When the perpetrator is family: grooming, abuse severity, and trauma outcomes in adult survivors of child sexual abuse

Although the effects of child sexual abuse are well documented, less is known about how abuse differs when the perpetrator is someone close to the child and how this shapes grooming and outcomes. This study surveyed 295 adult survivors using anonymous online questionnaires. Perpetrator relationship was measured on a 4-point scale from stranger to nuclear family member. As relational closeness increased, grooming involving drugs or alcohol (p = .002) and threats or violence (p = .028) also increased. Closer kinship was associated with earlier onset, greater severity (p < .001), and more frequent abuse (p < .001). Among 262 participants reporting gender (223 female, 39 male), girls were more likely than boys to be abused by closely related perpetrators (d = .77). Kinship was also linked to higher trauma symptoms on the TSC-40 (p = .016). These findings highlight the importance of considering relational context in assessment and intervention.PRACTICE IMPACT STATEMENTFor clinicians, these findings emphasise the importance of assessing the relational proximity of the perpetrator as part of trauma-informed intake and case formulation. Survivors of intrafamilial abuse may present with more complex symptom profiles and require tailored interventions. For researchers, the study contributes to understanding how perpetrator relationship shapes abuse dynamics and long-term psychological outcomes, supporting the development of more precise risk models and targeted prevention strategies.