The Signs, Types, and Effects of Childhood Abuse on Victims

This article explores some of the signs of abuse, types of abuse, and factors influencing the effects of childhood abuse on victims. These are difficult but important topics to discuss in the context of counselling and therapy.

In situations involving physical abuse, signs may include children giving evasive or unconvincing stories about injuries and parents who disclose examples of discipline that they do not recognize as physical abuse. Children may be neglected who wear dirty or inappropriate clothing or who are with hygiene and body odor issues. The same signs may be present for children with inadequate medical or dental care, or being left alone without supervision.

In situations involving sexual abuse, it is not usually self-reported, and detection may come from children who share or display signs related to sleep disturbance, encopresis or enuresis, complaints of abdominal pain, appetite disturbances and weight changes, behavior changes, regression, sexualized behavior, suicidal thoughts, running away, substance misuse, parentified roles, relationship difficulties, and inappropriately seeking affection or intimacy.

There are a number of factors influencing the effects of childhood sexual abuse on victims. These include the duration and severity of abuse, family response to disclosure, and victims misplacing blame on themselves for abuse. These factors can negatively impact victims by contributing to PTSD, depression, suicide, sexual promiscuity, problems in intimate relationships and sexual functioning.

Children are less powerful and less able to protect themselves. There are predictors of child abuse in families that are outside a child’s control or responsibility. These include economic hardships and isolation from community support systems. Many children don’t disclose abuse, or if they do, it is done privately when there is a enough safety and trust involved with another person, including the counsellor.

For therapists, it’s challenging to identify the abuse because parents, relatives, or caregivers who are involved, may not disclose recognition of the abuse. It seems hard to believe, but sometimes even the adults who are aware of the abuse don’t report it because they may feel deeply ashamed about it happening within their own family. They may also justify the behavior in some way to normalize the situation or protect those involved. Like violence, sexual abuse happens more often than it is reported. The adults or older children involved in perpetrating the abuse are initiating an interaction with a child because they are motivated by sexual stimulation or gratification for their own pleasure.

Most sexual abuse involves male perpetrators and female victims. Although, this is only what is known based on cases that are reported and it is also well-established that males tend to underreport, especially if they are victims. This has much to do with socially and culturally learned male gender roles and what is perceived about appearing strong and powerful, instead of weak or vulnerable. It is also known that because males are assumed to be physically stronger, that it is less likely that they can be victims of sexual abuse by female perpetrators. But the abuse that does occur, doesn’t necessarily require the physical overpowering of one person over a child. Sometimes it only requires psychological manipulation and control. If it is an adult who is abusing a child, most adults are physically stronger than children, regardless of gender identity. I believe assumptions about gender identities of victims and perpetrators promotes stereotypes that are often false. This does an injustice for everyone who suffers from abuse.

Perpetrators and victims of sexual abuse are unlikely to self-report. Therefore, detection of such situations are relied upon by therapists who are interpreting indirect behaviors as the signs and signals. Legal implications of this abuse require great care, especially in courtroom testimony. The retraumatizing effects of disclosing the abuse must be managed with care as well, to protect children from further harm and emotional distress.

It’s possible to assess sexual abuse through a biopsychosocial lens, by observing the physical condition, behavior, and social context of the situation that the child is involved in. Physical symptoms may include sleep disturbances, abdominal pain, appetite changes, encopresis or enuresis, and weight changes. Behavioral symptoms may include sudden or unexplained anxiety or depression, regression, sexualized behavior or knowledge, suicidal thoughts, running away, or substance use/abuse. Social symptoms may include a parentified role, problems with parental coping skills, relationship difficulties where a parent seeks physical affection, social isolation, substance use, and a history of parental abuse.

Finally, it's important to acknowledge that one of the most long-term negative impacts of child sexual abuse is the experience of interpersonal and sexual functioning problems with intimate relationships in adulthood. It’s a long road and journey of healing through posttraumatic stress, depression, anxiety, suicidal thinking, and sexual behaviors that may inflict continued pain and suffering on the victim. Additional suffering is compounded in the situation when victims of child sexual abuse also misplace blame on themselves for the abuse, deepening the wounds of their already overwhelming sense of shame.

Sources

Bager-Charleson, S., & Van Rijn, B. (2011). Understanding Assessment in Counselling and

Psychotherapy. SAGE.

Herman, J. L. (2015). Trauma and Recovery: The Aftermath of Violence--From Domestic

Abuse to Political Terror. Basic Books.

Patterson, J., Williams, L., Edwards, T. M., Chamow, L., & Grauf-Grounds, C. (2018). Essential

Skills in Family Therapy, Third Edition: From the First Interview to Termination. Guilford

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