Encyclopedia of Sociology

CHILDHOOD SEXUAL ABUSE

into the private family lives of others, or beyond
the walls of institutional life, and so to offer great-
er visibility of children’s experiences (Gough 1996a).

DIRECTIONS FOR FUTURE RESEARCH

Perusal of the literature in this domain suggests
several avenues for future studies. First and fore-
most, large-scale, longitudinal investigations of child
victims are needed that examine global function-
ing, abuse-specific functioning, and attributional
and coping strategies along with abuse, child, family,
and community factors. Such studies could pro-
vide information about both the initial effects of
sexual abuse and the factors that influence adjust-
ment at later developmental stages and into adult-
hood. Because not all victims of childhood sexual
abuse develop adjustment problems, a better un-
derstanding of who is likely to experience such
problems is needed.

Second, further research is needed regarding
the efficacy of various approaches for the treat-
ment of related problems (see Cosentino and Col-
lins 1996; O’Donohue and Elliot 1993 for reviews).
The utility or effectiveness of any particular treat-
ment modality has yet to be demonstrated using a
large-scale, randomized study in which treatment
outcomes are measured using standardized instru-
ments and untreated control groups. Consequent-
ly, treatment decisions often are made by clini-
cians without empirically tested guidelines.

Third, greater attention needs to be paid to
methodological rigor in the conduct of childhood
sexual abuse studies (Green 1993; Plunkett and
Oates 1990; Trickett and McBride-Change 1995).
In particular, investigators need to: (1) define it
clearly and consistently; (2) use instruments with
documented psychometric properties; (3) use con-
trol or comparison groups, when appropriate; and
(4) employ large sample sizes whenever this is
feasible. Studies of treatment modalities should
also conduct multiple follow-up assessments to
determine whether intervention effects are sus-
tained over time. Finally, studies are needed that
clearly disentangle the effects of sexual abuse from
other forms of abuse or maltreatment.

SUMMARY

Childhood sexual abuse is a significant and wide-
spread problem in our society, no matter how it is

defined. Since it was first brought to the public’s

attention in the 1960s, a vast amount of research

has been conducted in an effort to understand its

impact on victims. From the various reviews on the

topic, several conclusions can be drawn. First,

despite the considerable heterogeneity among sexu-

al abuse victims, as a group, sexually abused child-

ren and adolescents tend to display significant-

ly higher levels of symptomatology than their

nonabused, nonclinic-referred peers. Second, com-

pared to other clinic-referred children, two prob-

lem areas appear to differentiate sexually abused

children and adolescents: post-traumatic stress dis-

order symptomatology and sexuality problems.

Third, the type and severity of sequelae experi-

enced by victims depends on the specific charac-

teristics of the abuse situation and the perpetrator.

Fourth, research on adult survivors suggest that

abuse-related problems tend to persist into adult-

hood. Indeed, childhood sexual abuse histories

are common among several clinical populations,

including patients initially diagnosed as depressed

or as having a borderline personality disorder.

Taken together, these findings suggest that

clinicians and health care providers should screen

for sexual abuse among children, adolescents, and

adults. For instance, questions about childhood

sexual abuse could become part of routine intake

procedures. Moreover, it is important that a wide

range of service providers are sensitive to, and

have staff trained to deal with, issues of childhood

sexual abuse when it emerges. Service providers’

policy and practice guidelines should explicitly

acknowledge the prevalence and impact of it on

women, men, and children.

Schools also need to have greater involvement

in the prevention and diagnosis of childhood sexu-

al abuse, especially since it generally occurs be-

tween the ages of six and twelve (Finkelhor 1994a;

Sedlak and Broadhurst 1996). School-based edu-

cation programs may be a useful vehicle for inter-

vention and prevention. Teachers need to be edu-

cated and trained about their role in recognizing

and reporting suspected cases.

Finally, further community awareness is need-

ed to help prevent it from occurring. Greater

community efforts toward providing treatment

services for persons with a history of childhood

sexual abuse are needed as are programs targeting