The Effect of Emotion Regulation on Post-Traumatic Stress Disorder among Student Victims of Sexual Harassment: The Mediating Role of Self-Esteem

Authors

  • Eko Sujadi Institut Agama Islam Negeri Kerinci, Sungai Penuh, Indonesia
  • Bukhari Ahmad Institut Agama Islam Negeri Kerinci, Sungai Penuh, Indonesia

DOI:

https://doi.org/10.23887/bisma.v7i3.71495

Keywords:

Post-traumatic stress disorder, emotion regulation, self-esteem

Abstract

Sexual harassment is a global problem that often affects female students both inside and outside the campus environment. Sexually aware victims can be at risk of experiencing post-traumatic stress disorder (PTSD). This study aims to investigate the influence of emotional regulation and self-esteem on PTSD, and analyze the role of self-esteem in mediating the relationship between the two. Researchers used an online cross-sectional design to reduce face-to-face meetings with respondents. The population of this study consisted of undergraduate students from various universities in Indonesia. The sampling technique used quota sampling, so that 1,439 students were obtained. However, only 170 people who said they had been victims came forward. Researchers adapted three research scales, namely the PTSD CheckList - Civilian Version (PCL-C), the Emotion Regulation Difficulties Scale: The DERS-16, and the Rosenberg Self-Esteem Scale. The data analysis technique uses Partial Least Squares Structural Equation Modeling (PLS-SEM). Research findings prove that emotional regulation and self-esteem have a significant influence on PTSD in open victims. In addition, self-esteem provides a mediating effect between the relationship between emotion regulation and PTSD. The latest information in this research has implications for preventing and handling cases of sexual disclosure on campus. University leaders need to make special regulations regarding open cases. Apart from that, there is a need for programmed guidance and counseling services for students who are victims of sexual thoughts.

References

Almuneef, M. (2021). Long term consequences of child sexual abuse in Saudi Arabia: A report from national study. Child Abuse & Neglect, 116, 103967. https://doi.org/10.1016/j.chiabu.2019.03.003.

Ayhan, A. B., & Beyazit, U. (2021). The Associations between Loneliness and Self-Esteem in Children and Neglectful Behaviors of their Parents. Child Ind Res, 1863–1879. https://doi.org/10.1007/s12187-021-09818-z.

Behrouian, M., Ramezani, T., Dehghan, M., Sabahi, A., & Zarandi, B. E. (2020). The Effect of Emotion Regulation Training on Stress, Anxiety, and Depression in Family Caregivers of Patients with Schizophrenia: A Randomized Controlled Trial. Community Mental Health Journal, 56, 1095–1102. https://doi.org/10.1007/s10597-020-00574-y.

Bhilwar, M., Upadhyay, R. P., Rajavel, S., Singh, S. K., Vasudevan, K., & Chinnakali, P. (2015). Childhood Experiences of Physical, Emotional and Sexual Abuse among College Students in South India. Journal of Tropical Pediatrics, 61(5), 329–338. https://doi.org/10.1093/tropej/fmv037.

Bjureberg, J., Ljótsson, B., Tull, M. T., Hedman, E., Sahlin, H., Lundh, L.-G., … Gratz, K. L. (2016). Development and Validation of a Brief Version of the Difficulties in Emotion Regulation Scale: The DERS-16. Journal of Psychopathology and Behavioral Assessment, 38(2), 284–296. https://doi.org/10.1007/s10862-015-9514-x.

Bonar, E. E., DeGue, S., Antonia Abbey, A. L. C., H., C., Lindquist, Heather L. McCauley, Elizabeth Miller, Charlene Y. Senn, M. P., & Thompson, Quyen M. Ngo, R. M. C. & M. A. W. (2020). Prevention of sexual violence among college students: Current challenges and future directions. Journal of American College Health, 10–14. https://doi.org/10.1080/07448481.2020.1757681.

Bressler, R., Erford, B. T., & Dean, S. (2018). A Systematic Review of the Posttraumatic Stress Disorder Checklist (PCL). Journal of Counseling & Development, 96(2), 167–186. https://doi.org/10.1002/jcad.12190.

