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Child sexual abuse is a widespread social problem found to be associated with detrimental outcomes in both the short and long term. Efforts by researchers to develop comprehensive understandings of the factors and processes associated with abuse occurrence and outcome have been hampered by a lack of consensus across theory and epistemology. The complexity of the problem has also meant that few studies have attempted to examine risk factors for the occurrence of child sexual abuse simultaneously with outcomes. Attending to this observed gap in the literature, this thesis examined the relationship between factors specific to children, their families and social environments, and the occurrence and outcomes of child sexual abuse for participants in an Australian prospective longitudinal cohort study. Guided by a conceptual framework based on concepts from developmental psychopathology, ecological theory and the ‘Integrated Risk-Sequelae’ model of child maltreatment (Higgins & McCabe, 1994), the thesis investigated the hypothesis that sexually abused and non-abused children differ significantly across child, family and environmental factors, and that these differences in context synergistically influence both the occurrence and outcome of child sexual abuse. To clarify these relationships, the study assessed the relative influence of sexual abuse and contextual factors upon child outcomes by exploring the potential of sexual abuse to affect outcomes through both direct and indirect pathways. The data source for the study (de-identified survey data with linked child protection information) provided a unique life course perspective on the experiences of sexually abused children, and in contrast to other studies, enabled a wide range of contextual factors to be investigated as potential risk factors for the occurrence of child sexual abuse and its outcome or sequelae over time. The study finds that when compared to their non-abused counterparts, sexually abused children experience greater vulnerability and disadvantage across multiple aspects and phases of their life. While mothers of sexually abused children report significantly higher rates of child problems when compared to mothers of non-abused children, no significant differences exist between sexually abused and non-abused children’s self report of social, emotional and behavioural outcomes. Examination of the relationship between contextual factors and sexual abuse confirm the hypothesis that observed differences between the contextual domains of sexually abused and non-abused children are associated with increased risk for both the occurrence and outcome of child sexual abuse. Assessment of the relative influence of sexual abuse and contextual factors upon maternal and child self-reported outcomes for all children, finds that when the effect of contextual factors is taken into account, sexual abuse does not make a significant contribution to report of child health outcomes. Exploration of the potential for sexual abuse to affect outcomes through indirect pathways finds little support for the presence or operation of moderation or confounding effects, but does find considerable support for the proposition that contextual factors mediate the relation between sexual abuse maternal reports of child outcome. This thesis also finds that factors specific to the sexual abuse experience are significantly associated with sexually abused children’s self-reported outcomes even when the effects of contextual factors are considered. This effect does not hold for maternal report of child outcomes, suggesting that while contextual factors exert a strong influence on maternal-reported outcomes, characteristics of the sexual abuse experience, rather than the sexual abuse itself, may be an important influence on sexually abused children’s self reported outcomes. Collectively, the findings of this thesis suggest that the occurrence and outcomes of child sexual abuse exist as a function of multiple factors that operate via dynamic processes or mechanisms over time. The study is unique in the Australian context and makes several important findings that add to the knowledge base for child sexual abuse.

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