Long-Term Effects of Childhood Sexual Abuse

As noted by Charak, DiLillo, Messman-Moore, and Gratz (2017), sexual violence has been a major health concern which is associated with a vast range of adverse behavioural interpersonal, cognitive as well as emotional outcomes. Although there are prime periods over which the risk of sexual violence is high, it may still happen to children. Nonetheless, a majority of cases where children have been sexually abused have not been reported and as such the children did not get any professional help. This paper seeks to explore the various types of sexual abuse on children and identify the common perpetrators. In addition to this, it will identify the immediate effects which result from the sexual abuse, but a lot of emphases will be placed on the long-term effects. Lastly, this paper will explore ways in which childhood sexual abuse affects how the victims maintain relationships and handle stressors. 

Child Sexual Abuse

As noted by Bhandari, winter, Messer & Metcalfe, (2011), sexual abuse occurs where one individual dominates or exploits another person using sexual suggestions or activities. Child sexual abuse, therefore, as suggested in Bhandari, winter, Messer & Metcalfe, (2011), involves all sexual acts, whether covert or overt, between an adult and a child, in which the participation of this child is obtained through means of coercion or seduction. Regardless of whether the child engages without resistance when they are seduced, at the end they suffer tremendous psychological impacts. According to a survey, 12%-18% of men and 28-33% of women were victims of sexual abuse in a survey conducted in the US. This shows that the extent to which the rate of sexual abuse is happening is alarming. 

Stages of Childhood Sexual Abuse

The initial stage in childhood sexual abuse begins with the engagement between the perpetrator and the child. The perpetrator of the sexual looks for a perfect victim by considering several factors (Shevlin, 2017). These factors may include the physical attractiveness of the child, how easy it is to access the child and perceived vulnerability of the victims. As such, this has made it common for a majority of perpetrators to be family members as they can easily get access to the children. 

They begin by engaging the children with some nonsexual issues to earn the affection and trust of the children hence developing an emotional connection with the child. Basically, this is attained through rewarding the child with gifts and satisfying the need for closeness as well socialization for children (Shevlin, 2017). Children whose parents are drug addicts, and neglect them are at a risk of being victims of sexual abuses. 

This is followed closely by sexual interaction whereby the perpetrator begins engaging the child in some inappropriate sexual activities (Shevlin, 2017). Often the perpetrators begin with what seems to be accidental touches which gradually escalate to intimate touches. For instance, they may begin with giving the child hugs, back massages and graduate to erotically fondling the child and kissing them. This, in the end, might result in an actual sexual intercourse. From this stage, the perpetrator ensures there is a high secrecy level which is maintained through bribery or threats. The secrecy ensures that the offender has access to the child and continues to engage in the sexual activity. Disclosure is the subsequent stage which might occur on purpose or coincidentally. This affects the family to a great deal. Thereafter, suppression might occur, whereby the caregivers of the child may resist from dealing with the ordeal and thus resort to denial or minimization. 

Types of Childhood Sexual Engagement

There are various types of sexual engagements as noted below 

1. Sexual Assault

Essentially sexual assault is understood as offenses which the perpetrator uses the minor for the purposes of satisfying their sexual urges (Shevlin, 2017). For example, this can include rape which is, inclusive of sodomy, or sexual penetrations of other objects in the child. As a result, this leaves behind a physical indication that there was actual sexual engagement. Consequently, this can physically and emotionally traumatize the child. They feel betrayed by the individual whom they had trusted. 

2. Sexual Exploitation 

On the other hand, sexual exploitation occurs when the child may be victimized by the perpetrator for purposes such as sexual gratification and profit such as prostituting the children (Shevlin, 2017). 

3. Sexual Grooming 

This is a type of abuse whereby the sex offender tries to lure the child by making their advances more appealing (Shevlin, 2017). For example, they can do appealing things to lure the child to accept their advances.

Types of Abusers

Family

In most cases, perpetrators of child sexual abuse are close family members as they can easily get access to the child. Notably, 30% of offenders of child sexual abuses are family members. However, a high percentage of victims are female as noted in research conducted in 2012, whereby 82% of juvenile victims were girls. The sexual abuse is directed at both boy and a girl child. The report showed that at least one in every six boys is sexually abused while one in every four girls is sexually abused (Shevlin,2017). A point to note is that in the past few decades the number of cases of women sexually abusing children has also increased rapidly. 

