  • Mahler, M. S. (1971). A study of the separation-individuation process and its possible application to borderline phenomena in the psychoanalytic situation. Psychoanalytic Study of the Child, 26, 403–424.

    PubMed  Google Scholar 

  • Mahler, M. S. (1972). Rapprochement subphase of the separation-individuation process. Psychoanalytic Quarterly, 41, 487–506.

    PubMed  Google Scholar 

  • Masterson, J. (1972). Treatment of the borderline adolescent: A developmental approach. New York: Wiley-Interscience.

    Google Scholar 

  • National Research Council, Commission on Behavioral and Social Sciences and Education, Panel on Research on Child Abuse and Neglect. (1993). Understanding child abuse and neglect. Washington, DC: National Academy Press.

    Google Scholar 

  • National Victim Center. (1992). Rape in America: A report to the nation. Arlington, VA: National Victim Center.

    Google Scholar 

  • Ogata, S. N., Silk, K. R., Goodrich, S., Lohr, N. E., Westen, D., & Hill, E. M. (1990). Childhood sexual and physical abuse in adult patients with borderline personality disorder. American Journal of Psychiatry, 147, 1008–1013.

    PubMed  Google Scholar 

  • Pribor, E. E, & Dinwiddie, S. H. (1992). Psychiatric correlates of incest in childhood. American Journal of Psychiatry, 149, 53–56.

    Google Scholar 

  • Putnam, E. W. (1985). Dissociation as a response to extreme trauma. In R. P. Kluft (Ed.), Childhood antecedents of multiple personality (pp. 65–97 ). Washington, DC: American Psychiatric Press.

    Google Scholar 

  • Putnam, E. W, Guroff, J. J., Silberman, E. K., Barban, L., & Post, R. M. (1986). The clinical phenomenology of multiple personality disorder: A review of 100 cases. Journal of Clinical Psychiatry, 47, 258–293.

    Google Scholar 

  • Ross, C. A. (1989). Diagnosis and treatment of multiple personality disorder. New York: Guilford Press.

    Google Scholar 

  • Ross, C. A., Anderson, G., Fleisher, W. P, & Norton, G. R. (1991). The frequency of multiple personality disorder among psychiatric inpatients. American Journal of Psychiatry, 148, 1717–1720.

    PubMed  Google Scholar 

  • Russell, D. E. H. (1986). The secret trauma: Incest in the lives of girls and women. New York: Basic Books.

    Google Scholar 

  • Saxe, G. N., Kolk, B. A., Berkowitz, R., Chinman, G., Hall, K., Lieberg, G., & Schwartz, J. (1993).

    Google Scholar 

  • Dissociative disorders in psychiatric inpatients. American Journal of Psychiatry, 150,1037–1042.

    Google Scholar 

  • Shapiro, S. (1987). Self-mutilation and self-blame in incest victims. American Journal of Psychotherapy, 41, 46–54.

    PubMed  Google Scholar 

  • Surry, J., Swett, C., Michaels, A., & Levin, S. (1990). Reported history of physical and sexual abuse and severity of symptomatology in women psychiatric outpatients. American Journal of Orthopsychiatry, 60, 412–417.

    Article  Google Scholar 

  • Swanson, L., & Biaggio, M. K. (1985). Therapeutic perspectives on father-daughter incest. American Journal of Psychiatry, 142, 667–674.

    PubMed  Google Scholar 

  • Terr, L. C. (1991). Childhood traumas: An outline and overview. American Journal of Psychiatry, 148, 10–20.

    PubMed  Google Scholar 

  • Ulman, R B, & Brothers, D. (1988). The shattered self. Hillsdale, NJ: Analytic Press.

    Google Scholar 

  • Vaillant, G. E. (1992). The beginning of wisdom is never calling a patient borderline. Journal of Psychotherapy Practice and Research, 1, 117–134.

    PubMed  Google Scholar 

  • Kolk, B. A. (1987a). The psychological consequences of overwhelming life experiences. In B. A. Kolk (Ed.), Psychological trauma (pp. 1–30 ). Washington, DC: American Psychiatric Press.

    Google Scholar 

  • Kolk, B. A. (1987b) Psychobiology of the trauma response. In B. A. Kolk (Ed.), Psychological trauma (pp. 63–79 ). Washington, DC: American Psychiatric Press.

    Google Scholar 

  • Kolk, B. A., & Kadish, W. (1987). Amnesia, dissociation and the return of the repressed. In B. A. Kolk (Ed.), Psychological trauma (pp. 173–190 ). Washington, DC: American Psychiatric Press.

    Google Scholar 

  • Kolk, B. A., & Hart, 0. (1989). Pierre Janet and the breakdown of adaptation in psychological trauma. American Journal of Psychiatry, 146, 1530–1540.

    PubMed  Google Scholar 

  • Kolk, B. A., Perry, J. C., & Herman, J. L. (1991). Childhood origins of self-destructive behavior. American Journal of Psychiatry, 148, 1665–1671.

    PubMed  Google Scholar 

  • Watkins, J. G., & Watkins, H. H. (1979). The theory and practice of ego-state therapy. In H. Grayson (Ed.)

    Google Scholar 

  • Short-term approaches to psychotherapy (pp. 176–220). New York: Human Sciences Press.

    Google Scholar 

  • Zanarini, M. C., Gunderson, J. G., & Marino, M. F. (1987). Childhood experiences of borderline patients. Comprehensive Psychiatry, 30, 18–25.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Dissociative Disorders Program, McLean Hospital, Belmont, Massachusetts, 02178, USA

    James A. Chu

  2. Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, 02115, USA

    James A. Chu

Authors
  1. James A. Chu
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. The Pennsylvania State University, University Park, Pennsylvania, USA

    Larry K. Michelson  & William J. Ray  & 

Rights and permissions

Reprints and permissions

Copyright information

© 1996 Springer Science+Business Media New York

About this chapter

Cite this chapter

Chu, J.A. (1996). Posttraumatic Responses to Childhood Abuse and Implications for Treatment. In: Michelson, L.K., Ray, W.J. (eds) Handbook of Dissociation. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-0310-5_18

Download citation

  • DOI: https://doi.org/10.1007/978-1-4899-0310-5_18

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4899-0312-9

  • Online ISBN: 978-1-4899-0310-5

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation