School age children's coping with sexual abuse: abuse stresses and symptoms associated with four coping strategies.

Strategies used by 84 sexually abused children, ages 7 to 12, to cope with their abuse were evaluated, along with child abuse-related symptoms, parent-reported behavioral symptoms, and teacher-reported behavioral symptoms. Principal components analysis of coping yielded four strategies that were labeled avoidant coping, internalized coping, angry coping, and active/social coping. Each coping strategy was found to be associated with a unique set of abuse characteristics, abuse-related social environment, and symptoms. In contrast to findings with adult survivors and adolescents, use of avoidant coping strategies among school-age children was found to be related to fewer behavioral problems, although it was also associated with greater sexual anxieties. Internalized coping was found to be associated with increased guilt and PTSD hyperarousal symptoms. Active/social coping was the only strategy found to be unrelated to symptoms, but neither was it associated with measured benefits. In contrast to some clinical opinion that externalizing blame and venting anger is a helpful strategy, angry coping was found to be associated with a wide range of behavioral and emotional problems as rated by the child's home-room school teacher. Results are discussed in terms of a proposed mediational model.