Acquaintances 

The second categories of sexual offenders who take advantage of children to sexually molest them are acquaintances of the family. In a case conducted at the Idaho found out that 46% of the juvenile sex offenders comprised of the family members (Shevlin, 2017). This is because; just like the family member, they can easily win the trust of the child. As a result, they become the best people to sexually abuse the children.

Strangers 

There have also been cases of strangers who have sexually abused children. A common class of strangers who sexually abuse children are paedophiles (Shevlin, 2017). These individuals have sexual preferences for prepubescent children regardless of whether there is an attraction or not. In most cases, they get lured to act on their impulses which lead them to commit such crimes. In most cases, the strangers groom their prey by luring them to fall into their traps and maintaining their contact a secret. However, others might use force or threats to sexually abuse the child. 

Immediate Effects of Child Sexual Abuse on the Victim

Undoubtedly, when the child is abuse, this has both physical and emotional effects on the child. As their bodies are underdeveloped, the sexual acts lead to massive bleeding and swelling of the vagina. As s result, this causes a lot of pain to the child. In a case where the offender used excessive force, there may be bruises and cuts which are visible. The child may also contract sexually transmitted infections or develop a burning sensation in their genitals as a result. As such, this affects how the child walks or sits. 

Immediately the child is abused, this may affect their behaviour from what they were used to doing. For example, the child may begin to experience nightmares as a result of the abuse. Those who are advanced in age and able to reason may inflict injuries in their bodies or develop suicidal thoughts. Other children may return to some regressive behaviour which they had forgotten over such as thumb sucking. For an adolescent, their academic performance might be severely affected, and they may begin failing in subjects which they were previously good at. In addition to this, some children may change their hygiene routines, such that the child either refuses to take a bath, or they spend a lot of time bathing than normal. 

Subsequent Effects

Impulsivity and Compulsivity 

As noted by Dworkin et al., (2014), child sexual abuse is associated with impulsivity and compulsivity among the victims. Both impulsivity and compulsivity are adopted by the victim as a way of coping with the trauma of the abuse. Nonetheless, they are distinct, and each plays its role. For instance, impulsivity contributes to reduced cognitive controls such that the victim engages in risky behaviours and has behavioural disinhibition. An example is a case where the person may develop disordered eating behaviours which may include overeating or eating at the spur of the moment. Another example would show the tendency for the individual to start engaging in petty crime and running away from school. 

Compulsivity, in contrast, is associated with over-control of behaviours by an individual. Essentially, this may be marked by an individual avoiding a particular behaviour, then engaging in the behaviours thereafter repetitively as well seeking to avoid harm. For example, one might observe the victim exercising for longer periods to avoid adding a lot of eight. Similarly, the victims might begin encouraging some compensatory behaviour to avert negative effects. Notably, the compensatory behaviours, as highlighted by Dworkin et al., (2014), is associated with perfectionism which is more common in women. However, there are instances where the compensatory behaviours, such as purging can be as a result of impulsivity. A victim of child sexual abuse tends to adopt these behaviours with time as a way of avoiding intrusive thoughts regarding the abuse. 

Avoidance

Moreover, with time a victim of child abuse may begin developing avoidant behaviours in an attempt to cope with the ordeal Charak, DiLillo, Messman-Moore, and Gratz (2017). As a result, the victim may begin engaging in some dysfunctional activities such as avoiding some abusive-specific memories. Moreover, they may begin engaging in drug and substance abuse. For every instance, the behaviour may be a representative of a conscious or an unconscious decision to take part in the destructive behaviours rather than experiencing fully the pain associated with abuse memories. Engaging in the dysfunctional activities ultimately sets a path for the individual to develop low self-esteem with time and develop feelings of anger and guilt. 

