The Relationship of Child Sexual Abuse and Youth Suicide: A Qualitative Systematic Review

BACKGROUND: In 2023, suicide emerged as the second leading cause of death for 10- to 24-year-olds in the United States, accounting for over 40,000 deaths across the age group. Recent research identified childhood adverse experiences, including sexual, physical, and emotional abuse and neglect, as possible links with youth suicidal behavior. AIMS: This review aimed to synthesize qualitative evidence on childhood sexual abuse (CSA) and the relationship to self-harm, suicidal ideation, or attempts. METHODS: CINAHL, OVID Medline, and PsycInfo databases were searched for qualitative research articles relevant to youth sexual abuse, trauma, and suicidal behaviors. RESULTS: Of 442 records screened, 11 qualitative studies met the criteria for the systematic review. Four themes emerged: CSA and the perpetrators; suicidal behaviors and self-harm; shame, self-blame, and guilt; and disclosure. CONCLUSIONS: Despite the growing prevalence of childhood sexual abuse and other traumas, there is a lack of boundaries and safety for youth and an absence of effective strategies to mitigate CSA and related suicidality. Opportunities for youth disclosure about child sexual abuse initiate the work of healing from shame and should be provided in a timely manner. Researchers acknowledge the powerful impact of disclosure and advise ongoing therapy for recovery, with emphasis on safe environments.