Overview of Child Sexual Abuse

There are three essential forms of child abuse: physical, sexual, and emotional (Somers, 1992). Physical abuse involves any form of striking a child of the threat of such violence. Sexual abuse involves touching or speaking to a child in a sexual manner. Emotional abuse comes in many forms including verbal abuse, manipulations, cruelty, and neglect. By definition, physical and sexual abuse entail emotional abuse as well. In reality, much sexual abuse does not occur under conditions of danger, threat, or violence but the trauma resulting from sexual abuse occurs from the meaning of the act as much as from the physical danger (Spaccarelli, 1994).

Sexual abuse is far more common than most people think; so is incest (Stark, 1993). Sexual abuse happens most often to children. Girls are more likely to be abused than boys. Children are most in danger of being sexually abused when they are between the ages of nine and twelve years old. Boys are more likely to be abused outside the family (Finkelhor, 1990).

Some boys are afraid that being abused by a man makes them homosexual. (Stark, 1993). In our society, boys and men are expected to be tough. If you cry, people may say you're a sissy. If you can't protect yourself, people may say you're a wimp. Of course this thinking is silly. But it's one reason why 9 out of 10 cases of sexual abuse are never reported when males are the victims.

Sexual abuse can cause serious problems even when there is no violence or intercourse (Stark, 1993). Sexual abuse can also cause problems when a child becomes an adult. Adults who were sexually abused often don't trust others. Or they may want to avoid sex altogether. The longer sexual abuse goes on, the more damage it can cause.

Not all children who are sexually abused suffer long-term effects. If the abuse is stopped early and the child finds someone they trust to talk to, many of the harmful effects of sexual abuse can be prevented (Stark, 1993).

Sexual abuse is the secret that is now being shared (Stark, 1993). Sexual abuse is on TV and the radio and in the newspapers. Young people all over are speaking out.

Sometimes the abuser is a stranger. But more often he or she is a relative, a family friend, or an adult who is respected in the community--someone the child knows. The abuser could be a scout leader, a doctor, a neighbor, a teacher, or the father of a friend (Stark, 1993). The abuser can even be another child. Often the abuser is a family member, usually a father or a brother.

Father-daughter incest is a particularly disturbing form because it damages the child's main source of support and socialization (Cole & Putnam, 1992). Father-daughter incest is far more common than previously realized, with an estimated incidence of 1 in 70 females. Incest by a father is rarely a discrete traumatic event. The abuse usually arrives within a context of broader family dysfunction. The first sexual contact of father-daughter incest is usually with the eldest daughter, typically when she is 7-9 years old. The duration of father-daughter incest is longer than some other forms of child sexual abuse, partly due to the insular nature of the family.

Incest victims must cope with multiple aspects of the abusive experience (Cole & Putnam, 1992). The child must contend with physical and psychological trauma in the form of the actual sexual experiences, including the violation of his or her body. The emotional component of abuse occurs in the form of extended periods of apprehension, guilt, and fear between sexual contacts. Also, the child must deal with the shattered trust of an emotionally significant person in their life.

There has been an explosion of studies centered on sexual child abuse since 1985 that compared nonabused clinical individuals with sexually abused persons (Kendall-Tackett, Meyers-Williams, & FinkelhorSince, 1993). A difference was found in all of these studies where sexual abuse victims displayed an increased symptomatology in the following: fear, nightmares, general posttraumatic stress disorder (PTSD), withdrawn behavior, neurotic mental illness, cruelty, delinquency, sexually inappropriate behavior, regressive behavior (including enuresis, encopresis, tantrums, and whining), running away, general behavior problems, self-injurious behavior, internalizing, and externalizing.

Sadly, some children appear to be more susceptible to child abuse than other children (Vander Zanden, 2003). These include children who were premature infants, were born out of wedlock, who are handicapped, or were “difficult” babies. Overall, children viewed as being “strange” or “different” are more at risk than other children in the family. Understandably, child abuse more often occurs under the hand of parents suffering from mental illness and drug addiction.

Many of the risk factors of abuse for young children are due to poverty, as well as with the disorganization and disruption of the family (Rak & Patterson, 1996). Likewise, families that are socially isolated or away from neighborhood support are more likely to abuse children than families with a full support system (Vander Zanden, 2003). Few parents have any real training in the art of parenting and a child's needs may be neglected or vented on them when their parents' coping abilities are stressed by reality's money problems, work stresses, marital discord (Rak & Patterson, 1996). Parents need to learn that children prosper within a loving and nurturing environment where there are clear expectations for responsible behavior. Many parents need help learning the two-way process of communication so that they can listen and validate their children's needs, feelings, concerns, and desires. Love needs to be regularly verbalized and not withdrawn as a punishment.

In reality, punishment is often more related to the parents' moods than to the child's behavior (Rak & Patterson, 1996). Parents need to understand that their child's capacity for resilient behavior is significantly diminished when they experience a high degree of emotional turmoil and uncertainty. A family circumstance that creates an especially high risk factor for child abuse is early parenthood that often occurs without marriage and is followed by economic hardship and repeat pregnancies. The parents, often single mothers, become overwhelmed by their responsibilities, struggle to meet physical necessities, and experience stresses that challenge the ability to provide and emotionally secure and nurturing environment for their children.

Some factors appear to buffer children from being abused (Vander Zanden, 2003). Some of these protective factors are children whose mothers have a large support system, are involved within their communities, have more casual expectations for their children, encounter fewer stressful life events, have a supportive partner or spouse, had positive school experiences as children themselves, have made a conscious decision not to continue the cycle of violence or abuse in their family, and who have a strong and supportive religious affiliation (Vander Zanden, 2003). Other protective factors include the temperament of the child, unexpected sources of support in the family and community for the child, and child self-esteem (Rak & Patterson, 1996). These individual characteristics lead to a majority of at-risk children to succeed in life.

It is hard to generalize about parents who abuse their children (Vander Zanden, 2003). Multiple factors of individuals, times, and social environments are usually involved. However, though research suggests that child abuse is more prevalent among poverty-stricken families, abuse is certainly not confined to the lower-socioeconomic population. Child abuse occurs across the class spectrum and is related to social stress in families. A higher incidence of child maltreatment has been found in correlation to high levels of marital conflict, interspousal physical violence, and job loss.

Family problems may precede or even increase the likelihood that sexual abuse will occur while, likewise, intrafamilial or extrafamilial sexual abuse can exacerbate the level of conflict in a family or otherwise distort family relationships (Spaccarelli, 1994). Case studies have found support that families with victimized children actively exhibit greater family conflict, less effective problem solving, and more confused role boundaries than non-victimized families. In a retrospective study, family environments of sexual abuse victims possessed less cohesion and adaptability.

Incestuous families are often ruled by an overly dominant father who is likely physically abusive to the mother and by a mother who is withdrawn and submissive (Spaccarelli, 1994). Maternal withdrawal is consistently seen in clinical accounts with a daughter who takes over the role of meeting the father’s emotional and sexual needs. Studies have found that wife abuse is present in more than 10% of incestuous families and that behavior problems are more common in families whose mother had been a victim of physical abuse.

Sexual abuse often consists of multiple episodes of sexual contact occurring over an extended period of time and the abuse typically leads to other events that are stressful for the child (Spaccarelli, 1994). Several categories of stressful events thought to contribute to the impact of sexual child abuse are the degree of trust violation, a longer period of abuse, the severity of the abuse, and the frequency of the abuse.

It is possible, however, that both the duration and degree of sexual exposure are confounded with coercion, incestuousness, family conflict, or other aspects of the abusive situation.

An incestuous exposure with a father or stepfather had been associated with greater distress than by all other offenders in numerous studies (Spaccarelli, 1994). This relationship did not hold when comparing all intrafamilial and extrafamilial offenders, however. The more recent review of child sexual abuse supports this strong incestuous effect in that seven of nine studies found that symptoms were greater when perpetrators were closely related to their victims.

Clinical literature on sexual abuse suggests that several stressful events may occur or become intensified as a result of the onset of sexual abuse (Spaccarelli, 1994). These plausible events include an increased family conflict or strain on family relationships, parental separation, increased social isolation of the child or family, and negative or unsupportive reactions to attempts at disclosure.

A terrifying aspect of child sexual abuse is the actual disclosure of the abuse by the child to a trusted individual. Clinical reports suggest that perpetrators often restrict a child's contacts with peers or family members to increase the emotional dependency or to reduce the likelihood of disclosure (Rak & Patterson, 1996). Mothers of incest victims have been characterized as frequently being nonsupportive of disclosures or as actively colluding with the offender in clinical reports. Empirical data on this issue suggest that nonsupportive responses do occur in a significant minority of documented cases. Research has found that nonsupporive reactions by mothers were rated as highly stressful by adolescent incest victims. Other research has indicated that these parental reactions to disclosure are an important factor in the ability to successfully cope with the experience of sexual abuse.

Psychologists have argued that the reactions of parents and public authorities to disclosure may be the most stressful aspect of sexual victimization and could account for much of the negative sequelae associated with sexual abuse (Rak & Patterson, 1996).

Some other disclosure-related events that may stress children include investigative or therapeutic interviews, involvement in perpetrator adjudication, and undesirable outcomes of the adjudication process. Court proceedings in which the child is openly confronted and challenged have also been described as significant stressors for many victims, as well. Children may be emotionally damaged by workers or therapists who expect them to make complete and consistent disclosures or else disregard their allegations.

Having been abused does not always lead to being abusive (Vander Zanden, 2003). Evidence suggests that the pattern of abuse is unwittingly transmitted from parent to child, generation after generation. Researchers and professionals have referred to this as the “cycle of violence” and the “intergenerational transmission of violence.” Studies have shown that among adults who experienced abusive childhoods, between 1/5 and 1/3 grow up to abuse their own offspring. The increased frequency of violence in childhood likewise increases the chances that the victim will be a violent parent him or herself. As stated in Vander Zanden (2003), Milner, Robertson, and Robers found that merely witnessing physical abuse as a child has been associated with an increased abuse potential as an adult. One commonality of sexual abuse victims is the desire to break the cycle of abuse (Somers, 1992).

