The Effects of Child Sexual Abuse

Anne A. Student

CHF1500 Human Development Professor Day

Summer Semester 2010

Abstract
When I was five years old, I was sexually abused by a friend of my mother’s, the abuse continued for about a year. The day my sixteen year old brother heard what had been happening he confronted the perpetrator. During their argument my brother was brutally murdered. I have always felt a sense of guilt for his death. Additionally, I have always wondered if there was a connection between the sexual abuse I suffered as a child, the other traumatic events I experienced and the thought patterns and actions I used throughout my childhood and adolescence. Sadly, child sexual abuse (CSA) is prevalent in all societies, cultures, and occurs in every socioeconomic status, it knows no boundaries. Experts agree that experiencing this type of abuse during such a pivotal point in development can have detrimental effects on a child’s psyche. What are the common results of CSA and why do some survivors seem to be affected more deeply than others? What are the ramifications as they grow into adulthood? And do the coping strategies survivors use, create a possibility of further abuse? These are the questions researchers have been asking for years. My goal through the examination of this research is to discover the different implications of CSA so that I can completely understand myself; and as a prospective educator, I will be fully equipped with the knowledge needed to recognize the signs and symptoms of child abuse. I will look at three recently published studies targeting both the short and long term effects of child sexual abuse on both genders. In conclusion, I will create and describe my own interpretation of the information. The first study attempts to discover the short-term effects of CSA on girls aged seven to twelve in order to determine how these children were performing in school after the abuse in a

variety of contexts including: academically, socially, emotionally and behaviorally. The second study surveys a large sample of female college students, focusing on the psychological disorders caused by CSA and the factors that played a role in their revictimization as an adult. The authors reviewed these maladaptive coping strategies to predict the likelihood that survivors of CSA would be revictimized. The final study focuses on a large sample of Icelandic youth to determine whether or not CSA affects male and females differently and what type of coping responses the respective genders use. Additionally, the authors look at the psychological impairments the survivors have and the externalizing behaviors used as a result.

First Study Summary
Social, behavioral and academic functioning in sexually abused girls Isabelle V. Daignault, Martine Hébert (2009). Profiles of School Adaptation: Social, behavioral and academic functioning in sexually abused girls. Child Abuse and Neglect, 33, 102-115. The objective of this multi-method study was to determine the short term effects of CSA on young girls in the hope of establishing services to help those who are sexually abused make a smooth transition back into school. The authors believe that there is a need for services that are targeted to the specific way the child adapts in this region. Sample: The authors recruited participants from the Socio-Judicial Pediatric Clinic of the Mother and Child University Hospital Center in Montreal, Canada where a team of psychologists and doctors evaluate children after their abuse is reported. Of the original 189 girls who consulted the clinic during a three year recruitment period, only 100 girls aged 7 to 12 and their mothers met the criteria and agreed to participate in the study. Single parent families represented 50% of the sample, 57% were below the low income cutoff, 60% of the mother’s finished high school and 43% of them were also abused as children. Half of the sample experienced intrafamilial abuse, and for 40% of the total sample, abuse continued for longer than 6 months. Method: The mothers and teachers completed surveys regarding the child’s behavioral, emotional, social and academic processes at school. The children fulfilled testing and surveys designed to assess their cognitive level, social adjustment and parental support. They also completed the CATC test to assess their cognitive functioning one month after their abuse was reported. The authors utilized the Child Behavior Check List to assess social competence and behavioral difficulties from reports completed by the mothers and teachers, from which three domains of

