Understanding Childhood Sexual Abuse and its Association With Psychological Traumatisation,Re-traumatisation,and Shame in Adult South Asian Women: A Scoping Review

Abstract

Research on childhood sexual abuse (CSA) often reflects Eurocentric perspectives, limiting understanding of its cultural dimensions in collectivist societies. This scoping review examined how CSA shapes adult South Asian women’s experiences of shame, and how this culturally embedded shame contributes to re-traumatisation, re-victimisation, and barriers to help-seeking in India, Pakistan, and Bangladesh. Using PRISMA-ScR guidelines, we systematically searched CINAHL, Medline, and PsycINFO databases for studies published between 2012 and 2024 in English. Out of 52 screened records, nine studies met the inclusion criteria. Narrative thematic synthesis identified key patterns, including the impact of cultural constructs (izzat and sharam), barriers to disclosure, and systemic challenges like poverty and complex legal systems. Significant gaps remain, particularly regarding the experiences of marginalised communities and the culturally mediated pathways linking CSA to re-traumatisation and re-victimisation. Findings highlight the need for culturally grounded and decolonially informed trauma approaches, alongside strengthened trauma-informed services and policy reforms in South Asia.

Plain Language Summary

Understanding Childhood Sexual Abuse for Adult South Asian Women: A Scoping Review

This review examines how childhood sexual abuse affects adult women from South Asia, specifically those from India, Pakistan, and Bangladesh. It shows that abuse in childhood can lead to long-lasting emotional distress, recurring trauma responses, and deep feelings of shame. In many South Asian communities, strong cultural expectations around family honour and shame often make it difficult for survivors to speak about their experiences or seek support. The review analysed nine research studies published between 2012 and 2024. These studies highlight how cultural pressures shape survivors’ experiences of trauma. Concepts such as izzat (honour) and sharam (shame) can discourage disclosure, while factors like poverty, limited resources, and complex legal systems create additional barriers to accessing help. A key finding is the limited research on how childhood abuse may contribute to re-traumatisation later in life. The review emphasises the need for mental health services that are culturally sensitive and responsive to the lived experiences of South Asian women. Tailoring therapeutic approaches to the cultural contexts of survivors can support more effective healing. Overall, this review calls for stronger research, greater cultural awareness, and more accessible support systems to help survivors of childhood sexual abuse recover and reduce the ongoing effects of their experiences.

Keywords

childhood sexual abuse shame re-traumatisation re-victimisation South Asia decolonising psychology scoping review trauma

Introduction

English language literature on the incidence, prevalence, and experiences of child sexual abuse is extensive. However, theorising and publications are largely informed by Eurocentric perspectives, creating a gap in understanding the role of culture, particularly collectivist cultures, in shaping CSA experiences. This gap reflects a broader critique within decolonial scholarship, which argues that psychological knowledge, particularly trauma theory, has historically centred Western assumptions about the self, healing, and harm (Adams et al., 2015). Decolonial approaches call for recognising how colonial histories, caste and gender hierarchies, and collectivist social structures shape both the meaning of CSA and the possibilities for disclosure, justice, and recovery in South Asian contexts (Kirmayer, 2012).

Although scholars recognise intersecting identities such as gender, caste, religion, and class, culturally inclusive analyses of CSA among South Asian women remain limited (Futa et al., 2001; Kenny & McEachern, 2000). While individualist cultures value independence and autonomy (Kitayama et al., 2006), collectivist societies emphasise interdependence and reciprocal obligations for the sake of group harmony (Oyserman et al., 2002). Accordingly, in South Asia, an individual’s identity is closely intertwined with family and community identity (Alexander et al., 2004), shaping both vulnerability to CSA and responses to it.

Recent literature continues to show that, for contemporary South Asians, the “self” is rarely an autonomous unit but a relational weave. Fieldwork with second-generation migrants demonstrates what Ullah (2024) calls a hybrid calculus of loyalty, where ancestral norms and host-country expectations are internalised together, producing identities that are “never fully here nor there.”Neupane (2024) similarly shows how transnational mobility and patriarchal structures compel South Asian women to renegotiate professional and gendered identities, shaping how trauma is interpreted and silenced.

The following contemporary works (published after the search closed on 13 August 2024) are cited for contextual framing only and were not included in the scoping review evidence base. Baloch et al. (2025) find that South Asian women weigh the implications for their entire kin network when disclosing family violence, whereas Bicknell et al. (2025) find that perinatal mental-health trajectories are co-regulated by spouses and extended family. Autoethnographic work portrays identity as a continuous “cross-stitch” between cultural and academic worlds (Hou et al., 2025). Even popular culture reflects this collectivised understanding of suffering: in a 2025 Netflix special, comedian Vir Das quips, “my trauma has childhood,” highlighting how pain is experienced through communal rather than individual lenses (Das, 2025).

