Childhood Sexual Abuse: A Narrative Review

Background Childhood sexual abuse (CSA) remains a pervasive public health challenge with harms that extend across the life course. In the United States, at least one in four girls and one in twenty boys experience CSA before age 18. Methods The present narrative review synthesizes peer reviewed literature from the psychology, public health, behavioral health, and social sciences. Sources were identified through searches of major academic databases (e.g., PubMed, PsycINFO, Google Scholar) and reference lists of key articles. Priority was given to recent empirical studies, meta analyses, and national surveillance reports. The review integrates findings across domains, including prevalence and trends, psychological and behavioral mechanisms (e.g., emotion dysregulation, attachment disruption), risky sexual behavior, mental health outcomes, substance use, revictimization, and sexual offending. Results Evidence consistently shows that CSA is associated with a wide range of adverse outcomes across psychological, behavioral, and physical health domains. Mechanisms such as emotion dysregulation, attachment disruption, impulsivity, and trauma related coping contribute to elevated risks of depression, anxiety, PTSD, substance misuse, risky sexual behavior, and revictimization. Gender and racial disparities persist, with females reporting higher prevalence, males experiencing greater underreporting, and racially and ethnically diverse survivors underrepresented in research. Discussion The current narrative review highlights the extensive and enduring impact of CSA across psychological, behavioral, relational, and physical health domains. Consistent with decades of research, CSA remains a pervasive public health issue that disproportionately affects girls, gender diverse youth, and racially and ethnically marginalized populations. Despite increased awareness, CSA continues to be underreported, particularly among boys and communities where cultural stigma, fear of retaliation, and structural barriers inhibit disclosure. Conclusion A multidisciplinary approach is needed to effectively address this issue from a prevention, intervention, and treatment perspective. Continued public and psychological health efforts are warranted.