Resilience in Survivors of Child Sexual Abuse: A Systematic Review of the Literature.
OBJECTIVE
This review article summarizes empirical research on resilience in survivors of child sexual abuse (CSA) and discusses protective factors that are associated with adaptive functioning in spite of sexual victimization.


METHODS
A literature search to identify studies published up to November 2013 was performed within the databases PsycINFO, MEDLINE/PubMed, Web of Science, and PSYNDEXplus. Additional relevant studies were retrieved using a snowball technique. A total of 37 articles met the inclusion criteria and were included in the final sample.


RESULTS
In the studies included in this review, the percentage of CSA survivors who were found to have a normal level of functioning despite a history of sexual abuse ranged from 10% to 53%. The protective factors that had the best empirical support were found to be education, interpersonal and emotional competence, control beliefs, active coping, optimism, social attachment, external attribution of blame, and most importantly, support from the family and the wider social environment.


CONCLUSIONS
Preventive and clinical interventions for survivors of CSA should utilize psychoeducation and cognitive strategies that are adapted to the developmental level of the victim and that seek to enhance social support from significant others. Future research should focus on longitudinal research designs considering resilience rather as a dynamic process with multiple dimensions in a social and developmental context.
Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany matthias.domhardt@uniklinik-ulm.de.
Matthias
M
Domhardt
Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany.
Annika
A
Münzer
Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany.
Jörg M
JM
Fegert
Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany.
Lutz
L
Goldbeck
D000223:Adaptation, Psychological; D000328:Adult; D000069586:Adult Survivors of Child Adverse Events / Q000523:psychology*; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology*; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D009769:Object Attachment; D055500:Resilience, Psychological
child sexual abuse; protective factors; resilience; review