J Am Acad Child Adolesc Psychiatry. 2003 Mar;42(3):269-78.
Ten-year research update review: child sexual abuse.
Putnam FW.
Children's Hospital Medical Center, Cincinnati, Ohio, 45229-3039, USA.
Frank.Putnam@chmcc.org
OBJECTIVE To provide clinicians with current information on prevalence, risk
factors, outcomes, treatment, and prevention of child sexual abuse (CSA). To
examine the best-documented examples of psychopathology attributable to
CSA.METHOD Computer literature searches of and for key words. All
English-language articles published after 1989 containing empirical data
pertaining to CSA were reviewed.RESULTS CSA constitutes approximately 10% of
officially substantiated child maltreatment cases, numbering approximately
88,000 in 2000. Adjusted prevalence rates are 16.8% and 7.9% for adult women
and men, respectively. Risk factors include gender, age, disabilities, and
parental dysfunction. A range of symptoms and disorders has been associated
with CSA, but depression in adults and sexualized behaviors in children are
the best-documented outcomes. To date, cognitive-behavioral therapy (CBT) of
the child and a nonoffending parent is the most effective treatment.
Prevention efforts have focused on child education to increase awareness and
home visitation to decrease risk factors.CONCLUSIONS CSA is a significant
risk factor for psychopathology, especially depression and substance abuse.
Preliminary research indicates that CBT is effective for some symptoms, but
longitudinal follow-up and large-scale "effectiveness" studies are needed.
Prevention programs have promise, but evaluations to date are limited.
