This paper discusses the effects that childhood sexual abuse has on children. It states the basics and statistics of sexual abuse in children in our society. The immediate symptoms and signs of childhood sexual abuse are discussed as well as long term emotional effects, long lasting physical effects and psychological disorders due to sexual abuse. The treatment of childhood sexual abuse is also discussed to show how positive resources can help victims of sexual abuse.
In the United States, 1 in 5 girls and 1 in 20 boys are victims of sexual abuse (National Center for Victims of Crime, 2018). Sexual abuse is not an easy or common subject to talk about; however, it is more common than one would think. Sexual abuse in childhood causes massive trauma in a child’s life that disrupts childhood experiences and causes long lasting trauma responses. Sexual abuse is defined as when a child is engaged in sexual activities that he or she is not able to comprehend, for which they are developmentally unprepared for, is not able to give consent, and/or that violate the law or social taboos of society (Kellogg & Neglect, 2005). Perpetrators are often a family member or family friend, but could also be a teacher, pastor, acquaintance or stranger. The purpose of this paper is to understand the nature of trauma childhood sexual abuse causes children and the effects that it has on the remainder of the childhood experience.
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Sexual abuse comes in many forms and is often debated on what constitutes at sexual abuse. In a general sense, there are 3 basic categories of sexual abuse. The first is penetration, where anal or vaginal penetration occurs. Then there is what is considered contact only sexual abuse, which would be oral sex or fondling. Finally, there is non-contact sexual abuse where there is no physical contact but there is indecent exposure or inappropriate sexual suggestion (Graham, Rogers, & Davies, 2007). An example of non-contact sexual abuse would be child pornography or voyeurism.
Statistics on childhood sexual abuse can be alarming but are very important because they make the prevalence of sexual abuse known. According to the National Center for the Victims of Crime, children are the most vulnerable between the ages of 7 and 13 years old. According a National Institute of Justice report conducted in 2003, 3 out of 4 adolescents who experienced sexual assault knew their perpetrator. In a 2010 study, the Department of Human Services’ Children’s Bureau found that 9.2% of victimized children were sexually assaulted (Crime, 2018). It is important to remember that these statistics are only drawn from reported accounts of sexual abuse. Many cases of sexual abuse in children go unreported, so the prevalence may be much higher.
The immediate effects of sexual abuse can sometimes be hard to see, especially in younger children who are just learning about their bodies. There are a few different categories that sexual abuse signs can be divided into due to their nature. There are bodily signs, affective signs, sexual signs and verbal signs (Jensen, 2005). Some of the signs of sexual abuse are also signs of other forms of abuse or psychological disorders and are open to interpretation. This is why it is often hard to pin down the signs of sexual abuse because it can be mistaken as other kinds of abuse as well.
Bodily signs of sexual abuse consist of symptoms such as bedwetting, stomach aches, headaches, food aversions and soreness of genitals (Jensen, 2005). Bedwetting at night time is also a very common symptom of sexual abuse. Many children subconsciously use it as a defense mechanism. Affective signs of sexual abuse are more psychologically based signs such as fear, anxiety reactions, sadness, acting-out for no reason, mood shifts, and unusual behavior when the alleged abuser is around or talked about (Jensen, 2005). These signs can be controversial in identifying sexual abuse as they could be symptoms of other kinds of abuse or other medical problems.
Sexual signs of sexual abuse in children include sexualized play with dolls, unnatural sexual experimenting or touching of other children, drawing sexual activities they should not have encountered yet shouldn’t know about yet, and excessive touching of their own genitals (Jensen, 2005). Sexual signs are usually the most alarming and telltale signs that the individual is experiencing exposure to one of the three basic categories of sexual abuse or at the very least, something inappropriate is happening to the child. If not directly involved with sexual abuse these signs could suggest that the child is being exposed to abuse of another child or at the very least the child is being exposed to inappropriate materials or situations such as pornography. Verbal signs of sexual abuse include talking about sexual behaviors beyond their age and explicit disclosing of abuse (Jensen, 2005). However, obtaining a disclosure statement for the proper authorities is a difficult task to achieve due to a child’s inherent trust of a parent and fear of an unknown authoritative figure. They may be scared to disclose because of threats made by their abuser or they may have been be influenced by adults trying to get them to disclose and say something happened when it didn’t for the adult’s benefit. Disclosure is usually the final sign that an investigator needs to pursue a criminal case against a perpetrator.
