Abstract
Rape/sexual assault can profoundly affect the physical, mental, and social well-being of victims. Post-traumatic stress disorder (PTSD) and suicide in rape/sexual assault survivors are significantly more frequent than the national prevalence of the condition, indicating that existing treatments require improvement. In this case report, we presented an 11-year-old Iranian girl with PTSD and suicidal behaviors following rape/sexual assault. We specifically focused on the process of helping the victim to develop effective coping skills and overcome the trauma through 16 weekly sessions of Skill Training in Affective and Interpersonal Regulation (STAIR) plus Narrative Therapy-Adolescent Version (SNT-A). During this therapeutic approach, the patient regained emotional control over the traumatic experience and made sense of the experience. Our findings revealed that SNT-A might be an effective intervention to reduce suicidal ideation among adolescent victims of rape/sexual assault. Nonetheless, further investigations in this field need to be carried out through randomized controlled trials.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Abel, G. G., Jordan, A., Harlow, N., & Hsu, Y. S. (2019). Preventing child sexual abuse: Screening for hidden child molesters seeking jobs in organizations that care for children. Sexual Abuse, 31(6), 662–683. https://doi.org/10.1177/1079063218793634
Becker, M., & Correll, C. U. (2020). Suicidality in childhood and adolescence. Deutsches Ärzteblatt International, 117(15), 261–267. https://doi.org/10.3238/arztebl.2020.0261
Chivers-Wilson, K. A. (2006). Sexual assault and posttraumatic stress disorder: A review of the biological, psychological and sociological factors and treatments. McGill Journal of Medicine, 9(2), 111–118.
Davidson, J. R., Hughes, D. C., George, L. K., & Blazer, D. G. (1996). The association of sexual assault and attempted suicide within the community. Archives of General Psychiatry, 53(6), 550–555. https://doi.org/10.1001/archpsyc.1996.01830060096013
De Berardis, D., Fornaro, M., Orsolini, L., Ventriglio, A., Vellante, F., & Di Giannantonio, M. (2020). Emotional dysregulation in adolescents: Implications for the development of severe psychiatric disorders, substance abuse, and suicidal ideation and behaviors. Brain Sciences, 10(9), 591. https://doi.org/10.3390/brainsci10090591
De Berardis, D., Marini, S., Serroni, N., Iasevoli, F., Tomasetti, C., de Bartolomeis, A., Tempesta, M. M. D., Valchera, A., Pompili, M. F. M., Sepede, G., Vellante, F., Orsolini, L., Martinotti, G., & Di Giannantonio, M. (2015). Targeting the noradrenergic system in posttraumatic stress disorder: A systematic review and meta-analysis of prazosin trials. Current Drug Targets, 16(10), 1094–1106. https://doi.org/10.2174/1389450116666150506114108
De Berardis, D., Vellante, F., Fornaro, M., Anastasia, A., Olivieri, L., Rapini, G., Serroni, N., Orsolini, L., Valchera, A., Carano, A., Tomasetti, C., Varasano, P. A., Pressanti, G. L., Bustini, M., Pompili, M., Serafini, G., Perna, G., Martinotti, G., & Di Giannantonio, M. (2020). Alexithymia, suicide ideation, affective temperaments and homocysteine levels in drug naïve patients with post-traumatic stress disorder: An exploratory study in the everyday ‘real world’clinical practice. International Journal of Psychiatry in Clinical Practice, 24(1), 83–87. https://doi.org/10.1080/13651501.2019.1699575
Fontes, L. A., & Plummer, C. (2010). Cultural issues in disclosures of child sexual abuse. Journal of Child Sexual Abuse, 19(5), 491–518. https://doi.org/10.1080/10538712.2010.512520
Goodarzi, M. A. (2003). Evaluating validity and reliability of Mississippi posttraumatic stress disorder scale. Journal of Psychology, 7(2), 153–178. (Persian).
