A review of the short-term effects of child sexual abuse

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Abstract

This is the first of a two-part report that critically evaluates empirical studies on the short- and long-term effects of child sexual abuse. With the exception of sexualized behavior, the majority of short-term effects noted in the literature are symptoms that characterize child clinical samples in general. Among adolescents, commonly reported sequelae include sexual dissatisfaction, promiscuity, homosexuality, and an increased risk for revictimization. Depression and suicidal ideation or behavior also appear to be more common among victims of sexual abuse compared to normal and psychiatric nonabused controls. Frequency and duration of abuse, abuse involving penetration, force, or violence, and a close relationship to the perpetrator appear to be the most harmful in terms of long-lasting effects on the child. The high prevalence of marital breakdown and psychopathology among parents of children who are sexually abused makes it difficult to determine the specific impact of sexual abuse over and above the effects of a disturbed home environment. Given the broad range of outcome among sexual abuse victims, as well as the methodological weaknesses present in many of the studies reviewed, it is not possible at this time to postulate the existence of a “post-sexual-abuse-syndrome” with a specific course or outcome.

Résumé

Cette partie est la première d'un rapport qui évalue les études empiriques sur les effets à court et à long terme des sévices sexuels à l'égard des enfants. A l'exception du comportement sexualisé, la majorité des effets à court terme signalés dans la littérature sont des symptômes qui caractérisent n'importe quel échantillon clinique d'enfants. Parmi les adultes et les adolescents, les séquelles généralement rapportées concernent la dissatisfaction sexuelle; la promiscuité, l'homosexualité et un risque accru de revictimisation. Les dépressions, les idées suicidaires ou le comportement suicidaire semblent également être plus fréquents parmi les victimes d'abus sexuel que parmi les contrôles normaux et psychiatriques non-abusés. La fréquence et la durée de l'abus, l'abus avec pénétration, l'appel à la force ou l'utilisation de la violence et la relation proche avec l'abuseur semblent être les éléments les plus néfastes en terme d'effets à long terme sur l'enfant. La prévalence élevée de rupture conjugale et de pschopathologie parmi les parents d'enfants ayant subi des sévices sexuels ne permet pas de déterminer l'impact spécifique de l'abus sexuel par rapport aux effets d'un environnement familial perturbé. Etant donné l'ampleur des effets décrits parmi les victimes d'abus sexuels et les faiblesses méthodologiques présentées dans deaucoup d'études passées en revue, il n'est pas possible actuellement de postuler l'existence d'un “syndrome post-abus-sexuel” avec un développement et un pronostic spécifique. Des directives méthodologiques et des recommendations pour des recherches futures sont discutées.

Resumen

Este es el primero de un reporte en dos partes, que evalúa críticamente las investigaciones empíricas de las consecuencieas a corto y a largo plazo del abuso sexual contra los niños. Con la excepción de la conducta sexualizada. la mayoría de las consecuencias a corto plazo que se describen en la literatura, son síntomas que caracterizan las muestras clinicas de menores en general. Entre los adolescentes y adultes, las secuelas comunmente mencionadas incluyen insatisfacción sexual, promiscuidad, homosexualidad, y un aumento en el reisgo de revictimización. La depresión y la ideación o concuducta suicida también parecen ser más comunes en las víctimas de abuso sexual al compararlos con grupos de control normales y de pacientes psiquiátricos no abusados. Las consecuencias que parecen ser las más dañinas en cuanto a que tienen efectos más duraderos en el niño(a) son: la frecuencia y duración del abuso, el uso de fuerza, violencia o penetración, y una relación íntima con el perpetrador. La elevada prevalencia de rompimientos maritales y psicopatología en los padres de niños que son sexualmente abusados dificulta determinar el impacto específico del abuso sexual además de los efectos de un ambiente familiar perturbador. Considerando la amplia gama de consecuencias que presentan las víctimas de abuso sexual, así como las debilidades metodológicas presente en muchas de las investigaciones revisadas, no es posible postular en estos momentos la existencia de un “síndrome post-abuso-sexual” con un curso y consecuencias específicas. Se discuten ciertas recomendaciones y sugerencias metodológicas para las investigaciones futuras.

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    This paper is a revised version of a final report submitted to Health and Welfare Canada (Grant No. 6606-3440-CSA), February 1988.

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