PTSD and Victims of Child Sexual Abuse

Running head: PTSD and Victims of Childhood Sexual Abuse

PTSD And Victims of Childhood Sexual Abuse

Alison Gordon
Binghamton University

PTSD and Victims of Child Sexual Abuse

Abstract
Posttraumatic stress disorder (PTSD) is the most frequent problem noted in sexually abused
children. According to a recent text, Family Violence Across the Lifespan, PTSD may occur
when a person lives through/witnesses an event that appears to be life-threatening and
experiences intense fear or helplessness (Barnett, 2011). Child survivors of sexual abuse have
an extremely high rate of experiencing PTSD symptoms. Recent studies indicate estimates that
about 1/3 of the population of sexually abused children suffers from PTSD. Additionally, child
sexual assault survivors are more like to experience PTSD than survivors of other sorts of abuse.
Gender also is a factor when analyzing PTSD as it relates to childhood sexual abuse. Metaanalysis of CSA research demonstrates that females are more likely than males to experience
child abuse, PTSD and assault, though men are exposed to more traumatic events overall. In
other words, the higher prevalence of PTSD among females cannot be written off as a result of
higher instances of CSA, because there are other mitigating factors, statistically speaking.
Victims of childhood sexual assault often form trauma bonds with their perpetrators. PTSD and
other ongoing symptoms of trauma can be an indicator of a trauma bond. For children who suffer
from PTSD, the way the system operates in trying to aid survivors itself is often re-traumatizing.
Trauma informed-care as a response to treating childhood victims of PTSD operates using safety,
choice, empowerment, collaboration and trust as core values in order to facilitate effective
treatment (Fallot & Harris, 2001).

PTSD and Victims of Child Sexual Abuse

Child Sexual Abuse and PTSD

The development of societys attitudes towards mental health issues has been a long slow
journey. One diagnosis still gaining acceptance and understanding today is post-traumatic stress
disorder and in recent years, a more robust evidence base regarding the management of
individuals involved in traumatic events has emerged (Bisson 2007).
Originally, the movement of post-traumatic stress disorder becoming popularized and
socially accepted, amongst the common populace and the medical community alike, came about
as a result of the Vietnam War. As veterans returned home from duty, mental health professionals
noticed extreme symptomology in this population. Then, in the 1970s, a time of revolution and
new flow of ideas everywhere, a group of the pioneers seeking to understand and treat the mental
health problems of crime victims began comparing notes with colleagues treating Vietnam
veterans suffering from what seemed to be related aftereffects of trauma. It was from this
collaboration that we have come to understand the idea of PTSD and other sorts of trauma.
Theoretical concepts researchers learned studying by studying trauma in Vietnam
veterans taught mental health professionals to become familiar with the concept of second
victimization. Originally enunciated by psychiatrist and former New York City police officer
Martin Symonds, second victimization asserted that victims were often harmed as much by the
systems response as by the crime perpetrated upon them itself. It became widely accepted that
even dealings with friendly justice professionals could generate acute stress in victims
(Participants Text). Today, crime victims rights associations fight for more sensitivity
training to be administered to police and other law enforcement professionals in order to fight the
phenomenon of second victimization.
The introduction of second victimization of a concept was monumental for the mental
health community in terms of making progress towards understanding trauma and trauma
disorders. The various syndromes associated with second victimization were being discussed in

PTSD and Victims of Child Sexual Abuse

the mental health community within the context of a new diagnosiswhat we now know today
as posttraumatic stress disorder, or PTSD.
The identification of PTSD was important because the world now had a general diagnosis
that did not stigmatize or otherwise negatively categorized the victim. A diagnosis rather,
clarified and legitimized the victims normal response to an abnormal and often painful situation.
In 1980, this diagnosis was recognized when the description of PTSD was placed in the
Diagnostic and Statistical Manual (third edition) of the American Psychiatric Association (APA),
the authoritative diagnostic tool of mental health professionals.
Among displayed symptoms of PTSD sufferers are diminished responsiveness, chronic
physiological arousal leading to symptoms like sleepiness, and flashbacks. Sadly, these
symptoms, especially in juvenile populations can come off to an uneducated observer as simple
disobedience or acting out. One new factor structure chronicled in Family Violence Across The
Lifespan, which is based on the stories of 2,378 female sexual assault survivors, suggests four
unique components of PTSD. These components are avoidance, re-experiencing, dysphoria and
hyperarousal.
Child survivors of sexual abuse have an extremely high rate of experiencing PTSD
symptoms. Recent studies indicate estimates that about 1/3 of the population of sexually abused
children suffers from PTSD. Additionally, child sexual assault survivors are more like to
experience PTSD than survivors of other sorts of abuse, such as psychological maltreatment or
childhood physical abuse.
Howard I. Bath PhD, the Australian Childrens Commissioner of the Northern Territory
asserts that children who have suffered from complex trauma, or extended exposure to
traumatizing situations, such as ongoing CSA, are vulnerable to the symptoms of PTSD but often
fall short of formal diagnosis because the criterion for PTSD was originally formulated for adults

