Sgroi's Ten Impacts of Abuse

1. "damaged goods" syndrome
2. guilt
3. fear
4. depression
5. low self-esteem and poor social skills
6. repressed anger and hostility
7. inability to trust
8. blurred role boundaries and role confusion
9. pseudomaturity
10. self-mastery and control

(Vulnerable Populations: Evaluation and Treatment of Sexually Abused Children and Adult Survivors, Suzanne Sgroi 1988)

Effects of abuse - Finkelhor's categories

1. Traumatic sexualisation

• results from inappropriate sexual contacts and relationships
• the effects that victims may experience include avoidance of sex, disgust with anything sexual, a consuming interest in sex, or problems with sexual identity

2. Stigmatisation

• results as children realise that social abuse is socially and morally unacceptable behaviour and believed that they are responsible for the abuse or feel guilty because they have been abused
• as a result, children may withdraw from friends and family members

3. Betrayal

• results when children realise that the adult they had trusted has hurt them
• children may have a difficult time trusting other adults after they have been abused

4. Powerlessness

• feelings of powerlessness can occur when children realise that they cannot stop the abuse or they may occur at a later time, if and when they reveal the abuse, when the intervention process beings, and they are overwhelmed by all that is happening to them

Finkelhor (1984)

See also article on general issues page

Effects of Sexual abuse - Department of Health, UK Government

Disturbed behaviour – including self-harm, inappropriate sexualised behaviour, depression and a loss of self-esteem – have all been linked to sexual abuse. Its adverse effects may endure into adulthood.The severity of impact on a child is believed to increase the longer the abuse continues, the more extensive the abuse, and the older the child. A number of features of sexual abuse have also been linked with severity of impact, including the relationship of the abuser to the child, the extent of premeditation, the degree of threat and coercion, sadism, and bizarre or unusual elements. A child’s ability to cope with the experience of sexual abuse, once recognised or disclosed, is strengthened by the support of a non-abusive adult carer who believes the child, helps the child understand the abuse, and is able to offer help and protection.  The reactions of practitioners also have an impact on the child’s ability to cope with what has happened, and his or her feelings of self worth. (See also Child Sexual Abuse: Informing Practice from Research, 1999.)

A proportion of adults who sexually abuse children have themselves been sexually abused as children.They may also have been exposed as children to domestic violence and discontinuity of care.However, it would be quite wrong to suggest that most children who are sexually abused inevitably go on to become abusers themselves.

From “Working Together to Safeguard Children” (2006) by HM Government, paragraph 9.8 and 9.9 - available here

What is the impact of sexual abuse in children? - Life’s Challenges

It is difficult to recognize the signs of sexual abuse in children since they tend to not share what is happening to them. Therefore, it is up to concerned adults or friends to recognize the signs. The impact of sexual abuse on children is vast and varied.

The most commonly experienced impact of sexual abuse is posttraumatic stress disorder (PTSD). This type of stress falls into three categories: re-enactment of the event, avoidance or withdrawal and physiological hyper-activity. Each child is different though, and may experience any or all of these in various degrees of behavior.

A frequent problem with sexual abuse is that the child engages in more sexualized behavior compared to children who are not sexually abused. Since the abuse took place on and in the body, the body becomes the enemy. They carry a great deal of pain and memories. They desperately try to cope with the pain which can lead to eating disorders, self-inflicting injuries, inability to have sex, or engaging in sex often, poor body image, generalized separation from and disregard for one's body, dissociation, sexual impurity, and gender-identity issues.

Survivors who live through the impact of childhood sexual abuse may have difficulty knowing where their personal boundaries are, how to maintain them, and how to protect themselves from those who do not respect or try to violate their boundaries. They are then vulnerable to further abuse.

Trust becomes a very big issue. Trust is harder to develop when the person who abused the child is a caregiver. The abuser is often someone who has a close relationship with them and should be someone the child can trust.

Problematic coping behaviors include: addictions, prostitution, overworking, inability to work, high-functioning, low-functioning, argumentative, avoiding conflict, perfectionism, and wanting to please others.

There are also many emotional effects such as helplessness, feeling dirty, confusion, powerlessness, and pain. Victims may not display these emotions by invalidating them by saying, "It wasn't so bad, it didn't really hurt." This is a way of self-protection leading to self-blame and self-hatred. Negative self image perspectives come into play with "I am bad, no one loves me, no one could love me, I am unlovable, and dirty. It's my fault, I am horrible."

