Cited by 1,144Child Abuse and TraumaMilitary, Security, and Education StudiesSexual Assault and Victimization Studies

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A Meta-Analysis of the Published Research on the Effects of Child Sexual Abuse

Paolucci, Elizabeth ODDONE, Genuis, Mark L., Violato, Claudio·2001·The Journal of Psychology

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Abstract

A meta-analysis of the published research on the effects of child sexual abuse (CSA) was undertaken for 6 outcomes: posttraumatic stress disorder (PTSD), depression, suicide, sexual promiscuity, victim-perpetrator cycle, and poor academic performance. Thirty-seven studies published between 1981 and 1995 involving 25,367 people were included. Many of the studies were published in 1994 (24; 65%), and most were done in the United States (22; 59%). All six dependent variables were coded, and effect sizes (d) were computed for each outcome. Average unweighted and weighted ds for each of the respective outcome variables were .50 and .40 for PTSD, .63 and .44 for depression, .64 and .44 for suicide, .59 and .29 for sexual promiscuity, .41 and .16 for victim-perpetrator cycle, and .24 and .19 for academic performance. A file drawer analysis indicated that 277 studies with null ds would be required to negate the present findings. The analyses provide clear evidence confirming the link between CSA and subsequent negative short- and long-term effects on development. There were no statistically significant differences on ds when various potentially mediating variables such as gender, socioeconomic status, type of abuse, age when abused, relationship to perpetrator, and number of abuse incidents were assessed. The results of the present meta-analysis support the multifaceted model of traumatization rather than a specific sexual abuse syndrome of CSA.

