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Cited by 140Child Abuse and TraumaSexual Assault and Victimization StudiesMilitary, Security, and Education Studies

Psychological injury in victims of child sexual abuse: a meta-analytic review

Open access
Amado, Bárbara G., Arce, Ramón, Herraiz, Andrés·2015·Psychosocial Intervention
DOI 10.1016/j.psi.2015.03.002
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Abstract

In order to assess the effects of child/adolescent sexual abuse (CSA/ASA) on the victim's probability of developing symptoms of depression and anxiety, to quantify injury in populational terms, to establish the probability of injury, and to determine the different effects of moderators on the severity of injury, a meta-analysis was performed. Given the abundant literature, only studies indexed in the scientific database of reference, the Web of Science, were selected. A total of 78 studies met the inclusion criteria: they measured CSA/ASA victimization or injury in terms of depression or anxiety symptoms, measured the effect size or included data for computing them, and provided a description of the sample. The results showed that CSA/ASA victims suffered significant injury, generally of a medium effect size and generalizable, victim shad 70% more probabilities of suffering from injury, and clinical diagnosis was significantly a more adequate measure of injury than symptoms. The probability of chronic injury (dysthymia) was greater than developing more severe injury, i.e., major depressive disorder (MDD). In the category of anxiety disorders, injury was expressed with a higher probability in specific phobia. In terms of the victim's gender, females had significantly higher rates of developing a depressive disorder (DD) and/or an anxiety disorder(AD), quantified in a 42% and 24% over the baseline, for a DD and AD respectively. As for the type of abuse, the meta-analysis revealed that abuse involving penetration was linked to severe injury, whereas abuse with no contact was associated to less serious injury. The clinical, social, and legal implications of the results are discussed.

AI snapshot

Written from the paper’s full text.

TL;DR

This meta-analysis of 78 studies (19,360 subjects; 149 effect sizes) found that child/adolescent sexual abuse victims had significant, generalizable, medium-sized psychological injury in depression and anxiety, with about 70% higher probability of internalizing injury than non-victims. Clinical diagnosis was more sensitive than symptoms, dysthymia exceeded major depression, specific phobia was highest among anxiety disorders, females showed higher diagnosed depression/anxiety, and penetrative abuse was linked to greater injury than no-contact abuse.

Key findings

  • CSA/ASA victims showed significant, positive, generalizable injury of medium size: victims had a 70% higher probability (CLES) of general internalizing injury than non-victims, 66% for depression, and 68% for anxiety; injury was quantified as 34%, 28%, and 31% for general sequelae, depression, and anxiety, respectively. The paper reports that 93 studies with non-significant results would be required to accept the null hypothesis.
  • Clinical diagnosis was a significantly more adequate measure of injury than symptoms: anxiety diagnosis vs. anxiety symptoms, q_s = 0.152, p < .01; depressive diagnosis vs. depressive symptoms, q_s = 0.108, p < .05. Dysthymia had an odds ratio of 6.59 vs. 3.25 for major depression, with injury of 46% vs. 31%, and the difference was significant, q_s = 0.176, p < .01. Specific phobia had the highest anxiety-disorder odds ratio (7.62) and injury (49%), significantly higher than social phobia (q_s = 0.112, p < .05) and generalized anxiety disorder (q_s = 0.100, p < .05).
  • Gender moderated diagnosed outcomes: female victims had 42% injury for depressive disorder and 24% for anxiety disorder, with odds ratios of 5.40 and 2.43 vs. non-victims; male victims had 10% and 14%, with odds ratios of 1.44 and 1.66. Depressive disorder effects were significantly higher in females, q_s = 0.093, p < .05, and anxiety disorder effects were significantly higher in females, q_s = 0.104, p < .05; anxiety symptoms were significantly higher in males, q_s = 0.095, p < .05, with odds ratios of 2.76 for males vs. 1.95 for females.
  • Abuse involving penetration was linked to significantly greater injury than no-contact abuse for depression, q_s = 0.093, p < .05, and anxiety, q_s = 0.092, p < .05.

