Ten-year research update review: child sexual abuse.
OBJECTIVE To provide clinicians with current information on prevalence, risk factors, outcomes, treatment, and prevention of child sexual abuse (CSA). To examine the best-documented examples of psychopathology attributable to CSA. METHOD Computer literature searches of and for key words. All English-language articles published after 1989 containing empirical data pertaining to CSA were reviewed. RESULTS CSA constitutes approximately 10% of officially substantiated child maltreatment cases, numbering approximately 88,000 in 2000. Adjusted prevalence rates are 16.8% and 7.9% for adult women and men, respectively. Risk factors include gender, age, disabilities, and parental dysfunction. A range of symptoms and disorders has been associated with CSA, but depression in adults and sexualized behaviors in children are the best-documented outcomes. To date, cognitive-behavioral therapy (CBT) of the child and a nonoffending parent is the most effective treatment. Prevention efforts have focused on child education to increase awareness and home visitation to decrease risk factors. CONCLUSIONS CSA is a significant risk factor for psychopathology, especially depression and substance abuse. Preliminary research indicates that CBT is effective for some symptoms, but longitudinal follow-up and large-scale "effectiveness" studies are needed. Prevention programs have promise, but evaluations to date are limited.
Putnam
Frank W
FW
Children's Hospital Medical Center, Cincinnati, Ohio, 45229-3039, USA. Frank.Putnam@chmcc.org
D001364:Awareness; D002648:Child; D002650:Child Abuse, Sexual / Q000517:prevention & control* / Q000523:psychology / Q000706:statistics & numerical data; D002675:Child, Preschool; D003865:Major Depressive Disorder / Q000453:epidemiology / Q000209:etiology; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007223:Infant; D016901:Intergenerational Relations; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012725:Sexual Behavior / Q000523:psychology