Impact of Child Sexual Abuse on Child Health: Literature Review

This literature review examines the profound impact of child sexual abuse (CSA) on the mental and physical health of children. It delves into the various forms of CSA, its prevalence, and the associated risk factors, highlighting the increased vulnerability of girls. The review analyzes the Four-Factor Traumagenics Model, which explains how CSA disrupts a child's emotional and cognitive development, leading to issues of intimacy, trust, and feelings of powerlessness. It explores the short and long-term physical health risks, including chronic pain, heart disease, and cancer, and the mental health challenges, such as depression, anxiety, and self-harm. The review also discusses the importance of early detection, awareness of symptoms, and intervention programs to address the adverse consequences of CSA, emphasizing the need for universal educational programs and the role of healthcare providers in identifying and supporting affected children. The review concludes by underscoring the critical need for future interventions to mitigate the effects of CSA and protect children.

Student Name
INSTITUTIONAL AFFILIATION(S)
AMU1017

P a g e | 1
Impact of child sexual abuse on mental and physical health of a child
Literature Review
Introduction
Child sexual abuse (CSA) has become one of the critical global health issues which
can be associated with a varied range of negative outcomes. Research shows that there is a
close connection between health-related, psychological outcomes and childhood sexual abuse
along with issues such as psychosocial problems, psychiatric disorder, self-harm and physical
health diagnosis like obesity and HIV (Hailes, Yu, Danese, & Faze, 2019). In this light, this
literature review will examine how SCA impacts the mental and physical health of children
along with finding how such issues must be dealt with suitable interventions.
Discussion and analysis
The term CSA comprises several activities such as forceful intercourse, oral-genital
contact, exhibitionism or child being exposed to adult activity and using children for
pornography. In the year 2002, WHO estimated that around 150 million girls and 73 million
boys under 18 years of age had experienced varied forms of sexual abuse. The US
Department of Justice and The Centre's for Disease Control conducted another study and
found that 11% girls and 4% of boys studying in high schools had been forced to indulge in
sexual activities in some point of their lives ( Singh, Parsekar, & Nair, 2014). Other than this,
many children become subjected to biases and discrimination due to which objective
information concerning CSA remains underreported and most of them go unobserved.
According to Murray, Nguyen, & Cohen (2014), CSA often takes place beside other forms of
neglect or abuse or in a family environment where the child may feel low family support and
high stresses due to low parental education, high poverty, single parenthood, domestic

P a g e | 2
violence, low caregiver warmth, etc. Furthermore, children who are emotionally needy,
impulsive and who pose physical or learning disability and mental health issues show to be at
greater risk.
In terms of risk factors, females or girls are considered to be at greater risk as
compared to males or boys. Some researchers, however, pinpoint that boys are more
frequently abused than girls probably because they are more reluctant to report abuse faced.
Whether a girl or a boy, both faces adverse outcomes due to CSA. Collin-Vézina, Daigneault,
& Hébert (2013) stated that among several models to measure impacts caused due to CSA,
Four-Factor Traumagenics Model asserts that CSA modifies child's emotional and cognitive
orientation towards the world and results in trauma by disrupting their affective and self-
concept capabilities. This model underlines the problems of intimacy and trust which are
specially interpreted among CSA victims. This unique nature of maltreatment causing CSA is
further highlighted by four stress-causing dimensions victims may face: traumatic
sexualization, stigmatization, betrayal and powerlessness. While traumatic sexualization is
referred to victim’s sexuality which is distorted by CSA, betrayal refers to the loss of trust in
caregivers which shatters relationship that never supports or protects child from being abused
or reports of any such incident. Powerlessness can be expressed through power-related
problems where the child is unable to change the situation even though, he/she feels the
situation threatening and stigmatization occurs when perpetrators reinforce manipulative
discourse for the victim due to dominant social negative attitude.
Other than emotional stress, CSA can be associated with long-short term physical
health risks as well as negative health outcomes. Research evidence states that mental-health-
related issues in child survivors stem out of complex matrix formed due to inter-relationship
between emotional, behavioural, cognitive and social factors. Physically, the sexually abused
child remains more than often ill and have multiple surgeries. They are prone to chronic pain