Conceptual and Contextual Framework

Understanding CSA in South Asia requires consideration of the cultural, social, and structural factors that shape how abuse is perpetrated, interpreted, silenced, or disclosed. The region’s collectivist orientation, patriarchal family structures, and historically embedded hierarchies—such as caste, class, and religion—inform both vulnerability to CSA and the psychological processes surrounding trauma and disclosure. The following framework outlines the core cultural and contextual elements that underpin CSA experiences among women in India, Pakistan, and Bangladesh and provides foundational clarity for interpreting the findings of this scoping review.

Cultural Constructs: Honour, Shame, and Familial Identity

In collectivist societies, sexual transgressions are rarely interpreted as individual events; instead, they carry implications for the family’s social standing and moral reputation. Concepts such as izzat (honour) and sharam (shame) are deeply embedded in South Asian cultural norms (Gilbert et al., 2004). These constructs locate family dignity within women’s bodies and behaviour, establishing powerful incentives to conceal abuse rather than expose it. Survivors are often pressured to maintain silence to avoid bringing disgrace upon the household (Cowburn et al., 2014).

Shame is not only externally imposed but also deeply internalised. The traumagenic model of sexual abuse suggests that stigmatisation becomes part of the survivor’s identity, producing enduring feelings of defectiveness and self-blame (Finkelhor & Browne, 1985). In South Asian contexts, these internal processes are magnified by social expectations of female modesty and sexual purity (Gill & Brah, 2014). As a result, shame frequently becomes the primary barrier to disclosure, overshadowing concerns about personal safety or justice.

Epidemiological and Structural Factors Across South Asia

CSA in South Asia occurs within structural conditions marked by gender inequality, limited access to justice, socioeconomic marginalisation, and weak institutional safeguards. These conditions manifest differently across India, Pakistan, and Bangladesh, but share common features shaped by patriarchal norms, caste or class hierarchies, and barriers to institutional support (Rahim et al., 2021).

Prevalence data highlight the severity of the issue. In India, the National Crime Records Bureau reports that most CSA cases involve perpetrators known to the child, underscoring the centrality of familial or community relationships in abuse dynamics (Crime in India, 2021). Data from Dalit rights organisations indicate that caste-oppressed girls are at elevated risk due to intersecting vulnerabilities and social exclusion (AIDMAM, 2024).

In Bangladesh, reports from the United Nations Development Programme show that children and adolescent girls comprise the majority of sexual assault survivors, with many incidents occurring in homes rather than public spaces (Faruk et al., 2023; UNDP, 2022). Pakistan similarly reports high levels of gender-based violence, including rape and honour-related crimes, compounded by low conviction rates and significant barriers to reporting (Sustainable Social Development Organization, 2024).

Across all three countries, poverty, overcrowding, child labour, and inadequate legal infrastructures further contribute to the normalisation, concealment, and underreporting of CSA (Carson et al., 2013; Deb & Walsh, 2012). These structural determinants create an environment where abuse can persist unchecked and survivors have limited pathways to safety.

Psychological Trauma, Shame, and the Dynamics of Re-traumatisation and Re-Victimisation

CSA disrupts core developmental capacities, including trust, autonomy, and emotional regulation. Survivors frequently experience hypervigilance, dissociation, chronic anxiety, or avoidance-based coping strategies (Perry, 2008; Perry et al., 1995). In adulthood, unresolved trauma can manifest as post-traumatic stress disorder (PTSD), depression, relationship difficulties, and sexual dysfunction (Herman, 1992; Messman-Moore & Long, 2000).

Re-traumatisation refers to the re-experiencing of trauma symptoms when exposed to reminders of past abuse, including clinical contexts where survivors do not feel safe or believed (Batten & Naifeh, 2012). Although not formally recognised in the DSM-5, re-traumatisation is widely reported among adult CSA survivors, particularly when therapeutic environments replicate power imbalances or disregard cultural sensitivities.

Shame plays a central role in both trauma processing and vulnerability to re-victimisation. Research shows that shame not only predicts later involvement in harmful or unsafe relationships but also triggers re-traumatisation, as survivors internalise self-blame and remain hypervigilant to cues that echo the original abuse (Kessler & Bieschke, 1999). Shame can disrupt core beliefs about safety and self-worth, making survivors more susceptible to coercion, boundary violations, and cyclical patterns of harm.

For South Asian women, cultural frameworks linking sexual purity to family honour intensify these pathways: shame fuels re-victimisation by limiting help-seeking and assertive resistance, and fuels re-traumatisation by reinforcing silence, secrecy, and unresolved distress. Constructs such as izzat (honour) and sharam (shame) heighten the psychological burden survivors carry, prolonging cycles of stigma and narrowing the social possibilities for disclosure, protection, or healing.

Barriers to Disclosure and Challenges in Treatment Provision

Disclosure of CSA is shaped by cultural taboos around discussing sexuality, reverence for elders, and fear of disrupting familial harmony (Morrison et al., 2018). Children often lack safe adults who will believe or protect them, and many are explicitly instructed to remain silent to preserve family reputation (Carson et al., 2013). Underreporting is further fuelled by concerns about marriage prospects, parental disbelief, and fear of retaliation from perpetrators (Deb & Modak, 2007; Verma, 2021).

