Discuss the effects of child sexual abuse on victims: emotional, psychological, adult intimate relationships, and medical
What will be an ideal response?
EMOTIONAL DISTRESS
Angerâ€"toward self, the abuser, or some other party who should have stopped the abuse but did not.
Poor self-esteemâ€"due to the feeling that something must be wrong or bad in their character to have allowed the abuse to occur and to continue.
Self-blameâ€"because the abuser was a beloved family member who "could do no wrong," and to blame the perpetrator would destroy the victim's ideal image of the abuser.
Shameâ€"stemming from self-blame.
Guiltâ€"over engaging in forbidden, immoral, sinful acts, the failure to tell anyone, or the perception of causing the abuse.
Isolation and lonelinessâ€"stemming from the belief that the victim is unworthy of love, closeness, and intimacy with another person.
PSYCHOLOGICAL DISORDERS
Self-destructive behaviorâ€"such as dangerous risk taking, self-mutilation (cutting, burning, etc.), unsafe promiscuous sexual behavior, eating disorders, or reckless or intoxicated driving.
Abuse of alcohol and other drugsâ€"often as an attempt at self-medication to deaden depression, pain, or unpleasant emotional reactions.
Anxiety, panic, and phobic disordersâ€"stemming from the abuse itself, from the fear that others may discover the past abuse that the victim feels compelled to keep hidden, from the fear and mistrust felt in all current relationships, or from the loneliness and isolation from which victims often suffer.
Denialâ€"pretending, distorting reality, glossing over the truth, or refusal to accept or acknowledge having experienced CSA.
Dissociationâ€"using various psychological escape mechanisms that alter or block out awareness and memory; symptoms may include "out of body" experiences; fantasies or daydreams that seem real; loss of awareness of blocks of time, from minutes to days; or in some cases of especially violent and sadistic abuse, the development of multiple personalities.
Posttraumatic stress disorderâ€"a syndrome characterized by reliving the abuse (flashbacks); avoiding situations, thoughts, and feelings related to the abuse; emotional numbing; sleep disturbances; heightened startle response; hypervigilance; and difficulty concentrating.
Learning disabilitiesâ€"these are more common among CSA survivors than among the general population.
Suicidal behaviorâ€"including thinking about or planning suicide, attempting suicide, and succeeding at suicide, is all more common among CSA survivors than among the population in general.
ADULT INTIMATE RELATIONSHIP PROBLEMS
Revictimizationâ€"a significantly greater chance of becoming a victim of sexual violence such as rape and partner abuse as adults.
Emotional distanceâ€"from intimate partners and often friends and family.
Less trustâ€"in others in general and in intimate partners in particular.
Feelings of danger in intimate relationshipsâ€"an inability to feel safe and secure in an intimate relationship for fear of betrayal or harm.
Lack of enjoyment in sexâ€"which, for many survivors, reactivates the emotional trauma of the abuse, resulting in low or absent sexual desire. Moreover, the body may react in ways that inhibit sexual responding altogether.
Anxiety over sexual performanceâ€"due to memories of abuse.
Specific sexual problemsâ€"such as those discussed in Chapter 7, "Sexual Problems and Solutions," including erectile disorder, inability to achieve orgasm, inhibited sexual arousal, vaginismus, and dyspareunia.
Forcing sex on a partnerâ€"as do perpetrators of sexual assaults, rapes, and child sexual abuse.
Increased promiscuityâ€"due at least in part to such factors as low self-esteem, lack of trust in intimate relationships, emotional distance, and lack of feelings of a secure attachment.
MEDICAL CONSEQUENCES
Alcoholismâ€"possibly stemming from depression, anxiety, or low self-esteem.
Obesityâ€"perhaps secondary to low self-worth, self-blame, avoidance of romantic or sexual entanglements, or self-destructive behavior.
Tobacco useâ€"likely due to such issues as low self-worth, self-blame, avoidance of romantic or sexual entanglements, stress, or self-destructive behavior.
STIsâ€"probably related to the combination of the greater number of sexual partners and the self-destructive practice of unsafe sexual behaviors.
Gastrointestinal problemsâ€"such as irritable bowel syndrome and others commonly precipitated by chronic anxiety.
Gynecological disordersâ€"possibly related to the combination of a greater number of sexual partners and the avoidance of gynecological exams due to reactivation of past sexual abuse experiences.
Chronic painâ€"such as headache, stomach pain, and pelvic pain, for which CSA survivors are treated by physicians and hospitalized in exceptionally high numbers.
Insomniaâ€"often linked to stress, anxiety, and depression.
Eating disordersâ€"perhaps arising from issues of powerlessness and lack of control, poor self-esteem and body image, self-destructive behavior, or depression.
Asthmaâ€"which may be triggered by psychological factors.
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What will be an ideal response?