Methods

  • Meta-analysis of studies indexed in Web of Science, restricted to publications since 1995; 78 studies met inclusion criteria, totaling 19,360 subjects and 149 effect sizes (62 for anxiety, 87 for depression). Inclusion required measurement of CSA/ASA victimization or injury in terms of depression/anxiety, effect-size data or computable statistics, sample description, ground truth for abuse classification, and mutual exclusion from other maltreatment.
  • Main analysis used a correlational meta-analytic procedure (Hunter & Schmidt, 2004), weighting effect sizes by sample size and correcting for predictor and criterion reliability. Various statistics were converted to correlations, Cohen’s d, or Hedges’ g; U1, odds ratio, and CLES were calculated; outliers ±2 SD were removed, eliminating 6 studies.
  • Moderators examined were gender, type of measure (clinical diagnosis vs. symptoms), type of abuse (no contact, contact, penetration), and the interaction of type of measure and gender.

Limitations

  • Stated in the paper: primary studies’ abuse classification generally rests on retrospective self-report, with memory limitations and false positives/false negatives, especially for males; primary studies assume injury is sequelae to abuse without appraising other possible causes; effects were not completely isolated from physical abuse, neglect, and other categories; and some studies lacked control groups, so the normative population was used as contrast, potentially distorting effect sizes.
  • Stated in the paper: some moderator analyses had very small k (e.g., male anxiety disorder diagnosis k = 4; specific phobia k = 3), and the paper notes that moderators could not be assessed in some cases and further research is required.
  • Evident from the text: inclusion was restricted to Web of Science-indexed, post-1995 studies and English/Spanish descriptors, which may limit coverage; several meta-analytic cells show low %VE (e.g., 2.82% for general sequelae), indicating substantial unexplained heterogeneity.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.psi.2015.03.002

Cites

111 of 111 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 29 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    In the category of anxiety disorders, injury was expressed with a higher probability in specific phobia.

    “In the category of anxiety disorders, injury was expressed with a higher probability in specific phobia.”
    • Also stated in: § Discussion · plain
      “being the highest in specific phobias.”
    Quote in the paperNot a substantial claim
  • Findingreasoning

    Clinical diagnosis was significantly a more adequate measure of injury than symptoms.

    “clinical diagnosis was significantly a more adequate measure of injury than symptoms”
    • Also stated in: § Discussion · plain
      “Clinical diagnosis was a measure of injury significantly more ade quate than symptoms.”
    Quote in the paperSubstantial claim
  • Findingown data

    The probability of chronic injury (dysthymia) was greater than developing major depressive disorder (MDD).

    “The probability of chronic injury (dysthymia) was greater than developing more severe injury, i.e., major depressive disorder (MDD).”
    • Also stated in: § Effects of the type of measure. · plain
      “the effect size for the diagnosis of dysthymia was significantly larger than for major depressive disorder.”
    • Also stated in: § Discussion · plain
      “the probability of chronic injury (dysthymic) was greater than more serious injury (major depressive disorder).”
    Quote in the paperSubstantial claim
  • Findingreasoning

    Females suffered 9% more injury in depression than males.

    “This translates into quantifying injury in females as suffering from 9% more injury in depression than males.”
    Quote in the paperSubstantial claim
  • Findingown data

    The diagnosis of a depressive disorder was significantly more sensitive than the report of depressive symptoms (q_s = 0.108, p < .05).

    “the diagnosis of a depressive disorder was significantly more sensitive, q s = 0.108, p < .05,for CSA/ASA victims than the report of depressive symptoms.”
    Quote in the paperSubstantial claim
  • May combine two claims. 49
  • Classified as probably not a substantial claim. 5

  • May combine two claims.

    Findingown data

    Abuse involving penetration was linked to severe injury, whereas abuse with no contact was associated to less serious injury.

    “abuse involving penetration was linked to severe injury, whereas abuse with no contact was associated to less serious injury.”
    • Also stated in: § Effects of the type of abuse. · plain
      “injury derived from abuse with penetration, both in depression and anxiety, was significantly higher than injury in the no contact abuse condition”
    • Also stated in: § Discussion · plain
      “Abuse with penetration led to injury in depression and anxiety significantly greater than abuse with no contact.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Injury to mental health is sequelae to abuse (cause-effect relationship).

  • May combine two claims.

    Findingown data

    Females had significantly higher rates of developing a depressive disorder (42% over baseline) and an anxiety disorder (24% over baseline) than males.

