The sequelae of sexual abuse are extensive, pervasive, and severe. Numerous studies exist showing a constellation of mental health problems associated with the experience of sexual trauma. These problems have been identified as depression, low self-esteem, repeated victimization, self-destructive behaviour, substance abuse, chronic tension and fatigue, difficulties in intimate relationships, problems with parenting, difficulties trusting, difficulties in achieving intimate relationships, an increased incidence of domestic violence, and a higher rate of teen pregnancy. PTSD is among the most common of all psychiatric disorders experienced by survivors of sexual abuse.
Terrifying experiences that destroy an individual’s sense of predictability, security and foundational assumptions about the world can subsequently alter the way one deals with emotions and the environment. Such experiences can include war trauma, physical and sexual assault accidents, and natural disasters. PTSD can vary in severity among affected individuals but is characterized by the combination of intrusive and numbing symptoms. When the intrusive reliving of the trauma dominates an individual’s life, the individual tries to organize life around avoiding the intrusion. Avoidance may entail ingesting drugs or alcohol that numb awareness of emotions, staying away from things that remind the individual of the trauma, or using dissociation to keep traumatic memories from entering consciousness.
Conditioned hyperarousal, a sense of helplessness in escaping the intrusion of the traumatic event into the activities of daily life, and other trauma-related changes can permanently alter how a person views the world and the concept of self within the world. The world becomes an unsafe and unpredictable place. The long-term effects of trauma include generalized hyperarousal with difficulties in self-regulation and modulation of impulses, problems with social attachments including excessive dependence or isolation, alterations in stimulus discrimination which include dissociation and somatization, conditioned fear responses to trauma-related stimuli, loss of trust, hope and a sense of agency, and social avoidance characterized by a loss of meaningful attachments and a lack of participation in preparations for the future.