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How can we help adult survivors of Childhood Sexual Abuse?

I was recently interviewed by a FIU student on the topic of sexual abuse. He was doing a project on victims of sexual abuse and wanted to know more about the symptoms adult survivors of childhood sexual abuse present and how the society can help these survivors. Below some excerpts of the interview:

Question: Are there similarities in the behavior of patients who have been abused as children? Are there types of abuse that generally lead to behaviors that are ultimately self-destructive?

Ana Gouvea: Yes, there are similarities in the behavior of adult survivors of childhood sexual abuse (CSA). Mental health professionals call these behaviors symptoms. Some of these behaviors/symptoms are self-destructive. For example, research shows that adult survivors of CSA present symptoms such as depression, suicide, drug addiction and risky sexual behavior. Other symptoms include revictimization, anxiety, shame, negative self-image and poor interpersonal skills. Also, CSA is a good predictor of post-traumatic stress disorder (PTSD) in adulthood. Recent research also shows a high risk of adult obesity, and a high risk of diabetes Type 2 in adult women. Thus, we know that if CSA is left untreated, it causes damage that persists into adulthood.

Question: How common is abuse, in your experience?

Ana Gouvea: Unfortunately, abuse is more common than we imagine. In the United States, the Center of Diseases and Control (CDC) estimates that 1 in 6 boys and 1 in 4 girls are sexually abused before age 18. Because often abuse is underreported, these numbers are probably very conservative. I worked in a shelter for domestic violence for a year, and I noticed that often my clients at the shelter had suffered some type of abuse during childhood (sexual, physical or neglect). It was like the harm suffered during childhood impacted these women partners' choice during adulthood.

Question: What can the community (friends, classmates, acquaintances) do to ensure that those who have suffered do not allow for torment to destroy their lives through various forms? Are we as a society ‘insensitive’ to the plight of those who have suffered abuse?

Ana Gouvea: One of the difficulties to treat abuse is that often individuals that suffered abuse feel ashamed to report. They think that the abuse was their fault. Also, abusers often threat the abused child. Thus, the child feels very vulnerable and afraid to report. As a community, particularly at schools and at home, teachers, friends and family members need to be attentive to some changes in behavior that a child may present such as grade changes, aggressive behavior, social withdrawing, somatic complaints, poor body image/self-esteem, eating and sleep disturbances, suicidal ideation, and extreme generalized fear. Also, these children may present an age inappropriate detailed knowledge of sexual behavior, may masturbate excessively and in public, and may produce sexual drawings and stories. If you know that someone is been abused, you need to call 1800-96-ABUSE or the Department of Children and Families. I do not think that as a society we are insensitive to abuse. I think often friends and family do not “catch” the symptoms, and unfortunately, sometimes, people do not believe the abuse history. The percentage of children that lie about being abused is minimal (1-5%). Thus, in 95-99% of the cases the report is true. As a society, we need to believe these children and act immediately. Negligence in acting against the perpetrator can occur too. An astonishing example is the sexual abuse that occurred for years in the American gymnasts team that was not investigated until recently.

Question: Do you feel that society is prepared to understand and aid the victims of abuse?

Ana Gouvea: Children victim of abuse need psychological treatment so that the pervasive consequences of abuse do not damage their adulthood. Adult survivors of childhood sexual abuse need psychological treatment too if they did not receive treatment during childhood. Nowadays there are several evidence-based treatments to help alleviate CSA symptoms. Thus, children and adults survivors of CSA need the help of an experienced and qualified mental health professional. Also, more information about abuse and how to report it need to be disseminated. Education about abuse is extremely important so that abuse symptoms are recognized, and the victims do not feel ashamed to report it.

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