    “females had significantly higher rates of developing a depressive disorder (DD) and/or an anxiety disorder (AD), quantified in a 42% and 24% over the baseline, for a DD and AD respectively.”
    • Also stated in: § Discussion · plain
      “higher probability of developing a depressive or anxiety disorders in females with injury of 42 and 24%, respectively.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Victims of CSA/ASA had a 70% higher probability of internalizing injury (general sequelae) than non-victims, with 66% for depression and 68% for anxiety.

    “victims had 70% more probabilities of suffering from injury”
    • Also stated in: § Global analysis · plain
      “victims of CSA/ASA had a 70% higher probability (CLES) of internalizing injury (general sequelae) than non-victims, with 66% for depression and 68% for anxiety.”
    • Also stated in: § Discussion · hedged
      “A higher probability, around 70% in each of the different measures, of suffering from internalized injury, depression, and anxiety.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Injury to mental health is sequelae to abuse (cause-effect relationship).

  • May combine two claims.

    Findingown data

    CSA/ASA victimization had a significant positive effect on mental health (injury), of medium effect size, generalizable.

    “The results showed that CSA/ASA victims suffered significant injury, generally of a medium effect size and generalizable”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Injury to mental health is sequelae to abuse (cause-effect relationship).

  • May combine two claims.

    Findingown data

    The effect sizes in depressive symptoms were significant, positive, small, generalizable, and similar (ns) for both males and females.

    “The effect sizes in depressive symptoms were significant, positive, of small sizes, generalizable, and similar (ns) for both males and females.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    For the diagnosis of anxiety disorders, effect sizes were positive, significant, and small for both males and females, generalizable for females but not for males.

    “for the diagnosis of anxiety disorders the effect sizes were positive, significant, and of a small size for both males and females, generalizable for females, but not so for males”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The meta-analysis of major depressive disorder and dysthymia confirmed a significant positive medium effect, generalizable.

    “The meta-analysis of major depressive disorder and dysthymia (persistent depressive disorder) nesting in the diagnosis of depression (see Table 5), confirmed a significant and positive effect, of a medium size, and generalizable.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingreasoning

    Male CSA/ASA victims had a 2.76 probability (odds ratio) of developing significantly more anxiety symptoms than male non-victims, and female victims a 1.95 probability than female non-victims.

    “male CSA/ASA victims had a 2.76 probability (odds ratio) of developing significantly more anxiety symptoms than male non-victims, and female victims a 1.95 probability than female non-victims.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In the diagnosis of depressive disorders, effect sizes were positive and significant for both males and females, small for males and medium for females, generalizable for females but not for males.

    “In the diagnosis of depressive disorders (see Table 7), the effect sizes were positive and significant for both males and females, of a small size for males and a medium one for females, which were generalizable for females, but not for males”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingreasoning

    Female victims had 2.43 (odds ratio) more probability of developing anxiety disorders than female non-victims, and male victims 1.66 more probability than male non-victims.

    “female victims had 2.43 (odds ratio) more probability of developing anxiety disorders than female non-victims, and male victims 1.66 more probability than male non-victims.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Injury quantification was 46% for dysthymia and 31% for major depression.

    “In terms of injury quantification, it was of 46% for dysthymia and 31% for major depression.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Injury derived from abuse with penetration was significantly higher than injury in the no contact abuse condition for depression (q_s = 0.093, p < .05) and anxiety (q_s = 0.092, p < .05).

    “injury derived from abuse with penetration, both in depression and anxiety, was significantly higher than injury in the no contact abuse condition for depression, q s = 0.093, p < .05,and anxiety, q s = 0.092, p < .05.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The meta-analysis on generalized anxiety disorder, specific phobia, social phobia, and panic disorder found a significant positive medium-to-large effect, generalizable for every diagnosis.

    “the meta-analysis on generalized anxiety disorder, specific phobia, social phobia, and panic disorder were nested in anxiety disorders (see Table 5) found a significant and positive effect, of a medium to large, and generalizable for every diagnosis.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Male CSA/ASA victims showed a significant positive small effect in depression and anxiety, generalizable in depression but not in anxiety.

    “the meta-analysis revealed for male CSA/ASA victims a significant effect, positive, and of a small size in depression and anxiety, being generalizable in depression, but not so in anxiety”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The injury caused was quantified as 34%, 28%, and 31% in general sequelae, depression, and anxiety, respectively.

    “The injury caused was quantified as 34, 28, and 31% in general sequelae, depression, and anxiety, respectively.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Injury to mental health is sequelae to abuse (cause-effect relationship).