Brooks, S., Amlôt, R., Rubin, G. J., & Greenberg, N. (2020). Psychological resilience and post-traumatic growth in disaster-exposed organisations: overview of the literature. BMJ Military Health, 166(1), 52–56. https://doi.org/10.1136/jramc-2017-000876.

Bucich, M., Steel, Z., & Berle, D. (2022). Posttraumatic stress disorder (PTSD) symptom profiles among people who have experienced abuse: Findings from the NESARC-III study. Psychological Trauma: Theory, Research, Practice, and Policy, 16(1), 76–85. Retrieved from https://psycnet.apa.org/record/2022-22104-001.

Chang, C., Kaczkurkin, A. N., McLean, C. P., & Foa, E. B. (2018). Emotion regulation is associated with PTSD and depression among female adolescent survivors of childhood sexual abuse. Psychological Trauma: Theory, Research, Practice, and Policy, 10, 319–326. https://doi.org/10.1037/tra0000306.

Cloitre, M., Khan, C., Mackintosh, M.-A., Garvert, D. W., Henn-Haase, C. M., Falvey, E. C., & Saito, J. (2019). Emotion regulation mediates the relationship between ACES and physical and mental health. Psychological Trauma: Theory, Research, Practice, and Policy, 11(1), 82–89. https://doi.org/10.1037/tra0000374.

Danaher, J. (2018). The law and ethics of virtual sexual assault. In Research handbook on the law of virtual and augmented reality (pp. 363–388). https://doi.org/10.4337/9781786438591.00021.

David, M. M., Kwambo, D. Z., Clement, G. P., & Dami, B. E. (2019). Self-esteem, posttraumatic stress disorder and suicidal ideation among victims of sexual violence. Journal of Psychology & Clinical Psychiatry, 4, 147–154. https://doi.org/10.15406/jpcpy.2019.10.00644.

Dégeilh, F., Viard, A., Guénolé, F., Gaubert, M., Egler, P.-J., Egret, S., … Guillery-Girard, B. (2017). Brain alterations in pediatric PTSD Functional brain alterations during self-reference processing in adolescents with sexual abuse related posttraumatic stress disorder: A preliminary report. Neurocase, 23(1), 52–59. https://doi.org/10.1080/13554794.2017.1290807.

Ekinci, S., & Kandemir, H. (2015). Childhood trauma in the lives of substance-dependent patients: The relationship between depression, anxiety and self-esteem. Nordic Journal of Psychiatry, 69(4), 249–253. https://doi.org/10.3109/08039488.2014.981856.

Fasciano, L. C., Dale, L. P., Shaikh, S. K., Hodge, A. L. L., Gracia, B., Majdick, J. M., … Ford, J. D. (2020). Relationship of childhood maltreatment, exercise, and emotion regulation to self-esteem, PTSD, and depression symptoms among college students. Journal of American College Health, 69, 653–659. https://doi.org/10.1080/07448481.2019.1705837.

Fletcher, S., Elklit, A., Shevlin, M., & Armour, C. (2017). Predictors of PTSD Treatment Response Trajectories in a Sample of Childhood Sexual Abuse Survivors: The Roles of Social Support, Coping, and PTSD Symptom Clusters. Journal of Interpersonal Violence, 36(3–4), 1283–1307. https://doi.org/10.1177/0886260517741212.

Ford, J. D. (2017). Emotion regulation and skills-based interventions. APA Handbook of Trauma Psychology: Trauma Practice, Vol. 2, pp. 227–252. https://doi.org/10.1037/0000020-011.

Frías, S. M., & Erviti, J. (2014). Gendered experiences of sexual abuse of teenagers and children in Mexico. Child Abuse & Neglect, 38(4), 776–787. https://doi.org/10.1016/j.chiabu.2013.12.001.

Glaser, D. (2015, July). Child sexual abuse. Rutter’s Child and Adolescent Psychiatry, pp. 376–388. https://doi.org/10.1002/9781118381953.ch30.

Gnambs, T., Scharl, A., & Schroeders, U. (2018). The Structure of the Rosenberg Self-Esteem Scale. Zeitschrift Für Psychologie, 226(1), 14–29. https://doi.org/10.1027/2151-2604/a000317.

Gross, J. J. (2015). Emotion Regulation: Current Status and Future Prospects. Psychological Inquiry, 26(1), 1–26. https://doi.org/10.1080/1047840X.2014.940781.

