Modeling the response to trauma: accumulation of and accommodation to child sexual abuse
Child sexual abuse (CSA) often lasts for more than a few years. Various kinds of clinical symptoms appear in CSA victims, depending on the persistent damage. Trauma response such as problematic sexual behavior is a highly specific feature in CSA victims. Nevertheless, it remains unclear how the developmental status of a child relates to the trauma response resulting from CSA. The aim of this study was to (ⅰ) describe accumulation of and accommodation to CSA effect in relation to age and the duration of victimization, (ⅱ) estimate the developmental transition of inhibition function, and (ⅲ) predict the trauma response via a computational conflict model regarding CSA effect and inhibition function. The data was collected by the national survey in Japan (December 2020). Four hundred ninety-two CSA cases were met the inclusion criteria. The proposed model was implemented in Stan. All chains were well mixed and converged. The results indicated that (ⅰ) the impact of CSA on trauma response was cumulative over the duration of victimization, (ⅱ) the magnitude of the cumulative added impact was inversely proportional to the duration of victimization, (ⅲ) developmental transitions of inhibition function varied with the trauma responses, and (ⅳ) some types of trauma response might be observed only at a particular age and only for a specific duration of victimization. The proposed conflict model regarding clinical outcomes will be widely applicable and give us interpretable predictions.