Being neglected or abused as a child increases an individual’s later risk for delinquency, adult criminal behavior, and violent criminal behavior (Vander Zanden, 2003). Conversely, the majority of neglected and abused youngsters do not become delinquent, criminal, or violent.

Most chiild abuse researchers have long believed that CSA is associated with a wide range of reactions and outcomes, from devastation to no detectable harm, may or may not be traumatic, and may or may not lead to mental health problems in the short or long term (Ondersma, Chaffin, Berliner, Cordon, Goodman, & Barnett, 2001).

Resiliency in children is the capacity of those who are exposed to identifiable risk factors to overcome those risks and avoid negative outcomes such as delinquency and behavioral problems, psychological maladjustment, academic difficulties, and physical complications (Rak & Patterson, 1996). "These children are often termed 'invulnerables,' 'superkids,' 'stress resistant,' or 'resilient' ". Research has found that only a minority of at-risk children experience serious difficulties in their personality development. In one of the most ambitious studies of resilient children, Werner and her colleagues, as cited in Rak and Patterson (1996), followed the progress of over 200 high-risk children in Hawaii for a period of 32 years. Among multiple risk factors, 1 of 3 of these high-risk children grew into competent and successful young adults who "loved well, worked well, played well, and expected well" by 18 years of age.

Studies on resilience have sought to understand how children who are subjected to risk factors in childhood nevertheless develop satisfactorily (Rak & Patterson, 1996). Some aspects attributed to youth resiliency after child abuse and neglect are their natural abilities, temperaments, networks of social support, and their participation in therapy (Vander Zanden, 2003). The bulk of past research on childhood sexual abuse has suggested two important findings in regards to resiliency (Saywitz, Mannarino, Berliner, & Cohen, 2000). First, the impact of child sexual abuse is highly variable. Some children show no detectable negative effects; others show highly adverse reactions with severe psychiatric symptomatology. Second, negative psychological effects of childhood sexual abuse often persist into adulthood (Coffey, Leitenberg, Henning, Turner, & Bennett, 1996). Childhood sexual abuse does not guarantee the development of adult disorders but the experience of abuse leaves the survivor at higher risk for serious and long-lasting psychological and social distress when compared to nonabused groups. Specific characteristics of the abusive experience—father-daughter incest, physical force, and level of sexual activity—tend to be associated with a more negative long-term outcome in women.

Variability in the effects of child sexual abuse is not surprising given the wide range of experiences that constitute sexual abuse and the disparate contexts in which it can occur (Saywitz, Mannarino, Berliner, & Cohen, 2000). The effects depend not only on the characteristics of the incident but also on a given child's vulnerability and resilience. Findings from both clinical and community samples emphasize that sexually abused children exhibit more symptoms than nonabused children in comparison groups. No one symptom characterizes the majority of sexually abused children, though, and there is no evidence of a single cohesive syndrome resulting from child sexual abuse.

As with any potentially traumatic experience, the harmful effects to the child are influenced by the child's level of preabuse functioning of temperament, neurodevelopmental reactivity, and attachment status, and by the existence of risk and protective factors, including the social resources (e. g. , family functioning), emotional resources (e. g. , mental health of nonoffending parents), and financial resources (e. g. , access to treatment) available to help the child cope with the abusive incident or incidents (Saywitz, Mannarino, Berliner, & Cohen, 2000). Sometimes abuse exacerbates preexisting problems and the abuse can overwhelm children who have been functioning reasonably well because sequelae unseat protective factors. An example of such sequelae is if children are relocated because of divorce or foster placement which causes the loss of attachment figures, friends, mentors, and activities that provided recognition, like athletics and school (Saywitz, Mannarino, Berliner, & Cohen, 2000). Some children experience events legally defined as sexual abuse but show no immediate symptoms requiring psychological treatment;

Different children can react altogether differently to the same form of abuse, this occurs frequently to child abuse victims who are part of the exact same family. In her book on the effects of abuse, Suzane Somers ( ) states that, “one child who is beaten may internatlize the violence, coming to believe that there is a logical reason for it: he must be bad and therefore deserving of such treatment. Another child faced with the very same beatings may harbor an ever-growing rage, a rage he may ultimately seek to quell with drugs or alcohol.“ Studies examining base rates for elevated symptomatology have shown that between 20% and 50% of sexually abused children are asymptomatic when evaluated with measures commonly used in psychopathology research (Spaccarelli, 1994).

Asymptomatic victims are mostly ones who have suffered less serious and have adequate psychological and social resources to cope with the stress of abuse (Filkenhor, 1990). In empirical studies, 70% of asymptomatic children remain symptom free over time while the last 30% do develop symptoms later on in life (Saywitz, Mannarino, Berliner, & Cohen, 2000). The proportion of sexually abused children who present with no detectable symptoms varies across studies from 21% to 49%. In some cases, children may be experiencing symptoms not measured by investigators, or children may be at an early stage before symptoms emerge.

Another possibility why children appear asymptomatic are because those victims have yet to manifest their symptoms (Bonanno, 2004). This occurs when children are effectively suppressing symptoms, have not yet processed their experiences, or because true traumatization occurs at subsequent developmental stages when the abuse status comes to have more meaning or consequences for them. We would expect these children to manifest symptoms later on in their development. A final explanation is that perhaps asymptomatic victims are truly less affected.

The asymptomatic children might be those with the least damaging abusive experiences (Bonanno, 2004). They may also be the most resilient victims, the ones with the most psychological, social, and treatment resources to cope with the abuse. Research indeed suggests there is a relationship between the seriousness and duration of the abuse and the amount of impact. Currently, there is no reliable means of predicting, in individual cases, which children will have persistent symptomatology or will develop symptoms later and which children require no or minimal intervention, although some predictive variables have been identified (Saywitz, Mannarino, Berliner, & Cohen, 2000).

Research studies have tended to describe four sizable groups of children to be considered for psychological intervention (Saywitz, Mannarino, Berliner, & Cohen, 2000). About one-third of child abuse victims have no detectable difficulties on standardized measures of child behavior problems. A portion of victims show minor symptoms of emotional distress, anxiety, self-esteem or identity difficulties that do not reach clinical levels of concern. Other children exemplify serious psychiatric symptoms of depression, anxiety, substance abuse, aggression, sexualized behavior, self-esteem and identity difficulties, shame, cognitive distortions, as well as isolated post-traumatic symptoms of flashbacks, nightmares and repetitive play. The last 55% of child abuse victims meet full criteria of psychiatric disorders, namely PTSD, overanxious disorder, major depression and sleep disorders. In addition, co-morbidity is a significant problem with this last traumatized population of abused children (Saywitz, Mannarino, Berliner, & Cohen, 2000). Two-thirds to one-half of sexually abused children appear to improve over time, but many either do not improve or deteriorate.

It is important to determine what other factors beyond the characteristics of the abuse experience itself influences long-term adjustment and resilience (Coffey, Leitenberg, Henning, Turner, & Bennett, 1996). During the 1970s, a group of pioneering psychologists and psychiatrists began to draw the attention of scientists to the phenomenon of resilience in children at risk for psychopathology and problems in development due to genetic or experiential circumstances (Mastern, 2001). These pioneers argued that research on children who developed well in the context of risk or adversity held the potential to inform theories of etiology in psychopathology and to learn what makes a difference in the lives of children at risk that could guide intervention and policy. The great surprise of resilience research is that if child adaptation systems are protected and in good working order, development is robust even in the face of severe adversity. Conversely, if these major systems are impaired, antecedent or consequent to adversity, then the risk for developmental problems is much greater, particularly if the environmental hazards are prolonged (Mastern, 2001).

Initially, the term "resilient" referred to so-called "stress resistant" or "invulnerable" children who were characterized as unusually competent and capable (Anderson, 1997). These children not only survived, they thrived under adverse circumstances Resiliency research originally focused on uncovering the attributes that helped at-risk children resist stress. Protective factors in the children, their families, and their external support systems were found and defined. This research identified protective mechanisms in these three areas but did not show how these mechanisms interacted to produce invulnerability in children. Instead of viewing resiliency as the avoidance of stress factors, researchers recognized that resiliency is a process whereby risk was successfully engaged and adaptive changes were recognized when children successfully coped with stress. Soon, these children successfully engage in risk fostered outcomes of adaptation and competence (Anderson, 1997).

Researchers have found evidence of a resilience in severely abused children, with more serious symptoms not manifesting themselves until a year after disclosure (Saywitz, Mannarino, Berliner, & Cohen, 2000) . In other cases, asymptomatic children may represent a particularly resilient group that copes well and never shows symptoms. Other children may not display symptoms of trauma simply because the event was a relatively minor incident that was not experienced as traumatic, although it was exploitative and illegal (Maddi, 1999a).

It is clear that the human spirit can be diminished or crushed and that individuals sometimes reject growth and responsibility (Ryan & Deci, 2000). There are abndant examples of children and adults who are apathetic, alienated, or irresponsible regardless of social strata or cultural origin. The persistent, proactive, and positive tendencies of human nature in these individuals are clearly not invariantly apparent. The scientific fact that human nature can be either active or passive, constructive or indolent, suggests more than mere dispositional differences and is a function of more than just biological endowments. Social contexts catalyze both within- and between-person differences in motivation and personal growth, resulting in people being more self-motivated, energized, and integrated in some situations, domains, and cultures than in others. Research on the conditions that foster versus undermine positive human potentials has both theoretical import and practical significance in regards to sexual abuse reactions (Ryan & Deci, 2000). For this reason, psychologists are greatly searching for causes of resilience, self-determination, and hardiness in sexually abused children.

There is much evidence that hardiness is not merely a reflection of such basic demographic considerations as age, education, religion, marital status, ethnicity, and job level (Ryan & Deci, 2000). Although there are certainly lingering controversies, the picture that is emerging from ongoing research suggests some construct validity for hardiness as a personality composite of beliefs about self and world regarding the importance of a sense of commitment, control, and challenge.

