Ten-year research update review: child sexual abuse

J Am Acad Child Adolesc Psychiatry. 2003 Mar;42(3):269-78. doi: 10.1097/00004583-200303000-00006.


OBJECTIVE To provide clinicians with current information on prevalence, risk factors, outcomes, treatment, and prevention of child sexual abuse (CSA). To examine the best-documented examples of psychopathology attributable to CSA. METHOD Computer literature searches of and for key words. All English-language articles published after 1989 containing empirical data pertaining to CSA were reviewed. RESULTS CSA constitutes approximately 10% of officially substantiated child maltreatment cases, numbering approximately 88,000 in 2000. Adjusted prevalence rates are 16.8% and 7.9% for adult women and men, respectively. Risk factors include gender, age, disabilities, and parental dysfunction. A range of symptoms and disorders has been associated with CSA, but depression in adults and sexualized behaviors in children are the best-documented outcomes. To date, cognitive-behavioral therapy (CBT) of the child and a nonoffending parent is the most effective treatment. Prevention efforts have focused on child education to increase awareness and home visitation to decrease risk factors. CONCLUSIONS CSA is a significant risk factor for psychopathology, especially depression and substance abuse. Preliminary research indicates that CBT is effective for some symptoms, but longitudinal follow-up and large-scale "effectiveness" studies are needed. Prevention programs have promise, but evaluations to date are limited.

MeSH terms

  • Awareness
  • Child
  • Child Abuse, Sexual / prevention & control*
  • Child Abuse, Sexual / psychology
  • Child Abuse, Sexual / statistics & numerical data
  • Child, Preschool
  • Depressive Disorder, Major / epidemiology
  • Depressive Disorder, Major / etiology
  • Family Characteristics
  • Female
  • Humans
  • Infant
  • Intergenerational Relations
  • Male
  • Prevalence
  • Risk Factors
  • Sexual Behavior / psychology