Childhood Sexual Abuse: Epidemiology, Clinical Effects, Assessment, and Treatment

Narrative Review. This page provides the verified citation, abstract, and full-text PDF for the journal article.

Clinical boundary: Symptoms, behavior, or a normal examination cannot establish or exclude abuse. Suspected abuse, immediate danger, medical needs, or safeguarding concerns require trained local child-protection, forensic, medical, or emergency services.

Publication Details

Author: Christian Jonathan Haverkampf
Journal: The Journal of Psychiatry Psychotherapy and Communication
Publication date: 2025-03-31
Volume, issue, pages: 14(1), 1–10
Article type: Narrative Review

Recommended citation: Haverkampf, C. J. (2025). Childhood Sexual Abuse: Epidemiology, Clinical Effects, Assessment, and Treatment. The Journal of Psychiatry Psychotherapy and Communication, 14(1), 1–10.

Abstract

Childhood sexual abuse is a heterogeneous exposure rather than a diagnosis or a uniform life course. Prevalence estimates vary with definitions, sampling, and disclosure methods, and clinical outcomes range from little observable disturbance to post-traumatic stress disorder (PTSD), depression, anxiety, dissociation, behavioral change, sexual-health concerns, self-harm, substance use, somatic symptoms, and relationship difficulties. This review integrates research evidence and official clinical and safeguarding guidance publicly available through 28 February 2025. The review distinguishes epidemiology from case identification, safeguarding from treatment, medical findings from forensic conclusions, and childhood exposure from adult presentation. Normal physical findings are common and do not exclude abuse; symptoms and sexualized behavior warrant assessment but cannot establish that abuse occurred. Assessment should be developmentally appropriate, minimally repetitive, and coordinated with trained safeguarding and forensic services. Initial responses to disclosure should protect safety, dignity, choice, and accurate information without leading questions or pressure for a complete narrative. For symptomatic children and adolescents, developmentally adapted trauma-focused cognitive behavioral therapy has the most established evidence, often with involvement of a safe non-offending caregiver; treatment should nevertheless address current symptoms, functioning, and preferences rather than exposure alone. The review proposes two integrative frameworks: four levels of inference separating population, clinical, medical, and safeguarding/forensic conclusions, and four outcome domains separating safety, health, developmental and relational functioning, and justice-related processes. Alliance, caregiver response, and communication across services influence whether evidence-based treatment becomes usable care.

Keywords

childhood sexual abuse; child safeguarding; disclosure; forensic assessment; trauma-focused cognitive behavioral therapy; therapeutic alliance; caregiver support

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Website copy first made available on 27 August 2026. The journal citation retains the article’s issue date.