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The impact of child sexual abuse on adolescents

Children who have been sexually abused may display a range of emotional and behavioral reactions, many of which are characteristic of children who have experienced other types of trauma. A number of factors influence how a child reacts to a specific traumatic event including:

• Severity of the trauma
• Extent of exposure to the event
• History of or presence of other stressors
• Multiple episodes of abuse or exposure to violence
• Proximity to the trauma
• Preexisting mental health issues
• Personal significance of the trauma
• Separation from a caregiver during the trauma
• Extent of disruption in support systems during and after the trauma
• Parental mental health issues and parent distress
• Support available from family members
• Presence of supportive role models in the child’s life
• There is a growing body of literature that suggests that genetic factors may influence the strength of an individual’s response to any given traumatic event, producing more extreme responses in some children.
• Although many children who have experienced sexual abuse show behavioral and emotional changes, many others do not.

Traumatized may report vague physical complaints, seek attention from parents and teachers, withdraw from others, experience sleep difficulties, avoid school, show a decrease in school performance and even show regressive behaviors, like the inability to handle tasks and chores that they used to be able to handle. Traumatized adolescents may isolate themselves, resist authority, and become highly disruptive. Because adolescents may experience feelings of immortality, they may experiment with high-risk behaviors such as substance use, promiscuous sexual behavior, cutting, and suicidal behaviors or other risky behaviors, like driving at high speeds or picking fights. Coping behaviors don’t always appear to be negative. Adolescents that internalize things may become perfectionists and over achievers. Always having to prove themselves or be the best. They become good at hiding their pain by always being perfect.

Adolescents may also feel extreme guilt due to not preventing injury or loss to loved ones. They may fantasize about revenge against those they feel caused the trauma. Adolescents typically feel a very strong need to fit in with their peers. This may result in a reluctance to discuss their feelings, even denial of any emotional reactions. Finally, due to their increased maturity, adolescents may show traumatic responses similar to those seen in adults. These responses could include flashbacks, nightmares, emotional numbing, avoidance of reminders of the trauma, depression, suicidal thoughts, difficulties with peer relationships and anti-social behavior (e.g., criminal acts).

A list of other behaviors that traumatized adolescents may show includes:

• Withdrawal from peers/family
• Substance abuse
• Delinquent behaviors
• Perfectionism
• Change in school performance
• Self-destructive behaviors
• Detachment and denial
• Shame about their fear and vulnerability
• Abrupt changes in or abandonment of friendships
• Sexual promiscuity
• “Pseudo mature” actions such as getting pregnant, leaving school and getting married