Tuesday, March 14, 2006

Impact of Child Sexual Abuse

It is estimated that there are 60 million survivors of childhood sexual abuse in America today.

Approximately 31% of women in prison state that they had been abused as children.
Source: United States Department of Justice, 1991.

Approximately 95% of teenage prostitutes have been sexually abused.
Source: CCPCA, 1992.

It is estimated that children with disabilities are 4 to 10 times more vulnerable to sexual abuse than their non-disabled peers.
Source: National Resource Center on Child Sexual Abuse, 1992.

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.

Sexuality is regarded not simply as a part of the self limited to genitals, discrete behaviors, or biological aspects of reproduction, but is more properly understood as one component of the total personality that affects one's concept of personal identity and self-esteem.
Source: Whitlock & Gillman, 1989.

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.

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. 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. It was also suggested that sexual abuse may lead some girls to become sexually active at an earlier age and seek out older boyfriends who might, in turn, introduce them to drugs.

Psychiatric disorders were from 2.6 to 3.3 times more common among women whose CSA included intercourse, and the risk of substance abuse was increased more than fourfold, according to the results.

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.

Among both adolescent girls and boys, a history of sexual or physical abuse appears to increase the risk of disordered eating behaviors, such as self-induced vomiting or use of laxatives to avoid gaining weight. Among those at increased risk for disordered eating were respondents who had experienced sexual or physical abuse and those who gave low ratings to family communication, parental caring and parental expectations.

In light of these findings, the researchers conclude that "strong familial relationships may decrease the risk for disordered eating among youth reporting abuse experiences."
Source: Dr. Dianne Neumark-Sztainer, et al, University of Minneapolis, International Journal of Eating Disorders 2000;28:249-258.

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. Abused girls were more dissatisfied with their weight and more likely to diet and purge their food by vomiting or using laxatives and diuretics. Abused girls were also more likely to restrict their eating when they were bored or emotionally upset. Wonderlich suggests that abused girls might experience higher levels of emotional distress, possibly linked to their abuse, and have trouble coping. Food restriction and perhaps other eating disorder behaviors may (reflect) efforts to cope with such experiences.

The report also indicates that while girls who were abused were less likely to exhibit perfectionist tendencies (such as making extreme efforts to avoid disappointing others and a need to be 'the best'), they tended to want thinner bodies than girls who had not been abused.
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.

US Healthcare system missing most mentally ill children and adolescents. More than 7 out of 10 American adolescents with mental health problems are getting no care, according to data released today at the Surgeon General's Conference on Children's Mental Health.

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