Effects Of Child Sexual Abuse Across The Life Span

Although many mental health concerns may result from experience(s) of child sexual abuse, particular diagnoses may be relevant to those seeking to understand child sexual abuse and work with survivors. Depression and anxiety disorders may be common experiences for survivors of child sexual abuse.46 Because many survivors of child sexual abuse experience disruption in their ability to regulate their affect,47 many are at risk for developing substance abuse or substance dependence disorders.48 In addition, child sexual abuse survivors may develop PTSD, experience intrusive thoughts about their abuse, become hypervigilant to abuse-related stimuli, and develop avoidance strategies such as numbing and dissociation. There are also those survivors whose trauma experiences may have put them at risk for developing borderline personality disorder.49 Although the negative consequences of child sexual abuse are important to understand thoroughly, there has been a recent focus over the past ten years on the resilience experiences of survivors.50,51,5 Resilience may be understood as a survivor's ability to "bounce back" from adversity despite difficult experiences and may include both individual and collective components of resilience that may assist survivors in healing from child sexual abuse.32

Childhood and adolescence. Children and adolescents exposed to sexual abuse are at great risk for physical, social, and psychological challenges. Sexual abuse has been linked to a variety of negative consequences including disordered eating,52 suicidal behaviors,52,17 and sexual risk behaviors.53 Ackard and Neumark-Sztainer52 found that for girls and boys, experiencing a single form or more than one form of sexual abuse was associated with significantly higher rates of vomiting, taking diet pills, binge eating, skipping meals, and taking laxatives than for peers who were not sexually abused. In addition, they found that those reporting multiple forms of sexual abuse reported the highest rates of suicide attempts (52.9% girls; 58.5% boys). Similarly, Martin et al.17 found that sexually abused adolescents were much more likely to report "thoughts about killing themselves," to have "made plans," to have "made threats," to have "deliberately hurt themselves," and to claim attempt(s) to kill themselves, than nonabused. In a recent study, adolescents with a history of child sexual abuse were significantly more likely to have had sex in the last ninety days, engaged in unprotected sex, and supported fewer advantages of using condoms.53

According to Lovett,54 "The effects of child sexual abuse are quite variable and are influenced by a number of factors including the extent and nature of abuse, age of child, relationship to the perpetrator, violence involved, and other aspects of the child's life" (p. 581). These "factors" increase the likelihood that a child or adolescent will experience multiple short- and long-term consequences as a result of sexual abuse. Furthermore, exposure to abuse during childhood or adolescence increases the risk for difficulties in adulthood.55

Effects during adulthood. Adult survivors of child sexual abuse struggle with many of the short- and long-term consequences that child and adolescent survivors face. As discussed in the previous section, adult survivors similarly develop coping resources that developed to manage past experiences of trauma.47,48 The American Psychiatric Association reviewed the literature on the effects of child sexual abuse for adult survivors and identified increased rates of depression, autoimmune disorders (e.g., fibromyalgia), disordered eating, obesity, and addictive behaviors. For those survivors whose trauma symptoms rise to the level of a PTSD diagnosis, additional symptoms include hypervigilance, avoidance and numbing, and reexperience of the abuse.56 For these reasons, scholars have called for a holistic approach to healing for child sexual abuse survivors that includes attention to a wide range of physical and emotional effects for adult survivors.57,48

The American College of Obstetricians and Gynecologists58 outlined seven categories that may overlap with one another: emotional reactions, PTSD symptoms, self-perceptions, physical and biomedical effects, sexual effects, interpersonal effects, and social functioning. For instance, some adult women survivors of child sexual abuse may experience long-term effects in the form of disordered eating, self-injurious behavior, and dissociative disorders59—all behaviors that develop in an attempt to regulate emotional dysregulation that may result from these traumatic experi-ences.47 In addition, child sexual abuse survivors may experience long-term somatization effects, where they experience physical pain as a result of their abuse.60

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