Child sexual abuse, intimate partner violence, treatment attrition, posttraumatic stress, child cognitive self development


Child sexual abuse (CSA) is a worldwide problem, with two-thirds of all cases going unreported. A wealth of research over the last 30 years demonstrates the negative emotional, cognitive, physical, spiritual, academic, and social effects of CSA. As a result, researchers and mental health professionals frequently attempt to measure the efficacy of treatment modalities in order to assess which treatments lead to better outcomes. However, in order to effectively study treatment outcomes, researchers must be able to track the status of child functioning and symptomology before, during, and after treatment. Because high levels of treatment attrition exist among CSA victims, researchers are unable to effectively study outcomes due to large losses in research participants, loss of statistical power, and threats to external validity (Kazdin, 1990). Moreover, due to the high prevalence of concurrent family violence, caregivers with intimate partner violence are more than twice as likely to have children who are also direct victims of abuse (Kazdin, 1996). Caregivers ultimately make the decisions regarding whether or not a child stays in treatment, and therefore, it is important to examine the influence of both parent factors (e.g., intimate partner violence) and child factors (e.g., traumatization and/or disturbances in cognitive selfdevelopment) on treatment attrition. This two-pronged approach of examining both child and family characteristics simultaneously with attrition patterns offers a more complete picture for the ways concurrent family violence influences treatment than looking at child and caregiver factors separately. The purpose of this study was to investigate the relationships between caregiver intimate partner violence, child posttraumatic stress (Trauma Symptom Checklist for Children [TSCC]; Briere, 1996), child cognitive self-development (Trauma and Attachment Belief Scale [TABS]; iv Pearlman, 2003), and treatment attrition. The statistical analyses in this study included (a) Logistic Regression, (b) Poisson Regression, and (c) Chi-square Test for Independence. Elevated TSCC subscale scores in posttraumatic stress predicted both an increased number of sessions attended and increased number of sessions missed. Elevated TABS subscale scores in self-trust predicted an increased number of sessions attended and decreased number of sessions missed. Elevated TABS subscale scores of other-intimacy and self-control predicted an increased number of sessions missed. Moreover, the presence of past or current caregiver intimate partner violence predicted a decrease in number of sessions attended. While no relationship existed between child posttraumatic stress or cognitive self-development and whether a child graduated or prematurely terminated from treatment, children with parents who confirmed past or current intimate partner violence were 2.5 times more likely to prematurely terminate from treatment.


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Graduation Date





Daire, Andrew


Doctor of Philosophy (Ph.D.)


College of Education and Human Performance

Degree Program

Education; Counselor Education








Release Date

August 2012

Length of Campus-only Access


Access Status

Doctoral Dissertation (Open Access)


Dissertations, Academic -- Education, Education -- Dissertations, Academic