The Long Term Consequences of Child Sexual Abuse

Child sexual abuse (CSA) is an adverse childhood experience (ACE) that has serious long-term consequences for those who have been victimized. The Centers for Disease Control and Prevention (CDC) estimates that 1 in 4 girls and 1 in 13 boys will experience sexual abuse before they are 18. Not only are there psychological consequences to CSA, but longitudinal research has also found that CSA results in negative health, psychosocial, and socioeconomic outcomes for those who have been abused.

The Psychological Consequences of CSA

Many studies have examined the long-term psychological impact of CSA. A recent research review of over four million people found that those who experienced CSA are between two and three times more likely to experience the following disorders compared to adults who were not abused:

• Borderline personality disorder

• Depression

• Anxiety

• Post-traumatic stress disorder (PTSD)

• Eating disorders

• CSA is also strongly linked to drug and alcohol use, and those who experienced CSA are about 2.5 times more likely to make a suicide attempt than people who have not been abused.

It should be noted that many of the psychological consequences of CSA can take years to develop as the abuse is thought to alter brain structure and chemistry during its developmental period. For example, one study found that the average time between the abuse and the onset of depression was 11.5 years, while another study found an average of 9.2 years from the time of abuse to the onset of depression and 8 years until the onset of PTSD.

The Physical Consequences of CSA

Numerous studies have also shown that there are long-term impacts to the physical health of those who experienced CSA. Across studies, adults who experienced CSA were 1.35 to 2.12 times more likely to report health problems such as:

• Poorer overall health

• Pain/fibromyalgia

• Gastrointestinal symptoms

• Gynecological symptoms

• Cardiopulmonary symptoms

• Obesity
  

As a result of these health problems, adults with a history of CSA use health care more frequently than those without a history of CSA, spending on average 16% more per year. Notably, however, a history of CSA is also associated with lower odds of having health insurance and receiving a general check-up (preventative care) in the past year.

The Psychosocial Impacts of CSA

Researchers have also documented many negative social consequences of CSA including:

Relationship disruption (break-up/divorce)

Dissatisfaction with their relationships

Sexual unfaithfulness/promiscuity

Increased sexual dysfunction

Sadly, there is considerable evidence to suggest that those who have experienced CSA are also likely to be revictimized. A recent study involving 12,252 survivors found that 47.5% were sexually victimized again later in life. Similarly, there is also evidence to suggest that the children of women who have been abused are also more likely to be abused themselves, suggesting that the cycle of abuse may continue into the next generation.

From an economic perspective, it is estimated the average lifetime cost of child maltreatment (including CSA) per survivor is $830,928. Compared to adults who had not been abused, survivors of CSA were found to:

Earn on average $8,000 less per year

Be less likely to have a bank account, or own stock, a vehicle, or home

Be three times more likely to be out of work due to sickness and disability

Be 14% more likely to be unemployed in general

Be less likely to go to, or graduate from college

Be less likely to have a skilled job

As is clear from the research, CSA significantly negatively impacts all facets of life — not only for those who experience childhood sexual abuse themselves, but also for their loved ones and society at large. Thus, we must all do what we can to prevent sexual abuse before it happens, and provide support and services to those who have already experienced CSA.