Childhood s***** abuse is a subject that has received much attention in recent
years. Twenty-eight to 33% of women and 12 to 18% of men were victims of childhood
or adolescent s***** abuse (Roland, 2002, as cited in Long, Burnett, & Thomas, 2006).
S***** abuse that does not include touch and other types of s***** abuse are reported less
often, which means this number of individuals who have been s******* abused in their
childhood may actually be greater (Maltz, 2002). With such a high percentage of people
having experienced childhood s***** abuse, it is likely that many people seeking therapy
will have histories that include s***** abuse. It is imperative that counselors are aware of
and familiar with the symptoms and long-term effects associated with childhood s*****
abuse to help gain a deeper understanding of what is needed in counseling. This paper
will define childhood s***** abuse and review the impact it can have, explore the longterm
effects and symptoms associated with childhood s***** abuse, and discuss
counseling implications.

Childhood S***** Abuse
There are many forms of childhood s***** abuse. The s***** abuse can involve
seduction by a beloved relative or it can be a violent act committed by a stranger. S*****
abuse can be hard to define because of the many different forms it can take on, the
different levels of frequency, the variation of circumstances it can occur within, and the
different relationships that it may be associated with. Maltz (2002) gives the following
definition: “s***** abuse occurs whenever one person dominates and exploits another by
means of s***** activity or suggestion” (Maltz, 2001a, as cited in Maltz, 2002, p. 321).
Ratican (1992) defines childhood s***** abuse as:
any s***** act, overt or covert, between a child and an adult (or older
child, where the younger child’s participation is obtained through
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seduction or coercion). Irrespective of how childhood s***** abuse is
defined it generally has significant negative and pervasive psychological
impact on its victims. (p. 33)
The majority of s***** abuse happens in childhood, with i***** being the most
common form (Courtois, 1996, as cited in Maltz, 2002). The impact of childhood s*****
abuse varies from person to person and from case to case. A study compared the
experiences of women who experienced familial s***** abuse with women who
experienced non-familial abuse. They found that women who experienced familial abuse
reported higher current levels of depression and anxiety when thinking about the abuse.
Other variables they found to increase the levels of reported distress were abuse
experiences that involved more extensive s***** abuse, a higher number of s***** abuse
experiences, and a younger age during the first s***** abuse experience (Hartman, Finn,
& Leon, 1987). While the nature and severity of the s***** act may cause more serious
impact, many other factors may influence the degree of damage the victim experiences.
Other factors may include the perspective of the individual, the individual’s internal
resources, and the individual’s level of support (Courtois, 1988, as cited in Ratican,
1992). Although not all forms of childhood s***** abuse include direct touch, it is
important for therapists to understand that childhood s***** abuse can take on many
different forms that still exploit the victim s******* and cause harm. The perpetrator may
exploit the child by introducing them to p********** prematurely, assaulting them
through the internet, or manipulating them into taking pornographic photos.
Childhood s***** abuse infringes on the basic rights of human beings. Children
should be able to have s***** experiences at the appropriate developmental time and
within their control and choice. The nature and dynamics of s***** abuse and s*******
abusive relationships are often traumatic. When s***** abuse occurs in childhood it can
hinder normal social growth and be a cause of many different psychosocial problems
(Maltz, 2002). The next section of this paper will review literature and research
concerning these long-term effects of childhood s***** abuse.
The Long-Term Effects of Childhood S***** Abuse
Childhood s***** abuse has been correlated with higher levels of depression,
guilt, shame, self-blame, eating disorders, somatic concerns, anxiety, dissociative
patterns, repression, denial, s***** problems, and relationship problems.
Depression has been found to be the most common long-term symptom among
survivors. Survivors may have difficulty in externalizing the abuse, thus thinking
negatively about themselves (Hartman et al., 1987). After years of negative selfthoughts,
survivors have feelings of worthlessness and avoid others because they believe
they have nothing to offer (Long et al., 2006). Ratican (1992) describes the symptoms of
child s***** abuse survivors’ depression to be feeling down much of the time, having
suicidal ideation, having disturbed sleeping patterns, and having disturbed eating patterns
Survivors often experience guilt, shame, and self-blame. It has been shown that
survivors frequently take personal responsibility for the abuse. When the s***** abuse is
done by an esteemed trusted adult it may be hard for the children to view the perpetrator
in a negative light, thus leaving them incapable of seeing what happened as not their
fault. Survivors often blame themselves and internalize negative messages about
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themselves. Survivors tend to display more self-destructive behaviors and experience
more suicidal ideation than those who have not been abused (Browne & Finkelhor,
1986).