Much of resilience, hardiness, and self-determination are due to the positive and effective coping strategies that child abuse victims utilize post-abuse. Both strengths perspectives in social work and resiliency literature in developmental psychology recognize that children's ability to live well in the present depends on their ability to recognize and uncover their own strengths (Anderson, 1997). Some very effective coping strategies are direct resistance of the perpetrator, emotional support seeking, and purposeful disclosure of the sexual abuse (Spaccarelli, 1994). Although it may be tempting to suggest that the above strategies could protect a child from ongoing or increasing symptomatology, currently there is little evidence to support such a proposition.

Purposeful disclosure of personal child sexual abuse is very intimidating but initial data suggest that such disclosure may be stressful and anxiety provoking in the short term but adaptive in the long term (Spaccarelli, 1994). In past research it has been unclear whether disclosure caused increased anxiety and hostility or whether the direction of the causality was reversed. Regression analysis has indicated that child abuse victims who reported an available relationship with an adult or a sibling performed better coping skills and were thus rated as less symptomatic by their social workers. Several studies have found that the degree of support a person received from parents and others following disclosure of sexual abuse can moderate the negative long-term effects (Coffey, Leitenberg, Henning, Turner, & Bennett, 1996). It has also been reported that self-blame for the abuse is associated with poorer long-term adjustment. It is very important that counselors and practitioners monitor their counseling of child abuse victims and the effects of different forms of coping for each individual.

Sexual abuse and any form of maltreatment limit a child's coping resources as well as hinder his ability to use a variety of coping strategies (Diehl, 2002). Without adequate information regarding the methods children use to manage their sexual abuse, practitioners may attempt to change or eliminate problem behaviors that actually are essential strengths and coping strategies that are critical to children's survival (Anderson, 1997). For example, many children use wishful thinking such as fantasizing and daydreaming to distance themselves emotionally from the anguish of their sexual abuse and report that using wishful thinking is helpful to them even though professionals associate it with creating significant psychological distress for the child Instead of eliminating this survival strategy practitioners can help the child become aware that it is an important measure that he or she used to cope and that it can be shaped into managing other adverse situations for the child. Personality Psychology has much to say in regards to individual uses of coping strategies.

Personality psychology seeks to understand how individuals are like all other people, some other people, and no other person (Little, 2004). It formulates theories about the nature of human nature, the role of individual differences, and the study of single cases. Personality psychology provides one of the core basic sciences underlying many of the fields of applied psychology, including clinical, counseling, health, and organizational psychology. Understandably, Personality Psychology provides much information to practitioners and students on the realities of individual personalities and the coping methods used by victims of abuse. One recent finding of this field is that humans have a deeply rooted need to construct narratives within which their lives make sense. People construct stories not only about their relationships, but also about their achievements, their dreams, to establish an distinct personal identity, and to establish validation about the type of person he or she is or is becoming (Little, 2004). Finding these narratives of child abuse victims can greatly aid the individual and the counselor to nurture positive coping strategies by properly molding the individual’s personal narratives.

Personality is often regarded as an innate temperament, governed by internal, biological mechanisms, and is not susceptible to change in response to the influence of the environment (Branie, 2004) . The Big Five factors of personality are thought more likely to influence relationship qualities than vice versa. In contrast, within a contextual approach to personality the importance of life changes and role transitions on personality development is emphasized, suggesting that personality is fluid and prone to change as a result of environmental factors. Therefore, child abuse victims’ personalities can be altered by their abuse experiences and the reactions of those in their environment that they have disclosed the abuse to. Family relationships are so important for individual development that changes in these relationships are expected to affect Big Five personality factors (Branie, 2004). The purpose of this paper is to identify what factors in an individual‘s personality or coping strategies allows for some individuals to rise above their abuse experiences and symptomatology to be a resilient and valiant individual. What are the effects of abuse and how does abuse effect individuals at different developmental stages of childhood? What are the specific personality characteristics and coping strategies that foster positive life development and decreased symptomatology? Can a person learn these personality characteristics that resist negative life phenomenon? What are the implications of these known characteristic and strategies to the psychological treatment and research of child sexual abuse victims? Read on to find the answers to these important questions.

Key Definitions in Regards to CSA

CHILD SEXUAL ABUSE-

Sexual abuse means using a child for sexual pleasure (Stark, 1993, p. 13). A great deal of controversy has surrounded attempts to define Child Sexual Abuse (Ondersma, Chaffin, Berliner, Cordon, Goodman, & Barnett, 2001). The issue for the majority of researchers is not whether sex with children should be considered abuse but rather the gray areas of whether such acts of exhibitionism or exposure to pornography should be included in the definition of child sexual abuse. Some requirements that investigators have included in their operational definitions of CSA are the age of the child, the use of coercion, abuse involving physical contact or penetration, abuse perpetrated by an authority figure, and a negative reaction on the part of the child.

Researchers have argued that scientific clarity demands a definition based on empirical evidence of harm rather than legal or moral criteria (Ondersma, Chaffin, Berliner, Cordon, Goodman, & Barnett, 2001). However, if abuse is only classified as something that is harmful, then abuse as a concept ceases its importance and one need only speak of child harm, not abuse. We use the term “abuse” as it speaks of acts that are corrupt or improper in nature. A wide range of intention and harmful, but not abusive acts, such as surgery, would be wrongfully labeled as abuse if harmfulness was the only classification standard. Abuse definitions that require empirical evidence of harm are also problematic as causation of harm cannot be proven experimentally (Ondersma, Chaffin, Berliner, Cordon, Goodman, & Barnett, 2001).

Child sexual abuse is a moral and legal term and was never meant to be primarily a scientific construct (Ondersma, Chaffin, Berliner, Cordon, Goodman, & Barnett, 2001). Therefore, its definition should have a sociological rather than an empirical foundation. Researchers have argued that it truly is abuse as children are unable to provide full and informed consent of the act. In order to have true consent, children would need full knowledge regarding the act they are consenting to, as well as possessing absolute freedom to accept or decline. Reasonably, it can be argued that children are fundamentally incapable of meeting these preconditions of abuse. Clear evidence that children are fundamentally incapable of agreeing to abusive acts are the principles of the scientific and legal communities: Children are seen as incapable of free and informed consent to engage in research, enter into financial contracts, choose whether to be educated, accept or reject medical treatment, or engage in tobacco or alcohol use (Ondersma, Chaffin, Berliner, Cordon, Goodman, & Barnett, 2001). These positions are not based on evidence but rather on societal beliefs that children lack the maturity to make major life decisions and need to be protected from those who would exploit their immaturity. Setting an age of consent for behaviors such as driving, voting, or having sexual relationships is by its nature arbitrary because same-age children will vary in their capacities. However, the abusiveness of the vast majority of sexual acts involving children is quite unambiguous from a societal perspective.

A number of important and widely held values appear to converge to make CSA uniquely and consistently abusive (Ondersma, Chaffin, Berliner, Cordon, Goodman, & Barnett, 2001). Some examples of this truth are that children cannot truly consent to sex, that children should be protected from sexual experiences, that adults should not use children for their own sexual gratification, that such acts are always done for the sexual gratification of the adult, and that such acts have clear potential for harm that cannot be predicted beforehand. Psychological researchers Rind et al. abused the term of CSA and stated that the effect on society at large could be immediate if science and respected scientific societies were to define only unwanted sexual acts as abuse. Since this statement in 1998, pedophilia advocates have trumpeted Rind’s beliefs to support their rationalizations for engaging in sex with minors (Ondersma, Chaffin, Berliner, Cordon, Goodman, & Barnett, 2001).

According to James Vander Zanden (2003, p. 276), “sexual abuse of children is sexual behavior between a shild and an older person that the older person brings about through force, coercion, or deceit.” Vander Zanden goes on to list four types of child sexual abuse that are when the child is exposed to sexual behaviors that are sexually inappropriate, the child experiences a loss of control or sense of powerlessness, the child is stigmatized for participating in forbidden acts, and the youngster feels betrayed because a trusted adult has used, manipulated, or failed to protect him or her.

In the end, child sexual abuse is solely defined as acts intended for the sexual stimulation of an adult, nothing less and plenty more (Cole & Putnam, 1992).

INCEST-

Incest means having sexual activity with someone who is related to you. This can be a family member who lives in your house, like a father or sister. Or it can be a realtive who does not live with you, like your cousin or grandfather. Any sexual activity between a child and another family member can be called incest (Stark, 1993, p. 44).

RESILIENCY-

The Random House Dictionary, as cited in Ondersma, Chaffin, Berliner, Cordon, Goodman, & Barnett (2001) says that resiliency is "the power or ability return o the original form or position after being bent, compressed, or stretched." Alternatively, it is "the ability to recover readily from illness, depression, adversity, or the like." Both of these definitions greatly apply to resilience following child sexual abuse.

POST-TRAUMATIC STRESS DISORDER-

PTSD is essentially a clinical syndrome for which there is an emerging body of etiological theory from psychoanalytic, cognitive, and cognitive-behavioral perspectives (Spaccarelli, 1994) . In terms of repression and the unconscious completion tendency of individuals suffering from PTSD, some common symptoms are painful re-experiencing, obsessive thinking, and rumination. Researchers have stated that PTSD results from the uncontrollability of victimization experiences that violate a human need for perceived control over negative or dangerous events in his or her life.

SELF-EFFICACY-

The trauma of child sexual abuse compromises an individual's sense of agency or efficacy (Diehl & Prout, 2002). The very symptoms of child sexual abuse and posttraumatic stress disorder interfere with a sense of self-efficacy. Self-efficacy has been defined as an individual's belief about one's ability to perform certain actions as well as the cognitive representation that those actions can be performed successfully. Self-efficacy also involves the sense that one has authorship over one's actions, thoughts, and emotional experiences, that one has volition and control over one's behavior, and that one is the architect of his or her intentions and plans. Self-efficacy is often used interchangeably with the terms of self-agency and self-determination.