The long term effects of sexual abuse can be quite extensive. They can range from depression and low self-esteem, normalizing the abuse they have experienced, and all the way to becoming perpetrators themselves. The way that the trauma of sexual abuse affects a child depends on a lot of factors. However, according to Solakoglu, Driver and Belshaw there have been studies that show that more severe abuse can lead to a greater likelihood of social and psychological problems (Solakoglu, Driver, & Belshaw, 2018).
Studies have been able to link suicidal ideations and behaviors to sexual abuse during childhood. It has been found that both male and female victims of sexual abuse are more likely to experience self-harm, suicidal ideations, and suicide attempts as adolescents. One study argued that the reason behind this is that adolescents are using inadequate coping skills and turn their pain from the abuse inward and end up hurting themselves (Solakoglu, Driver, & Belshaw, 2018).
There is also a strong link between substance abuse and adolescents that have experienced sexual abuse. In a study done in 1993 by Watts and Ellis found that female adolescents who reported sexual abuse also had higher rates of drug and alcohol use compared to females that did not report sexual abuse (Solakoglu, Driver, & Belshaw, 2018). The same study also found that adolescent males who were sexually abused used more tobacco and marijuana products than those who did not report sexual abuse (Solakoglu, Driver, & Belshaw, 2018). Many studies have found that drug and alcohol abuse also starts at an earlier age in adolescents that have been sexually abused. This is because many adolescents do not know how to cope with the trauma of being sexually abused and drugs and alcohol are a defense mechanism.
Long Lasting Physical Effects of Sexual Abuse
Childhood Sexual Abuse can have some lasting physical effects in victim’s lives. According to the American Academy of Pediatrics, about 5% of sexually abused children acquire an STD from their abuse abuser (Kellogg & Neglect, 2005). Even though the prevalence is low, it is still concerning as some STDs can have permanent effects, some that could prove to ultimately prove fatal. Some effects of untreated STDs are infertility, increased risk for contracting HIV, systemic health problems, and spreading the disease (Boskey PhD, 2018).
Sexual abuse in childhood has also been linked to gastrointestinal disorders. According to the Journal of Sexual Medicine, the prevalence of sexual abuse in patients with gastrointestinal disorders ranges from 30% to 56% (Nicolai, et al., 2012). Gastrointestinal disorders can be a lifelong condition with painful and uncomfortable effects. It is unknown if sexual abuse is a direct cause of gastrointestinal disorders, but there seems to be a positive correlation between the two.
Childhood obesity can have many causes, however sexual abuse has been connected to causing overeating in children because of psychological reasons including coping with the negative event or to transform their own body into what they deem as sexualy untractive to try to discourage the abuser to continue. Childhood obesity is seen as a response to when children overeat as well as lack adequate physical activity. However, in addition to the basic physiological reasons for obesity there can usually be a psychological reason to why a child becomes obese. According to the Obesity Action Community, the association between obesity and sexual abuse is strongest in children and adults who have severe obesity, which affects 2 million children in the United States (Stevelos, 2018). Obesity can be caused by Binge Eating Disorder, which sexually abused children are three to four times more likely to develop (Stevelos, 2018). Obesity in childhood can have a lasting effect on a child’s life and can be very hard to overcome. Usually once a child is obese, they will continue to be obese as an adult.
Psychological Disorders due to Sexual Abuse
Childhood sexual abuse has been linked to many psychiatric disorders across all age groups. Depression, generalized anxiety disorder, panic disorder, phobias, and post-traumatic stress disorder are all linked to childhood sexual abuse (Child Sexual Abuse and Subsequent Psychopathology: Results From the National Comorbidity Survey, 2001). Childhood sexual abuse is such a traumatic experience during childhood that the emotional and psychiatric state of the victim is changed forever. One reason why childhood sexual abuse is so traumatic is because it disrupts the child’s developing sense of self. This leads to difficulty in relating to others, inability to regulate reactions to stressful events and other emotional challenges that make psychiatric disorders more prevalent (Child Sexual Abuse and Subsequent Psychopathology: Results From the National Comorbidity Survey, 2001).
