Ongoing concern over child sexual abuse is reflected in the increase in research in this area.A growing number of studies and literature reviews on child sexual abuse have appeared over the past twenty years. In order to examine what is currently known about the potential impact of child sexual abuse on mental health and to address the best available scientific evidence on the topic, this paper provides a qualitative and semi-quantitative analysis of the findings of the several reviews that have investigated the literature on the short- and long-term effects of child sexual abuse. According to recent guidelines for systematic reviews, a protocol was prospectively developed by the authors, detailing the specific objectives, criteria for study selection, approach to abstracting data and assessing study quality, outcomes, and statistical methods. First, seven internet-based databases (AMED, Cochrane Reviews, EBSCO, ERIC, MEDLINE, PsycINFO, and ScienceDirect) were searched for articles published between January 1966 and December 2008. Second, further articles were identified by a manual search of reference lists from retrieved papers. The authors independently evaluated the eligibility of all studies identified, abstracted data, and assessed study quality. Disagreements were resolved by consensus after review of the article and the review protocol. The internetbased search and the manual search of reference lists identified a total of 20,535 articles. Of these, only 64 fulfilled all inclusion criteria. Of these, 54 did not meet many of the quality criteria and had important limitations that could invalidate their results. For these reasons, these studies were judged “poor” and were rejected. Only 10 reviews were judged “fair” and were included in this systematic review.These reviews were published between 1995 and 2008 and reviewed a total of 349 studies. The main findings of these fifteen reviews were qualitatively and semi-quantitatively analyzed in an evidence-based, objective, and balanced fashion, with the highest quality evidence available receiving the greatest emphasis. In considering the results as a whole, there is evidence that survivors of child sexual abuse are significantly at risk of a wide range of psychological problems, although the magnitude of the relation between child sexual abuse and psychopathology ranged from small to medium and moderated by some variables, such as the size and the source of the sample. Nevertheless, the presence of confounding variables and the generally poor quality of the studies included in each review do not allow for causal inferences to be made.
