Any abuse or neglect in childhood has profound, lifelong consequences on both the physical and mental health of victims. Sexual abuse is particularly destructive. Symptoms can include: major depression, adjustment disorder, alcohol or other substance abuse, personality disorders, multiple personality, anxiety disorders, psychotic disorders, and psychosexual dysfunctions. The following symptoms, when presented together, are especially likely to indicate a history of sexual abuse: compulsive sexual behavior, substance abuse, sadomasochistic fantasies, problems with sexual identity, low energy or chronic fatigue and loss of interest in sex.

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• Emotional and Physical Effects of Sexual Assault chapter from "By the Numbers" manual - 2007