How does the impact of child sexual abuse present in children?
Rosaleen McElvaney helps us think about how the experience of sexual abuse affects children so that we can understand how this may influence their emotional and behavioural presentation[1]. This is simplified below
Stigmatisation
Where children internalize bad feelings from the bad experience of abuse
Occurs when the child has a low opinion, speaks negatively, doesn’t believe anything positive, about themselves.
Abuse can make the child feel damaged or dirty and can lead to feelings of shame or guilt.
The child may feel lonely and isolated but also wary of others as they may worry that others will reject them if they knew about the abuse.
Grief reactions
If abuse is perpetrated by someone the child loves or likes, the child may experience a grief reaction in relation to a loss of trust.
Relationships with others
If the child experiences a loss of trust in one adult this may impact their ability to trust others, including those who they can rely on. This may manifest as fear, anger or hostility and may extend to peers as well as adults.
At the other end of the spectrum the child may feel they do not want to be separated from others and may appear dependent on adults around them.
Fear
The child may be scared of the person who has abused them and consequently feel reluctant to have contact with them. This may extend to others who the child would otherwise trust.
Anxiety
The child may feel anxious about the abuse and may also have been threatened by the person abusing them. This can manifest in a number of ways including worries about going to school, playing with friends, difficulties sleeping, of being alone.
Low mood
The child may become quiet or withdrawn from friendships and may appear quiet, reluctant to talk or sad.
This can manifest is psychosomatic symptoms such as pain or headaches and may also impact the child’s immune system.
Difficulty regulating emotions
The child may struggle to regulate themselves and this may manifest in them appearing more irritable, hostile, impatient or angry.
Confusion with role boundaries
The child may experience some confusion with roles or boundaries and may oscillate between appearing ‘grown up’ and wanting to look after others, to appearing more ‘child like’ in their ability to complete tasks that would be expected at their developmental stage.
Sexual preoccupation
The child may present with sexualized behaviour that is incongruent with their developmental stage or may appear to have sexual knowledge that wouldn’t be expected for a child of their age (e.g. knowledge of oral or anal sex). They may appear preoccupied with sexuality and this may manifest in repetitive sexual behaviour, masturbation or a fascination with body parts.
Aggressiveness
The child may act out aggressively with other children – either the same age or younger.
Discomfort about sex and their bodies
Younger children may appear confused about boundaries and may interpret comfort as sexual.
Older children may appear embarrassed at times when sex is mentioned or may appear overly interested in sex.
Children may appear more conscious of their body and puberty may be a particularly challenging time as their body changes and sexual feelings may become confusing or act as a reminder of the abuse they have experienced.
Sense of efficacy or belief of impotence
The child may feel that abuse is inevitable in their life and may feel that theey lack any power over what happens to them. This can impact the child’s view of themselves as competent human beings. This is especially prominent for children who are abused over a long period of time.
Becoming abusive to others
The child may wish to have control over others in response to a feeling that they have lost control of their own lives. This may manifest in bullying behaviour
Rosaleen McElvaney helps us think about how the experience of sexual abuse affects children so that we can understand how this may influence their emotional and behavioural presentation[1]. This is simplified below
Stigmatisation
Where children internalize bad feelings from the bad experience of abuse
Occurs when the child has a low opinion, speaks negatively, doesn’t believe anything positive, about themselves.
Abuse can make the child feel damaged or dirty and can lead to feelings of shame or guilt.
The child may feel lonely and isolated but also wary of others as they may worry that others will reject them if they knew about the abuse.
Grief reactions
If abuse is perpetrated by someone the child loves or likes, the child may experience a grief reaction in relation to a loss of trust.
Relationships with others
If the child experiences a loss of trust in one adult this may impact their ability to trust others, including those who they can rely on. This may manifest as fear, anger or hostility and may extend to peers as well as adults.
At the other end of the spectrum the child may feel they do not want to be separated from others and may appear dependent on adults around them.
Fear
The child may be scared of the person who has abused them and consequently feel reluctant to have contact with them. This may extend to others who the child would otherwise trust.
Anxiety
The child may feel anxious about the abuse and may also have been threatened by the person abusing them. This can manifest in a number of ways including worries about going to school, playing with friends, difficulties sleeping, of being alone.
Low mood
The child may become quiet or withdrawn from friendships and may appear quiet, reluctant to talk or sad.
This can manifest is psychosomatic symptoms such as pain or headaches and may also impact the child’s immune system.
Difficulty regulating emotions
The child may struggle to regulate themselves and this may manifest in them appearing more irritable, hostile, impatient or angry.
Confusion with role boundaries
The child may experience some confusion with roles or boundaries and may oscillate between appearing ‘grown up’ and wanting to look after others, to appearing more ‘child like’ in their ability to complete tasks that would be expected at their developmental stage.
Sexual preoccupation
The child may present with sexualized behaviour that is incongruent with their developmental stage or may appear to have sexual knowledge that wouldn’t be expected for a child of their age (e.g. knowledge of oral or anal sex). They may appear preoccupied with sexuality and this may manifest in repetitive sexual behaviour, masturbation or a fascination with body parts.
Aggressiveness
The child may act out aggressively with other children – either the same age or younger.
Discomfort about sex and their bodies
Younger children may appear confused about boundaries and may interpret comfort as sexual.
Older children may appear embarrassed at times when sex is mentioned or may appear overly interested in sex.
Children may appear more conscious of their body and puberty may be a particularly challenging time as their body changes and sexual feelings may become confusing or act as a reminder of the abuse they have experienced.
Sense of efficacy or belief of impotence
The child may feel that abuse is inevitable in their life and may feel that theey lack any power over what happens to them. This can impact the child’s view of themselves as competent human beings. This is especially prominent for children who are abused over a long period of time.
Becoming abusive to others
The child may wish to have control over others in response to a feeling that they have lost control of their own lives. This may manifest in bullying behaviour