Psychological injury in victims of child sexual abuse: A meta-analytic review

Abstract

In order to assess the effects of child/adolescent sexual abuse (CSA/ASA) on the victim's probability of developing symptoms of depression and anxiety, to quantify injury in populational terms, to establish the probability of injury, and to determine the different effects of moderators on the severity of injury, a meta-analysis was performed. Given the abundant literature, only studies indexed in the scientific database of reference, the Web of Science, were selected. A total of 78 studies met the inclusion criteria: they measured CSA/ASA victimization or injury in terms of depression or anxiety symptoms, measured the effect size or included data for computing them, and provided a description of the sample. The results showed that CSA/ASA victims suffered significant injury, generally of a medium effect size and generalizable, victims had 70% more probabilities of suffering from injury, and clinical diagnosis was significantly a more adequate measure of injury than symptoms. The probability of chronic injury (dysthymia) was greater than developing more severe injury, i.e., major depressive disorder (MDD). In the category of anxiety disorders, injury was expressed with a higher probability in specific phobia. In terms of the victim's gender, females had significantly higher rates of developing a depressive disorder (DD) and/or an anxiety disorder (AD), quantified in a 42% and 24% over the baseline, for a DD and AD respectively. As for the type of abuse, the meta-analysis revealed that abuse involving penetration was linked to severe injury, whereas abuse with no contact was associated to less serious injury. The clinical, social, and legal implications of the results are discussed.