Depression is a very common psychiatric disorder that can follow childhood sexual abuse. The percentage of women with lifetime depression that reported child sexual abuse is 39.3% compared to 21.3% in the general population (Child Sexual Abuse and Subsequent Psychopathology: Results From the National Comorbidity Survey, 2001). However, depression is usually caused by a variety of reasons. Therefore, the relationship between depression and childhood sexual abuse is more of a positive correlation and not proven to be a stand alone causation.
Another psychiatric disorder associated with childhood sexual abuse is Post Traumatic Stress Disorder. Although PTSD is usually associated with war veterans, it has also been found in victims of sexual abuse. The reason why sexual abuse can cause PTSD is because childhood sexual abuse is characterized by an inescapable sexual threat and is usually repeated by the perpetrator multiple times (Feerick & Snow, 2005).While a war veteran’s experience with PTSD is caused by being exposed to repeated threats of physical violence, a child that has been sexually abused experiences PTSD differently. Sexual abuse does not usually involve the same amount of physical danger as being in a war, but it involves a massive amount of psychological danger, such as the meaning behind being used sexually and how they process the event (Feerick & Snow, 2005). PTSD can be a debilitating disorder that can last an individual for the entirety of their life. Someone with PSTD experiences cue-triggered, involuntary re-experiencing of the terror and all of the emotions they were feeling at the time of the traumatic experience (Bath, 2008). Certain sights, sounds, phrases, people and places can easily remind a sexual abuse victim of their traumatic experiences and often causes a huge disturbance in their life.
One method of effective treatment for sexually abused children is trauma informed therapy. This type of therapy involves a trained therapist that specializes in traumatic events and helping the patient heal from their traumatic experience. There are three elements that are associated with trauma informed care that are essential, safety, connections, and managing emotions (Bath, 2008).
Safety is the first component of trauma informed care. This is where the therapist creates a safe place for the child where they know they will remain safe (Bath, 2008). This is important because the child has felt unsafe because of the trauma they have experienced. The next important step a trauma informed therapist takes is to establish positive connections. Re-building positive relationships are important for healthy human development to help reverse the damage that the trauma did. Howard Bath talks about how the brains of traumatized children have learned to associate adults with negative emotions which can lead to behaviors characterized by suspicion, avoidance, and/or outright hostility (Bath, 2008). The duty for care providers and other counselors is to teach them how to restructure these associations so that the children can develop positive emotional responses such as happiness, joy, and safety with some adults and can learn to correctly tell the difference between those who mean to do harm to them and those that are there to help them (Bath, 2008).
The last important part of trauma informed therapy is managing emotions. The most impact on a child’s life from sexual abuse is with managing emotions, which can be very difficult for a trauma survivor. The therapist helps the child to identify their feelings, and through active listening, is able to help children vocalize their trauma, which is essential in trauma recovery (Bath, 2008). While trauma informed therapy is not the answer to every problem that a sexually abuse child will face, it is a good step in the right direction to help them to be able to deal with their trauma.
In conclusion, this paper has identified the effects that sexual abuse has on the life of a child. Sexual abuse in childhood is a very hard but important topic to discuss. There are many negative effects that happen to a child if they encounter any of the three main types of sexual abuse sexual abuse. The physical effects of STDs and the psychological effects of depression and PTSD are experiences that no human, especial a child should have to endure. Even with current information and rigorous studies of its effects, unfortunately sexual abuse is still occuring all over the world. Knowing the signs and treatment of sexual abuse in a child is very important in helping an individual receive the help they need as well as reduce the prevalence of continued sexual abuse. The more people that are informed of sexual abuse in children and what to look out for, the faster it can be stopped. Luckily, there are many resources that can help survivors of childhood sexual abuse learn how to cope with their trauma and be able to live healthy lives.
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