  • May combine two claims.

    Findingown data

    The true correlation between female and male participants for sequelae in depression was significantly higher in females (q_s = 0.093, p < .05), but not for anxiety (q_s = 0.073, ns).

    “the true correlation between female participants and male participants, sequelae in depression was found to be significantly higher, q s = 0.093, p < .05, in females, but not so for anxiety, q s = 0.073, ns.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The probability of developing these disorders as sequelae was similar except for specific phobia, which was significantly higher than social phobia (q_s = 0.112, p < .05) and generalized anxiety disorder (q_s = 0.100, p < .05).

    “The probability of developing these disorders as sequelae was similar except for specific phobia that was significantly higher than social phobia, q s = 0.112, p < .05,and generalized anxiety disorder, q s = 0.100, p < .05.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Female CSA/ASA victims showed a significant positive small effect, generalizable in depression and anxiety.

    “The results of the meta-analysis showed (see Table 4) a significant effect, positive, of a small size (Cohen's category: r = .10),and generalizable in depression and anxiety in female CSA/ ASA victims.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In prevalence rates (odds ratio), injury in depression for female and male victims was 2.26 and 1.60 times greater than for non-victims, and 2.26 and 1.73 times greater in anxiety for female and male victims, respectively.

    “In prevalence rates (odds ratio), injury in depression for female and male victims was 2.26 and 1.60 times greater than for non-victims, and 2.26 and 1.73 times greater in anxiety for female and male victims, respectively, in contrast to non-victims.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Female CSA/ASA victims had a 5.40 (odds ratio) more probability of meeting the criteria of depressive disorders than female non-victims, whereas males had a 1.44 more probability than male non-victims.

    “female CSA/ASA victims had a 5.40 (odds ratio) more probability of meeting the criteria of depressive disorders than female non-victims, whereas males had a 1.44 more probability than male non-victims.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingreasoning

    CSA/ASA victims had 5.12, 7.62, 4.85, and 5.60 (odds ratio) greater probability of developing generalized anxiety disorder, specific phobia, social phobia, and panic disorder, respectively, than non-victims.

    “this implied CSA/ASA victims had 5.12, 7.62, 4.85, and 5.60 (odds ratio) greater probability of developing generalized anxiety disorder, specific phobia, social phobia, and panic disorder, respectively, than CSA/ASA non-victims.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The meta-analysis on type of abuse (no contact, contact, penetration) revealed a significant positive small effect, generalizable in depression and anxiety.

    “The results of the meta-analysis on the type of abuse suffered (no contact, contact, and penetration) revealed a significant and positive effect, of small size, and generalizable in depression and anxiety (see Table 6).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The distributions for victims and non-victims (U1) in general sequelae, depression, and anxiety were totally independent (44%, 37%, and 41% respectively).

    “the distributions for victims and non-victims (U1) in general sequelae, depression, and anxiety were totally independent (44, 37, and 41% respectively), though they were expected to be similar.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The prevalence of dysthymic disorder in victims was 6.59 times higher than non-victims, and 3.25 times higher for major depression.

    “the prevalence of a dysthymic disorder in victims of abuse was 6.59 (odds ratio) times higher than for non-victims, 3.25 higher for major depression.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The effect size for females was significantly higher than for males (q_s = 0.388, p < .01), quantifying injury in 42% for female victims and 10% for males.

    “the effect size for females was significantly higher, q s = 0.388, p < .01,than for males, quantifying injury in 42% for female victims and 10% for males.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The effect size found in females was significantly higher than in males (q_s = 0.104, p < .05), with injury of 24% for female victims and 14% for males.

    “the effect size found in females was significantly higher, q s = 0.104, p < .05,than in males, with injury of 24% for female victims and 14% for males.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Injury was quantified as 41%, 49%, 40%, and 43% for generalized anxiety disorder, specific phobia, social phobia, and panic disorder, respectively.

    “Injury was quantified as 41, 49, 40, and 43% for generalized anxiety disorder, specific phobia, social phobia, and panic disorder, respectively.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    CSA/ASA victimization is associated with anxiety, with a weighted observed correlation of .26 and a corrected correlation of .31 (95% CI .25-.27; 90% credibility interval .10-.52).