PTSD and Victims of Child Sexual Abuse

(Bath 18). He goes on to state that the most universal symptom displayed by survivors of
complex trauma is the loss the ability to regulate ones internal state and feelings.
Unfortunately, victims of childhood sexual assault often form trauma bonds with their
perpetrators. PTSD and other ongoing symptoms of trauma can indeed be an indicator of a
trauma bond. For children who suffer from PTSD, the way the system operates in trying to aid
survivors is in itself often re-traumatizing. Trauma informed-care as a response to treating
childhood victims of PTSD operates using safety, choice, empowerment, collaboration and trust
as core values (Hannah, 2015) in order to treat and heal victims of CSA.
Baths research asserts that the three pillars of trauma-informed care are safety,
connections and managing emotions. The defining experience of a survivor of childhood
trauma, whether it be CSA or another form of mistreatment, is one of feeling unsafe, which can
lead to the pervasive mistrust of adults or authority figures. It follows that in order for a trauma
victim to be able to make progress in formal therapy, the critical element of establishing a feeling
of safety and security must be established.
All three of the pillars of trauma-informed care are interconnected, with the goal of
establishing safety only being possible by building and strengthening connections between the
survivor and care providers or mentors. In a neurodevelopmental sense, children who have
survived trauma have come to associate adults with negative emotions. It should be the goal of a
professional tasked with helping survivors of CSA who suffer from PTSD and other trauma
disorders to help them re-associate adults and authority figures with safety and security.
The ability to regulate ones emotions is one of the most important indicators of a
persons healthy development, and it is this ability to regulate oneself that survivors of complex
trauma often struggle with following their abuse. Therefore, the third pillar of trauma-informed
care speaks to the need for traumatized children to be taught new ways to modulate and regulate
their emotions and impulses. This is important because it allows professionals treating trauma

PTSD and Victims of Child Sexual Abuse

and civilians dealing with traumatized individuals to understand on a deeper lever that children
who act out or misbehave may be displaying the complex symptomology of a trauma survivor.
Though we generally view it as the responsibility of law enforcement officials to avoid
inflicting second victimization on a victim of CSA through sensitivity and training, new research
shows that even those who work closely with PTSD sufferers and trauma victims can
unintentionally inflict harm on a survivor. Thus, it is important for therapists and human services
professionals to also be cognizant of the difficulties and psychopathology that will present as a
result of PTSD in CSA survivors by vigilantly interpreting and applying new information about
trauma-informed care in order to better understand the population they serve.
Societys perceptions of how victims of incest and CSA present their symptomology are
incredibly flawed. We usually imagine somebody who hides from the memory their whole life,
repressing and rejecting it, and then finally breaking through to other side in therapy, and
emerging from this treatment renewed and reborn.
In reality, the stories of survivors are multi-faceted, layered and complex, and vary
immensely from person to person. In Yes Means Yes: Visions of Female Sexual Power and a
World Without Rape, survivor Leah Lakshmi Piepzna-Samarasihna tells her story. A queer female
of color who copes with her sexual abuse at the hands of her mother by becoming a radical
feminist who publishes a zine for teenage survivors and does a one-woman show discussing her
healing process, Lakshmi Piepzna-Samarasihna challenges everything we imagine about the
scared, cowering CSA victim. Though she describes herself as acting poly, slutty, and kinky
she also suffers from dissociative episodes, fibromyalgia, and chronic fatigue.
The myth that victims of sexual abuse will be shy and scared of touch or sexual acts is
one that is perpetrated at all levels of society, from the friends and family of survivors, in the
media and amongst the mental health community. In reality, some survivors of sexual assault will
seek out promiscuous and unsafe sexual situations later in life in a process named the repetition

PTSD and Victims of Child Sexual Abuse

compulsion by the 20th century giant of psychology, Dr. Sigmund Freud. Children have been
shown to be more vulnerable than adults to compulsive repetition, and one disturbing finding
asserts that victims of child sexual abuse are at a high risk of becoming prostitutes, though they
themselves would be unlikely to make the connection between the two circumstances.
Trauma-informed care acts on principles that are geared towards serving each unique
survivor with multiple stories of abuse and its effects. Trauma-informed care is by nature
individualized and person-centered, and ascertains that there are multiple paths to recovery
based on the unique strengths, needs and experiences (including trauma) of an individual
(Harris & Fallon, 2001). Additionally, proponents of trauma-informed care note that trauma has
often occurred in the context of service to survivors itself through the use of involuntary and
physically coercive practices.
The reason for the revictimization of crime victims can be attributed to a fundamental
misconception about how crime victims should be treated in our legal system. The
Constitutionoffers strong guarantees for the rights of the accused, but no corresponding
protections to crime victims, notes Judith Lewis Herman in a publication titled The Mental
Health of Crime Victims. As a result, victims who choose to seek justice may face serious
obstacles and risks to their health, safety, and mental health
These harmful practices, as well as other activities that trigger trauma-related reactions,
are still too common in our centers of help and care. Identifying this issue and using the key
tenets of trauma-informed care to combat it lends hope to those who hold to treat victims of child
sexual abuse and other traumas, who suffer from PTSD and other trauma-related afflictions.

PTSD and Victims of Child Sexual Abuse

References
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Bath, H. (2008). The three pillars of trauma-informed care. Reclaiming children and
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Bisson, J. (2007). Post-traumatic stress disorder. Occupational Medicine, 57(6), 399-403.
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