COPING-

Coping behaviors are a central aspect of stress (Vander Zanden, 2003, p. 340). When we confront difficult circumstances, we typically seek ways for dealing with them. Coping involves the responses we make in order to master, tolerate, or reduce stress. There are two basic types of coping: problem-focused coping and emotion-focused doping. Problem-focused coping changes the troubling situation, whereas emotion-focused coping changes one's appraisal of the situation.

LOCUS OF CONTROL-

Locus of control refers to people's perception of who or what is responsible for the outcome of events and behaviors in their lives (Vander Zanden, 2003, p. 359). People believe in external control when they perceive the outcome of an action as the result of luck, chance, fate, or powerful others. Conversely, when people interpret an outcome as the consequence of their own abilities or efforts, they believe in internal control.

MOTIVATION-

Motivation involves the inner states and processes that prompt, direct, and sustain activity. Motivation influences the rate of student learning, the retention of information, and performance (Vander Zanden, 2003, p. 357). Many psychologists differentiate between extrinsic and intrinsic motivation. Extrinsic motivation involves activity that is undertaken for some purpose other than its own sake. Rewards such as school grades, honor rolls, wages, and promotions are extrinsic, because they are independent of the activity itself and because they are controlled by someone else. Intrinsic motivation involves activity that is performed for its own sake. Intrinsic rewards are those over which we have a high degree of personal control and are inherent to the activity itself and Intrinsic motivation is that which successful child abuse victims utilize to overcome their abusive pasts.

Signs of Abuse

Although there are varied reactions and signs of abuse, some general signs of abuse can be provided. One major sign of some form of maltreatment or abuse occurring in the home is social withdrawal (Rak & Patterson, 1996). It is believed that the emotional enmeshment in incestuous families may prevent children from developing appropriate peer relationships, particularly in forming normal relations with the opposite sex in adolescence. And although no studies have conceptualized reduced social contact as an stressor, existing data do support the hypothesis that sexual abuse tends to increase symptoms of social withdrawal.

Maltreated children show a variety of symptoms that the American Humane Association listed as cited in Vander Zander (2003, p. 207). The following signs should be indications to teachers, caretakers, and child care providers that child abuse or neglect may be occurring within the child’s home. Does the child possess bruises, welts, or contusion, or simply complain of complaints of abuse at home? Is the child often early or late to school and other community programs? Is the child clean and full of energy or does the child often appear tired or unkempt? Has the child recently been injured? How does the child behave? Is the child overly aggressive or appear to enjoy destroying property? Or does the child normally act withdrawn and passive? An affirmative to any of the above questions would require an immediate call to child protection services and an ensuing child abuse investigation. Adult caretakers need remember that young children normally do not possess the vocabulary to explain the horrendous and overwhelming feelings that he or she is experiencing in their daily lives (Vander Zander, 2003). It is the responsibility of every adult to be aware of these silent indications of child abuse so that these damaged children can be aided in admitting and confronting their hidden demons.

Development of Self and the Interruption of Abuse on Child Development

Some theorists have considered the impact of sexual abuse from a developmental perspective. For example, adults molested as children appear to be at elevated risk for such symptomatology as borderline personality disorder, multiple personality disorder, somatization disorder, eating disorders, and substance use or abuse (Spaccarelli, 1994). It is of great importance as to when in development the abuse first occurred as well as the frequency of the abuse on the child's development of self-regulation skills, self-integrity, as well as the ability to appropriately socialize with their peer groups. Deficiencies in the above skill developments are seen as core problems for a variety of symptoms that could develop later in life. The coping strategies a child utilizes postabuse are crucial mediating variables in understanding and predicting later mental health.

The cognitive structure that we employ to select and process information about ourselves in the self (Vander Zanden, 2003, p. 261). The self gives us a feeling of placement in the social and physical world and of continuity across time (Cole & Putnam, 1992). Most psychologists perceive the damaged self-development of a child to be the worst effect post abuse, especially in regards to the development of physical and psychological self-integrity, and the development of self-regulatory processes such as impulse control. Abuse further damages the social development of the child, as well.

Sexual abuse by a parent violates the child's basic beliefs about safety and trust in relationships, disturbing both the sense of self and the ability to have satisfying relationships in which one feels loved and protected (Cole & Putnam, 1992). In fact, the typical child's social supports are, in incestuous families, the source of distress. Parental authority and societal standards, which value the privacy of the family, limit the likelihood of successful disclosure outside of the family and compromise the chance of the victim's achieving her developmental tasks both within or beyond the family environment.Infant and Toddler Victims of Abuse

Most life-span developmentalists reject the idea that the first five years of a child’s life are all-important (Vander Zanden, 2003, p. 60). More recent research suggests that the long-term effects of short, traumatic incidents are negligible in young children. According to Cole & Putnam (1992) "the tasks of infancy and toddlerhood related to social and self-development are (a) the discovery of a world of people and objects, (b) the establishment of secure social relationships within the family, (c) the establishment of a basic sense of self, (d) the development of an agentic or autonomous awareness, and (e) the acquisition of an initial sense of right and wrong (or good and bad)." In sum, during infancy and toddlerhood there are significant advances in the development of a sense of self, of initial self-regulatory functions, and of trust and sensitivity in social relations.

Much attention has been directed of late to the development of attachment in infants and toddlers (Cole & Putnam, 1992). Attachment is a construct that describes the establishment in the infant's mind of an emotionally secure relationship with the primary caregiver, typically the mother. Secure attachment in infancy predicts development of identity and self-knowledge, later childhood social competence, and the quality of adult relationships with partners and children.

Early attachment relationships lead to purposeful communication and then to the toddler’s creation of a coherent, positive sense of self. (Vander Zanden, 2003, p. 180). Part of attachment allows for the fear-wariness behavior system to develop in infants so that youngsters avoid new or dangerous people, objects, or situations that may be of danger to them. This development of the fear-wariness behavior system could be extremely important to the life of an infant that is highly at risk for child abuse (Vander Zanden, 2003, p. 185).

Compared with all other age groups, incest of infants and toddlers appears to occur at relatively low frequencies (Cole & Putnam, 1992). Though abused infants are unlikely to have an understanding of the impropriety of sexual acts perpetrated against them they are still affected by the physical trauma of acts such as attempts at penetration by a person or with an object. Specifically, the infant's basic sense of the physical integrity of a separate self, basic trust in the responsive love and protection of the parent, and sense of control over events are threatened or disintegrated. Since incest usually occurs later in childhood, the other important consideration is that incest may undermine these fundamental beliefs when it does occur (Cole & Putnam, 1992).

Preschool Victims of Abuse

The preschool years mark the transition from infancy to childhood and are generally marked as ages 2-5 or entry into elementary school (Cole & Putnam, 1992). At this time in life, the child's task is to learn to integrate its secure sense of an agentic self with the restrictions of the social world. Now, preschoolers set limits on one's own behavior, cooperate with others, and are accountable for rule violations. Recent research also has shown self-regulation of affect in preschoolers. Through interactions and through play, preschoolers learn the limits of and differences between what is real and what is not real.

Denial appears to be a common coping mechanism of preschoolers (Cole & Putnam, 1992). Empirical studies have exemplified how denial increases during the preschool years and also describes how preschoolers blame wrongdoing on someone else or use a pretend identity. Disasociative capacity also appears to increase rapidly during preschool years where visual hallucinations, spontaneous trance states, amnesias, rapid shifts in demeanor, imaginary playmates, and sleepwalking are not uncommon. Preschoolers are also restricted by the cognitive limits that Piaget called egocentrism where they are unable to distance intellectually from the immediate, concrete experience in their environment. Their perspective tends to be dominated by their actual experience and vantage point.

A small number of documented cases of incest began during the preschool years (Cole & Putnam, 1992). The controversy of preschoolers is whether their developmental status protects them against the effects of the abuse or whether it creates greater risk. Some hypothesize that preschoolers do not realize the taboo nature of the incest and are protected from guilt by their innocence. Others believe that incest occurring this early in ego development has a profound and pervasive negative effect on adult personality.

As stated above, victimized preschoolers may depend on coping through denial and dissociation (Cole & Putnam, 1992). Instrumental and avoidant coping are overridden by the social authority and physical proximity of the abusive father. The option of turning to other adults for help is limited by confusion about what is happening, feelings of guilt and shame, and fear of the consequences of disclosure. Many cases of incest of preschool age children are recognized through precocious knowledge of sexual activity rather than self-disclosure as some fathers actually instruct or terrorize their children about telling. The most common symptoms of preschool victims of abuse are anxiety, nightmares, general PTSD, internalizing, externalizing, and in-appropriate sexual behavior (Bonanno,2004). Sexual abuse at this age compromises the ongoing self-organization and self-regulation of the child (Cole & Putnam, 1992).

Childhood Victims of Abuse

At the beginning of childhood, children have an established sense of themselves as being human, being a particular gender and understanding his or her sex role, being a unique individual, and being a continuous, physical entity (Cole & Putnam, 1992). During childhood, the understanding of self comes gradually to include awareness of nontangible, psychological characteristics (thoughts, feelings, motivations) and a more acute sense of comparison of self with others.

The average age at which the first sexualized contact between father and child occurs is between 7 and 9 years (Cole & Putnam, 1992). Around age 8 or 9, self-criticism and awareness of feelings like shame and pride are more evident. Children also begin to develop the ability to conceptualize the self as having both positive and negative qualities at this time. Abuse at this age challenges the ability for the victim's increasing scope of social experience, as well as establishing a sense of self-competence in the social world beyond his or her home.

Abused children often experience intense guilt, shame, and confusion that diminish the likelihood of feeling secure enough to build friendships and to receive social support outside the home (Cole & Putnam, 1992). School-age victims of abuse most commonly display symptoms of fear, neurotic and general mental illness, aggression, nightmares, school problems, hyperactivity, and regressive behavior (Bonanno, 2004). The child may exhibit uncontrolled behavior or may vary between rigid and poor emotional control as they are unable to relate realistically to such emotionally intense experiences (Cole & Putnam, 1992). These children often lack an adequate model of flexible self-control in at least one parent. Sexually abused children tend to continue to utilize the coping skills of denial and dissociation even though other children usually develop beyond such coping skills by that age.