    “| Anxiety | 62 | 14587 | 77494 | 93075 | .26 | .14 | .31 | .17 | 3.73 | [.25, .27] | [.10, .52] |”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    CSA/ASA victimization is associated with social phobia, with a weighted observed correlation of .34 and a corrected correlation of .40 (95% CI .33-.35; 90% credibility interval .21-.60).

    “| Social Phobia | 10 | 4901 | 39701 | 44602 | .34 | .13 | .40 | .15 | 2.82 | [.33, .35] | [.21, .60] |”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    CSA/ASA victimization is associated with major depressive disorder, with a weighted observed correlation of .26 and a corrected correlation of .31 (95% CI .25-.27; 90% credibility interval .11-.52).

    “| Major Depressive Disorder | 24 | 9406 | 64284 | 84793 | .26 | .14 | .31 | .16 | 2.21 | [.25, .27] | [.11, .52] |”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    CSA/ASA victimization is associated with depressive symptomatology, with a weighted observed correlation of .18 and a corrected correlation of .21 (95% CI .17-.19; 90% credibility interval .04-.37).

    “| Depressive symptomatology | 59 | 6668 | 25533 | 33293 | .18 | .12 | .21 | .13 | 12.75 | [.17, .19] | [.04, .37] |”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    For intercourse abuse, CSA/ASA victimization is associated with depression, with a weighted observed correlation of .19 and a corrected correlation of .23 (95% CI .16-.22; 90% credibility interval .11-.34).

    “| Intercourse | 4 | 184 | 3228 | 3412 | .19 | .08 | .23 | .09 | 17.60 | [.16, .22] | [.11, .34] |”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    CSA/ASA victimization is associated with general sequelae, with a weighted observed correlation of .28 and a corrected correlation of .34 (95% CI .27-.29; 90% credibility interval .08-.59).

    “| General Sequelae | 91 | 19360 | 93988 | 125555 | .28 | .17 | .34 | .20 | 2.82 | [.27, .29] | [.08, .59] |”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    For contact abuse, CSA/ASA victimization is associated with depression, with a weighted observed correlation of .16 and a corrected correlation of .18 (95% CI .13-.19; 90% credibility interval .10-.27).

    “| Contact | 4 | 171 | 3228 | 3399 | .16 | .07 | .18 | .07 | 25.97 | [.13, .19] | [.10, .27] |”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    For intercourse abuse, CSA/ASA victimization is associated with anxiety, with a weighted observed correlation of .15 and a corrected correlation of .18 (95% CI .12-.18; 90% credibility interval .08-.28).

    “| Intercourse | 4 | 184 | 3225 | 3409 | .15 | .07 | .18 | .08 | 22.02 | [.12, .18] | [.08, .28] |”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    For non-contact abuse, CSA/ASA victimization is associated with depression, with a weighted observed correlation of .12 and a corrected correlation of .14 (95% CI .09-.15; 90% credibility interval .14).

    “| Non-Contact | 7 | 278 | 5431 | 5709 | .12 | .03 | .14 | 0 | 100 | [.09, .15] | [.14] |”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    CSA/ASA victimization is associated with depression, with a weighted observed correlation of .24 and a corrected correlation of .28 (95% CI .23-.25; 90% credibility interval .08-.49).

    “| Depression | 87 | 18910 | 92618 | 123735 | .24 | .14 | .28 | .16 | 4.10 | [.23, .25] | [.08, .49] |”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    CSA/ASA victimization is associated with depressive disorder, with a weighted observed correlation of .26 and a corrected correlation of .31 (95% CI .25-.27; 90% credibility interval .10-.52).

    “| Depressive Disorder | 28 | 12131 | 66986 | 90220 | .26 | .14 | .31 | .03 | 2.32 | [.25, .27] | [.10, .52] |”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    CSA/ASA victimization is associated with dysthymia, with a weighted observed correlation of .38 and a corrected correlation of .46 (95% CI .37-.39; 90% credibility interval .34-.56).

    “| Dysthymia | 8 | 4524 | 36668 | 41192 | .38 | .08 | .46 | .09 | 8.91 | [.37, .39] | [.34, .56] |”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The global prevalence of CSA/ASA is 11.8%.

    “A recent meta-analysis established the global prevalence of CSA/ ASA at 11.8% (Stoltenborgh et al., 2011).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Stoltenborgh et al., 2011

      Not checked in the free run.

  • May combine two claims.