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Kim‐Ju, G. M., Mark, G. Y., Cohen, R., Garcia‐Santiago, O., & Nguyen, P. (2008) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2007.12.005 · Cited by 43
Reports of child sexual abuse of boys and girls: Longitudinal trends over a 20-year period in Victoria, Australia
Mathews, B., Bromfield, L., Walsh, K., Cheng, Q., & Norman, R. E. (2017) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2017.01.025 · Cited by 43
Protective factors promoting resilience in the relation between child sexual victimization and internalizing and externalizing symptoms
Pérez-González, A., Guilera, G., Pereda, N., & Jarne, A. (2017) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2017.09.006 · Cited by 48
Risk of intimate partner violence: Role of childhood sexual abuse and sexual initiation in women in Japan
Yoshihama, M., & Horrocks, J. (2009) · Children and Youth Services Review · doi:10.1016/j.childyouth.2009.06.013 · Cited by 42
Adverse Childhood Experiences and Cervical Cancer Screening
Alcalá, H. E., Mitchell, E. M., & Keim‐Malpass, J. (2016) · Journal of Women s Health · doi:10.1089/jwh.2016.5823 · Cited by 45
Disclosure of sexual abuse, and personal and familial factors as predictors of post-traumatic stress disorder symptoms in school-aged girls
Bernard‐Bonnin, A., Hébert, M., Daignault, I. V., & Allard‐Dansereau, C. (2008) · Paediatrics & Child Health · doi:10.1093/pch/13.6.479 · Cited by 42
Adverse childhood experience and adult persistent pain and disability: protocol for a systematic review and meta-analysis
Bussières, A., Hartvigsen, J., Ferreira, M. L., Ferreira, P. H., Hancock, M. J., Stone, L. S., Wideman, T. H., Boruff, J., & Elklit, A. (2020) · Systematic Reviews · doi:10.1186/s13643-020-01474-8 · Cited by 40
The role of depression and dissociation in the link between childhood sexual abuse and later parental practices
Collin-Vézina, D., Cyr, M., Pauzé, R., & McDuff, P. (2005) · Journal of Trauma & Dissociation · doi:10.1300/j229v06n01_05 · Cited by 41
Childhood sexual abuse and the risk for recurrent major depression in Chinese women
Cong, E., Li, Y., Shao, C., Chen, J., Wu, W., Shang, X., Wang, Z., Liu, Y., Liu, L., Gao, C., et al. (2011) · Psychological Medicine · doi:10.1017/s0033291711001462 · Cited by 41
“This work was funded by the Wellcome Trust.”
BackgroundInfluential
Body satisfaction, eating disorders and suicide ideation in an Internet sample of self-harmers reporting and not reporting childhood sexual abuse
Murray, C. D., Macdonald, S., & Fox, J. (2007) · Psychology Health & Medicine · doi:10.1080/13548500701235757 · Cited by 41
The role of alexithymia in trauma therapy outcomes: Examining improvements in PTSD, dissociation, and interpersonal problems.
Zorzella, K. P. M., Muller, R. T., Cribbie, R. A., Bambrah, V., & Classen, C. C. (2019) · Psychological Trauma Theory Research Practice and Policy · doi:10.1037/tra0000433 · Cited by 51
Sexually transmitted infections in alleged sexual abuse of children and adolescents
Kelly, P. J., & Koh, L. J. (2006) · Journal of Paediatrics and Child Health · doi:10.1111/j.1440-1754.2006.00893.x · Cited by 41
Sleep and borderline personality disorder: A review
Hafizi, S. (2013) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2013.06.016 · Cited by 40
“Many studies have investigated the association of childhood abuse and sleep disturbances (Chen et al., 2010; Glod et al., 1997; Greenfield et al., 2011; Gregory and Barclay, 2009; Heitkemper et al., 2011; Noll et al., 2006; Paolucci et al., 2001; Poon and Knight, 2011) and have shown positive relationship between them.”
Background
Testing Posttraumatic Stress as a Mediator of Childhood Trauma and Adult Intimate Partner Violence Victimization
Messing, J. T., Flair, L. L., Cavanaugh, C. E., Kanga, M. R., & Campbell, J. C. (2012) · Journal of Aggression Maltreatment & Trauma · doi:10.1080/10926771.2012.686963 · Cited by 42
“A meta-analysis noted at least a 20% increase in PTSD for those who experienced CSA (Paolucci et al., 2001).”
Method
Bullying involvement in relation to personality disorders: a prospective follow-up of 508 inpatient adolescents
Antila, H., Arola, R., Hakko, H. H., Riala, K., Riipinen, P. K., & Kantojärvi, L. (2017) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-017-0946-6 · Cited by 40
Why Multiples Matter: Reconceptualising the Population Referred to Child and Family Social Workers
Spratt, T. (2011) · The British Journal of Social Work · doi:10.1093/bjsw/bcr165 · Cited by 40
Interpersonal polyvictimization and mental health in males
Burns, C. R., Lagdon, S., Boyda, D., & Armour, C. (2016) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2016.04.002 · Cited by 46
Annual Research Review: Mapping the multifaceted approaches and impacts of adverse childhood experiences – an umbrella review of meta‐analyses
Kim, B., & Royle, M. L. (2024) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.14022 · Cited by 41
Psychiatric Impact of Organized and Ritual Child Sexual Abuse: Cross-Sectional Findings from Individuals Who Report Being Victimized
Schröder, J., Nick, S., Richter‐Appelt, H., & Briken, P. (2018) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph15112417 · Cited by 46
“The reported prevalence rates are further in line with previous research that demonstrated a strong relationship between childhood trauma and the development of borderline personality disorders [70], eating disorders [71], PTSD and depression [39].”
BackgroundResult
Childhood adversity links to self-reported mood, anxiety, and stress-related disorders
King, A. R. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.05.112 · Cited by 43
Association between childhood sexual abuse and adult sexual victimization in a representative sample in Hong Kong Chinese
Chan, K. L. (2011) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2010.11.005 · Cited by 39
Relações entre abuso sexual na infância, transtorno de estresse pós-traumático (TEPT) e prejuízos cognitivos
Borges, J. L., & Dell’Aglio, D. D. (2008) · Psicologia em Estudo · doi:10.1590/s1413-73722008000200020 · Cited by 59
“…que as crianças abusadas sexualmente têm um risco aumentado em 20% para o desenvolvimento de TEPT, de 21% para depressão e suicídio, de 14% para comportamento sexual promíscuo, de 8% para a manutenção do ciclo de violência e de 10% para déficits no rendimento escolar (Paolucci et al., 2001).”
Background
Depressive Disorders and Interpersonal Processes
Segrin, C. G. (2010) · Wiley eBooks · doi:10.1002/9781118001868.ch25 · Cited by 39
Delayed reward discounting and increased risk for suicide attempts among U.S. adults with probable PTSD
Bryan, C. J., & Bryan, A. O. (2021) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2021.102414 · Cited by 38
Physical and sexual abuse in orphaned compared to non-orphaned children in sub-Saharan Africa: A systematic review and meta-analysis
Nichols, J., Embleton, L., Mwangi, A., Morantz, G., Vreeman, R., Ayaya, S., Ayuku, D., & Braitstein, P. K. A. (2013) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2013.09.012 · Cited by 38
Predictors of Maladaptive Coping in Incarcerated Women Who are Survivors of Childhood Sexual Abuse
Johnson, K. A., & Lynch, S. M. (2012) · Journal of Family Violence · doi:10.1007/s10896-012-9488-3 · Cited by 38
“Childhood trauma exposure and CSA in particular have long been empirically and theoretically linked to difficulties with emotion and emotional distress (Browne and Finkelhor 1986; Paolucci et al. 2001; Putnam 2003).”
Background
Prevalence and impact of childhood maltreatment in incarcerated youth.
Coleman, D. K., & Stewart, L. M. (2010) · American Journal of Orthopsychiatry · doi:10.1111/j.1939-0025.2010.01038.x · Cited by 38
“In two meta-analyses, the meta-analytic correlation of CSA to anxiety, depression or psychological distress ranged from .196 (R2 = .038) to .24 (R2 = .057; Paolucci et al., 2001; Weaver & Clum, 1995; Paolucci et al., 2001).”
Method
The role of traumagenic dynamics on the psychological adjustment of survivors of child sexual abuse
Cantón-Cortés, D., Arboleda, M. R. C., & Duarte, J. C. (2012) · European Journal of Developmental Psychology · doi:10.1080/17405629.2012.660789 · Cited by 38
Child sexual abuse: is it a risk factor for pregnancy?
Yampolsky, L., Lev‐Wiesel, R., & Ben-Zion, I. Z. (2010) · Journal of Advanced Nursing · doi:10.1111/j.1365-2648.2010.05387.x · Cited by 56
Health-related quality of life in the aftermath of child maltreatment: follow-up study of a hospital sample
Jud, A., Landolt, M. A., Tatalias, A., Lach, L., & Lips, U. (2012) · Quality of Life Research · doi:10.1007/s11136-012-0262-z · Cited by 38
The cycle of healing - dissociation and attachment during treatment of CSA survivors
Lahav, Y., & Elklit, A. (2016) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2016.09.009 · Cited by 38

