Childhood Sexual Abuse

Sadly, childhood sexual abuse is far too common in the United States today. It is estimated that as many as 1 out of every 5 adult females and 1 out of every 10 adult males in the U.S. may have been the victim of sexual abuse at some point during their childhood (American Academy of Pediatrics, 2000, para. 1). However, more research is revealing that childhood sexual abuse is most likely an even bigger problem than some studies have revealed, most likely because many individuals are too ashamed to admit that they have been sexually victimized (U.S. Department of Health and Human Services, 1993). Even more shocking, though, is the fact that the sexual abuse is usually at the hands of someone they know ("8 out of 10 reported cases") (American Academy of Pediatrics, 2000, para. 4). It is truly sickening to realize that so many children are sexually abused by those they trust and even love.

Even though there are actually organizations in the United States that insist that there is not anything wrong with sex between a child and an adult (e.g., the René Guyon Society), experts generally agree that sexual contact between adults and children often causes short-term and even long-term harm to the child (U.S. Department of Health and Human Services, 1993). Around the time children are sexually abused, they often exhibit behavior that is strange and completely out of character. They may become fearful of places and situations (e.g., physical exams by doctors) that remind them of the sexual abuse or place them in what they view as a vulnerable position. They may even become preoccupied with the victimization, drawing pictures that are sexual in nature or attempting to reenact the abuse with other children (American Academy of Pediatrics, 2000). Childhood sexual abuse, however, has also been linked to damaging effects that can continue into adulthood. Victims of childhood sexual abuse may have a difficult time developing healthy intimate relationships as adults, since they might have problems enjoying normal sexual activity and trusting others. Adults that have been sexually abused as children are also much more likely to engage in self-destructive behavior such as drug and alcohol abuse because they often blame themselves for the sexual abuse and feel the need to punish themselves (National Institute on Drug Abuse, 2002; U.S. Department of Health and Human Services, 1993).

Childhood sexual abuse has also been known to cause Post-Traumatic Stress Disorder (PTSD). Sexual abuse can be extremely traumatic for some children, especially if it occurs repeatedly or in a violent manner. The threat and danger of this abuse can stay vivid within the child's mind long after the victimization. This, in turn, may cause him/her to continuously relive the events, avoid things that remind him/her of the abuse, and still exhibit physical distress even though the danger has subsided. If these reactions are severe enough and do not subside, the child may develop PTSD (National Child Traumatic Stress Network, n.d.). The DSM-IV gives the following criteria for PTSD: First, the individual "has experienced or witnessed or was confronted with an unusually traumatic event that has both of these elements" - (1) the incident "involved actual or threatened death or serious physical injury to the person or to others, and the person felt intense fear, horror or helplessness" (PsychNet-UK, n.d., Criterion A). Then, he/she must continuously relive the incident in at least one of the following manners: (1) "intrusive, distressing recollections - thoughts, images;" (2) "repeated, distressing dreams;" (3) "flashbacks, hallucinations or illusions" or "acts or feels as if the event were
recurring;" (4) "marked mental distress in reaction to internal or external cues that symbolize or resemble the event;" and (5) physiological reactivity - such as rapid heart beat, elevated blood pressure in response to these cues" (PsychNet-UK, n.d., Criterion B).

Furthermore, the individual must frequently stay away from anything that reminds him/her of the event and have "numbing of general responsiveness (absent before the traumatic event) as shown by 3 or more of" the following: (1) "tries to avoid thoughts, feelings or conversations concerned with the event;" (2) "tries to avoid activities, people or places that recall the event;" (3) "cannot recall an important feature of the event;" (4)
"marked loss of interest or participation in activities important to the patient;" (5) "feels detached or isolated from other people;" (6) experiences a "restriction in ability to love or feel other strong emotions;" and (7) "feels life will be brief or unfulfilled (lack of marriage, job, children) (PsychNet-UK, n.d., Criterion C). Also, he/she must experience at least 2 hyperarousal symptoms (e.g., "insomnia (initial or interval), irritability, poor concentration, hypervigilance," or "increased startle response") that he/she did not experience before the incident (PsychNet-UK, n.d., Criterion D). And finally, the individual must experience the above symptoms for longer than a month and to such a degree that it markedly disrupts their necessary functioning (e.g., mental, personal, social, or work) (PsychNet-UK, n.d., Criteria E and F).

After reviewing some of the consequences of childhood sexual abuse, it is obvious that these victims need to receive effective treatment. It is important to note that any type of childhood abuse can cause a number of psychological problems, especially if the abuse is not dealt with right away, including depression and eating disorders. Therefore, during treatment, these disorders must be treated along with helping the victim learn how to cope with and eventually heal from the abuse. A multi-faceted treatment approach tailored to fit each individual is most effective. A combination of treatment options may be used, including individual counseling, group therapy, couples counseling, relationship counseling, play therapy, family therapy, or even medication to treat the resulting disorders. In the end, though, treating any type of childhood abuse can be very challenging, especially if the victim does not seek help until many years later. Ultimately, childhood abuse, including sexual abuse, can be awfully damaging to the victim, causing problems in every area of his/her life (Newton, 2001).

References:

American Academy of Pediatrics. (2000). Sexual abuse: What is child sexual abuse? Retrieved November 2, 2007, from Medem Medical Library Web site: http://www.medem.com/MedLB/article_detaillb.cfm?article_ID=ZZZ1LW3YA7C&sub_cat=348

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4^th ed., text rev.). Arlington, VA: American Psychiatric Publishing.

National Child Traumatic Stress Network. (n.d.). Understanding child traumatic stress. Retrieved November 2, 2007, from http://www.nctsn.org/nccts/nav.do?pid=ctr_aud_prnt_under

National Institute on Drug Abuse. (2002, April). Childhood sex abuse increases risk for drug dependence in adult women. Research Findings, 17(1). Retrieved November 2, 2007, from National Institute of Health, National Institute on Drug Abuse Web site: http://www.nida.nih.gov/NIDA_Notes/NNVol17N1/Childhood.html

Newton, C. J. (2001, April). Treatment for child abuse. In Child abuse: An Overview. Mental Health Journal. Retrieved November 2, 2007, from http://www.findcounseling.com/journal/child-abuse/abuse-survivors-counseling.html

PsychNet-UK. (n.d.). Disorder information sheet: Posttraaumatic stress disorder. Retrieved November 2, 2007, from http://www.psychnet-uk.com/dsm_iv/posttraumatic_stress_disorder.htm

U.S. Department of Health and Human Services. (1993). Section 2 - Definitions, scope, and effects of child sexual abuse. In Child sexual abuse: Intervention and treatment issues (User manual series). Retrieved November 2, 2007, from Child welfare Information Gateway Web site: http://www.childwelfare.gov/pubs/usermanuals/sexabuse/sexabuseb.cfm