    Study design and conductcitation

    As some studies had no control group, the normative population was taken as the contrast group, or it was not equivalent to the experimental one, with potential distortion in the calculated effect sizes.

    “as some studies had no control group, the normative population was taken as the contrast group, or it was not equivalent to the experimental one with the subsequent potential for distortion in the calculated effect sizes (Briere, 1992).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Briere, 1992

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    All selected studies had been published in double-blind peer-reviewed scientific journals indexed at the Web of Science.

    “All of the studies selected had been published in double blind peer-reviewed scientific journals indexed at the Web of Science.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Numerous empirical studies have established a relationship between CSA/ASA and psychological injury, which may become manifest in the short-term and/or become chronic.

    “numerous empirical studies have established a relationship between CSA/ASA and psychological injury (e.g., major depressive disorder, dysthymia, generalized anxiety disorder, phobic disorders), which may become manifest in the short-term and/or become chronic (Jumper, 1995;Paolucci, Genuis, & Violato, 2001).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Jumper, 1995

      Not checked in the free run.

    • cites Paolucci, Genuis, & Violato, 2001

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    In the interview, injury was linked to cause, whereas in the psychometric measures of CSA/ASA victimization it was not, allowing for other causes.

    “In the interview, indeed, injury was linked to cause, whereas in the psychometric measures of CSA/ASA victimization it was not, allowing for other causes.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    The diagnostic threshold was much stricter than for symptoms, which underscores its greater sensitivity and specificity.

    “Furthermore, the diagnostic threshold was much stricter than for symptoms, which underscores its greater sensitivity and specificity.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductnone given

    Outliers were removed using the criterion ±2 SD, so the results were generalizable to 96% of future samples.

    “Outliers in each of the measures (general sequelae, depression, and anxiety) were removed using the criterion ± 2 SD (bilateral) of the mean effect size, so the results were generalizable to 96% of future samples.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductcitation

    The ground truth of the primary studies for the classification of abuse generally rests on self-reports of a retrospective nature, relies on individual memory capabilities, and is related to false positives or false alarms.

    “the ground truth of the primary studies for the classification of abuse generally rests on self-reports of a retrospective nature, that relies on individual memory capabilities, and are related to false positives or false alarms (Amado, Arce, & Fariña, 2015;Schoedl et al., 2010).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Amado, Arce, & Fariña, 2015

      Not checked in the free run.

    • cites Schoedl et al., 2010

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    There is a higher prevalence of diagnosed depression and anxiety among females than males, including school-aged children and adolescents.

    “according to the leading international organisations classifying mental disorders (American Psychiatric Association, 2013; WHO, 2000), there is a higher prevalence of diagnosed depression and anxiety among females than males, including school-aged children and adolescents.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites American Psychiatric Association, 2013

      Not checked in the free run.

    • cites WHO, 2000

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Interpretationreasoning

    Offenders are not only criminally responsible for their deeds, but are also liable to civil compensation payments for injuries caused to victims.

    “This finding implies that offenders are not only criminally responsible for their deeds, but are also liable to civil compensation payments for injuries caused to victims.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Injury to mental health is sequelae to abuse (cause-effect relationship).

  • May combine two claims.

    Premisecitation

    The type of abuse suffered has effects on sequelae, relating the severity of the crime to the severity of the injury.

    “the type of abuse suffered (i.e., non-contact, contact, intercourse) has been shown to have effects on sequelae, which relates the severity of the crime to the severity of the injury (mild, moderate, severe) (Bulik et al., 2001;Cutajar et al., 2010;Fergusson et al., 2013;Jonas et al., 2011).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Bulik et al., 2001

      Not checked in the free run.

    • cites Cutajar et al., 2010

      Not checked in the free run.

    • cites Fergusson et al., 2013

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    All studies of the sample were examined by two independent researchers, with total agreement in their classifications (k = 1).

    “All of the studies of the sample were examined by two independent researchers, with total agreement in their classifications (k = 1).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationcitation

    The results of the meta-analysis were subject to little variability and were highly generalizable for the female population and for males except for the diagnosis of a disorder and the general measure of anxiety.

    “Alternatively, the results of the meta-analysis were subject to little variability, that is, Ns > 400 and a large k (Hunter & Schmidt, 2004) were highly generalizable (entirely for the female population, and for males with the exception of the diagnosis of a disorder and the gene ral measure of anxiety for the male population)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Hunter & Schmidt, 2004

      Not checked in the free run.

