What are the effects and treatment options of child sexual abuse?

Child sexual abuse is one of the serious societal problems in the modern word.  It is reported that the rate of the victims is approximately 15 to 20% of the female and 8 to 10% of the male in modern societies.[1]  It is necessary to pay attention to make progress toward its prevention and treatment. Moreover, child sexual abuse is clearly an issue which needs to understand for both male and female victims and their guardians.

What is The definition of  Child Sexual Abuse?

Child sexual abuse is “Typically includes unwanted and inappropriate sexual solicitation of, or exposure to, a child by an older person; genital touching or fondling; or penetration in terms of oral, anal or vaginal intercourse or attempted intercourse”._ [2]

This definition includes three categories:

1. Non-contact abuse

2. Touching or fondling and intercourse which contains oral, anal and vaginal intercourse

 3. The upper age of childhood is 18 years.

It is import to understand, in the most countries, 18 years of age is the legal cut-off used to define childhood, in most countries, especially for sexual activity. The most widely-reported definition of childhood in large population surveys of CSA is 18 years or less.

 What are the Effects of Child sexual abuse?

According to Studies  there are several short and long-term effects associated with the child sexual abuse including mental disorder, depression, panic disorder,  alcohol dependence, interpersonal problems physical health issues, suicide attempt, cognitive factors, conduct disorder, social anxiety ,brain development, aggressive behaviors[3][4] ,sexual difficulties and the lack of self esteem. [5]

5  Major Negative Effects of Child Sexual Abuse (CSA)

1. Interpersonal Relations

There are many recent  pieces of evidence that indicate children who have been sexually abused, thy mostly have interpersonal relationship issues. In addition, the fear of exposure and low self-esteem often create the aggressive behavior, sense of shame, confusing aspects and guilt in the abused child. [6] These negative attitudes can create several serious problems in the relationship. [7]

2. Physical health and overall developmental outcomes

Studies indicate that child sexual abuse may be linked to the variety of physical and overall health risk. It may lead to increasing the risk of having chronic pain, heart disease, chronic lung disease and headaches. Female victims of child sexual abuse were also at greater risk of sex-related health problems.

3. Link between CSA and sexual problems

There is strong relationship between child sexual abuse and sexual problems/ sexual dysfunction. CSA may lead to following sexual problems:

• ·         Silence about sex
• ·         Aggressive sexual behavior
• ·         Confusion about sexual identity
• ·         Create problem in Sexual orgasm and organs such  erection and vaginal problems
• ·         Hesitation in lovemaking and sex
• ·         Lack of sexual desire and interest
• ·         Sexual dysfunctions
• ·         Sexual arousal problems

 4. The link between CSA and mental health

There is an association between child sexual abuse and mental disorders have been established.[8]  

The primary effect of CSA is psychological effects including posttraumatic stress, painful emotions, All these effects can affect mental condition and mental growth.[9] Some significant mental issues which mostly related with CSA are below:

• ·         Cognitive Distortions

 The children who are sexually abused are often negative. Many studies demonstrate that they feel helplessness, hopelessness, impaired trust, self-blame, and low self-esteem. These cognitive changes and thoughts mostly continue in adolescence and adulthood.

• ·         Emotional Distress

It is well documented that there is the association between child sexual abuse and emotional pain.  Depression and anxiety and anger are the main reason of emotion distress.  

• ·         Depression

Depression is the symptom of most who sexually abused in childhood.

• ·         Anxiety

Anxiety has been associated with child victims of sexual abuse as well as also with the adult who was physically abused as children.

5.Suicide attempt and Child Sexual abuse

 Sexual abuse is associated with suicide attempt. Hopelessness and depressive attitude are strongly associated with sexual abuse that may lead to high suicide risk and attempt.

The Therapeutic Options of Child Sexual Abuse (CSA)

There are several clinics/ therapists that have effective behavioral programs and psychological approaches which can play a key role for the treatment of CSA. They apply some techniques and educational programs which help to reduce stress and normalize their emotions and aggressive behavioral reactions.  [10], [11]

5 Effective Therapies for Child Sexual Abuse Treatment

• ·         Cognitive behavioral therapy (CBT)
• ·         Trauma-focused cognitive behavioral therapy (TF-CBT),
• ·         PTSD is a remaining effective therapy in CSA
• ·         Eye Movement Desensitization and Reprocessing (EMDR)
• ·         Play Therapy

Every sexual victim should be treating individually.  Many times victim needs the treatment of sexual problems. The physician and sexologist can diagnose his medical sexual problems and provide the best solutions to his sexual problem.

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[1] Farrel Greenspan, Andreia G. Moretzsohn, Peter H. Silverstone, What Treatments are Available for Childhood Sexual Abuse, and How do They Compare?, International Journal of Advances in Psychology (IJAP) Volume 2 Issue 4, November 2013.

[2] Gavin Andrews, Justine Corry, Tim Slade, Cathy Issakidis and Heather Swanston, Child sexual abuse, Chapter 23, (www.who.int/publications/cra/chapters/)

[3] Judy Cashmore and Rita Shackel ,The long-term effects of child sexual abuse ,

[4] Andrews, Justine Corry, Tim Slade,Cathy Issakidis and Heather Swanston Child sexual abuse

[5] [5] Andrews, Justine Corry, Tim Slade,Cathy Issakidis and Heather Swanston Child sexual abuse

[6] Christiane Snderson, The Seduction of Children, Jessica Kingsley Publishers

London , 2005

[7] Gavin Andrews, Justine Corry, Tim Slade, Cathy Issakidis and Heather Swanston, Child sexual abuse, Chapter 23, (www.who.int/publications/cra/chapters/)

[8] Gavin Andrews, Justine Corry, Tim Slade, Cathy Issakidis and Heather Swanston, Child sexual abuse, Chapter 23, (www.who.int/publications/cra/chapters/)

[9] John N. Briere Diana M. Elliott, Immediate and Long-Term Impacts of Child Sexual Abuse

[10] B((John N. Briere Diana M. Elliott, Immediate and Long-Term Impacts of Child Sexual Abuse,)

enjamin E. Saunders, Ph.D., , Child Physical and Sexual Abuse: Guidelines for Treatment, National Crime Victims Research and the Treatment Center  Medical University of South Carolina Charleston, South Carolina ,2003.

[11] Farrel Greenspan, Andreia G. Moretzsohn, Peter H. Silverstone, What Treatments are Available for Childhood Sexual Abuse, and How do They Compare?, International Journal of Advances in Psychology (IJAP) Volume 2 Issue 4, November 2013.