Trying to understand why horrible things happen: attribution, shame, and symptom development following sexual abuse.

This study concerns the nature of specific attributions for sexual abuse and their relation to psychological distress over time. Participants (80 children and 57 adolescents) were seen within 8 weeks of discovery of the abuse and 1 year later They described why they believed the abuse happened, rated the extent to which internal and external attributions for the abuse event applied to them, and completed measures of general attribution styleforeveryday events, shame for the abuse, and symptoms of depression, PTSD, and self-esteem. Parents and teachers rated behavior problems. Abuse-specific internal attributions were consistently related to higher levels of psychopathology and were particularly importantforpredicting PTSD symptoms and parent and teacher reports of internalizing behavior problems, even after controlling for age, gender, abuse events, and general attributional style. Shame also was an important predictor of symptom level and mediated the relation between abuse-specific internal attributions and PTSD symptoms.