H’ebert, M., Smith, K., Caouette, J., C´enat, J. M., Karray, A., Cartierre, N., … Derivois, D. (2021). Prevalence and associated mental health outcomes of child sexual abuse in youth in France: Observations from a convenience sample. Journal of Affective Disorders, 820–828. https://doi.org/10.1016/j.jad.2020.12.100.

Hair, J., Hult, G. T. M., Ringle, C., & Sarstedt, M. (2017). A Primer on Partial Least Squares Structural Equation Modeling (2nd ed). SAGE Publications.

Hannan, S. M., Orcutt, H. K., Miron, L. R., & Thompson, K. L. (2015). Childhood Sexual Abuse and Later Alcohol-Related Problems: Investigating the Roles of Revictimization, PTSD, and Drinking Motivations Among College Women. Journal of Interpersonal Violence, 32(14), 2118–2138. https://doi.org/10.1177/0886260515591276.

Hébert, M., & Amédée, L. M. (2020). Latent class analysis of post-traumatic stress symptoms and complex PTSD in child victims of sexual abuse and their response to Trauma-Focused Cognitive Behavioural Therapy. European Journal of Psychotraumatology, 11(1), 1807171. https://doi.org/10.1080/20008198.2020.1807171.

Hébert, M., Amédée, L. M., Blais, M., & Gauthier-Duchesne, A. (2019). Child Sexual Abuse among a Representative Sample of Quebec High School Students: Prevalence and Association with Mental Health Problems and Health-Risk Behaviors. The Canadian Journal of Psychiatry, 64(12), 846–854. https://doi.org/10.1177/0706743719861387.

Hébert, M., Lavoie, F., & Blais, M. (2014). Post Traumatic Stress Disorder/PTSD in adolescent victims of sexual abuse: resilience and social support as protection factors. Ciencia & Saude Coletiva. https://doi.org/10.1590/1413-81232014193.15972013.

Henry, N., & Powell, A. (2018). Technology-Facilitated Sexual Violence: A Literature Review of Empirical Research. Trauma, Violence, & Abuse, 19(2), 195–208. https://doi.org/10.1177/1524838016650189.

Henseler, J., Ringle, C. M., & Sarstedt, M. (2015). A new criterion for assessing discriminant validity in variance-based structural equation modeling. Journal of the Academy of Marketing Science, 43(1), 115–135. https://doi.org/10.1007/s11747-014-0403-8.

Huang, Q., Zhang, Q., An, Y., & Xu, W. (2019). The relationship between dispositional mindfulness and PTSD/PTG among firefighters: The mediating role of emotion regulation. Personality and Individual Differences, 151, 109492. https://doi.org/10.1016/j.paid.2019.07.002.

Jones, A. C., Badour, C. L., Brake, C. A., Hood, C. O., & Feldner, M. T. (2018). Facets of Emotion Regulation and Posttraumatic Stress: An Indirect Effect via Peritraumatic Dissociation. Cognitive Therapy and Research, 42, 497–509. https://doi.org/10.1007/s10608-018-9899-4.

Khalifeh, H., Moran, P., Borschmann, R., Dean, K., Hart, C., Hogg, J., … Howard, L. M. (2015). Domestic and sexual violence against patients with severe mental illness. Psychological Medicine, 45(4), 875–886. https://doi.org/10.1017/S0033291714001962.

Khare, D. (2020). Effect of Emotion Regulation on Self-Esteem and Academic Self-Efficacy among young adults. Journal of Advance Research in Science and Social Science, 3(2), 10. https://doi.org/10.46523/jarssc.03.02.02.

Kim, Y. J., & Seo, Y. (2018). Mediating Effect of Adaptive Cognitive Emotion Regulation Strategies between Self-Esteem and College Students’ Adaptation to College Life. Korean Association For Learner-Centered Curriculum And Instruction.

Kizilhan, J. I., & Noll-Hussong, M. (2018). Post-traumatic stress disorder among former Islamic State child soldiers in northern Iraq. The British Journal of Psychiatry : The Journal of Mental Science, 213(1), 425–429. https://doi.org/10.1192/bjp.2018.88.