According to Cole & Putnam (1992), the "sense of self is a psychological construct, an inference derived from one's experience that organizes the experience into a sense of individuality, unity, and continuity". In childhood, the sense of self is socially formed by differentiation from others. In reality, self and social development are inextricably bound together at this time in life. Rebuilding self-esteem and pride is extremely important for children who have been sexually abused because the trauma permeates their identity and may leave them lacking in feelings of self-worth (Anderson, 1997). Dysfunction in self development is sure to show itself within the social context of the abused individual's life (Cole & Putnam, 1992).

Adolescent Victims of Child Sexual Abuse

As children approach adolescence, they start to integrate more cognitively sophisticated elements of loyalty and trust into their relationships. The increasing sphere of friends allows children new sources of support as well as a new opportunity for increasing self-regulation (Cole & Putnam, 1992). Whereas earlier in life, the child's moral sense was defined by the concrete consequences of wrongful actions and punishment, the child now develops a moral sense and attendant guilt. Problem solving is solidified by the development of inference, reflection, and reasoning. Now, children utilize rationale and the blaming of others in place of denial or dissociation.

Beginning in middle childhood, maltreated children report that they are less competent, reporting diminished self-efficacy, and are less accepted than non-maltreated peers of the same socioeconomic status (Diehl & Pront, 2002). The internal self, social self, and socially comparative self are more prominent during middle childhood. Middle-childhood children evaluate their abilities by comparing those abilities with their peers' abilities and by making a conclusion about their own self-agency. Sexual, physical, and psychological abuse disrupt the development of certain cognitive components of the self, such as self-agency. The abused child has to direct his attention to external threats rather than focus on developing self-awareness skills, such as the ability to attend to one's own needs, thoughts, and desires. Mannarino, Cohen, and Berman, as reported in Diehl & Pront (2002) found that sexually abused children reported heightened self-blame for negative events, reduced interpersonal trust, and a sense of being different from nonabused peers. Obviously, such a wall to self-agency could have disastrous results to the development of a sexually abused youth.

Probably the most confusing and powerful aspect of young adolescent development is the onset of puberty and an individual's emerging sexuality (Cole & Putnam, 1992). This is a time of intense physical changes that produce many psychological and social challenges. The youth must now integrate these new sex characteristics into their self-definition and social personality. Childhood friendships deepen with qualities of mutuality, intimacy, and exclusivity. Also, youth develop the ability for self-reflection and, thus, are now able to better understand his or herself. Now, starts a long struggle for figuring out their true identity in contrast to others in their environment. Clearly, abuse or incest will challenge this newly forming sexual identity of the child, as well as the development of opposite-sex peer relationships.

Incest or sexual abuse begins during adolescence for some victims, but for it begins for most victims before this time and continues through some portion of adolescence (Cole & Putnam, 1992). The most common behaviors exhibited by adolescent victims of abuse are depression, where they appear withdrawn, suicidal, or perform self-injurious behaviors; somatic complaints; illegal acts; running away; and substance abuse (Bonanno, 2004). Nightmares, depression, withdrawn behavior, neurotic mental illness, aggression, and regressive behavior are symptoms that are shown across all age groups of victims.Beyond challenging the ability to develop a well-functioning sense of self, sexual abuse effects can be greatly altered by the specific coping strategies of the victimized individual (Cole & Putnam, 1992). For example, if the youth utilizes denial and dissociation, there is a great risk for psychopathology. Reliance on such immature coping strategies can lead to the child acting out in delinquent manners when frustrated, depressed, or anxious. Cole & Putnam (1992) state that "adolescents whose first sexual victimization occurs after puberty may be less prone to these symptoms and to risk of severe adult psychopathology. For example, retrospective studies of women with multiple personality disorder show that the large majority report onset of abuse between ages 3 and 5 with 95% reporting onset before age."

Effects of Abuse

General Effects of Child Sexual Abuse Much sexual abuse does not occur under conditions of danger, threat, or violence (Filkenhor, 1990). Many abusers misuse their authority or manipulate moral standards and abuse the child's trust. The trauma of sexual abuse can result as much from the meaning of the act of exploitation as from the real physical danger. Sexual abuse is truly less of an occurrence than a situation, relationship, or process. It often continues for a good length of time. The trauma may derive from the distorted socialization in the relationship or in the situation. The problem for the child may not be in the failure to integrate the experience into existing schemata so much as in misrepresenting or applying the abuse to other situations where they are inappropriate.

There are a variety of symptoms in at least some portion of the abused population (Finkelhor, 1990). The most common symptoms are fear, anxiety, depression, anger, aggression, and sexually inappropriate behavior. If we exempt the severely abused children, the average percentage of victims with symptoms of PTSD are 32%, near the level of other frequently occurring symptoms such as poor self-esteem (35%), promiscuity (38%), and general behavior problems (37%) (Bonanno, 2004). Symptoms do not occur uniformly across all age groups. The question remains is whether changes in symptomatology occur within a given individual at different stages or if symptoms represent developmental changes in response to sexual abuse at the time of initial report.

Sexually abused children frequently exhibited cognitive distortions and negative self-attributions (Diehl & Pront, 2002). These cognitive distortions develop because the abuse often occurs when the child is not developmentally ready to make sense out of the abusive events. That disengagement strategies are used more often to deal with the stressful aspects of having been sexually abused is not surprising (Coffey, Leitenberg, Henning, Turner, & Bennett, 1996). It is understandable that youth would try to escape the stressful thoughts of secrecy, shame, embarrassment and powerlessness that occurs in abuse.

There is often an overlap between posttraumatic stress disorder (PTSD) symptoms in sexual abuse survivors and disengagement methods of coping in abuse victims (Coffey, Leitenberg, Henning, Turner, & Bennett, 1996). Researchers actually believe that there is a high probability of a reciprocal relationship between PTSD and avoidant coping strategies. This relationship is consistent with prior findings that avoidant methods of coping are associated with higher levels of psychological distress in child sexual abuse survivors, and PTSD occurs from high levels of psychological distress.

It is a popular belief that male victims of abuse exhibit externalizing symptoms postabuse while females manifest more internalizing behaviors (Bonanno, 2004). Boys are more often reported to be acting aggressively, such as fighting with abusers and girls are more often reported to be acting depressed. (Filkenhor, 1990) In reality, only a few studies have found support for consistent differences in symptoms between the sexes (Bonanno, 2004). The absence of such differences is interesting, however, as girls are more likely to experience intrafamilial abuse which has been associated with more severe effects. One proven difference in reaction to abuse between the sexes is that women often respond to sexual abuse by being depressed and afraid, whereas men drink (Finkelhor, 1990).

Overall, penetration of any sort has a stronger severity of effects in the majority of completed studies, regardless of the sex of the victim (Bonanno, 2004). The closer the relationship of the perpetrator to the victim is also a major mitigating factor in the effects of abuse. It is unclear at this time how the number of perpetrators impacts the effects of abuse, though. Another variable that has been assessed in very few studies is the time elapsed since the last abusive incident. Apparently, it is too early to determine whether time elapsed since the last incident is correlated with the number of symptoms or not.

Court proceedings in which the child is openly confronted and challenged have been described as significant stressors for many sexual abuse victims (Rak & Patterson, 1996). In a sample of child victims whose cases had been litigated, Rak & Patterson found that 21% of the victims perceived the investigation process as harmful, whereas 53% thought it was helpful. Victims found the act of testifying and succumbing to a high number of interviews to be more stressful than participating in the interview process. Two studies have shown that children who were still waiting for a trial 5 months after the initial investigation were less likely to have improved in their levels of depression and anxiety. The most important variable in recovery has been shown time and again to be family support, especially maternal support after disclosure of the abuse (Bonanno, 2004). Parents can greatly effect the way their children adapt to negative life experiences and cope with adversity. Parents need not make the mistake to treat all their children the same. This point is exemplified by James Vander Zanden (2003, p. 58) who stated, "children can--and often do--experience the same events differently, and this uniqueness nudges their personalities down different roads…Birth order, school experiences, friends, and chance events often add up to very different childhoods for siblings…Parents should respect their individuality, adapt to it, and cultivate those qualities that will help each child cope with life.”In summary, the findings of various studies reviewed indicated that molestations that included a close perpetrator; a high frequency of sexual contact; a long duration; the use of force; and sexual acts that included oral, anal, or vaginal penetration lead to a greater number of symptoms for sexual abuse victims. Similarly, the lack of maternal support at the time of disclosure and a negative outlook or coping style also led to increased symptoms. The influence of age at the time of assessment, age at onset, number of perpetrators, and time elapsed between the end of abuse and assessment is still somewhat unclear currently and should be examined in future studies.

Short Term Effects of Child Sexual Abuse

Some short term effects of child sexual abuse are that children may pull away from their regular activities, act apathetic, chronically worry about safety, play aggressively, and constantly be anxious about safety (Barbarin & Richter, 2001). The effects of the abuse may spill over into all relationships of the child that may create a circular effect of rejection from his or her peers. One reassuring fact is that relatively few children are reabused, at least in the short term (Filkenhor, 1990). Various studies have found only a rate of 15-19% of youth that have been reabused after initial report of child sexual abuse. The relatively low rate of reabuse primarily reflects that fact that victims are often separated from their abusers for various reasons and is not a testimony to the effectiveness of psychological and judicial intervention. General short term effects of child victims of abuse are disturbances in the regulation of mood, self-esteem, interpersonal behavior, and impulse control (Cole & Putnam, 1992).

An interesting study completed by a group at Tufts University, as cited in Filkenhor (1990), examined the abatement of symptoms shortly after initial assessment for sexual child abuse. This study evaluated 77 children 18 months after first assessment. The results of this study found 55% of the children to have improved substantially, particularly in the symptoms of sleep disturbances, fears of the offender, and basic signs of anxiety. Conversely, there was a substantial worsening of symptoms of fighting with others, conflict with parents, and inappropriate attention-seeking behaviors in 28% of the subjects. Interesting enough, only one-third of the children received psychotherapeutic intervention and these subjects showed the most symptoms of all within the study, yet they improved most over time, as well.

