Psychological Bulletin

A review of 45 studies clearly demonstrated that sexually abused children had more symptoms than nonabused children, with abuse accounting for 15—45% of the variance. Fears, posttraumatic stress disorder, behavior problems, sexualized behaviors, and poor self-esteem occurred most frequently among a long list of symptoms noted, but no one symptom characterized a majority of sexually abused children. Some symptoms were specific to certain ages, and approximately one third of victims had no symptoms. Penetration, the duration and frequency of the abuse, force, the relationship of the perpetrator to the child, and maternal support affected the degree of symptomatology. About two thirds of the victimized children showed recovery during the first 12—18 months. The findings suggest the absence of any specific syndrome in children who have been sexually abused and no single traumatizing process. Until recently, the literature on the impact of child sexual abuse consisted disproportionately of retrospective studies of adults. For example, the conclusions of a widely cited review ( Browne & Finkelhor, 1986 ) were based on only 4 studies of children, compared with 23 studies of adults. Not surprisingly, most reviews combined studies of both groups, because research focused on children was rare. Since 1985, however, there has been an explosion in the number of studies that have concentrated specifically on sexually abused children. Some studies have even focused on specific types of child victims, such as preschoolers, boys, or victims of ritualistic abuse. The studies of child victims have been distinct in several important ways from the research on adults. First, researchers studying children have often used different methodologies, many times relying on parents' or clinicians' reports rather than on children's self-reports. In addition, they have often evaluated specifically child-oriented symptoms, such as regressive behavior. These methodologies and the concentration on child-oriented symptoms make this research more relevant to intervention and treatment with children than the research on the effects of sexual abuse on adults, from which the implications for the treatment of children were difficult to extrapolate. Research on children has allowed for a developmental perspective and included the first efforts at longitudinal studies of sexual abuse victims. This literature also has important relevance to other theory and research concerning how children process trauma, for example, how trauma expresses itself at various developmental stages, its role in the development of later psychopathology, and the mediating effects of important factors such as familial and community support. Therefore, research on the effect of sexual abuse on children is worthy of its own review. We undertook such a review to (a) bring together literature from a broad spectrum of fields, including medicine, social work, psychology, and sociology; (b) highlight areas where there is agreement and disagrrement in findings; (c) draw conclusions that may be useful for clinicians currently working with child victims and researchers studying this problem; and (d) suggest directions for future research and theory.