The Impact of Sexual Abuse On Female Development: Lessons From a Longitudinal, Multi-Generational Research Study

This paper will describe the research design and findings of a 23-year longitudinal study of the impact of intrafamilial sexual abuse on female development. The conceptual framework of this research integrated concepts of psychological adjustment with theory regarding how psychobiological factors might impact development. Participants included 6-16 year old females with substantiated sexual abuse and a demographically similar comparison group. A cross-sequential design was used and six assessments have taken place, with participants at median age 11 at the first assessment and median age 25 at the 6th assessment. Mothers of participants took part in the early assessments and offspring took part at the 6th assessment. Results of many analyses (which have been published in more than 40 peer-reviewed articles – see examples below) , both within circumscribed developmental stages and across development, indicated that sexually abused females (on average) showed deleterious sequelae across a host of biopsychosocial domains including: earlier onsets of puberty, cognitive deficits, depression, dissociative symptoms, maladaptive sexual development, HPA attenuation, asymmetrical stress responses, high rates of obesity, more major illnesses and healthcare utilization, dropping out of high school, persistent PTSD, self mutilation, DSM diagnoses, physical and sexual re-victimization, premature deliveries, teen motherhood, drug and alcohol abuse, and domestic violence. Offspring born to abused mothers were at increased risk for child maltreatment and overall maldevelopment. There was also a pattern of considerable within group variability. Based on this complex network of findings, implications for optimal treatments are elucidated. Translational aspects of extending observational research into clinical practice are discussed in terms that will likely have a sustained impact on several major public health initiatives.

Examples of Publications Barnes, J., Noll, J., Putnam, F., & Trickett, P. (2009). Sexual and physical revictimization among victims of severe childhood sexual abuse. Child Abuse & Neglect, 33, 412–420. De Bellis, M. D., Chrousos, G. P., Dorn, L. D., Burke, L., Helmers, K., Kling, M. A., et al. (1994). Hypothalamic-Pituitary-Adrenal axis dysregulation in sexually abused girls. Journal of Clinical Endocrinology and Metabolism, 78(2), 249-255. Kim, K., Trickett, P. K., & Putnam, F. W. (2010). Childhood experiences of sexual abuse and later parenting practices among non-offending mothers of sexually abused and comparison girls. Child Abuse & Neglect, 34(8), 610-622. Noll, J. G., Schulkin, J., Trickett, P. K., Susman, E. J., Breech, L., & Putnam, F. W. (2007). Differential pathways to preterm delivery for sexually abused and comparison women. Journal of Pediatric Psychology, 1-11. Noll, J. G., Trickett, P. K., Harris, W. W., & Putnam, F. W. (2009). The cumulative burden borne by offspring whose mothers were sexually abused as children. Journal of Interpersonal Violence, 24(3), 424-449. Trickett, P. K., Noll, J. G., Reiffman, A., & Putnam, F. W. (2001). Variants of intrafamilial sexual abuse experience: Implications for short- and long-term development. Development and Psychopathology, 13, 1001-1019. Trickett, P. K., Noll, J. G., Susman, E. J., Shenk, C. E., & Putnam, F. W. (2010). Attenuation of cortisol across development for victims of sexual abuse. Development and Psychopathology, 22, 165–175.