Disassociation 

Furthermore, the individuals are likely to feel disassociated, which according to Charak, DiLillo, Messman-Moore, and Gratz (2017), is a disruption in the normal occurrence of a link between feelings, subjective awareness, memories, behaviours, and thoughts. For example, one can notice that the victim is disengaged from their immediate environment during stressful events or be emotionally numb. There can be distorted perception of one’s body and depersonalization. 

Long Term Effects

Interpersonal Difficulties 

According to Charak, DiLillo, Messman-Moore, and Gratz (2017), childhood, sexual abuse has been one of the causes of both the short and long-term alterations in social functioning. The interpersonal difficulties are as a result of the immediate cognitive as well as conditions response to the abuse. One good example of the personal difficulties is distrust, whereby, the victims find it difficult to trust people irrespective of the environment they are in. Another problem might be anger, and fear of people who are in power as they are afraid that they might victimize them again. In essence, this affects the person’s ability to form lasting relationships. This is because the child sexual abuse is done at the moment when a child is developing some form of intimacy with the perpetrator. Thus this makes it difficult for them to develop any intimacy with a person which in turn affects the ability to have healthy relationships. 

Emotional Distress 

Depression

Moreover, many people who have been victims of childhood sexual abuse often develop depression later in life (Bhandari, winter, Messer & Metcalfe, 2011). This is because the survivors may encounter some difficulties while internalizing the sexual abuse which in turn affect how they think of themselves. Consequently, the feeling of worthlessness makes them to constantly feel low and accommodate suicidal thoughts and disturbed sleeping patterns.

Anxiety

Naturally, child abuse is both threatening and disruptive and thus may tamper with the normal development of a sense of security and safer world for children. As a result, this makes such children to develop chronic feelings of anxiety and a lot of fear (Bhandari, Winter, Messer & Metcalfe, 2011)

Anger 

Another emotional sequel associated with child sexual abuse is anger (Bhandari, Winter, Messer & Metcalfe, 2011). That is, the individual is likely to express chronic irritability and uncontrolled or unexpected feelings of anger. This is more common to victims who experienced repeated cases of sexual abuse as children. 

Sexual Difficulties 

At the long run, victims of childhood sexual abuse develop dissociative patterns and depression which in turn tampers with their sexual function. Some of the problems which might arise include lack of sexual interests, viewing sex as an obligation, fearing or avoiding intercourse or having negative feelings when touched such as disgust, fear, and guilt. In some cases, the individual may feel an emotional distance from their partners. According to a study in the US, as highlighted by Bhandari, winter, Messer & Metcalfe, (2011), a majority of people in the US who had been victims of child sexual abuse often had erectile dysfunctions as well as premature ejaculations. 

Psychological Damages

Childhood sexual abuse results in severe psychological disorders as it disrupts the cognitive functioning and development of an individual. As a result, the victims might develop the following psychological disorders as developed in (Bhandari, Winter, Messer & Metcalfe, 2011). 

1. Post-Traumatic Stress Disorder (PSTD) 

Additionally, the victims may develop PSTD as a result of the trauma, whereby they frequently experience the event either through intrusive thoughts or nightmares. Recent research on the area has linked child sexual abuse to posttraumatic fears and anxiety as well as poor concentration. More adults who experienced childhood sexual abuse often have flashbacks of the event. 

2. Anxiety Disorder

In many cases, adults who had these experiences are likely to meet the criteria for anxiety disorders as compared to their peers who did not undergo such experiences. While anxiety is necessary to enable us to deal with some life challenges, in some situation the anxiety hardly goes away after gradually becomes worse. As in the case of victims who were sexually abused as children, they live with the fear that they might get sexually abused. 

3. Mood Disorder

A mood disorder can be as a direct result of childhood sexual abuse whereby a victim can develop several illnesses in this category. As noted earlier, a person may develop depression which can develop into a persistent depressive disorder. Moreover, they can develop a mild form of bipolar known as cyclothymic. This can be attributed to the intrusive thoughts constantly making them develop feelings of worthlessness. 

4. Drug and Substance Abuse Disorder 

In addition to this, a majority of victims of sexual abuse in their childhood often result to drug and substances to escape the memories of the pain from the abuse. As a result, this has led to the development of this disorder which in turn affects their lives in many ways. 