P a g e | 3
syndromes, ischemic heart disease, chronic lung disease, cancer, fibromyalgia and irritable
bowel systems. CSA can be more strongly associated with osteoarthritis, heart ailments,
chronic spinal pains and frequent headaches. Females survivors are a greater risk to health-
related issues such as unintended and aborted pregnancies, prepubertal period runaway, early
alcoholising and promiscuity. Increasing attention is also given to find the relationship
between childhood adversity, stress and CSA on one hand and dysfunction seen in brain
development on the other hand which causes neuroendocrine and immunological responses
( Cashmore & Shackel, n.d.). Putting succinctly, CSA is directly associated with adverse
mental and physical symptoms in child and for several children, the outcomes can even give
shape to other factors such as another form of exploitations and adversities in childhood.
A sexually abused child is more prone to sexually abusing substances so that they can
engage themselves in self-harm behaviour besides showing the tendency to commit suicide
and therefore, critical steps must be undertaken to address issues related to CSA. Adolescents
who are sexually abused reports more non-clinical psychotic experiences like hallucinations
and delusions. Women who have been sexually abused in childhood are likely to engage in
self-mutilation following 25 years of age, involves in risky sexual activities, experiences life
traumas, intake drugs and alcohol, PTSD and often fails to qualify high school ( Cashmore &
Shackel, n.d.). A universal educational program, intervened with individual preventive sphere
can potentially deliver a sense of responsibility in present generations. According to Collin-
Vézina, Daigneault, & Hébert (2013), a universal approach can prove advantageous in
several ways. Firstly, these programs can be offered cost-effectively, they are easy to be
implemented and can allow reaching a huge number of children while avoiding the focus on a
particular population. However, this approach has also been criticised as it places the child
prevention responsibility in few hands and thus may lack important factor like dealing with
those children who have faced CSA.

P a g e | 4
Behavioural and health challenges observed in child survivors of CSA reflects mental
and emotional distress that can be related to several vulnerabilities including atypical stress
response in later life. Such symptoms and findings raise a significant consideration to identify
categories of people who cannot respond or resist due to disability, age, state of
consciousness or fear to harm others or self. Regardless of whether any routine screenings are
made after a child is been abused sexually, it is critical for health and mental care providers to
remain aware of potential symptoms of CSA and its related sequelae. Caregivers can report
any concerning view about their child behaviours like difficulty in sleeping alone,
nightmares, or fear of dark, bedwetting, sadness, anger outburst or withdrawal from social
gatherings, etc. Additionally, every child must display sexual knowledge, behaviour or
language which is inappropriate at their age (Hanson & Wallis, 2018). It can be noted that
awareness of specific symptoms related to PTSD besides other symptoms associated with
CSA is reported appropriately to ensure that children are monitored and accessed accurately
to receive the best form of treatment.
Conclusion
Child sexual abuse can be associated with a wide array of negative consequences for
children throughout their lifetime. The review made on present research in CSA field show
that sexually abused child faces various mental and physical consequences such as social,
sexual, behavioural, health, and mental problems. To date, a clear link between CSA and the
presence of depression, eating disorders, multiple surgeries, intake of alcoholic substances
and anxiety-related issues can be seen. As an increased rate of re-victimization risks among
survivors is also demonstrated in literature for both male and female child, the above
literature review gathered some useful pieces of evidences and suggestions through which
future interventions can be shaped to reduce and fight against CSA.

P a g e | 5
References
Cashmore, J., & Shackel, R. (n.d.). The long-term effects of child sexual abuse. Retrieved
from https://aifs.gov.au/cfca/publications/long-term-effects-child-sexual-abuse/export
Collin-Vézina, D., Daigneault, I., & Hébert, M. (2013). Lessons learned from child sexual
abuse research: prevalence, outcomes, and preventive strategies. Child and
Adolescent Psychiatry and Mental Health, 7(22), 1-9.
Hailes, H. P., Yu, R., Danese, A., & Faze, S. (2019). Long-term outcomes of childhood
sexual abuse: an umbrella review. Lancet Psychiatry, 6, 830-839.
Hanson, R. F., & Wallis, E. (2018). Treating Victims of Child Sexual Abuse. The American
Journal of Psychiatry, 175(11), 1064-1070.
Murray, L. K., Nguyen, A., & Cohen, J. A. (2014). Child Sexual Abuse. Child Adolesc
Psychiatr Clin N Am., 23(2), 321–337.
Singh, M. M., Parsekar, S. S., & Nair, S. N. (2014). An Epidemiological Overview of Child
Sexual Abuse. Journal of Family Medicine and Primary Care, 3(4), 430-435.