Childhood sexual abuse has lifetime effects

Dominika Osmolska Psy.D.'s picture
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Childhood sexual abuse has profound psychological and physical effects that frequently persist into adulthood. Young girls who experience sexual abuse are plagued by higher rates of depression and obesity, as well as problems with regulation of brain chemicals, among other issues, says a new study.

The longitudinal study, published in the Cambridge University Press journal Development and Psychopathology, was conducted by researchers from the University of Southern California and the Cincinnati Children’s Hospital Medical Center, and followed a group of 80 girls ranging in age from 6 to 16 at the start of the study in 1987 for the next 23 years. The study participants were assessed by researchers six times at varying ages and developmental stages.

The girls, all residents of the Washington D.C. metropolitan area, were victims of incest, which was broadly defined as suffering sexual abuse by a male living within the home. On average, the girls were abused for about two years prior to the abuse coming to the attention of child protective services. Some girls were abused when they were as young as age 2. All received an average of three therapy sessions post abuse.

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The victims of incest all suffered sometimes severe setbacks in their mental and physical health. They were often sexually active at a much earlier age than their non-abused counterparts, suffered educational deficits and were challenged by more mental health problems.

Most surprising was the alteration in the victims’ cortisol profile. Cortisol is a stress hormone that is involved in the body’s fight or flight response. Both high and low cortisol levels have serious effects on the overall health and physical well-being of an individual. As children, the incest victims had elevated cortisol compared to the control group, which possibly contributed to a chronically stressed, anxious state. By age 15, however, the girls’ cortisol levels had fallen below average, implying that their stress response had “burned out.” A healthy, balanced stress response is needed for optimal functioning. For example, cortisol is important in stimulating an individual to cope, and may thus be instrumental in motivating problem-solving behaviors.

Low levels of cortisol are also associated with depression, obesity (perhaps by a metabolic course of action), and post-traumatic stress disorder (PTSD). The researchers were shocked to discover the girls’ cortisol profiles to be comparable to those of war veterans’. During the last assessment, when the women were in their 20’s, their cortisol levels remained low. They were often beset by a myriad of biopsychosocial challenges, such as sleep problems, risky behaviors and an underutilization of existing healthcare resources.

Back in the 1980’s there were not a whole lot of resources for the treatment of sexual abuse, and three counseling sessions may seem like a very small response to such a huge trauma. The question the researchers are now asking is whether psychological treatment helps prevent these damaging changes or whether it helps prevent them in the first place. No one knows. What we do know is that treatment does work, whatever its precise mechanism of action.

Prevention, and getting victims of abuse into treatment as early as possible can help prevent the kind of problems seen in this study – and that works for the benefit of the entire community. Prevention and treatment programs help lives become satisfying and productive, and communities as a whole more functional.

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