The Medical Minute: Sexual Abuse can have Long-term Effects

By Martha Peaslee Levine, M.D.

April has been designated as Sexual Assault Awareness Month. Sexual assault is, unfortunately, a rampant issue. According to RAINN (Rape, Abuse & Incest National Network), someone in the United States is sexually assaulted every two minutes. Approximately two-thirds of these assaults are committed by someone the victim knows. As a community, we need to recognize the devastating effects of sexual abuse. The impact is not just at the time of the event, but also long-term.

Working in the Eating Disorders Clinic at Penn State Milton S. Hershey Medical Center, I have witnessed how sexual assaults can essentially destroy victims’ lives. Many factors determine the impact. These include how early the abuse (assault) began, how long it continued, whether it was perpetrated by someone the individual knew, and whether others know about the assault and intervened.

Consider if a family member or close friend started abusing a child when she/he was young and this activity continued for years, and a parent was told about the abuse but denied that it was happening: How could this not yield long-term destruction on the individual’s life?

For instance, women struggling with eating disorders who have been victims of abuse often describe that they need to make themselves smaller so that they “won’t attract attention.” Their eating disorder becomes linked with their past trauma. If they can be smaller and smaller, they can disappear and leave the lingering effects of the sexual trauma. Other women use food to numb the residual pain. But having that food inside of themselves feels disgusting. They use their symptoms to get rid of the food and their negative view of themselves. Individuals who have been subject to assaults find it difficult to trust others. They often blame and berate themselves. They shoulder responsibility when they themselves were the victims.

Depression and post-traumatic stress disorder (PTSD) are common long after the abuse. If suffering from PTSD, individuals have nightmares or flashbacks related to the event. These events can be triggered by sensory experiences that rekindle vivid memories of the abuse. Imagine going through your day and perhaps a smell or sound puts you back into the exact moment of your childhood when a parent or another close individual sexually assaulted you. The ongoing insecurity an abuse victim experiences is understandable.

Abuse victims also can experience ongoing, disabling pain, which affects their life. They are at higher risk of suicide and can overdose just by virtue of trying to dull the physical and emotional pain. They are often under-employed based on these ongoing struggles.

Sexual assault and abuse has serious and severe impacts. We as a community need to recognize not only the number of people affected but also the destructive effects on these individuals’ lives. We need to acknowledge the prevalence of abuse in our society, accept victims’ stories and understand the long-term effects as we work to aid those who have been subject to these assaults.

To learn more about sexual abuse or assault, visit http://www.rainn.org/. If you believe you or someone you know has been a victim of sexual abuse or assault, call 800-4ACHILD or visithttp://www.rainn.org/get-help/national-sexual-assault-hotline.

Martha Peaslee Levine, M.D., is an assistant professor of Pediatrics, Psychiatry and Humanities at Penn State College of Medicine and director, Intensive Outpatient and Partial Hospitalization Programs in the Division of Adolescent Medicine and Eating Disorders at Penn State Hershey Medical Center.

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