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Facts: Impact of Child Sexual Abuse

Long term effects of child abuse include fear, anxiety, depression, anger, hostility, inappropriate sexual behavior, poor self esteem, tendency toward substance abuse and difficulty with close relationships.
Source: Browne & Finkelhor, 1986.

Clinical findings of adult victims of sexual abuse include problems in interpersonal relationships associated with an underlying mistrust. Generally, adult victims of incest have a severely strained relationship with their parents that is marked by feelings of mistrust, fear, ambivalence, hatred, and betrayal. These feelings may extend to all family members.
Source: Tsai and Wagner, 1978.

Guilt is universally experienced by almost all victims. Courtois and Watts described the “sexual guilt” as “guilt derived from sexual pleasure.”
Source: Tsai and Wagner, l978.

Sexual victimization may profoundly interfere with and alter the development of attitudes toward self, sexuality, and trusting relationships during the critical early years of development.
Source: Tsai & Wagner, 1984.

If the child victim does not resolve the trauma, sexuality may become an area of adult conflict.
Source: Courtois & Watts, 1982; Tsai & Wagner, 1984.

There is the clinical assumption that children who feel compelled to keep sexual abuse a secret suffer greater psychic distress than victims who disclose the secret and receive assistance and support.
Source: Finkelhor & Browne, 1986.

Early identification of sexual abuse victims appears to be crucial to the reduction of suffering of abused youth and to the establishment of support systems for assistance in pursuing appropriate psychological development and healthier adult functioning. As long as disclosure continues to be a problem for young victims, then fear, suffering, and psychological distress will, like the secret, remain with the victim.
Sources: Bagley, 1992; Bagley, 1991; Finkelhor et al. 1990; Whitlock & Gillman, 1989.

Adolescents with a history of sexual abuse are significantly more likely than their counterparts to engage in sexual behavior that puts them at risk for HIV infection, according to Dr. Larry K. Brown and associates, from Rhode Island Hospital, in Providence. Inconsistent condom use was three times more likely among youths who had been sexually abused than among the 55 who had not.
Source: Larry K. Brown, M.D., et al, American Journal of Psychiatry 2000;157:1413-1415.

A history of sexual abuse was also significantly associated with less impulse control and higher rates of sexually transmitted diseases. According to Dr. Brown, “These results suggest two things. Abused kids need adequate counseling around abuse issues. A lot of these kids keep re-experiencing the anxiety and trauma for years.” The second issue, he said, is that “most therapy does not address current sexual behavior” and the anxieties that sexually abused adolescents experience.
Source: Larry K. Brown, M.D., et al, American Journal of Psychiatry 2000;157:1413-1415.

Young girls who are forced to have sex are three times more likely to develop psychiatric disorders or abuse alcohol and drugs in adulthood, than girls who are not sexually abused. Sexual abuse was also more strongly linked with substance abuse than with psychiatric disorders.
Source: Kenneth S. Kendler, M.D., et al, Medical College of Virginia Commonwealth University, Archives of General Psychiatry 2000;57:953-959.
Also see review at Medscape

Family factors—parental education, parenting behavior, family financial status, church attendance—had little impact on the prevalence of psychiatric or substance abuse disorders among these women, the investigators observe. Similarly, parental psychopathology did not predict the association between CSA and later psychopathology.
Source: Kenneth S. Kendler, M.D., et al, Medical College of Virginia Commonwealth University, Archives of General Psychiatry 2000;57:953-959.
Also see review at Medscape

Young girls who are sexually abused are more likely to develop eating disorders as adolescents. The findings also add to a growing body of research suggesting that trauma in childhood increases the risk of developing an eating disorder.
Source: Stephen A. Wonderlich, M.D., et al, University of North Dakota School of Medicine and Health Sciences in Fargo, Journal of the American Academy of Child and Adolescent Psychiatry 2000;391277-1283.