The Long Term Effects On The Child Victim Of Sexual Assault

Long Term Effects On The Child Victim Of Sexual Assault

Introduction

Child sexual abuse is widely regarded as a cause of mental health problems in adult life. This article examines the impact of child sexual abuse on social, sexual and interpersonal functioning, and its potential role in mediating the more widely recognised impacts on mental health. In discussing the relationship between child sexual abuse and adult psychopathology, the authors evaluate a number of models, including the post-traumatic stress disorder model, the traumatogenic model, and developmental and social models.

Early research

The manner in which the long-term effects of child sexual abuse have come to be conceptualised reflects, in no small measure, the very particular circumstances that surrounded the revelation of child sexual abuse as an all too common event in the lives of our children.

Implications

The way child sexual abuse was placed on the public and health agendas put a stronger emphasis on the adult consequences of abuse than on the immediate implications for an abused child. It also emphasised the psychiatric implications of abuse because self-declared victims tended to focus on these, and these revelations often occurred in a broadly therapeutic context with mental health professionals.

Post-traumatic stress model

The relationship between child sexual abuse and adult psychopathology tended initially to be conceptualised in terms of a chronic form of post traumatic stress disorder. The post-traumatic stress model found its strongest support in the observations of clinicians dealing with individuals with histories of severe and repeated abuse. It was also often linked to notions of a highly specific post-abuse syndrome in which dissociative disorders were prominent.

Traumatogenic model

In the United States, a less medicalised model for the mediation of the long term effects of child sexual abuse was proposed by Finkelhor with his 'traumatogenic model'. This suggested that child sexual abuse produced a range of psychological effects at the time and, secondarily, behavioral changes. This model predicts a disparate range of psychological impairments and behavioral disturbances in adult life which contrasts with the post traumatic syndrome model with its specific range of symptoms.

Dangers of post-traumatic stress model

The belief that child sexual abuse is not only a potent cause of adult psychopathology but can be understood and treated within a post-traumatic stress disorder framework has spawned a minor industry in sexual abuse counselling. Though many working in this area have shifted, on the basis of their clinical experience, to broader conceptualisations, there remains a considerable vested interest in a specific post-abuse syndrome.

Family risk factors

Child sexual abuse is not randomly distributed through the population. It occurs more frequently in children from socially deprived and disorganised family backgrounds. Marital dysfunction, as evidenced by parental separation and domestic violence, is associated with higher risks of child sexual abuse, and involves intrafamilial and extrafamilial perpetrators. Similarly, there are increased risks of abuse with a stepparent in the family, and when family breakdown results in institutional or foster ...