The negative effects of incest, the most common form of sexual abuse, can be compounded by the reactions of parents, siblings, and other important people in the child's life. Sometimes siblings of the survivor blame the abused child, either because they believe the perpetrator's denials, or simply because of what reporting the abuser has done to the family. And when a child wonders if her mother knew about the abuse but did nothing to stop it, she can lose trust in both parents, not just one.

Let us look at the some of the signs of sexual abuse: There are physical and behavioral signs that may be seen. Physical signs include vaginal or rectal bleeding, pain, itching, swelling, or discharge, difficulty with bowel movements, urinating, or swallowing. The child may have recurring complaints of stomach-aches and/or headaches; trauma to breasts, buttocks, lower abdomen, or genital or rectal areas. Their undergarments may also be torn, stained, or bloody. They may have vaginal infections or venereal diseases, and they may display difficulty in walking or sitting.

From Life’s Challenges - available here

Effects of Sexual Abuse - Child Trauma Academy

There are a significant number of negative short-term effects of sexual abuse that impact a child’s functioning. The most commonly experienced effect of sexual abuse is posttraumatic stress disorder (PTSD). Posttraumatic stress disorder is a clinical syndrome whose symptoms fall into three clusters: reenactment of the traumatic event; avoidance of cues associated with the event or general withdrawal; and physiological hyper-reactivity. A recent review article suggested over 50% of sexually abused children meet at least partial criteria of PTSD and another study suggested a third of all sexually abused children develop full diagnostic criteria. If not effectively addressed, PTSD can become a chronic problem affecting the child well into adulthood. The development of sexualized behavior, also called sexually reactive behavior, is another common negative short-term effect of sexual abuse. Children who have been sexually abused engage in more sexualized behavior when compared to children who are not victims of sexual abuse, and when compared to clinical samples of children with other mental health issues. A recent report suggested that about a third of children who have been sexually abused subsequently manifest this symptom. Additionally, a third or more of child victims of sexual abuse report depression and anxiety. Other frequently occurring symptoms include promiscuity (38%), general behavior problems (30%), poor self-esteem (35%), and disruptive behavior disorders (23%). In some important recent research conducted, in part, by the Centers for Disease Control, risk for health problems in adult life including heart disease were increased by adverse childhood events, including sexual abuse.

It is estimated that somewhere between 21-49% of child sexual abuse victims appear asymptomatic post-victimization. Potential explanations for this include: difficulties with the methods used to detect problems in children, delays in symptom development post-sexual abuse, underreporting of symptoms, resiliency, and mitigating factors that may make the impact of the abuse less severe for some children.

Mitigating factors can increase or decrease distress related to sexual abuse and include characteristics of the crime itself, characteristics of the individual child, and characteristics of the environment. Regarding the crime itself, sexual abuse involving force and penetration are associated with increased distress as are multiple victimizations. If the perpetrator of the crime is a parent rather than an adult stranger or older child, the child is also more likely to experience distress. Child characteristics include age and developmental level. With advanced cognitive development, a child’s perspective regarding the victimization may include more or less distress. Children with lower self-esteem experience increased levels of distress. Children whose coping methods include avoidance are also more apt to develop distress symptoms. Characteristics of the environment include children who have a supportive relationship with an adult, parent, or sibling. These individuals generally have better adjustment than children who experience little support. Similarly, family cohesiveness is also a positive buffer for child victims of sexual abuse. Parental distress is associated with child distress, i.e., the more the parent is negatively affected by the crime, the more the child is negatively affected.

Evidence suggests that the negative psychological impact of child sexual abuse persists over time, often into adulthood. Potential long-term effects of child sexual abuse include depression, anxiety, posttraumatic stress disorder, sexual dysfunction, and substance abuse. Further, among the female adult outpatient population, individuals with sexual abuse histories as children were twice as likely to attempt suicide than their non-abused counterparts. Across the lifespan, individuals who were sexually abused as children are four times more likely to be at risk for developing a psychiatric disorder and are about three times more likely to abuse substances than their non-abused counterparts. It is estimated that approximately one third of child sexual abuse victims experience PTSD as adult survivors. Among women whose abuse involved penetration, an increased risk associated for the development of PTSD is experienced, resulting in about two thirds of this population developing PTSD at some point during their lifetime.

Child Trauma Academy - available here