Psychobiological Consequences of Childhood Sexual Abuse: Current Knowledge and Clinical Implications

Abstract

A large body of research has documented the long-term harms of childhood sexual abuse (CSA) on an individual’s emotional-adaptive function and mental health. Recent studies have also provided evidence of the biological impact of CSA, implicating specific alterations in many systems, including the endocrine and immune systems, and in DNA and chromatin, in the pathogenesis of medical disorders. Although the effects of CSA are often examined with regard to the general impact of early-life traumatic experiences, the study of CSA per sè, as a trigger of specific pathogenic pathways, would be more appropriate to understand their long-term implications and develop tailored diagnostic and therapeutic strategies. Based on these premises, this narrative minireview summarizes the research on the short-term and long-term sequelae of CSA, focusing on dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, the effects on the immune system, and the changes to DNA through altered methylation. Also, we discuss the literature that examines dysfunctional DNA telomere erosion and oxidative stress markers as a sign of CSA. Finally, recent evidence of the intergenerational transmission of the effects of CSA is reported. The impact of CSA on brain connectivity and functions is out of the scope of this review, thus brain imaging studies are not included. The results of this minireview are discussed, considering their implications for prevention and clinical practice.

In major depression, complex intersections between adverse childhood experiences and negative life events impact neuroticism, brooding, suicidal tendencies, insomnia, and cognitive interference

“…93 Finally, ACEs have been linked to reduced volume in the amygdala, hippocampus, and anterior cingulate cortex-regions of the brain responsible for emotion regulation and self-control-along with impairments in executive functions, which are indicative of impaired memory and cognitive flexibility. 6,25,84,[94][95][96] The potential impact of sexual abuse on neurocognitive function could be accounted for by the known cognitive function-altering effects of ACEs on various pathways, such as inflammation , 66,88,97 alterations in the HPA-axis, 97 and disruptions in the cortical and subcortical regions . 98 Likewise, NLEs have a plethora of detrimental effects on the same pathways, including the IRS, 99,100 oxidative stress pathways, 101 HPA-axis function, 102 and methylation processes.…”

Complex Intersections Between Adverse Childhood Experiences and Negative Life Events Impact the Phenome of Major Depression

“…93 Finally, ACEs have been linked to reduced volume in the amygdala, hippocampus, and anterior cingulate cortex-regions of the brain responsible for emotion regulation and self-control-along with impairments in executive functions, which are indicative of impaired memory and cognitive flexibility. 6,25,84,[94][95][96] The potential impact of sexual abuse on neurocognitive function could be accounted for by the known cognitive function-altering effects of ACEs on various pathways, such as inflammation, 66,88,97 alterations in the HPA-axis, 97 and disruptions in the cortical and subcortical regions. 98 Likewise, NLEs have a plethora of detrimental effects on the same pathways, including the IRS, 99,100 oxidative stress pathways, 101 HPA-axis function, 102 and methylation processes.…”

Intra verses extra familial sexual abuse in the Orthodox Jewish community as reported by mental health professionals.

“…Two meta-analyses revealed that childhood SA is estimated at 18% for girls and 7.9% for boys (Pereda et al, 2009; Stoltenborgh et al, 2011) while lifetime SA is estimated at as high as 23% for men and 37% for women (Chiu et al, 2013; Smith et al, 2018). There is extensive literature that shows that SA increases an individual’s vulnerability to a range of physical, psychological, and behavioral impairments (Atabay & Arman, 2019; Gladstone et al, 2004; Guiney et al, 2022; Kendall-Tackett et al, 1993; Lang et al, 2004; Lo Iacono et al, 2021) and that childhood SA is a key risk factor in the development of psychiatric disorders in adulthood (Read, 1997; Wurr & Partridge, 1996).…”