Authors: Paolucci, E. O., Genuis, M. L., & Violato, C.
Affiliations: University of Calgary (CA)
ORCID: Paolucci, Elizabeth ODDONE
Violato, Claudio
Venue: The Journal of Psychology
Publisher: Informa UK Limited
Published: 2001-01
Volume: 135
Issue: 1
Pages: 17-36
ISSN: 0022-3980 (ISSN-L)
1940-1019
DOI: 10.1080/00223980109603677
OpenAlex: W2017439967
Cited by: 1,144
References: 63
Citations by year: 2026: 18 · 2025: 27 · 2024: 34 · 2023: 43 · 2022: 30 · 2021: 56 · 2020: 62 · 2019: 59 · 2018: 79 · 2017: 66 · 2016: 61 · 2015: 64 · 2014: 63 · 2013: 72 · 2012: 59
FWCI: 3.74
Type: journal article
Language: en
Open access: closed
Locations: The Journal of Psychology (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
Social Sciences › Sociology and Political Science › Military, Security, and Education Studies
Social Sciences › Gender Studies › Sexual Assault and Victimization Studies
Keywords: child sexual abuse, post-traumatic stress disorder, depression, suicide, promiscuity, academic performance, long-term effects of abuse, mediators
MeSH terms: Child, Child Abuse, Sexual, Child, Preschool, Female, Humans, Male, Stress Disorders, Post-Traumatic, Suicide

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A Meta-Analysis of the Published Research on the Effects of Child Sexual Abuse

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