Not all sexual abuse victims
develop behavior problems following the abuse. Symptom development is dependent on event-specific factors, such as age of child, length of time abuse occurred, severity of abuse, response to disclosure and relationship of the offender
; personality differences in the child; and protective factors
. The following behaviors are more likely to occur in adolescents and adults with histories of child sexual abuse:
- Difficulties during adolescence - Children who have been sexually abused as children are more likely to be delinquent during adolescence and engage in illegal activities. They are more likely to be truant, drop out of school, and demonstrate poor academic achievement. Up to 90% of teenagers, who live on the streets as run-aways, left home because of sexual abuse. Many teenage boys and girls who enter prostitution to provide for basic needs as a run-away. Running away is a common behavior for children who experience ongoing abuse into adolescence and for adolescents abused by family members. Teenage pregnancy rates are higher among sexual abuse victims.
- Addictions - Addictions to alcohol and drugs, gambling, and other compulsive behaviors are avoidant behaviors. The victim of sexual abuse avoids life, feelings, and responsibility, by drinking and/or using other drugs. Sexually abused children have an increased likelihood of becoming addicted to alcohol and other drugs. The National Institute on Drug Abuse (NIDA) reports that 2/3 of adults in alcohol and drug treatment were abused as children. This avoidance inevitably makes the situation worse as these choices bring about significant losses in the person's life.
- Sexually abusive behavior - Development of sexualized behavior, often called sexually reactive behavior, is a common effect of child sexual abuse. These children engage in more sexualized behaviors when compared to children who have not been abused. The American Academy of Experts in Traumatic Stress reports that 1/3 of sexually abused children eventually act out in sexually abusive behaviors.
- Dissociation - Dissociation is an avoidant behavior used as a coping strategy. The victim or survivor escapes to another world in the mind. This escape increases the likelihood of substance abuse and high-risk behaviors, increases the probability of somatic behaviors, is related to psychological disorders, such as borderline personality disorder, and negatively affects relationships.
- Suicide attempts - Sexual abuse survivors are more likely to consider and attempt suicide. Stock (2002) reported up that studies found up to 87% of survivors reported suicidal thoughts. If a victim or survivor threatens self-harm repeatedly, the threat must still be taken seriously. Any child, adolescent, or adult who speaks of intention to commit suicide, needs to have a thorough suicide assessment to determine level of risk. Suicide is an attempt to escape pain, distress, guilt/shame, sorrow, and other painful emotions. Depression usually precedes the thoughts of hopelessness and helplessness. Depression itself changes brain chemistry and self-perpetuates negative thought and emotional patterns. The individual needs to be placed in a secure environment until she stabilizes and poses less risk of self-harm. As a mother, if your child has threatened suicide, take this seriously and obtain immediate help. The child may retract the threat, but this does not necessarily imply that the risk is reduced. Call for help.
- Sexualization and effects on sexuality - Victims and survivors of child sexual abuse have sex with more partners, fore frequently work in the sex industry, such as pornography and prostitution, and are more likely to develop a sexual addiction. These choices are high-risk as health is compromised, risk of disease is increased, and individuals are usually exposed to higher risk relationships. Child sexual abuse victims are confused about sexuality and have difficulties as adults because of fear of sex and dissatisfaction with adult sexual relationships. They may also experience problems related to sexual function, such as pain during intercourse, orgasmic disorders, erectile disorders, lack of sexual desire. Stock (2002) reported that up to 94% of sexual abuse survivors experience sexual problems as adults.
- Domestic violence - Haugaard and Reppucci (1988) report aggression as the most common behavioral response to boy victims. This aggression is an attempt to reestablish masculinity and bullying, picking fights, and antisocial behaviors are increased. This response may be reaction to the stress, rather than the sexual nature of abuse. Adult male victims are more likely to engage in domestic violence. The level of anger experienced by all victims predicts increased hostility and violence in adult relationships.
- Self-destructive behavior - Victims of sexual abuse often attempt to hurt themselves as a coping strategy and to avoid pain. Whether done to numb the pain, to punish the body, or to cope with negative emotions, these behaviors are self-harming and often high risk. Many individuals report that self-harm is a self-soothing behavior and reduces feelings of stress. Examples of self-harm are: cutting, burning, biting, scratching, stabbing, and poisoning. Although self-harm is not done in an attempt to suicide, suicide may accidentally occur. See Emotional and Psychological effects of sexual abuse.
- Revictimization - Schneider (2001) reports that the probability of victimization increases each time a person is victimized. Multiple victimizations over a short period of time is not unusual with these individuals. 14% of adults experience 70% of victimization experiences that are reported (p. 452). Childhood sexual abuse is a reliable predictor of adult victimization. Other factors in a child's life predispose her to becoming a victim. Some contributing circumstances include: Separation from parents, especially mothers; physical abuse or neglect; and rejection. Insecure attachment to adult caregivers reduces a child's resilience following a traumatic experience. Children who seek after affection, attention, and appreciation are more likely to be victimized. Children who are isolated and shy are also more likely to be victimized. Once victimization occurs, the child is vulnerable to repeated victimizations.
- School and employment problems - Problems in school are a common behavioral effect of child sexual abuse. These problems may be related to learning, ability to concentrate, anxiety, respect for authority, or behavioral acting-out, such as anger and fighting in male sexual abuse victims. Navalta et al. (2006) found that women with a history of repeated child sexual abuse performed more poorly on SAT tests than non-abused women and views this as related to changes that occur in the brain as a result of the stress involved in sexual abuse. Individuals with histories of long-term sexual abuse have reduced short term memory. Survivors of child sexual abuse may experience problems in all areas of their lives, and these impact function and performance at both work and school.
- Criminal behavior - Survivors of child sexual abuse are more likely to engage in criminal behaviors as adults. A high percentage of persons in prison for anti-social and criminal behaviors report childhood sexual abuse. Many of these individuals began acting out as children and adolescents. Most do not disclose sexual abuse and may not view the abuse as related to adult behaviors until in treatment or individual therapy.