Kobylinska, D., & Kusev, P. (2019). Flexible Emotion Regulation: How Situational Demands and Individual Differences Influence the Effectiveness of Regulatory Strategies. Frontiers in Psychology, 10. https://doi.org/10.3389/fpsyg.2019.00072.

Mainiero, L. (2020). Workplace romance versus sexual harassment: a call to action regarding sexual hubris and sexploitation in the #MeToo era. Gender in Management: An International Journal, 35(4), 329–347. https://doi.org/10.1108/GM-11-2019-0198.

Mathews, B., & Collin-Vézina, D. (2019). Child Sexual Abuse: Toward a Conceptual Model and Definition. Trauma, Violence, & Abuse, 20(2), 131–148. https://doi.org/10.1177/1524838017738726.

Mendoza-Meléndez, M. Á., Cepeda, A., Frankeberger, J., López-Macario, M., & Valdez, A. (2018). History of child sexual abuse among women consuming illicit substances in Mexico City. Journal of Substance Use, 23(5), 520–527. https://doi.org/10.1080/14659891.2018.1489478.

Morrison, S. E., Bruce, C., & Wilson, S. L. (2018). Children’s Disclosure of Sexual Abuse: A Systematic Review of Qualitative Research Exploring Barriers and Facilitators. Journal of Child Sexual Abuse, 27(2), 176–194. https://doi.org/10.1080/10538712.2018.1425943.

Nagulendran, A., & Jobson, L. (2020). Exploring cultural differences in the use of emotion regulation strategies in posttraumatic stress disorder. European Journal of Psychotraumatology, 11(1), 1729033. https://doi.org/10.1080/20008198.2020.1729033.

Nam, Y. S., & Hong, H. (2022). The Effect of Stress in Middle School Students on Depression: The Mediated Moderation Effect of Self-Esteem and Cognitive Emotion Regulation Strategies. KOREAN JOURNAL OF YOUTH STUDIES.

Omasu, F., Hotta, Y., Watanabe, M., & Yoshioka, T. (2018). The Relationship between Post-Traumatic Stress Disorder and Self-Esteem along with the Importance of Support for Children. Open Journal of Preventive Medicine, 8(4), 95–101. https://doi.org/10.4236/ojpm.2018.84009.

Pan, M. C., & Yang, E. (2021). PTSD symptoms, emotion regulation difficulties, and family functioning among trauma-exposed college students. Current Psychology, 42(7), 5728–5739. https://doi.org/10.1007/s12144-021-01896-0.

Pugach, C. P., Campbell, A. A., & Wisco, B. E. (2020). Emotion regulation in posttraumatic stress disorder (PTSD): Rumination accounts for the association between emotion regulation difficulties and PTSD severity. Journal of Clinical Psychology, 76(3), 508–525. https://doi.org/10.1002/jclp.22879.

Putra, E., Sujadi, E., Bustami, Y., & Indra, S. (2022). The Effect of Social Support and Emotional Intelligence on Culture Shock of the Newcomer Students: the Mediating Role of Resilience. ENLIGHTEN (Jurnal Bimbingan Dan Konseling Islam), 5(2), 66–79. https://doi.org/10.32505/enlighten.v5i2.4820.

Qassem, T., Aly-ElGabry, D., Alzarouni, A., Abdel-Aziz, K., & Arnone, D. (2020). Psychiatric Co-Morbidities in Post-Traumatic Stress Disorder: Detailed Findings from the Adult Psychiatric Morbidity Survey in the English Population. Psychiatric Quarterly. https://doi.org/10.1007/s11126-020-09797-4.

Rai, R., & Rai, A. K. (2020). Sexual violence and poor mental health of women: An exploratory study of Uttar Pradesh, India. Clinical Epidemiology and Global Health, 8(1), 194–198. https://doi.org/10.1016/j.cegh.2019.06.013.

Rinne-Albers, M. A. W., Boateng, C. P., van der Werff, S. J. A., Lamers-Winkelman, F., Rombouts, S. A. R. B., Vermeiren, R., & van der Wee, N. J. A. (2020). Preserved cortical thickness, surface area and volume in adolescents with PTSD after childhood sexual abuse. Scientific Reports, 10(1), 3266. https://doi.org/10.1038/s41598-020-60256-3.

