Beyond Cumulative Risk: A Scoping Review of the Application of the Polyvictimization Framework in Child Sexual Abuse Research

Abstract

Research on polyvictimization (PV) generally builds on a cumulative risk model to explain posttrauma functioning. However, evidence becomes unclear when child sexual abuse (CSA) in particular is assessed alongside other types of victimization, necessitating a closer examination of how CSA fits within the PV framework. This scoping review aimed to (a) identify conceptual and operational definitions of PV in CSA research, (b) map evidence on organizing CSA into the PV framework, and (c) highlight research trends and gaps. A systematic search was conducted across six databases for primary studies focusing on CSA in victim/survivor samples or as a central topic, with explicit application of the “polyvictimization” construct. From 1064 references initially retrieved, 62 met eligibility criteria. Four approaches to situating CSA within the PV framework were identified: (a) interconnection (CSA’s link to other abuse), (b) cumulative risk (additive effects), (c) comparative (CSA vs. other abuse/PV), and (d) configural (co-occurring patterns). Results highlighted substantial inconsistencies in how CSA characteristics and PV were measured and analyzed, precluding definitive conclusions regarding the distinct contribution of CSA versus collective impact of PV. The review concludes that a comprehensive PV framework for driving CSA studies should move beyond the simplistic “more is worse” posit to explore how different types of victimization interconnect, interact, accumulate, and aggregate to differentially impact psycho-behavioral development.