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Sexual victimization in the United States and throughout the world is increasing. Depending on the research, estimates of sexual trauma range between 20% and 40% of all women; that is, 20% to 40% of all women will experience some form of sexual assault during their lifetimes. Also depending on the research, approximately 10% to 20% of all males will experience some type of sexual victimization. Women with a history of childhood or adolescent sexual assault have been shown to have an increased risk of subsequent sexual victimization. That increased risk may cause these women to be 10 times more vulnerable to future assaults. Research elucidates that sexual trauma can have serious mental health consequences that can run the spectrum of diagnostic disorders. In addition to depression, anxiety, and low self-esteem, survivors often suffer from posttraumatic stress disorder, dissociative disorder, sexual dysfunction, interpersonal problems, ongoing guilt and shame, substance abuse issues, sexual addiction, and problems with suicidal ideation and acts. As noted by David A. Sandberg and associates, multiple victimization has been linked to increased rates of unemployment, unintended pregnancies, abortion, and a lower socioeconomic status. This entry discusses four major areas of sexual trauma: incest, sexual molestation, rape, and self-inflicted injury.

Incest

Incest is a type of sexual abuse that occurs within a familial context between those related by blood, marriage, family relationships, or close familiarity. Incest is distinguished from molestation, in that molestation is child sexual abuse that is performed by strangers or those who know the child at a distance. Sexual abuse in the form of incest may or may not include intercourse between members of the same family other than husband and wife. Sexual acts that are considered incestuous may include making sexually harassing statements and antiwomen jokes; treating someone as a sexual object; insisting that one dress in a sexual way that is inappropriate; minimizing feelings about sexuality; criticizing the victim sexually; insisting on unwanted, inappropriate, or uncomfortable touching; withholding affection unless the victim is sexual; calling the victim sexual names, such as “whore” or “frigid;” forcing the victim to undress; forcing particular unwanted sexual acts; forcing sex when the victim is sick or when it would be a danger to health; forcing sex for the purpose of hurting with objects or weapons; performing sadistic sexual acts; forcing any form of intercourse; raping or coercing sexually; performing oral-genital contact or anal penetration; sexually kissing and hugging; sexually staring at the victim; touching the victim's body accidentally or in a disguised fashion; making verbal invitations to engage in sexual activity; verbally ridiculing body parts; producing pornographic photography or video; reading sexually explicit material to children; and exposing the victim to inappropriate sexual activity. This list is quite extensive and covers all aspects of inappropriate sexual activity perpetrated by family members usually against children.

When incest occurs within the family, the family is often a protective mechanism and attempts to hide the abuse from those within and outside of the family. What often develops for the victim is the need to maintain the secret, which is engendered out of shame and loyalty for and among family members. Secrecy, however, causes more stress for the child, who is often blamed, not believed, and discouraged from reporting anything outside of the family. Because of the shame and loyalty, incest often remains unreported or reporting is delayed into adulthood. Additionally, incest often occurs within the context of family problems, communication problems, power differentials, and household violence and in the presence of alcohol or other substances. As a result, children often find that they have to parent themselves, and the disruptive lifestyle is both chaotic and inconsistent. The child experiences neglect because of the constant shifting of moods of the parents and experiences guilt and a sense of shame. Those feelings often lead to anxiety, depression, attachment issues, and dependency.

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