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Ten-Year Research Update Review: Child Sexual Abuse

NCJ Number
Journal of the American Academy of Child & Adolescent Psychiatry Volume: 42 Issue: 3 Dated: March 2003 Pages: 269-278
Frank W. Putnam
Date Published
March 2003
10 pages
This report provides clinicians with current information on the prevalence, risk factors, outcomes, treatment, and prevention of child sexual abuse (CSA) and examines the best-documented examples of psychopathology attributable to CSA.
Information and data were obtained from computer literature searches of "Medline" and "PSYCInfo" based on key words. The study also reviewed all English-language articles published after 1989 that contained empirical data relevant to CSA. A range of sexual activities is encompassed by the term child sexual abuse. These include intercourse, attempted intercourse, oral-genital contact, fondling of genitals directly or through clothing, exhibitionism or exposing children to adult sexual activity or pornography, and the use of the child for prostitution or pornography. This diversity ensures that there will be a range of outcomes. In addition, the age and gender of the child; the age and gender of the perpetrator; the nature of the relationship between the child and perpetrator; and the number, frequency, and duration of the abuse experiences all apparently influence some outcomes. The results of this review show that CSA constitutes approximately 10 percent of officially substantiated child maltreatment cases, numbering approximately 88,000 in 2000. Adjusted prevalence rates are 16.8 percent and 7.9 percent for adult women and men, respectively. Risk factors for CSA include gender, age, disabilities, and parental dysfunction. A range of symptoms and disorders has been related to CSA; however, depression in adults and sexualized behaviors in children are the best-documented outcomes of CSA. To date, cognitive-behavioral therapy (CBT) for the child and a nonoffending parent is the most effective treatment. Prevention efforts have emphasized education of the child to increase his/her awareness of the nature and harm of sexual abuse, together with home visitation designed to decrease risk factors. CSA has been found to be a significant risk factor for psychopathology, particularly depression and substance abuse. Preliminary research indicates that CBT is effective in addressing some symptoms, but longitudinal follow-up and large-scale evaluation studies are needed. Prevention programs have shown promise; however, evaluation of these programs to date has been limited. Suggestions for future research are offered. 18 references