Long-term effects of sexual abuse
Survivors Healing Center
There are predictable sequelae to sexual abuse in the long-term. These include Posttraumatic Stress Disorder, Cognitive Distortions, Emotional Distress, Avoidance, Impaired Sense of Self, and Interpersonal Difficulties.
1. Posttraumatic Stress Disorder. Adult survivors have been found to display more symptoms of PTSD than do research subjects who were not sexually abused as children.
2. Cognitive Distortions. Studies document chronic self-perceptions of helplessness and hopelessness in adulthood. Further, impaired trust, self-blame, and low self-esteem are characteristic of the adult survivor of childhood sexual abuse.
3. Emotional Distress. Among adult survivors the symptoms of emotional distress include depression (a four times greater risk than for non-survivors; see Stein, et al., 1988), elevated anxiety (Chu & Dill, 1990), and anger (survivors score higher on measures of anger and irritability that do non-survivors; see Briere & Elliott, 1994).
4. Avoidance. Avoidance behaviors on the part of adult survivors cluster around coping strategies designed to help the survivor cope with the abuse-specific memories and feelings induced by the trauma of childhood sexual abuse. These behaviors include dissociation, substance abuse, suicidal thoughts and attempts (Briere & Elliott, 1994), impulsivity, self-mutilation, and eating disorders (Briere & Conte, 1993).
5. Impaired Sense of Self. The development of the sense of self in childhood appears to be negatively affected by sexual abuse (Cole & Putnam, 1992). Without a sense of self, adult survivors have more problems than do non-survivors relating to and understanding others and have more problems perceiving their own internal states independently of the reactions or demands of others (Elliott, 1994). These problems translate into a continuing inability to define one's boundaries or rights and are associated with increased suggestibility, inadequate self-protectiveness, and a greater likelihood of being victimized or exploited (Briere, 1992).
6. Interpersonal Difficulties. The interpersonal difficulties of adult survivors of childhood sexual abuse fall broadly into the category of problems with intimacy. These difficulties center primarily on ambivalence and fear regarding interpersonal vulnerability (Briere & Elliott, 1994). Adult survivors report greater fear of both men and women and experience less interpersonal trust than do non-survivors (Briere & Runtz, 1990), have fewer friends (Gold, 1986), experience greater social discomfort and social isolation (Briere & Elliott, 1994), experience difficulty with sexual intimacy (Maltz & Holman, 1987). The effects of childhood sexual abuse on survivor's later sexuality are thought to contribute to the high incidence of sexual abuse histories found among adolescent and adult prostitutes (Bagley & Young, 1987), many of whom view their current occupation as an extension of their childhood experiences (Briere & Runtz, 1993).
1. Weiss, D. & Daro, D. (1995). Current trends in child abuse reporting and fatalities: the results of the 1994 annual fifty state survey. Chicago, IL: National Committee to Prevent Child Abuse
2. Langan, P., Wolf-Harlow, P., & Wolf-Harlow, C. (1994). Child rape victims, 1992. Washington, D.C.: Bureau of Justice Statistics, U.S. Department of Justice.
3. U.S. Department of Health and Human Services. (1999). Mental health: a report of the surgeon general-executive secretary. Rockville, MD: U.S. Department of HHS, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health.
4. Zellman, G.L., Coulborn-Faller, K. (1996). Reporting of child maltreatment. The American Professional Society on the Abuse of Children. (Briere, J., Berliner, L.,Bulkley, J.A., Jenny, C., & Reid, T. eds.). Thousand Oaks, CA: Sage Publications.
5. Goodman, G.S., Bottoms, B.L., & Shaver, P.R. (1994). Characteristics and sources of allegations of ritualistic child abuse. Washington, DC: National Center on Child Abuse and Neglect.
6. Briere, J.N., & Elliott, D.M. (1994). Immediate and long-term impacts of child sexual abuse. (Behrman, R.E., Ed.). The Future of Children. Los Altos, CA: The David and Lucile Packard Foundation.
7. Runtz, M. (1991). The influence of coping strategies and social support on recovery from physical and sexual maltreatment during childhood. Doctoral dissertation. University of Manitoba, Canada. Dissertation Abstracts.
8. Barahal, R., Waterman, J., & Martin, H. (1981). The social cognitive development of abused children. Journal of Consulting and Clinical Psychology 49 508-16.
9. Stein, J.A., Golding, J.M., Siegel, J.M., et al. (1988). Long-term psychological sequaelae of child sexual abuse: The Los Angeles epidemiological catchment area study. (Wyatt, G.E., & Powell, G.J. Eds.). Newbury Park, CA: Sage Publications; Chu, J.A., & Dill, D.I. (1990). Dissociative symptoms in relation to childhood physical and sexual abuse. American Journal of Psychiatry 147 887-92; Briere, J.N. & Elliott, D.M. (1994). Immediate and long-term impacts of child sexual abuse. (Behrman, R.Ed. Ed.). The Future of Children. Los Altos, CA: The David and Lucile Packard Foundation.
10. Briere, J.N., & Elliott, D.M. (1994). Immediate and long-term impacts of child sexual abuse. (Behrman, R.E. Ed.). The Future of Children. Los Altos, CA: The David and Lucile Packard Foundation; Briere, J.N., & Conte J. (1993). Self-reported amnesia for abuse in adults molested as children. Journal of Traumatic Stress 60 185-95.
11. Cole, P.M., & Putnam, F.W. (1992). Effect of incest on self and social functioning: A developmental psychopathology perspective. Journal of Consulting and Clinical Psychology 60 174-84; Elliott, D.M. (1994). Impaired object relations in professional women molested as children. Psychotherapy 31 79-86; Briere, J.N. (1992). Child abuse trauma: Theory and treatment of lasting effects. Newbury Park, CA: Sage Publication
12. Briere, J.N., & Elliott, D.M. (1994). Immediate and long-term impacts of child sexual abuse. (Behrman, R.E. Ed.). The Future of Children. Los Altos, CA: The David and Lucile Packard Foundation: Briere, J.N., & Runtz, M. (1990). Differential adult symptomatology associated with three types of child abuse histories. Child Abuse & Neglect 14 357-64; Gold, E.R. (1986). Long-term effects of sexual victimization in childhood: An attributional approach. Journal of Consulting and Clinical Psychology 54 471-75; Briere, J.N., & Elliott, D.M. (1994). Immediate and long-term impacts of child sexual abuse. (Behrman, R.E. Ed.). The Future of Children. Los Altos, CA: The David and Lucile Packard Foundation; Maltz, W., & Holman, B. (1987). Incest and sexuality: A guide to healing. Lexington, MA: Lexington Books; Bagley, C., & Young, L. (1987). Juvenile prostitution and child sexual abuse: A controlled study. Canadian Journal of Community Mental Health 6 5-26; Briere, J.N., & Runtz, M. (1993). Child maltreatment, later revictimization, and adult symptomatology: A causal analysis. Paper presented at the 1993 American Psychological Associating Annual Meeting. Toronto, August 1993