Body issues and eating disorders have also been cited as a long-term effect of
childhood s***** abuse. Ratican (1992) describes the symptoms of child s***** abuse
survivors’ body image problems to be related to feeling dirty or ugly, dissatisfaction with
body or appearance, eating disorders, and obesity. Survivors’ distress may also result in
somatic concerns. A study found that women survivors reported significantly more
medical concerns than did people who have not experienced s***** abuse. The most
frequent medial complaint was pelvic pain (Cunningham, Pearce, & Pearce, 1988).
Somatization symptoms among survivors are often related to pelvic pain, gastrointestinal
problems, headaches, and difficulty swallowing (Ratican, 1992).
Stress and anxiety are often long-term effects of childhood s***** abuse.
Childhood s***** abuse can be frightening and cause stress long after the experience or
experiences have ceased. Many times survivors experience chronic anxiety, tension,
anxiety attacks, and phobias (Briere & Runtz, 1988, as cited in Ratican, 1992). A study
compared the posttraumatic stress symptoms in Vietnam veterans and adult survivors of
childhood s***** abuse. The study revealed that childhood s***** abuse is traumatizing
and can result in symptoms comparable to symptoms from war-related trauma (McNew
& Abell, 1995).
Some survivors may have dissociated to protect themselves from experiencing the
s***** abuse. As adults they may still use this coping mechanism when they feel unsafe
or threatened (King, 2009). Dissociation for survivors of childhood s***** abuse may
include feelings of confusion, feelings of disorientation, nightmares, flashbacks, and
difficulty experiencing feelings. Denial and repression of s***** abuse is believed by
some to be a long-term effect of childhood s***** abuse. Symptoms may include
experiencing amnesia concerning parts of their childhood, negating the effects and impact
of s***** abuse, and feeling that they should forget about the abuse (Ratican, 1992).
Whether or not survivors can forget past childhood s***** abuse experiences and later
recover those memories is a controversial topic. Some therapists believe that s***** abuse
can cause enough trauma that the victim forgets or represses the experience as a coping
mechanism. Others believe that recovered memories are false or that the client is led to
create them (King, 2009)
Survivors of s***** abuse may experience difficulty in establishing interpersonal
relationships. Symptoms correlated with childhood s***** abuse may hinder the
development and growth of relationships. Common relationship difficulties that survivors
may experience are difficulties with trust, fear of intimacy, fear of being different or
weird, difficulty establishing interpersonal boundaries, passive behaviors, and getting
involved in abusive relationships (Ratican, 1992). Feinauer, Callahan, and Hilton (1996)
examined the relationship between a person’s ability to adjust to an intimate relationship,
depression, and level of severity of childhood abuse. Their study revealed that as the
severity of abuse increased, the scores measuring the ability to adjust to intimate
relationships decreased. S***** abuse often is initiated by someone the child loves and
trusts, which breaks trust and may result in the child believing that people they love will
hurt them (Strean, 1988 as cited in Pearson, 1994). Kessler and Bieschke (1999) found a
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significant relationship between women who were s******* abused in childhood and adult
victimization.
Many survivors experience s***** difficulties. The long-term effects of the abuse
that the survivor experiences, such as, depression and dissociative patterns, affect the
survivors s***** functioning. Maltz (2001a, as cited in Maltz, 2002) gives a list of the top
ten s***** symptoms that often result from experiences of s***** abuse: “avoiding,
fearing, or lacking interest in s**; approaching s** as an obligation; experiencing
negative feelings such as anger, disgust, or guilt with touch; having difficulty becoming
aroused or feeling sensation; feeling emotionally distant or not present during s**;
experiencing intrusive or disturbing s***** thoughts and images; engaging in compulsive
or inappropriate s***** behaviors; experiencing difficulty establishing or maintaining an
intimate relationship; experiencing vaginal pain or orgasmic difficulties (women); and
experiencing erectile, ejaculatory, or orgasmic difficulties (men; p. 323). A study done on
the prevalence and predictors of s***** dysfunction in the Untied States revealed that
victims of s***** abuse experience s***** problems more than the general population.
They found that male victims of childhood s***** abuse were more likely to experience
erectile dysfunction, premature e**********, and low s***** desire, and they found that
women were more likely to have arousal disorders (Laumann, Piel, & Rosen, 1999).
It is important to point out that although research has shown there to be significant
relationships between long-term effect variables and childhood s***** abuse, each
victim’s responses and experiences will not be the same. Although it is often viewed as a
traumatic experience, there is no single symptom among all survivors and it is important
for clinicians to focus on the individual needs of the client.