In a more recent study, Bonanno (2004) found 50 -67% of all subjects became less symptomatic in the first year or year and a half after disclosure, while 10-24% become more so. Six to nineteen percent experienced additional sexual abuse after initial disclosure. Aggressiveness and sexual preoccupations were the most likely to increase in symptoms while fears and somatic symptoms abated the most quickly. Family support clearly assisted recovery the most while certain court experiences tended to delay recovery of negative symptoms post-abuse

Many symptoms after abuse are due to the way children think and perceive themselves and their situation. Research significantly support the fact that victims of serious maltreatment and abuse often manifest a low self-esteem which is exemplified by subjects describing themselves as less competent, inadequate, and partaking in self-blame, self-denigration, and low self-efficacy (Diehl & Pront, 2002). Child sexual abuse hinders the development of self-efficacy through negative self-evaluations and negative core beliefs. These negative actions to the self are exacerbated by negative and injurious coping mechanisms that child victims of abuse use.

Disengagement and avoidant defense mechanisms can be very harmful to abuse survivors. These coping strategies are employed frequently by child abuse victims but are associated with poorer adult adjustment later in life (Coffey, Leitenberg, Henning, Turner, & Bennett, 1996). For this reason, survivors of child sexual abuse should be counseled that the use of such disengagement coping methods, though apparently helpful immediately after the abuse, may prove harmful in the long run.

Long Term Effects of Child Sexual Abuse

The most frequently noted long-term effects of child sexual abuse are self-destructive behavior, depression, anxiety, low self-esteem, inability to trust others, feelings of isolation and stigma, sexual maladjustment, as well as tendencies toward revictimization and substance use (Finkelhor, 1990). Sexually abused children often develop into adults who use ineffective emotional-regulation strategies (Diehl & Pront, 2002). Emotion-focused coping strategies are similar to the symptoms of PTSD and are often used in situations where one believes oneself to have little control.

There are many overall similarities in the manner men and women respond to child sexual abuse in the long-term. In a study performed by Finkelhor (1990), both male and female victims surveyed had more marital disruption, less sexual satisfaction, and lower levels of religiosity than nonvictims. Another research study by Urquiza found that male and female college students who had suffered from abuse in childhood were experiencing high levels of depression, sleep problems, posttraumatic symptoms, low self-esteem, sexual problems, suicidal ideation, and drug use. Only three differences were noted between the sexes in the latter experiment in that women were more likely to be depressed, men expressed the desire to hurt others more, and men expressed a sexual interest in children. This last difference is very interesting as not many investigators ask their subjects about possible sexual interest in children. Results from Urquiza's study strongly supported the hypothesis that male victims may be at higher risk for becoming abusers.

According to findings by Cole & Putnam (1992), incest victims have a strong probability of developing anxious and depressive symptoms in alignment with social and self disturbances. They found that women who were victims of incest have more difficulty trusting adults and peers and experiencing psychological intimacy. These women have less satisfaction in dating and marriage partners and struggle with managing their sexuality. These women also fight with sexual dysfunction and in feeling confident, organized, and proficient at mothering.

Recent studies have begun to explore how different coping strategies women victims of abuse use have long-term impact (Coffey, Leitenberg, Henning, Turner, & Bennett, 1996). Researchers Johnson and Kenkel found in 1990 that use of wishful thinking and substance use as means for coping with the adolescent abuse were associated with greater psychological distress. Likewise, Leitenberg, Greenwald, and Cado learned in 1992 that poor psychological adjustment resulted from women who used avoidant or emotion-suppressing coping strategies to deal with their childhood abuse.

Poor attachment with parents has been names a new culprit to long-term impact of sexual abuse (Spaccarreli, 1994). Oftentimes, sexual abuse is associated with an insecure or disorganized attachment of the victimized child with at least one primary caregiver. The variety of symptoms seen in adult survivors of abuse is consistent with the effects of reactive attachment disorder. Spaccarrelli (1994) has linked specific subcategories of disturbed attachment to certain types or levels of abuse symptomatic outcome. Resistant attachment would lead an adult survivor to employ an approach-oriented coping style that focuses on love relationships, overidealizing partners, and adopting negative view of oneself. This resistant attachment often leads to symptoms of anxiety and depression that are typical of child sexual abuse victims.

Last year, a very interesting aspect of the long-term effects of child sexual abuse was investigated. Six couples were interviewed about their perceived effects of the child abuse for self and partner and their perceptions regarding their awareness of these effects (Wiersma, 2003). Wiersma investigated the marked personal and relationship distress experienced by the romantic partners of childhood sexual abuse survivors. It is believed that partners of primary survivors may become, in effect, "secondary victims" of the abuse experienced by their beloved. Speculation about the effects of secondary sexual trauma is based almost exclusively on informal clinical reports of males as adjunct participants in the therapy of female partners who have been raped

Results found were that both primary and secondary survivors of abuse have a lack of self-efficacy in expressing how they are effected by the abuse (Wiersma, 2003).

Present findings also suggest that primary survivors may be unmotivated to disclose abuse-related effects to their partner, assuming that their partner already know about the effects. Many primary victims experience distress and fear in regards to over-burdening their loved one with disclosure, also fearing their partner may be uninterested in the information. And much as primary survivors may suppress past abuse and its effects on self, secondary survivors may make efforts to block out a partner's past abuse and the effects on that partner. Wiersma's results suggest that premature attempts to share abuse-related responses may be unfruitful, or even damaging, particularly if either partner is not sufficiently advanced in the healing process to recognize and label his or her abuse-related responses.

Treatment of Child Abuse

According to Filkenhor (1990), the classic PTSD case occurs as a result of "an overwhelming event resulting in helplessness in the face of intolerable danger, anxiety and instinctual arousal". Clearly, manly child abuse victims suffer from post traumatic stress disorder as they reel from the inability to understand the magnitude of the personal violation that they have experienced. Children with PTSD often exhibit symptoms of extreme anxiety, panic, and fears, numbing and helplessness, bedwetting, increased irritability and aggressiveness, exaggerated startle response, sleep disturbances, and dissociative behaviors (Vander Zanden, 2003 & Bonanno, 2004).

For centuries, practitioners have linked violent or life-threatening events with psychological and physiological dysfunction and, finally, there is now considerable support for the usefulness of interventions with individuals meeting PTSD criteria (Bonanna, 2004). To help child sexual abuse victims reduce their stress, therapists and families need to restore a sense of security and safety for the child (Vander Zanden, 2003). Cognitive-behavioral treatments that aim to help traumatized individuals understand and manage the anxiety and fear associated with trauma-related stimuli have proved the most effective (Bonanno, 2004). Child-trauma experts suggest that art and play therapy illuminate the child's inner turmoil and distress, in contrast to conventional adult talk therapies (Vander Zanden, 2003). Some children need longer-term therapy before they experience a reduction in distress symptoms.

Studies show that anywhere from 10% to 24% of child sexual abuse victims appear to get worse over time (Bonanno, 2004). Sometimes symptoms abate for periods of time. Though research has located a long list of correlates of improvement over time, few of these correlates have been demonstrated in more than one study. Interestingly enough, neither age, nor gender, race, or socioeconomic status strongly factor in child recovery of abuse.

Is psychological intervention effective with children and adolescent victims of sexual abuse?

Historically, researchers have struggled to locate which symptoms respond best when targeted for monitoring and treatment (Anderson, 1997). This problem is exacerbated by the fact that children are not completely reliable informants about their own mental states, as their self-awareness, vocabulary, reasoning, and metacognitive abilities are still developing. Also, it is difficult to locate such symptoms as child abuse victims are not usually referred to treatment for emotional or behavior problems but for the fact that sexual abuse is either suspected or has been identified.

Improvement due to psychological intervention for child abuse victims is dependent on the efficacy of the treatment, the nature and severity of the child's impairment, and the level of functioning of the adults whom care for the patient (Anderson, 1997). Issues of parental mental health or marital discord, as well as basic family functioning, community and cultural factors, and other stressful life events all influence the degree to which a child can improve and remain improved. A major factor in treatment outcome was found to be the parental belief and support that the abuse did indeed occur to their child. It is hard to treat children living in multiproblem homes as these children may be experiencing other domestic and community violence beyond the sexual abuse in their history. Also, high spontaneous remission rates also make it difficult to evaluate treatment outcome. Lastly, research designs are complicated and confounded by the symptoms that change within child abuse victims as they move through different levels of biological and societal development (Anderson, 1997).

In the last 25 years, substantial support from research was found for employing professional behavioral and cognitive-behavioral interventions with children and adolescents suffering from behavior problems, anxiety-related symptoms, and depression (Anderson, 1997). Some confounding factors have been located in such children undergoing treatment, indicating that certain therapies can only be employed when circumstances and child capabilities allow them. For example, Target and Fonagy found that it is impossible to conduct family therapy while children are moving constantly for foster care placements. Another confounding factor to treatment is that children who have not been abused display the same classic symptoms of child sexual abuse as its victims exemplify. Past meta-analyses have demonstrated that psychosocial therapies are more effective for children and adolescents suffering from child sexual abuse than the passage of time alone (Anderson, 1997). It is possibly efficacious to treat child and adolescent externalizing behaviors of depression, anxiety and poor coping skills with cognitivebehavioral therapy (CBT), parent management training, and coping skills training. Though behavioral approaches may not be best for all types of children dealing with varied problems, research has generally supported the use of behavioral therapy and CBT over nonbehavioral therapies for child psychotherapy.

Outcome Studies of Child Sexual Abuse Treatment

Most studies of successful child sexual abuse treatment have focused on abuse-specific therapies such as family involvement, coping skills training, and cognitive-behavioral techniques in conjunction with psychoeducational interventions (Anderson, 1997). These prior studies have all displayed a significant improvement in the lives of these sexually abused and treated children over time. However, it is still unclear as to whether this displayed improvement is due to the actual treatment and not other factors outside of the treatment. Also, time has been founded to help all sexually abused children, those whom have had treatment and those that have not. One important point found throughout these studies is that not all sexual abuse victims respond to treatment.

