It should be clear by now that the sexual abuse of children is a serious social problem. The purpose of this section is to discuss child sexual abuse from the victim's perspective, specifically focusing on the myriad of consequences facing child sexual- abuse victims. Research shows that the consequences of child sexual abuse are far reaching, often extending into the child's adult life.
Consequences of Child Sexual Abuse
In the late 1970s, a national conference on the sexual abuse of children was held in Washington D.C. The conference consisted of professionals from different disciplines, including medicine, psychiatry, children's advocacy, and social work. One speaker, a professional who had worked on issues of child sexual abuse (incest specifically), reported that according to his unpublished evidence, "some incest may be a positive, healthy experience or at worst dull and neutral" (Green, 1980, p. 1). This statement reveals another common myth pertaining to child sexual abuse victims— that harm done to the victim is minimal.
Much clinical and empirical research has overwhelmingly pointed to a multitude of negative effects of child sexual abuse. The extent and magnitude to which children are affected by abuse varies based on many factors, including the age of abuse onset, the relationship of the child to the offender, the duration of the abuse (e.g., one-time-only versus chronic), the child's support system, and whether the child disclosed the incident(s). As Briere and Elliott (1994) observed, "there is no single universal or uniform impact of sexual abuse, and no certainty that any given person will develop a posttraumatic response to sexual abuse" (p. 62).
Researchers and clinicians have long noted the emotional distress felt by many victims of child sexual abuse. Depression is the most commonly reported consequence, with one study finding that abused patients were four times more likely to have depressive symptoms, compared to non-abused patients (Browne & Finkelhor, 1986). Sexually victimized children are also at high risk of developing anxiety disorders (including panic attacks, phobias, and post-traumatic stress disorder) immediately following their abuse, as well as years later (Valente, 2005). In an attempt to cope with the chronic trauma of sexual abuse, victims may engage in avoidant behaviors, including:
- • Substance abuse and addiction: Many studies have tested the association between sexual abuse during childhood and later substance abuse during adolescence and adulthood. One study found that adults who reported child sexual abuse were 1.5 to 2 times as likely to have alcohol problems, severe alcohol dependence, drug problems, or severe drug dependence, compared to adults who did not experience child sexual abuse (Molnar, Buka, & Kessler, 2001). Research has also underscored the importance of addressing unresolved traumas involving child sexual abuse with substance-abuse treatment patients. Not addressing the abuse is associated with rapid substance-abuse relapse (Rohsenow, Corbett, & Devine, 1988).
- • Suicide: Victims of child sexual abuse are at increased risk for self-injury and suicide. Research has revealed that the frequency of suicidal ideation and actual attempts are significantly greater for child sexual-abuse victims during adolescence and young adulthood, compared to non-victims (Silverman, Reinherz, & Giaconia, 1996). Recent estimates reveal that those with histories of victimization are approximately 2.5 times more likely to attempt suicide than those not victimized (Devries et al., 2014).
- • Tension-reducing behaviors: Certain behaviors reported by victims of child sexual abuse can be seen as fulfilling a need to numb the pain of unresolved trauma. Such activities are often characterized as "acting out," and can include risky sexual behaviors, eating disorders, and self-mutilation. Adolescents with a history of child sexual abuse often report inconsistent condom use, less impulse control, and less knowledge of HIV/AIDS than their non-abused counterparts, effectively putting them at greater risk of HIV infection (Brown, Lourie, Zlot- nick, & Cohn, 2000). Studies that have examined the association between child sexual abuse and eating disorders (e.g., anorexia nervosa, bulimia, and binge eating) have found an association, although studies have generally reported the associations are weak, at best (Smolak & Murnen, 2001).
Researchers have found that child sexual abuse predicts a host of psychological problems during adulthood for both male and female victims, including anxiety, depression, dissociation, and anger/irritability (Briere & Elliott, 2003). Additionally, situational characteristics of the abuse were found to intensify the symptoms. Sexual abuse that occurred at a later age, involved multiple incidents and/or multiple abusers, and involved oral, anal, or vaginal penetration led to even more severe negative consequences during adulthood.
Research has also demonstrated that early child sexual abuse can shape dysfunctional sexual behaviors later in life. One study showed that child sexual abuse predicted dysfunctional sexual behaviors during adulthood, such as using sex as a bargaining/negotiating tool, having multiple sexual partners, and sex with strangers (Briere & Runtz, 1990). There is also evidence for the revictimization hypothesis, which predicts that individuals (namely, women) who are child sexual abuse victims have an increased risk of assaults during adulthood.
One study of adult, female child sexual-abuse victims found support for the revictimization hypothesis. Child sexual-abuse victims were significantly more likely than their non-victim counterparts to have experienced unwanted sexual experiences (from fondling to violent sexual assault), minor and severe physical abuse, and psychological maltreatment (Messman-Moore & Long, 2000).