How Victims Handle Stressors and Maintain Relationships

Mainly, victims of childhood sexual abuse face a lot of discrimination when the public gets to know of the events. As a result, this makes them be targets of insulting words by people who look down upon them. In a case where teenagers are involved, they may be perceived to have lured the victim to commit the act. These and other factors such as shame, trauma, anger, just to mention but a few, are some of the stressors that they have to overcome to be able to lead a normal life (Bhandari, winter, Messer & Metcalfe, 2011). As such, a majority of them develop avoidant behaviours, whereby they hardly attend any social gathering and prefer to be isolated. 

However, some of the abusers can seek therapeutic interventions in counselling services to enable them to handle the stressors and maintain healthy relations (Bhandari, winter, Messer & Metcalfe, 2011). This is because; many of the effects of the abuse are as a result of difficulties of the individual has in processing the events which in turn affect their behaviours. As s social worker, there is the need for one to understand that the clients may find it difficult to disclose about the events. Hence, as a social worker, one should be able to use relationship building techniques such as encouragement and validation to the get the client to open up. Moreover, a social worker should empower the client them to process and uncover anger which in turn leads to improved self-efficacy of the client. 

This research has been inspired by the fact that I have been a witness to a case of childhood sexual abuse, with my cousin as the victim at the age of 12years. Fortunately, the perpetrator was a close acquaintance of my family, and he was arrested and convicted. Nonetheless, I have seen her suffer from the ordeals of that event which affected how she connected with the rest of the family members. As such, this population interested me because I wish to be of help to such individuals to enable them to get through the trauma. 

In conclusion childhood, sexual abuse has been in existences for a significant period of time. As noted above, the perpetrators of these acts are family members, acquaintances or strangers. Before the sexual abuse can occur, it passes through several stages. Once the offender has warmed up to the victim and gets a chance they immediately take the opportunity and try to keep it a secret. However, this abuse has resulted in a number of immediate effects such as the physical injuries they attain. These effects continue throughout the years, and they exhibit signs of avoidance, suicide, and depression. Some long-term effects may include the development of psychological disorders and emotional disorders. Through counselling, such patients can be helped to cope with these stressors.

References

Charak, R., DiLillo, D., Messman-Moore, T. L., &Gratz, K. L. (2017). Latent Classes of Lifetime Sexual Victimization Characteristics in Women in Emerging Adulthood: Differential Relations With Emotion Dysregulation. Psychology Of Violence, doi:10.1037/vio0000154

Dallam, S. J., Gleaves, D. H., Cepeda-Benito, A., Silberg, J. L., Kraemer, H. C., & Spiegel, D. (2001). The effects of child sexual abuse: Comment on Rind, Tromovitch, and Bauserman (1998). Psychological Bulletin, 127(6), 715-733. doi:10.1037/0033- 2909.127.6.715

Dworkin, E., Javdani, S., Verona, E., & Campbell, R. (2014). Child sexual abuse and disordered eating: The mediating role of impulsive and compulsive tendencies. Psychology Of Violence, 4(1), 21-36. doi:10.1037/a0031779

(Bhandari, Winter, Messer & Metcalfe, 2011)Your Bibliography : Bhandari, S., Winter, D., Messer, D., & Metcalfe, C. (2011). Family characteristics and long-term effects of childhood sexual abuse. British Journal of Clinical Psychology , 50 (4), 435-451. http://dx.doi.org/10.1111/j.2044-8260.2010.02006.x

Lamoureux, B. E., Palmieri, P. A., Jackson, A. P., &Hobfoll, S. E. (2012). Child sexual abuse and adulthood-interpersonal outcomes: Examining pathways for intervention. Psychological Trauma: Theory, Research, Practice, And Policy, 4(6), 605-613. doi:10.1037/a0026079

Shevlin, M., Murphy, S., Elklit, A., Murphy, J., & Hyland, P. (2017). Typologies of Child Sexual 

Abuse: An Analysis of Multiple Abuse Acts among a Large Sample of Danish Treatment-Seeking Survivors of Childhood Sexual Abuse. Psychological Trauma: Theory, Research, Practice, And Policy, doi: 10.1037/tra0000268