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Investigations on the psychological sequelae of childhood sexual abuse constituted the first wave of CSA research, where the early and long-term effects of sexual abuse on children were examined. This resulted in the identification of a range of difficulties that plagued victims of CSA, including,

• greater evidence of dysfunctional sexual behaviour, where the victims had used sex to get something they wanted or needed, or had controlled others through the use of sex, or got into trouble because of their sexual behaviour,

• an increased rate of homosexual experiences in adolescence or adulthood and struggling with gender identity issues in both male and female victims,

• an extensive pre-occupation with sexuality and promiscuity resulting from over-sexualised behavior, which is often accompanied by sexual aggressiveness,

• parenting difficulties resulting from low maternal confidence and other correlates of CSA, like depression and anxiety, which affect children’s adjustments,

• anxiety and fear, due to a sense of helplessness, powerlessness, and a lack of support on the part of family members,

• self-destructive ideation and behavior among both genders, with an increased frequency of suicide attempts,

• interpersonal relationships characterized by turmoil, anger outbursts, and chronic complaining, with expressions of hostility and aggression,

• poor self-esteem as a consequence of negative effects of development in the domain of the self and social functioning,

• difficulty trusting others in adulthood due to impairment in their intimate relationships resulting from childhood sexual abuse,

• post-traumatic stress disorder and depression due to a greater level of emotional distress at the time of the abuse,

• more dissociative experiences following traumatic stress during childhood, adolescence,

• psychotic symptoms, including the presence of hallucinations, delusions, and thought disorder,

• conduct and personality disorders due to the damage that child sexual abuse can cause to a child’s self-concept, sense of trust, and perception of the world as a relatively safe place,

• more substance abuse dependence symptoms which in turn led to further sexual victimization experiences,

• a tendency toward re-victimization because being sexually abused causes cognitive, emotional, and behavioural reactions (e.g., a fixation with sexuality and over-sexualised behavior) that in turn increase the risk for adolescent or adult victimization, and

• a heightened risk to become a child sexual abuser, usually beginning in adolescence.

The psychological symptom profile of sexually abused Chinese is similar to those found in other Western countries. However, the results indicated that Singaporean women reported elevated psychological symptom levels as measured by the SCL-90-R GSI index, compared to their non-abused peers and to U.S. women in their sample.

Although some of these psychological health problems are, inevitably, borne through adulthood, the reported mental health outcomes of these studies resulted in some variability, with a significant proportion of survivors having no symptoms on current diagnostic measures.

Outcome studies comparing samples of male and female CSA survivors have been mixed; with some indicating that there are discernible differences in symptoms. However, men exhibited more anxiety, interpersonal sensitivity, depression, and phobic anxiety than women in the university-based sample, whereas Little and Hamby reported that women had more problems with self-esteem, relationships, trust, sex, and work than males.

Heath, Bean, & Feinauer discovered that the level of severity of the abuse accounted for most of the variation for both men and women for each of the five measures of trauma symptoms (i.e. dissociation, anxiety, depression, sexual dysfunction, and sleep disturbance).

However, in an earlier study, Gold, Elhai, Lucenko, & Swingle, found no gender differences in the nature, extent, or duration of sexual abuse on the psychological sequelae of the victims.

Mediating Factors for Childhood Sexual Abuse

The second wave of research focused on identifying background variables and potential factors that mediate direct association between child sexual abuse and negative psychological outcomes. These variables included,

• parental support that facilitated attachment relationship with the sexually abused child, thereby engendering family cohesion,

• early disclosures of the abuse that often led to rehabilitative and therapeutic benefits for the young victim,

• protective factors, specifically dispositional attributes, intellectual ability, sense of self-worth, internal locus of control, external attribution of blame, ego-control, and ego-resilience that play a role in children’s ability to cope with trauma,

• positive coping strategies like cognitive restructuring, seeking social support, and reframing and acceptance, and

• other CSA-related variables such as age of onset and relationship to perpetrator, coerced abuse, duration of abuse, where greater long-term harm is associated with abuse involving a father or a stepfather, and abuse involving penetration. Where longer duration of abuse appears to be associated with greater impact, and the use of force or threat of force is associated with greater harm.

This is synopsis of a segment of my postgraduate thesis. Relevant material will be summarized in this blog over the coming weeks. References and citations have been omitted to condense the article and improve readability.

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