The most recent wave of studies has suggested that all forms of treatment provided relief of PTSD symptoms and the use of CBT to the nonoffending parents resulted in great improvement to child depressive symptoms and overall parenting skills (Anderson, 1997). Research completed by Cohen and Mannarino, as cited in Anderson (1997), found that abuse-focused CBT has an overall stronger effect on sexually inappropriate behaviors, internalizing and externalizing symptoms, and PTSD symptoms than nondirective supportive therapy. There still remains one pressing problem in the psychological field that is greatly expressed by Anderson (1997) who stated, “{there} remains the need to study children who initially present with no or few symptoms. Informed policy decisions about who should be offered what kinds of services demand a better understanding of how asymptomatic children who have been sexually abused respond to the abuse and to treatment over time“ (p. 598) . Protective factors of Child Sexual Abuse

Resiliency-

Wolin and Wolin, as cited in Anderson (1997), proposed that resiliency occurs in three life stages: childhood, adolescence, and adulthood. These areas represent clusters of strengths that interact with one another to help people survive adverse experiences. Their seven proposed themes are insight, independence, initiative, relationships, morality, creativity, and humor. These themes of resilience provide a conceptual framework for practitioners who are interested in uncovering strengths in sexually abused children while validating and discussing their trauma. Mental health practitioners can use these seven resiliencies as guidelines to identify and support the strategies that their abused clients use and have used to manage their sexual abuse. It is very important that counselor’s remember that the recovery process is different for every client.

Insight-

Children typically sense that something is not right with their family but they do not possess the maturity to describe what is wrong (Anderson, 1997). Insight allows the child to understand that his or her family is "not what it's supposed to be" (Spaccarrelli, 1997). Families may blame victims for the abuse they have suffered or may completely deny its occurrence (Anderson, 1997). Over time, a child will realize that the sexual abuse was not an expression of love and through emotion, intellectual, and social development, will be able to verbalize the injustice that has occurred.

Independence-

A very successful coping strategy for child sexual abuse victims is to immerse themselves in individual activities outside of their family environment where they can gain confidence and affirmation (Anderson, 1997). Such an action is an example of independence. While participating in outside activities, a victim of abuse is actively distancing him or herself emotionally from the dysfunctional family. This distance allows for the child to grow and heal.

Initiative -

“Initiative occurs through taking risks to make one's life controllable despite the sexual abuse,” stated Anderson (1997, p.599). Here, children experiment to try to learn what parts of their family are controllable and what aspects are not. Songs examples of initiative are planning for the future when he or she is an adult, hoping that the abuse will one day end, and belief in God. Ultimately, the child’s initiative will show how much he or she is striving to protect him- or herself.

Relationships-

According to Anderson (1997), children may build on family relationships during periods of calm and distance themselves during periods of chaos. Such distance has already been described as a major resiliency factor for child sexual abuse victims but the relationships that children create are another. Sometimes abuse victims seek other positive adult relationships with teachers, youth pastors, and the parents of their childhood friends. Dolls and pets are another solution for a positive relationship outside of the abusive relationship in the child’s life. It is essentially important that these children find alternative family members and role models that will allow them to feel control in essential relationships in their lives.

Morality-

Morality is defined by Anderson (1997) as the expression of an informed conscience and is demonstrated through empathy, compassion, and caring toward others. As child sexual abuse victims realize that they have received an imperfect family, they often fight to find justice and compassion for other hurting individuals. The actions of these victims are best summed up by Anderson (1997) who stated, “during adolescence, children's morality may be channeled into fighting for justice at home by protecting younger family members and standing up to their perpetrators. They may sacrifice their bodies to prevent their siblings from being molested. Or they may rebel against the rules and demands of the perpetrator, such as curfew or dating restrictions” (p. 599).

Creativity and Humor-

A victim of child sexual abuse can channel their pain into creative and humorous expressions (Anderson, 1997). Young victims of abuse may manage their destructive environment through imaginative play. Therapists use play therapy to aid these young victims as it helps the children to cope with the real-life trauma in a slightly detached manner. Abused children often fantasize about a different life where they are protected from harm. As children grow through adolescence, their child’s play is refined into more concentrated creative activities and their sense of humor greatly develops. Beyond play, abused youth may draw, write, sing, play music or sing, or act on the stage to deal with their grief.

Werner, as described in Rak & Patterson (1996), identified several additional factors in the lives of resilient children. One factor is the actual temperament of the abused individual. Another is a positive attached relationship with a caregiver in the first year of life. Since many children are not devastated for life after experiencing child sexual abuse, it is extremely important for psychologists to find what exactly protects those victims from the hazards they face.

Personal Characteristics of Resilient Children

In the 1970s, a group of astute and sensitive psychiatrists and psychologists came together to investigate the phenomenon of resilience in children at risk for psychopathology due to genetic and experiential circumstances, drawing the attention of many scientists (Masten, 2001). These pioneers believed that finding what characteristics of personality and circumstance provided resilience in children surviving risk and adversity would provide much information on future intervention and policy. Resilience appears to occur as a natural phenomenon in the basic human adaptational system. According to Masten (2001), “If those systems are protected and in good working order, development is robust even in the face of severe adversity; if these major systems are impaired, antecedent or consequent to adversity, then the risk for developmental problems is much greater, particularly if the environmental hazards are prolonged” (p. 251).

In 1993, Wolin and Wolin, broadened the definition of resilience in the field of psychology to include the specific individual characteristics that develop in children surviving adversity (Anderson, 1997). They emphasized that resiliency can occur in any person enduring hardship and that it is not limited to persons who escape risk with few problems. People who have survived traumatic childhoods are considered resilient because they have enduring strengths that developed throughout their lives to protect themselves from their troubled experiences. Their resilience is based on their survival abilities. The resiliency of sexually abused children is grounded in how they managed the traumatic experience, with or without the assistance of others.

Resilience refers to a class of phenomena characterized by good outcomes in spite of serious threats to adaptation or development (Masten, 2001)..Resilient individuals are those that have had a significant threat to their development. Many times, the risk factors that determine a resilient individual include actual predictors of undesirable outcomes found in past psychological research. Many risk factors, such as a child growing up in a violent alcoholic home, are well-established statistical predictors of subsequent developmental problems.

Two major psychological approaches have characterized the resilience studies aimed at explaining the variation in outcomes among high-risk children (Masten, 2001). Multivariate statistic tests are used in Variable-focused approaches to test for linkages among measures of the degree of risk or adversity, outcome, and potential qualities of the individual or environment that may function to compensate for or protect the individual from the negative consequences of risk or adversity. Person-focused approaches compare different person’s profiles within or across time to ascertain what differentiates resilient children from children who are apparently un-resilient. The variable focus approach often maximizes statistical power and is well suited to locating predictors of outcomes that can later be used to formulate treatment interventions. This approach, however, may fail to grasp distinctive regularities among real people that can indicate who is at a greatest risk or needs a particular intervention. The person focus approach is very useful in locating common and uncommon patterns of living through time that may result from multiple benefits or constraints on development. However, person-focused approaches can obscure specific linkages that provide essential clues to explanatory processes (Masten, 2001).

Many longitudinal studies have provided perspectives on the critical developmental personality factors that distinguish resilient children from those who become overwhelmed by the risk factors in their lives Rak & Patterson (1996). A significant large number of resilient children have been the first born in their families. These individuals recovered more quickly from childhood trauma and were rememberd by their mothers as having been active and good-natured infants. Some other personality factors of children that are hardy to risk factors are those who have an active and creative approach toward problem-solving, a positive and likeable temperament, a natural ability to gain others‘ positive attention, a tendency to seek novel experiences, an ability to maintain a positive outlook on life and an optimistic view of their current experiences in the midst of suffering, an ability to be alert and autonomous, and a proactive perspective in life. Also, better intellectual abilities have been found to protect school-age children from developing conduct disorders in the face of highly adverse circumstances (Masten, 2001).

Variable-focused studies have found that parenting qualities, intellectual functioning, socioeconomic status, and positive self-perceptions have broad and pervasive correlations with multiple domains of adaptive behavior (Rak & Patterson, 1996). Resilience investigators have concluded that parenting quality has protective power for children exposed to risky environments (Masten, 2001). In severe adversity, poor parenting and cognitive skills have increased bad outcomes in many tests for such children.

There is an array of family factors that contribute to a buffering effect on children in the wake of everyday and severe stressors (Rak & Patterson, 1996). Some of the most salient factors are the age of the opposite-sex parent, four or more children in the family spaced more than 2 years apart, an array of alternative caretakers in the life of the child, an attached nurturing relationship in the first year of life with little separation from the primary caretaker, exposure to a multiage network of kind who provide counseling and support to the child on values and beliefs, the presence of a structured household with rules for the child to follow during adolescence despite poverty or stress, and the availability of a sibling caretaker or another young person with whom the child can have a strong confidant relationship.

Variable-oriented and person-oriented studies of resilience converge to provide information concerning the at-risk youth and the environment outside the family that has repeatedly been found to provide competence and psychopathology (Masten, 2001). Role models outside of the family act as buffers for such vulnerable child (Rak & Patterson, 1996). Persons who can greatly effect the life of an at-risk child include, but are not limited to, school counselors, neighbors, teachers, coaches, scout leaders, workers in community centers, mental health workers, supervisors in after-school programs, and clergy. Resilient children in these studies often had a number of mentors outside the family throughout their development. Masten (2001) makes a strong point in regards to minority children who are additionally at-risk in life by stating that minority youth need to be taught to “reject rejection”, to pursue the help of others in their environment even if they do not at first sense a welcoming.

Besides the buffering factors of temperament and family and environmental support, research has shown self-concept and self-esteem to play a role in resiliency. According to Rak & Patterson (1996), the capacities to understand self and self-boundaries in relation to long-term family stressors like psychological illness, to enhance positive self-esteem as a result of adaptive life competencies, and to steel oneself in the wake of stress all act as protective factors for at-risk youths. Some of these personal protective factors include cognitive and self-regulation skills, positive views of self, and intrinsic motivation to be effective in the environment (Masten, 2001; Rak & Patterson, 1996). Rak and Patterson (1996) found in their studies that when stressful events do not overwhelm the ability to cope, the victory over adversity for the child actually enhances a sense of self-competence which increases self-esteem.

