P3A154: Experiences and Perspectives of Adult Survivors of Childhood Sexual Abuse and Incest

Background: Incest-related childhood sexual abuse (IRCSA) is challenging to study due to shame and secrecy experienced by its survivors. Ramifications of IRCSA worsen when it is unidentified and interventions are not made. IRCSA perspectives are essential for future prevention and intervention strategies. However, there is limited understanding about this population’s experiences, perspectives and long-term struggles. To date research for IRCSA has utilized data from treatment programs and qualitative research with cohorts of 10-20 people, Much of the data is from 10-40 years prior.

Methods: In June 2018 an anonymous online survey was posted to multiple social media sites (e.g., Facebook IRCSA groups) and sexual abuse resource sites. Survey responses were collected for a year. The survey collected non-identifying demographics, IRCSA experiences and outcomes data.

Results: We obtained 1310 completed surveys. Demographics of all age, racial backgrounds, financial backgrounds and genders were obtained, majority identified as white (81%) and female (76%). Childhood sexual abuse (CSA) started before the age of 6 in 49% and was endured for more than 1 year in 84% of respondents, 39% reported 10 or more years of abuse. CSA by multiple perpetrators occurred in 58%, while 8% had 10 or more perpetrators. CSA by perpetrators under 21 years old was reported by 46%. Female perpetrators were reported by 28% of respondents. Fathers were highest reported sexual abusers at 60%, mothers were reported at 17%. Only 16% reported that at least one of their perpetrators were prosecuted for sexual abuse of a minor. Respondents confirmed that 54% of the time they informed an adult of the abuse; only 2% agreed that “an intervention was made by the family that protected me.” A majority reported that IRCSA has negatively impacted their intimate/sexual relationships (96%) and mental health (96%). A majority reported negative impacts on biological family relationships (88%), physical health (73%), finances (59%), educational achievement (57%), employment (56%). When asked about suffering from addiction, 85% of respondents answered yes. Prevention strategies selected most by respondents include: early school education around CSA prevention (67%), removing the statute of limitations for reporting CSA (69%), improved laws protecting IRCSA survivors (63%).

Conclusion: The data document that IRCSA can be pervasive, and the dearth of intervention and support for survivors has major lasting impacts. Survivors have a unique and valuable perspective on what interventions are needed to prevent IRCSA and support survivors; their voice has long been unheard in crafting prevention and intervention policies and services. These results thus provide an important call to action from these critical stakeholders.

Pediatricians should recognize that perpetrators can be pediatric patients, women and parents. Pediatricians can advocate for more early CSA prevention education and policy changes that remove the statute of limitations for reporting CSA.