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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. 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. Childhood sexual abuse CSA is a severe public health concern, affecting roughly 1 in 4 girls and 1 in 13 boys worldwide Center for Disease Control and Prevention, As with other forms of abuse, CSA is characterized by the complex manipulation and coercion of the perpetrator and the unbalanced and power-based relationship that is established by leveraging and exploiting vulnerability.
Childhood sexual abuse includes sexually connotated physical contact or non-contact activities. The former includes intercourse, attempted intercourse, or oral-genital contact with the penis, fingers, or any object; masturbation; and fondling the genitals or other erogenous areas through the clothing or directly. The latter entails forcing a child to participate in adult sexual pleasure such as sexual harassment and prostitution or exposing a child to adult sexual activities, such as pornography, voyeurism, and exhibitionism Putnam, ; Slep et al.