52 of 52

  • The authors state this as an assumption.

    Injury associated to CSA/ASA victims is general.

    “Though injury associated to CSA/ASA victims is assumed to be general, certain moderators are expected to explain differences in the degree of injury.”

  • The paper relies on this without support.

    Injury to mental health is sequelae to abuse (cause-effect relationship).

    “primary studies assume that injury to mental health is sequelae to abuse, without appraising other possible causes (cause-effect relationship) (Jumper, 1995;Vilariño et al., 2013).”
2 of 2

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • The risk of anxiety after childhood sexual abuse was higher in females than in males.

    “and the risk of anxiety after childhood sexual abuse was higher in females than in males.5”

    From Long-term outcomes of childhood sexual abuse: an umbrella review (2019) · cites this paper as [5]

    In “Effects of the type of abuse,” the meta-analysis reports a higher effect size for diagnosed anxiety disorders in female than male victims. But the same section reports a significantly higher effect size for anxiety symptoms in males. The unqualified claim about anxiety omits that distinction. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Studies have reported associations between childhood sexual abuse and psychosocial problems, self-harm, psychiatric disorders, and physical health diagnoses such as HIV and obesity.

    “Studies have reported associations between childhood sexual abuse and many psychosocial and health-related outcomes, including psychosocial problems,2,3 self-harm,4 psychiatric disorders,5–7 and physical health diagnoses such as HIV8 and obesity.9”

    From Long-term outcomes of childhood sexual abuse: an umbrella review (2019) · cites this paper as [5]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Limitation conflicts with the stated exclusion rule

    Minor

    The methods say studies that did not separate sexual-abuse victims from other maltreatment categories were excluded. The limitations instead say that many primary studies grouped those categories together, preventing the effect from being isolated.

  • Male anxiety-symptom sample total is smaller than its two groups

    Minor

    Table 7 reports 153 participants in the experimental group and 594 in the control group, which sum to 747, not the reported total of 727.

    Reported 727 · recomputed 747

  • The stated total subject count is also labeled the experimental-group count

    Minor

    The methods call 19,360 the total number of subjects, but Table 3 labels 19,360 as the experimental-group sample for general sequelae and separately lists a control group and a larger total.

3 of 3

Cites

Flagged first, then by citations

Research works printed but not linked: 2

  1. Nunnally, J.C., & Berstein, I.H. (1994). Psychometric theory (3rd ed.). New York, NY: McGraw-Hill.
  2. World Health Organization. (2000). Women's mental health: An evidence based review. Geneva, Switzerland: Author.

Cited by

Sorted by citations

Related

Authors
Amado, B. G., Arce, R., & Herraiz, A.
Affiliations
Universidade de Santiago de Compostela (ES)
ORCID
Amado, Bárbara G.
Venue
Psychosocial Intervention
Publisher
Colegio Oficial de la Psicologia de Madrid
Published
2015-01
Volume
24
Issue
1
Pages
49-62
ISSN
1132-0559 (ISSN-L)
DOI
10.1016/j.psi.2015.03.002
OpenAlex
W1978637848
Cited by
140
References
111
Citations by year
2026: 14 · 2025: 13 · 2024: 15 · 2023: 18 · 2022: 28 · 2021: 11 · 2020: 12 · 2019: 15 · 2018: 6 · 2017: 4 · 2016: 4
FWCI
5.79
Type
journal article
Language
en
Open access
Licence
Locations
  • Psychosocial Intervention (publishedVersion, cc-by-nc-nd)
  • LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (publishedVersion, other-oa)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Hispana (submittedVersion, cc-by-nc-nd)
  • Repositorio institucional da Universidade de Santiago de Compostela (University of Santiago de Compostela) (submittedVersion, cc-by-nc-nd)
  • Redalyc (Universidad Autónoma del Estado de México) (submittedVersion)
  • Scientific Electronic library online (Sciences Carlos III Health Institute) (submittedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
  • Social Sciences › Gender Studies › Sexual Assault and Victimization Studies
  • Social Sciences › Sociology and Political Science › Military, Security, and Education Studies
Keywords
child sexual abuse, adolescent sexual abuse, psychological harm, depression, anxiety disorders, major depressive disorder, dysthymia, specific phobia, gender differences, sexual penetration

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-10.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-10.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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