Nine years after child sexual abuse.
OBJECTIVE
During 1988-1990, 103 children presented to Child Protection Units (CPU) at two children's hospitals in Sydney, Australia. Nine years later, the psychological adjustment of these young people (mean age=19.1 years, SD=3.4 years; range=14-25 years) was compared with that of non-abused young people of similar age and gender to assess group differences and examine potential risk factors.


METHODS
At intake, data on the nature of the index sexual abuse, demographics and the family environment were collected by clinicians. A comparison group, of similar age and gender, was selected from schools in the catchment area of the CPUs. Six years after presentation for the abuse, records of the statutory child protection authority were checked to determine any further notifications for abuse and/or neglect. Nine years after intake, 49 of the abused young people and 68 of the non-abused young people and/or their parents were interviewed and assessed.


RESULTS
The sexually abused young people performed more poorly than non-abused young people on psychometric tests of depression (p=.001), self-esteem (p<.001), anxiety (p<.001), behavior (Child Behavior Checklist: p=.01; Youth Self Report: p=.01; Young Adult Self Report: p<.001), and despair (p=.001). They were also more likely to have a history of bingeing (p=.002), self-inducing vomiting (p=.02), smoking cigarettes (p=.01), and using amphetamines (p=.002), ecstasy (p=.002) and cocaine (p=.004). Potential risk factors were in two groups, family and child. Family factors: family functioning, parental drug/alcohol problems, mother's sexual abuse history, mother's depression and socio-economic status. Child factors: despair and hopefulness, number of negative life events, ratings of their father's care, previous notifications for child sexual abuse and placements in out-of-home care by the statutory child protection authority. In the presence of other risk factors, child sexual abuse was a significant predictor of self-esteem, behavior and bingeing.


CONCLUSIONS
Rather than focusing only on the individual's child sexual abuse, treatment may also need to address the family's functioning and the individual's feelings of despair.
Swanston
Heather Y
HY
Department of Paediatrics and Child Health, The University of Sydney, and The Children's Hospital at Westmead (Royal Alexandra Hospital for Children), Locked Bag 4001, Westmead, NSW 2145, Australia.
Plunkett
Angela M
AM
O'Toole
Brian I
BI
Shrimpton
Sandra
S
Parkinson
Patrick N
PN
Oates
R Kim
RK
D000223:Adaptation, Psychological / Q000145:classification*; D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000453:epidemiology; D002032:Bulimia / Q000453:epidemiology; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology*; D003863:Depression / Q000453:epidemiology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D009517:New South Wales / Q000453:epidemiology; D011336:Probability; D011594:Psychometrics; D012649:Self Concept; D013995:Time