Michael J. Prince, B.A., Psychology


National Center for PTSD: Child Sexual Abuse
- Julia Whealin, Ph.D.

Child sexual abuse includes a wide range of sexual behaviors that take place between a child and an older person. These sexual behaviors are intended to erotically arouse the older person, generally without consideration for the reactions, choices, or effects of the behavior upon the child. Specific behaviors that are sexually abusive often involve bodily contact, such as in the case of sexual kissing, touching, fondling of genitals, and oral, anal, or vaginal intercourse. However, behaviors may be sexually abusive even if they donít involve contact, such as in the case of genital exposure ("flashing"), verbal pressure for sex, and sexual exploitation for purposes of prostitution or pornography.

Who are the Perpetrators of Child Sexual Abuse?

Legal definitions of what constitutes child sexual abuse usually require that the perpetrator be older than the victim. For example, in some states perpetrators must be at least five years older than their victims.

Most often, sexual abusers know the child they abuse but are not relatives. In fact, about sixty percent of perpetrators are non-relative acquaintances, such as a friend of the family, baby sitter, or neighbor.

About thirty percent of those who sexually abuse children are relatives of the child, such as fathers, uncles, or cousins.

Strangers are perpetrators in about 10% of child sexual abuse cases.

Men are found to be perpetrators in most cases, regardless of whether the victim is a boy or a girl. However, women are found to be perpetrators in about 14% of cases reported against boys and about 6% of cases reported against girls.

Child pornographers and other perpetrators now also use the Internet to make contact with children who log in to computers on-line.

How does one know if a child has been sexually abused?

Researchers estimate that, in our country, about 10% of boys and 25% of girls have been sexually abused.

Unfortunately, there are often no obvious signs that a child has been sexual abused. Because sexual abuse often occurs in private, and because it often does not result in physical evidence, child sexual abuse can be difficult to detect.

There is not a "child sexual abuse syndrome," or any symptom that is characteristic of a majority of sexually abused children.

What are some symptoms that a sexually abused child can show?

Some children may show symptoms of PTSD, including agitated behavior, frightening dreams, and repetitive play in which aspects of the abuse are expressed.

Because of their sexual abuse, children may show sexual behavior or seductiveness that is inappropriate for their age.

Children, especially boys, tend to "act out" with behavior problems, such as cruelty to others and running away, as a result of abuse.

Other children "act in" by becoming depressed or withdrawing from friends or family.

Sometimes children may try to injure themselves or attempt suicide.

What can parents and caretakers do to help keep their child safe?

Talk to your children about the difference between "good touch" and "bad touch." Tell children that if someone tries to touch their body and do things that feel uncomfortable, "say NO to the person and tell me right away."

Let children know that they have the right to forbid others to touch their bodies in a "bad way." Let them know that respect does not always mean doing what those in authority tell them to do. Donít tell them to do EVERYTHING the baby-sitter or group leader tells them to do.

Alert your children that perpetrators may use the Internet and monitor your childrenís access to on-line web sites.

Most importantly, provide a safe, caring environment so children feel able to talk freely about sexual abuse.

What should parents and caretakers can do if they suspect abuse?

If a child says she or he has been abused, try and remain calm.

Reassure the child that what has happened was not his or her fault.

Seek a medical examination and psychological consultation immediately.

Know that children can recover from sexual abuse, particularly if they have the support of a caring, available parent.

Get help yourself. It is often very painful to acknowledge that your child has been sexually exploited. Parents can harm children further if they inappropriately minimize the abuse or harbor irrational fears related to the abuse. Therapy can help caretakers deal with their own feelings about the abuse so that they are able to provide support to their children.

What are the possible long-term effects of child sexual abuse?

If child sexual abuse is not effectively treated, long-term symptoms may last into adulthood. These may include:

PTSD and/or anxiety Depression and thoughts of suicide Sexual anxiety and disorders Poor body image and low self-esteem The use of unhealthy behaviors, such as alcohol abuse, drug abuse, self-mutilation, or bingeing and purging, to help mask painful emotions related to the abuse

If you were abused as a child, and suffer from any of these symptoms, it may help you to seek help from a mental health professional who has expertise in working with people who have been sexually abused.

Recommended Books That Address Child Sexual Abuse

Allies in Healing: When the Person You Love Was Sexually Abused As a Child, a Support Book by Laura Davis, (1991). Harperperennial Library; ISBN 0060968834

The Courage to Change: A Guide for Women Survivors of Child Sexual Abuse by Ellen Bass and Laura Davis, (1994). Harperperennial Library; ISBN 0060950668

Trauma and Recovery: The Aftermath of Violence from Domestic Abuse to Political Terror by Judith Herman, (1997). Basic Books; ISBN 0465087302.

Shattered Assumptions: Toward a New Psychology of Trauma by Ronnie Janoff-Bulman, (1992). The Free Press; ISBN 0029160154

Victims No Longer: Men Recovering from Incest and Other Sexual Child Abuse by Mike Lew, forward by Ellen Bass, (1990). HarperCollins; ISBN 0060973005

Wounded Boys Heroic Men: A Manís Guide to Recovering from Child Abuse by Danial Jay Sonkin and Lenore E. A. Walker, (1998). Adams Media Corporations; ISBN 1580620108

Selected References:

Ackerman, P. T., Newton, J. E. O., McPherson, W. B., Jones, J. G., & Dykman, R. A. (1998). Prevalence of post traumatic stress disorder and other psychiatric diagnoses in three groups of abused children (sexual, physical, and both). Child Abuse & Neglect, 22, 759-774.

Boney-McCoy, S. & Finkelhor, D. (1996). Is youth victimization related to trauma symptoms and depression after controlling for prior symptoms and family relationships? A longitudinal, prospective study. Journal of Consulting and Clinical Psychology, 64, 1406-1416.

Collings, S. J. (1995). The long-term effects of contact and noncontact forms of child sexual abuse in a sample of university men. Child Abuse and Neglect, 19, 1-6.

Jumper, S. (1995). A meta-analysis of the relationship of child sexual abuse to adult psychological adjustment. Child Abuse and Neglect, 19, 715-728.

Kendall-Tackett, K. A., Williams, L. M., & Finkelhor, D. (1993). Impact of sexual abuse on children: A review and synthesis of recent empirical studies.Psychological Bulletin, 113, 164-180.

Neumann, D. A., Houskamp, B. M., Pollock, V. E., & Briere, J. (1996). The long-term sequelae of childhood sexual abuse in women: A meta-analytic review. Child Maltreatment, 1, 6-16.