Sexual Abuse

There are many forms of sexual violations, all of which are abusive and often result in sexual trauma.  Two major delineations exist:  childhood sexual abuse and adult sexual violence.  All acts under these two categories are considered sexual violence, especially if these are non-consensual or have been committed under duress.

Both childhood sexual abuse and adult sexual violence is further categorised as:

  1. Contact abuse — range of which includes sexual touching to outright rape.  Contact sexual violence may encompass completed or attempted penetration involving any of these parts: penis, vagina, anus, and mouth.  It can also involve sexual touching of the breasts, genitals, groin, inner thighs, buttocks, or anus.
  1. Non-contact abuse — may involve forced participation in pornography, exhibitionism, and inappropriate modelling of sexually provocative clothes or behaviour. Non-contact abuse or violence is usually voyeuristic and can include verbal and behavioural harassment.

Sexual abuse or violence is considered a childhood tragedy if the victim is under 18 years of age at the time the crime was committed.  Adult sexual violence refer to victims who are 18 years or older.

Psychological Effects of Childhood Sexual Abuse

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Mental disorders often follow sexual abuse, particularly when the individuals in question are children.  Post Traumatic Stress Disorder (PTSD) is a common result among sexually molested children who because of a traumatic event or a series of them, experience terrifying feelings of extreme fear, helplessness, shame, and worthlessness.  These victims often exhibit negative coping symptoms such as numbness, lack of responsiveness, paranoia on perceived threats, and recurring nightmares.  As such a number of such patients additionally suffer from depression, anxiety disorder, substance abuse, and eating disorders.  Many may have suicidal thoughts and intentions as well.  These symptoms may impair an individual’s quality of life, making him unable to hold a job, get work, maintain relationships with friends and family, or do everyday tasks requiring some form of social contact.

Sexually abused children may grow up to be either sexually inhibited adults or highly promiscuous ones.  Because of repeated early exposure to sexual abuse, promiscuity may be patterned after the behaviour of the sexual abuser or perpetrator.  Those however who develop frigidity or low sexual drive may have difficulty entering into and maintaining close relationships.

Individuals who have been particularly severely sexually abused in their early years may develop Borderline Personality Disorder (BPD).  BPD is a difficult mental condition to treat and is characterised by maladjusted and immutable personality traits.  People afflicted with BPD often exhibit suicidal symptoms and have the propensity for self-harm, substance abuse, unsafe sex, and the like.

Unfortunately, survivors of childhood sexual abuse may develop both BPD and PTSD which some classify as complex PTSD.  People with complex PTSD may be plagued by extreme mood swings, unexplained physical pain, symptoms that defy medical explanation, and altered states of consciousness.  They may also exhibit other personality disorders characterised by extreme paranoia (Paranoid Personality Disorder); extreme shyness and a huge inferiority complex (Avoidant Personality Disorder); or the extreme need for admiration and lack of empathy (Narcissistic Personality Disorder).

Psychological Effects of Adult Sexual Violence

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Adult victims may develop short-term and long-term psychiatric symptoms.  PTSD symptoms such as sleeping problems, emotional numbness, and panic attacks can show a short time after the traumatic event but may taper off in severity after a few months.  There are, however, survivors that live with PTSD symptoms for years.

Research however has focused mostly on PTSD as the psychological repercussion of adult sexual violence.  Other disorders may be overlooked such as clinical depression; Body Dysmorphic Disorder characterised extreme attention to physical faults; or compulsory body mutilations such as excessive body piercing and tattooing.

How well adult survivors of sexual violence can cope after traumatic events had to do with their belief system used to interpret life experiences.  The more stringent this personal belief system is, the more psychologically distressed the survivor may be.  For instance, a woman who believes that her rape was a result of an outfit that showed more skin than usual, may possess higher degree of self blame and embarrassment.  If the victim also feels she has no control over her recovery or does not realise that she can empower herself against future sexual violence, she may be more mentally distressed than those who believe that the power of recovery lies in their willingness to change their perceptions or outlook for the better.

Sexual Abuse: A Public Health Concern

The psychological consequences of sexually abused people make for a public health problem.  More sexually abused victims increases the population of psychologically impaired citizens.  This has serious ramifications on a country’s social, economic, and physical well-being.  It is imperative to empower sexually abused victims with the psychological tools geared toward allowing them to take control of their emotional healing and recovery of self-worth.

There is no cut-and-dried response treatment to sexual abuse.  People react to abuse in many different ways and degrees, from mild to life-threatening.  Resultant emotions or behaviour may manifest immediately or be significantly delayed and their duration may vary from short-term to one lasting several years.

Psychiatrists however are now more aware of the strong link between abuse and ill mental health so that survivors of sexual abuse or violence may be better identified and referred to the right specialists for treatment.