Chapter Summary and Learning Objectives
- Describe the definition and scope of child sexual abuse, including problems inherent in measuring this form of abuse.
- Identify the various risk factors associated with child sexual abuse.
- Summarize the consequences of child sexual abuse including both short- and long-term outcomes.
- Discuss the various intervention and prevention efforts that have been developed to address child sexual abuse, including evidence of their effectiveness.
No one knows exactly how many children experience sexual abuse each year. The difficulty in determining accurate rates of CSA stems from the problems inherent in defining and studying any complex social problem. Although no precise figures are available, it is clear that adults sexually exploit large numbers of children. Conservative estimates derived from the most methodologically sound studies suggest that in the United States, 20 percent of women and between 5 percent and 10 percent of men have experienced some form of CSA.
Research has demonstrated the heterogeneity of CSA victim and offender populations. Victims and perpetrators represent all possible demographic and psychological profiles. A number of risk factors, however, have been consistently associated with CSA. Victims often are female, have few close friends, and live in families characterized by poor family relations and the absence or unavailability of natural parents. Perpetrators of CSA are most often male, and they are often relatives or acquaintances of their victims. The heterogeneity of victim and perpetrator populations has contributed to scholars’ difficulty in establishing a single explanation for the occurrence of CSA. One perpetrator may abuse a certain type of child for one reason, and another may abuse a different type of child for a different reason. Risk factors for CSA span various individuals and systems involved in CSA, including individuals as well as the context in which they reside. Several theories have been developed in an attempt to integrate individual risk factors across multiple ecological levels.
The psychological sequelae associated with CSA are variable and consist of short-term as well as long-term effects. Difficulties associated with CSA include a variety of symptoms that affect emotional well-being, interpersonal functioning, behavior, sexual functioning, physical health, and cognitive functioning. The variability of outcomes for victims is associated with a number of factors including preabuse characteristics of the victim, the severity of the sexual behavior, the degree of physical force used by the perpetrator, the response the victim received following disclosure, and the relationship of the perpetrator to the victim.
In recognition of the significance of the CSA problem, many professionals are involved in responding to the needs of victims and the treatment of perpetrators. Researchers and mental health practitioners have developed an array of treatment interventions in an effort to address the multiple causes and far-reaching consequences of CSA. Regardless of the type of approach, the therapeutic goals for child victims and adult survivors of CSA generally include addressing significant symptoms as well as common emotions associated with abuse, such as guilt, shame, anger, depression, and anxiety. Treatment programs for offenders include a variety of approaches, but most typically incorporate cognitive and behavioral components to reduce deviant sexual arousal and cognitive distortions associated with abuse. These approaches demonstrate some promise, but further studies are needed to address the limitations of extant research methodologies and to examine potential alternative treatments.
The prevention of CSA begins with social awareness and the recognition that expertise, energy, and money are needed to alleviate the conditions that produce CSA. Many experts maintain, however, that society has not yet sufficiently demonstrated a commitment to prevention. In most communities, monetary resources are tied up in responding to, rather than preventing, CSA. Increasing commitment to the prevention of CSA, however, is evidenced in the many prevention programs appearing across the United States. Several of the strategies employed in these programs seem especially promising. Although additional evaluations are needed, available research indicates that these programs have tremendous positive potential.