Riwanto, A., Harisudin, M. N., Suryaningsih, S., & Firmandiaz, V. (2023). Addressing Campus Sexual Violence: A Collaborative Governance Approach to Legal Policy. Volksgeist: Jurnal Ilmu Hukum Dan Konstitusi, 6(2). https://doi.org/10.24090/volksgeist.v6i2.9523.

Roberts, A. L., Liu, J., Lawn, R. B., Jha, S. C., Sumner, J. A., Jae H. Kang, ScD; Eric B. Rimm, S., & Francine Grodstein, ScD; Laura D. Kubzansky, PhD, MPH; Lori B. Chibnik, PhD, MPH; Karestan C. Koenen, P. (2022). Association of posttraumatic stress disorder with accelerated cognitive decline in middle-aged women. JAMA Network Open, 5(6). https://doi.org/10.1001/jamanetworkopen.2022.17698.

Russo, J. E., Dhruve, D. M., & Oliveros, A. D. (2023). Childhood Trauma and PTSD Symptoms: Disentangling the Roles of Emotion Regulation and Distress Tolerance. Research on Child and Adolescent Psychopathology, 51(9), 1273–1287. https://doi.org/10.1007/s10802-023-01048-x.

Rutherford, H. J. V, Wallace, N. S., Laurent, H. K., & Mayes, L. C. (2015). Emotion regulation in parenthood. Developmental Review, 36, 1–14. https://doi.org/10.1016/j.dr.2014.12.008.

Sanjeevi, J., Houlihan, D., Bergstrom, K. A., Langley, M. M., & Judkins, J. (2018). A Review of Child Sexual Abuse: Impact, Risk, and Resilience in the Context of Culture. Journal of Child Sexual Abuse, 27(6), 622–641. https://doi.org/10.1080/10538712.2018.1486934.

Sareen, J. (2014). Posttraumatic stress disorder in adults: Impact, comorbidity, risk factors, and treatment. Canadian Journal of Psychiatry, 59(9), 460–467. https://doi.org/10.1177/070674371405900902.

Schnyder, U., Ehlers, A., Elbert, T., Foa, E. B., R., B. P., Gersons, Patricia A. Resick, F. S., & Cloitre, M. (2015). Psychotherapies for PTSD: what do they have in common? European Journal of Psychotraumatology, 6(1). https://doi.org/10.3402/ejpt.v6.28186.

Scoglio, A. A. J., Rudat, D. A., Garvert, D., Jarmolowski, M., Jackson, C., & Herman, J. L. (2015). Self-Compassion and Responses to Trauma: The Role of Emotion Regulation. Journal of Interpersonal Violence, 33(13), 2016–2036. https://doi.org/10.1177/0886260515622296.

Seligowski, A. V., Rogers, A. P., & Orcutt, H. K. (2016). Relations among emotion regulation and DSM-5 symptom clusters of PTSD. Personality and Individual Differences, 92, 104–108. https://doi.org/10.1016/j.paid.2015.12.032.

Short, N. A., Boffa, J. W., Clancy, K., & Schmidt, N. B. (2018). Effects of emotion regulation strategy use in response to stressors on PTSD symptoms: An ecological momentary assessment study. Journal of Affective Disorders, 230, 77–83. https://doi.org/10.1016/j.jad.2017.12.063.

Sigurdardottir, S., & Halldorsdottir, S. (2021). Persistent Suffering: The Serious Consequences of Sexual Violence against Women and Girls, Their Search for Inner Healing and the Significance of the #MeToo Movement. International Journal of Environmental Research and Public Health, 4(1849). https://doi.org/10.3390/ijerph18041849.

Simon, G. E., Shortreed, S. M., Rossom, R. C., Beck, A. L., Clarke, G., Whiteside, U., … Smith, J. J. (2022). Effect of Offering Care Management or Online Dialectical Behavior Therapy Skills Training vs Usual Care on Self-harm Among Adult Outpatients With Suicidal Ideation: A Randomized Clinical Trial. JAMA, 327(7), 630–638. https://doi.org/10.1001/jama.2022.0423.

