From silence to sharing: A six-month prospective study on adult disclosure of childhood sexual abuse

Background Disclosure of childhood sexual abuse (CSA) is often assumed to be beneficial. However, prospective research examining outcomes associated with disclosure remains scarce, limiting evidence-based guidance for adults considering disclosure. Objective The primary aim was to examine changes in posttraumatic stress disorder (PTSD) symptoms following first-time disclosure of CSA to personal contacts and to test whether perceived supportiveness of confidants' responses moderated these changes. The secondary aim was to explore characteristics of CSA disclosure. Methods Forty adults with a history of CSA who had not previously disclosed the abuse to personal contacts completed two assessments, at baseline and at follow-up six months later. Participants who disclosed their CSA to a personal contact during the follow-up period were classified as disclosers, whereas those who did not were classified as non-disclosers. Results During the follow-up period, 60% ( n = 24) disclosed for the first time to personal contacts, after on average 31.5 years ( SD = 16.2), most often to friends (47%). Disclosers showed a clinically relevant, greater reduction in PTSD symptoms than non-disclosers. Perceived supportiveness of confidants' responses was moderate to high but did not significantly moderate changes in PTSD symptoms. Conclusions First-time disclosure of CSA in adulthood to personal contacts was associated with a clinically relevant reduction in PTSD symptoms. Nevertheless, individual differences in symptom change indicate that outcomes following disclosure vary. Guidance should therefore move beyond the question of whether to disclose and consider when, under what circumstances, and for whom disclosure may be beneficial.