school adaptation were selected: academic performance, social functioning and externalized behaviors. Findings: From the data four clusters of categorized functioning emerged: 1. The Academic Specific cluster accounted for 15% of the total sample; these girls were most likely to have severe academic problems. Although their academic functioning was the lowest, they were functioning at a higher socio-emotional level than all other clusters except the resilient group. These girls were found to have experienced intrafamilial sexual abuse, were more often a witness to parental abuse, and half were found to have academic difficulties before the abuse. 2. The Acting out/ Withdrawn group was 16% of the sample; the cognitive functioning of these girls on the academic level was found to be average but these girls were found to externalize negative feelings using violent behavior or withdrawing socially. This group showed a high percentage of extra-familial abuse, frequent use of physical force and 80% of them were exposed to other forms of victimization. These children used avoidance to cope with the effects of their abuse. 3. The Polyclinical cluster was added after the authors noticed that 22% of the sample data showed that this group of girls fit into more than one of the groups. These girls were most likely to be bullied or rejected by their peers and exhibited suspicious behavior. The mother surveys confirmed that these girls presented the highest abuserelated decline academically, socially and behaviorally. This group showed peak rates in extra-familial abuse, threats of physical punishment and a greater exposure to other victimizations. They were exposed to more familial stress, other traumatic

events and the severity of their abuse was found to be higher. Furthermore, the girls were found to have higher rates of PTSD and anxiety. 4. The girls who were found to have adjusted the most effectively after the abuse fit into the Resilient cluster (47%); this group had the lowest scores rating the severity of the abuse, and was less likely to have experienced any other stressful events or other victimizations. The authors emphasize the importance of using these groups to be able to recognize the symptoms of CSA and develop in school prevention programs. There is a need for a program of intervention designed with these clusters in mind and used at different levels of intensity to help these children learn effective coping and adapting strategies.

Second Study Summary
Child Sexual Abuse, Coping Responses, Self-Blame, Posttraumatic Stress Disorder, and Adult Sexual Revictimization. Filipas, Henrietta H., Sarah E. Ullman (2006). Child Sexual Abuse, Coping Responses, SelfBlame, Posttraumatic Stress Disorder, and Adult Sexual Revictimization. Journal of Interpersonal Violence, 21, 652-672. This retrospective study used a large college sample of high-functioning ethnically diverse students to compare CSA survivors to those who have been revictimized by measuring PTSD symptoms and cognitive factors such as the degree of self-blame and other coping methods. They were attempting to see if there was a correlation between CSA and adult sexual assault (ASA). Sample: Of the original number of students that took the 20 page packet 92% finished and turned it in. There were 577 ethnically diverse college females who participated in this study most of which were unmarried which included CSA only, ASA only, and both CSA and ASA. Method: The authors used a comprehensive approach; the survey used asked questions regarding CSA, coping strategies, attribution of blame, and specific questions from the Post Traumatic Stress Scale and Sexual Experience Survey. A chi-square analysis was used to see if CSA survivors compared with non abused participants were likely to be revictimized as adults. The authors then completed an analysis of the study variables including self- blame, PTSD, CSA and the amount of ineffective coping strategies they used to find the correlations. In order to predict PTSD the authors used a multiple regression analysis and used selfblame, coping responses and CSA. A logistic regression analysis was used to predict

revictimization. Findings: The data showed that about 27% of the entire sample had experienced CSA before the age of 14. 16% reported CSA only, about 10% experienced only Adult Sexual Assault, 12% reported both CSA and ASA, and 61% of the sample reported no abuse. The majority of survivors knew the perpetrator and experienced abuse from weeks to years. The most widely used coping strategy was trying to forget while about half withdrew socially, and 1out of 4 acted out sexually, violently, or used drugs and alcohol. The women that were the most likely to use drugs, alcohol or act out sexually were survivors of both CSA and ASA. Close to half of the participants that were sexually abused as a child were revictimized as adults, but only 14% of the women who didn’t experience CSA were survivors of ASA. They found that the best predictor of PTSD in this study were the amount of ineffective coping strategies that the survivor used. The authors suggest that although the effects of these mistreatments will always be imprinted on the individual’s psyche, it is important for them to be aware of the effects and learn more effective ways of adapting so they can live productive lives.