Additional Protective Factors

There are many other protective factors that positively act in the lives of children who have been exposed to child sexual abuse. Following, each of these factors will be described briefly. Locus of control

The effects of violence and abuse for children can vary in mode (e. g. , direct victimization, indirect—or vicarious—exposure, witnessing, residence in dangerous communities) and in locus (e. g. , family versus community) (Barbarin & Richter, 2001). According to Phillips and Gully (1997), locus of control is a personality attribute reflecting the degree to which one generally perceives events to be under their control (internal locus) or under the control of powerful others (external locus). People who feel in control of a situation experience a sense of empowerment (Vander Zanden, 2003, p. 341). Likewise, individuals with a high sense of mastery believe that they can control most aspects of their lives, but those who are unable to gain mastery, to exert influence over their circumstances, feel helpless. In studies by Ryan & Deci (2000), a woman’s perception of control over the situation or her body, or lack thereof, were found to be the core of trauma manifesting after childhood sexual abuse.

Internal control typically increases with the age of a child. (Vander Zanden, 2003). Scores on psychological measures of internal/external control tend to be relatively external at the third grade level with internality increasing by the eighth and tenth grades. Empirical studies report mixed findings on the subject of locus of control but, in general, the magnitude of an individual’s locus of control (LOC) is dependent upon the duration of the abuse, with longer durations leading to more externalized LOC (Phillips & Gully, 1997). Learning goal orientation has been associated with a higher need for achievement and an internal LOC.

MotivationMotivation concerns all aspects of activation and intention, including energy, direction, persistence and equifinality (Ryan & Deci, 2000). People are moved to act according to very different types of factors with highly varied experiences and consequences. The term extrinsic motivation refers to the performance of an activity in order to attain some separable outcome while intrinsic motivation refers to doing an activity for the inherent satisfaction of the activity itself. Intrinsic motivation involves the inherent tendency to rise to challenges, seek out novel experiences, to explore and learn, and to exercise one’s capacities. Much of what people do prior to childhood is geared by extrinsic motivation speared on by social pressures. Motivation has been found to be a key factor in the resilience of child sexual abuse victims. Self-determination

Persons who possess qualities that make up self-determination are said to be more resilient to child sexual abuse (Ryan & Deci, 2000). Persons that are energized to work hard against the roadblocks of life and are self-motivated are said to be self-determined. A person who has self-determination is able to move successfully within and between person differences in a variety of social situations and therefore has a advantage over other individuals who are struggling to survive in life. The Self-Determination Theory investigates people’s inherent growth tendencies. innate psychological needs, and personality integration that fosters these positive adaptive processes. The needs of competence, autonomy, and relatedness appear to be the most essential factors present in the lives of self-determined individuals to provide optimal functioning, constructive social development, and personal well-being. Self-Efficacy

According to Diehl and Prout (2002), sexual abuse and any form of maltreatment limit a child's coping resources as well as hinder his ability to use a variety of coping strategies. The very symptoms of child sexual abuse and PTSD interfere with developing or maintaining a sense of self-efficacy. Self-efficacy has been defined as the belief of one’s ability to succeed or a sense of agency that assures the individual that the will perform successfully in life. Later in life, self-efficacy includes one‘s authorship over his or her actions, thoughts, and emotional experiences, that one has volition and control over his or her behavior, and that he or she alone is the architect of his or her life.

Beginning in middle childhood, maltreated children report that they are less competent and accepted than non-maltreated peers of the same socioeconomic status (Diehl & Prout, 2002). Physical, sexual, or psychological abuse disrupts the capability to develop certain cognitive components of the self, such as self-efficacy. Instead of developing skills of self-awareness and the ability to attend to one’s needs, dreams, and feelings, the abused child is forced to focus on external thoughts to his or her livelihood. Also, child abuse victims often berate and blame themselves for their abuse and they are particularly unlikely to use healthy emotional-regulation skills to seek social support or advice for problem-solving in their lives. Much research has shown a high correlation between self-efficacy and better emotional health.

Self-efficacy is believed to reflect both an interval’s self-motivation and positive self-regard of personal abilities (Phillips & Gully, 1997). An individual’s self-efficacy has been found to affect personal goal level, with individuals who possess greater self-efficacy setting higher goals and obtaining higher performance successes. Self-efficacy has been found to contribute to performance above and beyond both ability and goal level. Of interesting import, little research has been completed to determine what causes certain individuals to set higher goals than their peers. Some researchers have proposed that possible key factors of self-efficacy are vicarious experiences, past performance, psychological states, and verbal persuasion. Still such factors of performance goal orientations, learning, and locus of control are unknown in the area of personal self-efficacy.

Hardiness

Hardy individuals are said to be more confident and better able tu use social support and active coping skills in the face of distressing or traumatic situations (Bonanna, 2004). A growing body of psychological research is showing that the personality trait of hardiness helps to buffer individuals to extreme distress. Hardiness is said to consist of three dimensions. One, the ability to find meaning or purpose to life. Two, the belief that one can influence his or her surroundings and the outcomes of events. And three, the belief that one can learn and grow from either positive or negative life experiences. Some adult victims of abuse found to be more hardy possessed a good sense of humor and often repressed their memories of their traumatic childhoods. Bonanno (2004) suggests that much research in personal hardiness in needed in connection with child abuse recovery. Religion

Religion and spirituality¹ are integral components in the lives of many individuals within the United States with approximately 95% of adults within the union stating their belief in God and 88% reporting that they pray to God on a regular basis (Tix & Frazier, 1998). Religious coping has been defined as the use of cognitive or behavioral techniques, in the face of stressful life events, that arise out of one's religion or spirituality. Religious coping involves searching for comfort, reassurance, and guidance through God (Krause, 1998). Some religious coping activities include confessing one's sins, prayer, and seeking strength and comfort from God in response to a particular stressful event. One of the truths of religion is that it helps people to cope with the adversity in their lives.

Some hypotheses of why religion helps people cope in tough times are that religion replenishes feelings of personal control and self-worth and that often other parishioners provide assistance during traumatic times (Krause, 1998). This author also believes that faith in God provides a quiet confidence that someone else is in control of life and will safely see each individual through the hardest of storms that undoubtedly helps believers to see traumas through to the end. There is some research that provides support for religion being a key factor in dealing with some of life’s most traumatic events, such as the Oklahoma City bombing. An odd fact is that, even though religion is such an important aspect to he lives of American citizens and people around the world, there is a meager amount of research that seeks to understand the role of religion in coping. In fact, Tix and Frazier (1998) performed a literature search of the PsycINFO database using the key words "coping" and "coping and religion and found that only about 1% of all articles on coping with stressful life events included a religion component.

Conclusion

There have been many constraints and issues in research of the effects of child sexual abuse and the resiliency factor of its victims. One issue in studying this topic is that researchers have often grouped victims of all childhood development stages together in order to discuss symptoms (Bonanno, 2004). Doing this can mask symptoms or confuse certain characteristics that may not actually be due to the sexual abuse. In the future, researchers should make sure to always break subject groups down to the preschool, school, adolescent, and young adult age ranges to assure for true effect and results within their studies. For studying adults who were abused as children, it would probably be wise to group this subjects by age as well, perhaps for people in their twenties, thirties, forties, and so forth. Developmental Psychology has shown that persons of the same age share similar life events and environmental conditions and maintaining adult subjects in groups of their genre will allow for a minimum of outside differences effecting research outcomes.

Since certain intimacy or sexual problems can emerge for child victims of sexual abuse with growth and age, it would be wise to perform tests on subjects of child abuse at varying time in life to view the true effects of their traumatic experiences (Bonanno, 2004). Often researchers have performed a one-shot test that only shows the effects of abuse at that specific time in the subjects’ lives. However, there are many costs and difficulties inherent to longitudinal studies of child abuse. Considering all of these factors, it would appear wise to perhaps only study subjects at ages fifteen, thirty, forty-five, and sixty. This testing procedure would be limiting in cost but would provide a broad example of the effects of child sexual abuse.

Regarding the issue of how people show effects of child sexual abuse through life, Saywitz, Mannarino, Berliner, and Cohen (2000), suggest that researchers create measures with different norms and forms of collection. Some examples of these measures would be those that differ in gender, socioeconomic status, reading and writing ability, age, vocabulary level, and location. Of course, if a limited longitudinal study as described above were to be used to research this topic, the same modes of information allocation need to be employed each time throughout the research process.

There is a major issue with any form of childhood trauma that can effect research which is subject recollection, conscious or unconscious suppression of memories, and possible intentional misrepresentation for personal gain (Bonanno, 2004). To this date, there is no reliable way of knowing if subjects are committing any one of these actions. One suggestion for avoiding intentional misrepresentation would be to not provide monetary supplements for research participation. Another issue to consider is whether the researchers are considered mandatory reporters or not. If subjects know that we have to report abuse that is disclaimed they may falsely state that someone abused them to bring problems against another individual with whom they have relationship issues.

One report has found that older women report less molestation or child sexual abuse than do younger women (Bonanno, 2004). This action may be due to embarrassment or viewing the sexual abuse as more stigmatizing. Due to this finding, research studies should focus initially on young adults or new adults to hopefully access the most accurate number of victims of child sexual abuse in the area that is being studied.

There is still much research that needs to be completed on the issue of personal resiliency after child sexual abuse. It is of great interest to this author to further these studies and focus on resiliency factors that occur in families where multiple siblings were abused but whom reacted differently to that abuse. It will be of great import to the field of Psychology and to counseling to find out what external, internal, and direct factors allow some individuals to rise above their abuse experience while their siblings do not, all factors of environment, socioeconomic status, gender, and race being identical. This author plans to complete this proposed study for her final research project while obtaining her Master’s degree in Educational Psychology with Capella University.