The Long‐Term Clinical Correlates of Childhood Sexual Victimization

Abstract

Despite the contention of some clinicians and researchers that sexual child abuse is not necessarily traumatic or harmful,’-’ most recent studies indicate that sexual victimization during childhood produces both shortand long-term psychological effects. In their comprehensive review of over 35 studies, most of which were published or presented since 1980, Browne and Finkelhor conclude that “sexual abuse is a serious mental health problem, consistently associated with very disturbing subsequent problems in some important portion of its victims. ”’ Among other difficulties, it appears that women sexually abused as children are more likely than their nonabused peers to report depression, guilt, feelings of inferiority, and low self-e~teem?~ interpersonal problems, delinquency, and substance a b ~ s e ~ ” ~ ” s~icidality,~*’~.’’ anxiety and chronic tenSion,5.6.12,14 sexual problem^,^^'^^^^^'^^^ and a tendency toward revictimization in adultThese findings appear to be relatively stable across a variety of groups (i.e., clinical, university student, and community samples), and may hold for both males and females.” Until very recently, in what may be referred to as the “first wave” of sexual abuse research, investigators devoted considerable time and energy to “effects research”-documenting that adults with histories of childhood sexual abuse have more mental health problems than similar adults with no such history. As reflected in the Browne and Finkelhor4 review, this goal has been more or less accomplished. What remains in this area may be described as the “second wave” of investigation-determining the actual relationship between aspects of the abuse (what Finkelhor20.2’ refers to as “traumagenic” factors) and specific psychological symptomatology. Such data are important, since they (a) offer clinicians and others a greater understanding of abuse-related symptom development, potentially leading to more specific and effective treatment procedures, and (b) increase our ability to identify and treat sexual abuse victims who are specifically “at risk” for certain types of problems (e.g., suicidality or substance abuse) later in life, by virtue of the specific type( s) of trauma they experienced. Finally, such research is “good science,” increasing our ability to explain and predict sexual victimization effects. Unfortunately, as noted by Browne and Finkelhor: “only a few studies on the effects of sexual abuse have had enough cases and been sophisticated enough methodologically . . . [to study traumagenic factors] empirically,” and little consensus has been reached regarding specific abuse-effects relationships.