Goodyear, M. D., Krleza-Jeric, K., & Lemmens, T. (2007). The declaration of Helsinki. BMJ, 335(7621), 624–625. https://doi.org/10.1136/bmj.39339.610000.BE
Gudiño, O. G., Leonard, S., & Cloitre, M. (2016). STAIR-A for girls: A pilot study of a skills-based group for traumatized youth in an urban school setting. Journal of Child & Adolescent Trauma, 9(1), 67–79. https://doi.org/10.1007/s40653-015-0061-0
Gudiño, O. G., Leonard, S., Stiles, A. A., Havens, J. F., & Cloitre, M. (2017). STAIR narrative therapy for adolescents. evidence-based treatments for trauma related disorders in children and adolescents (pp. 251–271). Springer.
Hornor, G. (2010). Child sexual abuse: Consequences and implications. Journal of Pediatric Health Care, 24(6), 358–364. https://doi.org/10.1016/j.pedhc.2009.07.003
Kalra, G., & Bhugra, D. (2013). Sexual violence against women: Understanding cross-cultural intersections. Indian Journal of Psychiatry, 55(3), 244–249. https://doi.org/10.4103/0019-5545.117139
Klonsky, E. D., May, A. M., & Saffer, B. Y. (2016). Suicide, suicide attempts, and suicidal ideation. Annual Review of Clinical Psychology, 12, 307–330. https://doi.org/10.1146/annurev-clinpsy-021815-093204
Laughlin, K. (2018). What Puts Survivors at Increased Risk for Suicide and How to Help. https://www.nsvrc.org/blogs/what-puts-survivors-increased-risk-suicide-and-how-help
Murray, L. K., Nguyen, A., & Cohen, J. A. (2014). Child sexual abuse. Child and Adolescent Psychiatric Clinics of North America, 23(2), 321–337. https://doi.org/10.1016/j.chc.2014.01.003
O’Brien, B. S., & Sher, L. (2013). Child sexual abuse and the pathophysiology of suicide in adolescents and adults. International Journal of Adolescent Medicine and Health, 25(3), 201–205. https://doi.org/10.1515/ijamh-2013-0053
Orsolini, L., Latini, R., Pompili, M., Serafini, G., Volpe, U., Vellante, F., Fornaro, M., Valchera, A., Tomasetti, C., Fraticelli, S., Alessandrini, M., Rovere, R. L., Trotta, S., Martinotti, G., Di Giannantonio, M., & De Berardis, D. (2020). Understanding the complex of suicide in depression: from research to clinics. Psychiatry Investigation, 17(3), 207–223. https://doi.org/10.30773/pi.2019.0171
Silverman, W. K., Ortiz, C. D., Viswesvaran, C., Burns, B. J., Kolko, D. J., Putnam, F. W., & Amaya-Jackson, L. (2008). Evidence-based psychosocial treatments for children and adolescents exposed to traumatic events. Journal of Clinical Child and Adolescent Psychology, 37(1), 156–183. https://doi.org/10.1080/15374410701818293
Ullman, S. E., & Brecklin, L. R. (2002). Sexual assault history and suicidal behavior in a national sample of women. Suicide and Life-Threatening Behavior, 32(2), 117–130. https://doi.org/10.1521/suli.32.2.117.24398
Yazdkhasti, F., & Oreyzi, H. (2011). Standardization of child, parent and teacher’s forms of child behavior checklist in the city of Isfahan. Iranian Journal of Psychiatry and Clinical Psychology, 17(1), 60–70. (Persian).
Funding
The authors received no specific funding for this work.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interests
The authors declare that they have no potential conflict of interest.
Ethical Standards and Informed Consent
All procedures were according to the latest version of the Declaration of Helsinki. Prior to participation, written informed consent was obtained from the patient and her parents/legal guardians after a comprehensive explanation of the study procedures.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Khosravi, M., Adibi, A. STAIR Plus Narrative Therapy-Adolescent Version (SNT-A) in An 11-Year-Old Girl With PTSD and Suicidal Behaviors Following Rape/Sexual Assault: A Case Report. Journ Child Adol Trauma 15, 943–948 (2022). https://doi.org/10.1007/s40653-021-00430-5
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40653-021-00430-5