Sexual assault and abuse during childhood can have a huge impact on normal growth and development.
Unfortunately, the statistics show that sexual assault is a huge problem in Australian society.
There are many signs which could indicate a child is or has experienced sexual assault/abuse. These may include:
- Inappropriate sexual behaviour (eg sexualised play with dolls);
- Age-inappropriate sexual knowledge;
- Requesting sexual stimulation from adults or other children;
- Problems at school;
- Regressive behaviour (eg bed-wetting, thumb sucking);
- Self-harming behaviours (cutting, burning, hitting oneself);
- Suicidal ideation;
- Illegal behaviour;
- Running away;
- Substance abuse.
Most of these signs will also be seen in adults who have experienced sexual assault.
Sexual Assault Impacts Mental Health
A significant body of literature demonstrates a strong, though complex, relationship between people’s experiences of sexual victimisation and poor mental health outcomes.
The empirical research regarding the relationship between child sexual abuse and adverse mental health outcomes is particularly robust.
Numerous studies have found that adults with child sexual abuse histories have a higher risk of having mental health problems such as depression, anxiety, substance abuse and self-harm when compared to community populations (Banyard, Williams, & Siegel, 2001; Briere & Elliott, 2003; Henderson & Bateman, 2010; Horvarth, 2010).
Comprehensive reviews of the literature were published by the Australian Institute of Family Studies in 1998 (Mullen & Flemming, 1998) and again in 2013 (Cashmore & Shackel, 2013). Cashmore and Shackel noted that mental health problems consistently associated with child sexual abuse included:
- anxiety disorders (including post-traumatic stress disorder);
- substance abuse;
- conduct disorders, aggressive behaviour and negativity;
- eating disorders;
- psychotic disorders; and
- personality disorders.
A 45-year follow-up study by Cutajar and colleagues (Cutajar, Ogloff, & Mullen, 2011), and the Christchurch Health and Development Study (a longitudinal study in New Zealand), suggests that childhood sexual abuse is a risk factor for the development of later mental health problems such as anxiety disorders, depression, substance use, and suicidality, as well as lower prevalence disorders such as psychotic disorders and conduct/anti-social personality disorders.
Cutajar and colleagues found that the lifetime record of contact with public mental health services was 23.3 percent of victims compared to 7.7 percent of the control (the electoral roll) (Cutajar et al., 2010).
The Impacts of Childhood Sexual Assault
The impacts of childhood sexual assault can last well into adulthood, with survivors more likely to:
- develop physical conditions such as heart disease; obesity; cancer; chronic obstructive pulmonary disease; and liver disease.
- engage in risky health behaviours such as smoking and alcohol and other drug abuse and other problems of addiction (eg gambling, eating);
- have autobiographical memory problems (that is, can’t remember parts of their lives);
- exhibit increased problems with depression, anxiety and other mental illnesses;
- use self-harming behaviours (eg, cutting, burning) to manage their distress; and
- struggle with suicidal tendencies.
Psychologically, the impacts of child sexual abuse can be categorised into four symptom clusters:
- Re-experiencing (intrusion);
- Alterations in cognitions (thoughts and thought processes).
Many adult survivors of child sexual assault continue to experience these impacts.
1 – Re-experiencing (intrusion)
- Recurrent, involuntary and intrusive memories.
- Traumatic nightmares related to trauma.
- Dissociative reactions (eg flashbacks) which may occur on a continuum from brief episodes to complete loss of consciousness. These episodes aren’t remembering what happened, they are re-living what happened.
- Intense or prolonged distress after exposure to traumatic reminders (ie triggers – may be a sight, sound, smell, physical sensation).
- Marked physiological reactivity after exposure to trauma-related stimuli (eg trembling, blushing, profuse sweating).
2 – Avoidance of:
- Trauma-related thoughts or feelings.
- Trauma-related external reminders (eg people, places, conversations, activities, objects or situations).
Avoidance symptoms might include:
- Making an effort to avoid thoughts, feelings, or conversations about the traumatic event.
- Making an effort to avoid places or people that remind you of the traumatic event.
- Having a difficult time remembering important parts of the traumatic event.
- A loss of interest in important and once positive activities.
- Feeling distant from others.
- Experiencing difficulties having positive feelings, such as happiness or love.
- Feeling as though your life may be cut short.
3 – Arousal
As a consequence of childhood sexual assault, the individual may exhibit signs in adulthood such as:
- Irritable or aggressive behaviour.
- Self-destructive or reckless behaviour.
- Hyper-vigilance (that is, being constantly on high alert).
- Exaggerated startle response.
- Problems with concentration.
- Sleep disturbance.
4 – Alterations in cognitions (thoughts and thought processes)
- Inability to recall key features of the traumatic event.
- Persistent (and often distorted) negative beliefs and expectations about oneself or the world.
- Persistent distorted blame of self or others for causing the traumatic event or for resulting consequences.
- Persistent negative trauma-related emotions (eg fear, horror, anger, guilt or shame).
- Markedly diminished interest in previously significant and enjoyable activities.
- Feeling alienated from others (eg detachment or estrangement).
- Constricted affect (that is, persistent inability to experience positive emotions).
Overall, the experience of sexual assault changes one’s usual way of understanding self and the world, including spirituality. It alters the individual’s capacity to recognise, tolerate and integrate emotions, and maintain a compassionate inner connection with self and others.
If you, or somebody close to you, is suffering from the impacts of childhood sexual assault, I encourage you to seek out counselling from an experience professional who works in a person-centred, trauma-informed way.
Author: Merryl Gee, BSocWk, AMHSW, MAASW, MACSW, MANZMHA, MPACFA.
Merryl Gee is a psychotherapist working from a strengths-based, person-centred framework. With over 30 years’ experience, she has a particular interest people who have experienced trauma such as sexual assault or childhood sexual abuse.
To make an appointment with Brisbane Psychotherapist Merryl Gee try Online Booking. Alternatively, you can call M1 Psychology Brisbane on (07) 3067 9129.