OBJECTIVE: The primary purpose of this review is to highlight the
progress made in the area of child sexual abuse during the recent
decade and to identify the gaps in our current knowledge about this
syndrome. METHOD: More than 100 articles on child sexual abuse were
reviewed, the majority written from 1980 to the present concerning the
demographics of child sexual abuse, the psychological effects of child
sexual victimization, the psychopathology encountered in adult
survivors of child sexual abuse, hypotheses regarding the nature of
the trauma, a critique of the research, and approaches to
intervention. RESULTS: Although a wide variety of psychological
sequelae have been documented in sexually abused children referred for
evaluation or treatment, there appears to be considerable variability
in the severity of the symptoms, and we remain ignorant of sequelae in
abused children who never enter the mental health system. However,
some of these children may become symptomatic in adult
life. Validation of sexual abuse is hampered by the lack of specific
behavioral markers. Methodological difficulties in child sexual abuse
research include problems with definition, failure to measure severity
of the abuse, sampling problems, failure to use standardized or
appropriate instruments, problems with validation, and failure to use
control groups. CONCLUSIONS: Despite an increased focus on child
sexual abuse in the recent decade, many gaps remain in our
knowledge. Prospective longitudinal follow-up studies of sexually
abused children and treatment outcome studies are urgently needed.