Third Study Summary Gender and the associated impairments of childhood sexual abuse.
Gault-Sherman, Martha, Eric Silver, Inga Do´ra Sigfu´sdo´ttir (2009). Gender and the associated impairments of childhood sexual abuse: A national study of Icelandic youth. Social Science and Medicine, 69, 1515-1522. This multi method cross-sectional population-based study focuses on both male and female Icelandic youth. The authors concentrated on the externalizing and internalizing impairments of CSA victims. About 80% of the students selected for participation completed the survey. Sample: The authors of this study used a sample of 8,618 Icelandic middle class youth (3,933 females and 4479 males) from a group of 10,472 students aged 16 to 20 who were either nonvictims or survivors of CSA that were sexually abuse before the age of 15. 70% of the sample came from a household with both parents. 6.1% of the sample experienced physical abuse. Method: Using a survey developed by the Icelandic Centre for Social Research and Analysis, the current study measured the type, duration and severity of abuse. The authors used control variables that included age, family structure, SES, and physical abuse. The students were asked by their teacher to participate in the study, and completed the survey during class which asked them 169 questions regarding their sexual experiences, abuse histories and their family and social background. Additionally they reported on issues including: depression, self-esteem, anxiety and anger. Using regression analyses they were able to determine whether or not the types of behavior outcomes varied significantly by gender.

Findings: The data collected showed that abuse suffered by boys was reported only about one third as often as it was for girls. However, the severity of the boys’ abuse was found to be marginally higher with self reports showing that over 95% were abused by a family member. In contrast, the girls reported that 86.5% of them were abused by a family member. The authors found that girls exhibited more internalizing behaviors such as depression, and anxiety disorders. Although boys showed more externalizing than internalizing behaviors there was not a major difference between the genders for theft, violence or eating disorders. Additionally the older teenage survivors who were physically abused and reported a stronger attachment to their parents (who completed more schooling), were more likely to exhibit internalizing behaviors. Those who exhibited theft and violent behavior were younger, experienced physical abuse and friends with children who tended to get in trouble.

General Summary and Personal Synthesis
This is a very personal subject for me as it is for anyone who has experienced this type of abuse. However, researching these studies has created in me a moment of awakening, the realization that I’m not “crazy”, and that many of the risky things I did and felt as a child are common for a survivor of CSA. I now understand that because of the events that occurred when I was a child I learned ineffective coping strategies that resulted in my battle with addictions, promiscuity, anorexia and bulimia as an adolescent. In addition I frequently struggle with selfesteem, irrational fear and OCD issues. Maladaptive coping mechanisms often manifest themselves in a survivor’s life so they are able to deal with the effects of the abuse as a child. The way a child deals with the abuse in the short and long term is dependent upon the time of development they were in when the abuse occurred. Some effects are psychological causing panic attacks, eating disorders, low self-worth and many times the psychological aspects later lead to drug and alcohol abuse, promiscuity, theft and violent behavior. Therefore, it is critical for parents, educators and any professional that comes in contact with children to be able to identify all the signs and symptoms of CSA. It is our responsibility as adults to provide the safest environment for children, and if they are abused to find the most effective ways to help them adjust to the mistreatment in hopes of preventing further psychological problems. My hope for all survivors is that they have the courage to report the abuse and to take advantage of available resources. This experience has empowered me to love who I am, with all my faults, weaknesses and just as many virtues, and has given me the renewed inspiration to create who I want to be. In

spite of all the crises I have been through, or have yet to go through I know I can overcome any obstacle life puts in my path.

References
Isabelle V. Daignault, Martine Hébert (2009). Profiles of School Adaptation: Social, behavioral and academic functioning in sexually abused girls. Child Abuse and Neglect, 33, 102-115. Filipas, Henrietta H., Sarah E. Ullman (2006). Child Sexual Abuse, Coping Responses, SelfBlame, Posttraumatic Stress Disorder, and Adult Sexual Revictimization. Journal of Interpersonal Violence, 21, 652-672. Gault-Sherman, Martha, Eric Silver, Inga Do´ra Sigfu´sdo´ttir (2009). Gender and the associated impairments of childhood sexual abuse: A national study of Icelandic youth. Social Science and Medicine, 69, 1515-1522.