What are the Long Term Effects of Childhood Sexual Abuse

What are the Long Term Effects of Childhood Sexual Abuse?

Childhood sexual abuse includes direct sexual contact such as intercourse and groping, and non-physical activities such as indecent exposure and the display of pornography in the presence of a child. The parents of abuse victims often wonder about the long term effects of such conduct.

Much has been written about the long term effects of childhood sexual abuse. The most obvious effect is psychological harm which includes, but is not limited to, depression, post traumatic stress disorder, behavioral problems, including sexualized behavior, poor self-esteem, academic problems and suicide. Victims of childhood sexual abuse can expect to incur higher future health care costs due to these effects, and it is not uncommon for victims to "victimize" others or become sexually promiscuous at an early age. Prostitutes and pedophiles often explain that their first sexual experience was being molested as a child.

The long term effects of childhood sexual abuse can be serious and that is why victims need psychological evaluation, care and treatment. Victims need time to deal with what has happened to them. Long term psychiatric and psychological care is expensive and often is not covered by insurance. When it is covered, the treatment periods are usually limited. Provision has to be made for likely future treatment around foreseeable stressful periods in a person's adult life, including dating, marriage and having a family. Prior episodes of childhood sexual abuse can be replayed in a victim's mind at these stressful times.

Counseling and therapy are the best ways to mitigate the long term effects of sexual abuse. Unfortunately, health insurance generally limits the amount of therapy it will cover and the victims must bear the costs of extensive treatment. Because many victims cannot afford to pay the high costs of the necessary therapy and simply do not receive all the treatment they need, the long term effects of sexual abuse are more pronounced.

Serious long term consequences of child abuse also include the following:


-One third of abused children will eventually victimize their own children
-80% of abused children meet the diagnostic criteria for at least one psychiatric disorder at age 21 (including but not limited to anxiety, depression, post-traumatic stress disorder and eating disorders).
-Abused children are 25% more likely to experience teen pregnancy.
-Abused teens are three times less likely to practice safe sex.
-14.4% of all men imprisoned in the United States were abused as children.
-36.7% of all women in prison were abused as children.
-Children who have been sexually abused are 2.5 times more likely to develop alcohol abuse.
-Children who have been sexually abused are 3.8 times more likely to develop drug addictions.
[See, Administration for Children & Families of the US Department of Health and Human Services, "Child Maltreatment Report, 2003; National Institute on Drug Abuse 2000 Report.]

It is important to recover the costs of the necessary treatment from the perpetrator or the organization that enabled the perpetrator to have access to the vulnerable victims to ensure that the resources are available to the victim to cope over time with the devastating effects of sexual abuse. To recover these costs, it is important to act quickly to preserve the evidence needed to prove a sexual abuse case. Witnesses, documents and scientific evidence (e.g., DNA) tend to disappear relatively fast in these cases.

Certainly, it is stressful for a child to go through a civil lawsuit to attempt to recover monetary damages for current and future psychological and psychiatric treatment. A parent must balance this against the likely long term effects of future stress if the family does not have the resources to provide appropriate treatment. It is often wise to discuss these issues with a family physician or counselor, and a lawyer who specializes in this type of work.

The privacy of the victim is paramount, and in civil cases seeking monetary damages the victim's identity is protected because the case is brought by a parent or guardian using a fictitious name (e.g., John or Jane Doe) for the victim. Most of these cases do not proceed to trial and when they are settled, the privacy of the victim also is maintained. The goal is maximizing the monetary recovery for the victim while minimizing the impact of having to bring a civil lawsuit.

1. Briere, J., Methodological Issues in the Study of Sexual Abuse Effects, Journal of Consult.ing and Clinical Psychology, (1992), p.199.
2. Gauthier, L., Stollak, G., Messe, L. and Arnoff, J., Recall of Childhood Neglect and Physical Abuse as Differential Predictors of Current Psychological Functioning. Child Abuse and Neglect, (1996), pp. 20, 549-59.
3. Kendall-Tackey, K. A., Williams, L. M. & Finkelhor, D., Impact of Sexual Abuse on Children: A Review and Synthesis of Recent Empirical Studies. Psychological Bulletin, (1993), Vol. 113, No. 1, pp.164-180.
4. Dozier, M., Stovall, K. C. & Albus, K., Attachment and Psychopathology in Adulthood. In J. Cassidy and P. Shaver (Eds), Handbook of Attachment, (1999), pp.497-519.
5. Freyd, J. J., Putnam, F. W., Lyon T. D., Becker-Blease K. A., Cheit, R. E., Siegel, N. B. & Pezdekm, K. The Science of Child Sexual Abuse, Science 308 (2005).
6. Arnow, B., Relationships Between Childhood Maltreatment, Adult health and Psychiatric Outcomes and Medical Utilization. Journal of Clinical Psychiatry 65 (Supp. 12:10-5), (2004).
7. Widom, S., Dumont, K., Czaja, S., A Prospective Investigation of Major Depressive Disorder and Co-Morbidity in Abused and Neglected Children Grown Up. Archives of General Psychiatry 64 (1):49, (2007).
8. Roose, M. W., Reinholtz, C., Angelini, P. J., The Relation of Child Sexual Abuse and Depression in Young Women: Comparisons Across Four Ethnic Groups. Journal of Abnormal Child Psychology 27 (1):65-76, (1999).
9. Widom, C. S., Post Traumatic Stress Disorder in Abused and Neglected Children Grown Up. American Journal of Psychiatry, 156(8):1223-1229, (1999).
10. Levitan, R. D., Rector, N. A., Sheldon, T., & Goering, P., Childhood Adversities Associated with Major Depression and/or anxiety Disorders in a Community Sample of Ontario: Issues of Co-Morbidity and Specificity. Depression and Anxiety, (2003), pp. 17, 34-42.
11. Dinwiddie, S., Heath, A. C., Dunne, M. P., et al., Early Sexual Abuse and Lifetime Psychopathology: A Co-Twin Control Study. Psychological Medicine, (2000), 30:41-52.
12. Whealin, Julia, Ph.D., Childhood Sexual Abuse. National Center for Post Traumatic Stress Disorder, U.S. Department of Veterans' Affairs, (2007).