OBJECTIVE: To assess change in behavior, depression, and
self-esteem in sexually abused children after 5 years and to determine
which factors predict later functioning. METHOD: Sixty-eight of 84
children and their nonoffending parents were reassessed after 5 years
for depression, self-esteem, and behavior problems in the children;
parental mental health; and family functioning. RESULTS: There were no
significant changes in depression, self-esteem, or behavior over 5
years. Forty-three percent of the children were now sad or depressed,
43% had low self-esteem, and 46% had behavioral dysfunction. While
some children improved, a nearly equal number deteriorated, with no
clear pattern of change. The only abuse-related variables associated
with 5-year functioning were further contact with the abuser, which
was significantly associated with depression and self-esteem, and
sexual abuse prior to intake, which was related to an increased
incidence of behavior problems. Older children showed more depression
and lower self-esteem but less behavioral dysfunction. Poor family
functioning at 5 years was associated with low self-esteem and
behavior problems. Treatment had no effect on depression, self-esteem,
or behavior. Multivariate analysis showed that depression and
self-esteem at intake were prognostic indicators of 5-year
outcome. CONCLUSION: Many sexually abused children have continuing
problems with behavior, self-esteem, and depression. Family and
abuse-related variables do not appear to be good predictors of
outcome, although sexually abused children who are sad or depressed
and have low self-esteem at intake are likely to have continuing
problems in these areas.