Solehati, T., Pramukti, I., Kosasih, C. E., Hermayanti, Y., & Mediana, H. S. (2022). Determinants of Sexual Abuse Prevention Knowledge among Children’s Schools in West Java Indonesia: A Cross-Sectional Study. https://doi.org/10.3390/socsci11080337.

Sujadi, E., Meditamar, M. O., & Ahmad, B. (2022). Pengaruh Stres Akademik dan Self-Efficacy terhadap Penyesuaian Diri Santriwati Pondok Pesantren Tahun Pertama: Efek Mediasi Self-Esteem. Indonesian Journal of Guidance and Counseling: Theory and Application, 11(3), Indonesian Journal of Guidance and Counseling: The. https://doi.org/10.15294/ijgc.v11i3.60895.

Sujadi, E., Meditamar, M. O., Fadhli, M., Ahmad, J., Bustami, Y., & Indra, S. (2023). Posttraumatic stress disorder among sexual harassment victims: the role of social support, resilience, and religious coping. International Journal of Public Health Science, 12(2), 846–858. https://doi.org/10.11591/ijphs.v12i2.21952.

Tavakoli, S., & Wu, J. (2024). The Mediation Effect of Posttraumatic Perception between Self-esteem and PTSD among Student Veterans. Journal of College Student Psychotherapy, 38(1), 89–104. https://doi.org/10.1080/87568225.2022.2133761.

Tull, M. T., Vidaña, A. G., & Betts, J. E. (2020). Chapter 10 - Emotion regulation difficulties in PTSD (M. T. Tull & N. A. B. T.-E. in P. S. D. Kimbrel, Eds.). https://doi.org/10.1016/B978-0-12-816022-0.00010-7.

Viskarini, P. A., & Suharsono, Y. (2023). Pengaruh dukungan sosial terhadap harga diri remaja putri korban pelecehan seksual. Cognicia, 11(1), 47–53. https://doi.org/10.22219/cognicia.v11i1.25003.

Wagenmans, A., van Minnen, A., Sleijpen, M., & de Jongh, A. (2018). The impact of childhood sexual abuse on the outcome of intensive trauma-focused treatment for PTSD. European Journal of Psychotraumatology, 9(1), 1430962. https://doi.org/10.1080/20008198.2018.1430962.

Weindl, D., Knefel, M., Glück, T., & Lueger-Schuster, B. (2020). Emotion regulation strategies, self-esteem, and anger in adult survivors of childhood maltreatment in foster care settings. European Journal of Trauma & Dissociation, 4(4), 100163. https://doi.org/10.1016/j.ejtd.2020.100163.

Wilhite, E. R., Mallard, T., & Fromme, K. (2018). A longitudinal event-level investigation of alcohol intoxication, alcohol-related blackouts, childhood sexual abuse, and sexual victimization among college students. Psychology of Addictive Behaviors, 32, 289–300. https://doi.org/10.1037/adb0000353.

Wolf, N. M., & Elklit, A. (2020). Child Maltreatment and Disordered Eating in Adulthood: a Mediating Role of PTSD and Self-Esteem? Journal of Child & Adolescent Trauma, 13, 21–32. https://doi.org/10.1007/s40653-018-0224-x.

Yazdizadeh, P., Hafezi, F., Ehteshamzadeh, P., Heidari, A., & Saadi, Z. E. (2023). Effectiveness of reality therapy on emotion regulation difficulty and academic self-handicapping of students: A pilot study. Caspian Journal of Health Research, 8(3), 163–170. https://doi.org/10.32598/CJHR.8.3.446.2.

Zhang, J., Guo, F., Chen, Z. Y., He, H. W., Long, Y., & Li, Q. (2020). Relationship between social support, resilience, self-esteem and post-traumatic stress disorder in intensive care unit nurses. Zhonghua yi xue za zhi, 100(1), 32–36. https://doi.org/10.3760/cma.j.issn.0376-2491.2020.01.008.

Zhou, X., Wu, X., & Zhen, R. (2017). Understanding the relationship between social support and posttraumatic stress disorder/posttraumatic growth among adolescents after Ya’an earthquake: The role of emotion regulation. Psychological Trauma: Theory, Research, Practice, and Policy, 9, 214–221. https://doi.org/10.1037/tra0000213.

Downloads

Published

2023-12-25

Issue

Section

Articles