Furthermore, mental health and legal systems across South Asia often lack culturally informed or trauma-sensitive responses. Therapeutic approaches such as Trauma-Focused Cognitive Behavioural Therapy (TF-CBT), though evidence-based, do not always translate effectively in settings where discussing sexual experiences openly is taboo or where treatment requires family involvement in ways that conflict with collectivist dynamics (Damra et al., 2014; Singh & Kometiani, 2020). Clinicians also report insufficient training in trauma-specific care and limited resources for supporting survivors, particularly in rural or low-resource settings (Choudhary et al., 2024).

These barriers contribute to delayed intervention, increased risk of re-victimisation, and chronic psychological consequences that extend into adulthood. They also highlight the need for culturally grounded, community-based, and survivor-informed approaches to prevention and care.

Study Objectives and Review Questions

The objective of this scoping review was to synthesise published evidence on how childhood sexual abuse (CSA) shapes adult women’s experiences of shame, and how this culturally mediated shame contributes to re-traumatisation, re-victimisation, and barriers to disclosure and help-seeking in South Asia.

Review Questions

What does the existing literature reveal about how shame shapes the traumatic impacts of childhood sexual abuse for adult women in India, Pakistan, and Bangladesh, including its role in re-traumatisation and re-victimisation?

What is known about how shame, honour, and cultural expectations shape barriers to disclosure and access to support among adult women in India, Pakistan, and Bangladesh?

Methods

Study Design and Review Approach

This scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR; Peters et al., 2017). The purpose of the review was to map the extent and nature of academic literature examining childhood sexual abuse (CSA) among adult women in India, Pakistan, and Bangladesh, with attention to trauma, shame, and re-traumatisation in adulthood.

This review focused exclusively on peer-reviewed academic literature to identify how CSA is conceptualised within mainstream scholarship. Following the first round of peer review (June 2025), additional 2024 to 2025 publications were incorporated only into the Introduction and Discussion for contextual framing. These newer sources were not part of the scoping-review evidence set, as the final search occurred on 13 August 2024. This scoping review synthesised published, de-identified data and did not involve direct human participants; therefore, institutional ethics approval and informed consent were not required.

Eligibility Criteria

Studies were included if they met all of the following criteria:

Population: Adult women (18 years or older) from India, Pakistan, or Bangladesh who had experienced childhood sexual abuse.

Phenomenon of Interest: Experiences, impacts, or interpretations of CSA, including trauma, shame, stigma, re-traumatisation, or re-victimisation.

Study Design: Qualitative, quantitative, or mixed-methods designs, including:

● phenomenology

● grounded theory

● ethnography

● qualitative description

● feminist research

● descriptive cross-sectional studies

● case series or case reports

Publication Characteristics:

● Published between 2012 and 2024

● English language

● Peer-reviewed journal articles

Studies were excluded if they:

Focused on adult sexual assault rather than CSA,

Included male or transgender participants,

Examined populations outside the named South Asian countries,

Were theses, dissertations, conference abstracts, opinion pieces, or grey literature.

Search Strategy

The search strategy was developed and executed by the first author in consultation with a university research librarian and under the supervision of the second author. An initial limited search of PsycINFO and MEDLINE helped identify key terms and refine the strategy.

A comprehensive search was then run across the following databases:

Ovid MEDLINE

Ovid PsycINFO

CINAHL (EBSCOhost)

Search Terms

To ensure a comprehensive search, we used both controlled vocabulary (e.g., MEDLINE Medical Subject Headings [MeSH]) and keywords. Controlled vocabulary captures articles indexed under standardised subject headings, whereas keywords retrieve relevant articles using contemporary or variant terminology. These terms were combined using Boolean operators (AND/OR) to systematically link synonyms and concepts. An example of the search string used in MEDLINE is provided below:

(“child sexual abuse” OR “CSA” OR “childhood sexual trauma” OR “sexual victimization”)

AND (women OR female*)

AND (India OR Pakistan OR Bangladesh)

AND (trauma OR retraumat* OR “psychological impact” OR shame OR stigma)

Complete database-specific search strategies for MEDLINE, PsycINFO, and CINAHL are provided in Supplemental Appendix B.

Study Selection

All citations identified through database searches were exported into an Excel spreadsheet (Supplemental Appendix A), and duplicates were removed. Study selection occurred in two stages:

Title and Abstract Screening: Two independent reviewers screened each record against the inclusion criteria.

Full-Text Review: Full texts of potentially relevant studies were independently assessed by the same reviewers.

Reviewer Agreement and Disagreements

Both reviewers independently screened all 52 records.

Three disagreements occurred during full-text screening.

Disagreements were resolved through discussion during weekly supervisory meetings.

A third reviewer was not required.Nineteen full-text articles were assessed for eligibility, of which nine met inclusion criteria.

Data Extraction

Data extraction was performed independently by two reviewers using a structured data-extraction sheet. Extracted information included:

Author(s) and year

Country

Study design and methodology

Sample characteristics

Definitions or conceptualisations of CSA

Key findings related to trauma, shame, stigma, re-victimisation, or re-traumatisation

Implications for practice or policy

Any discrepancies in extraction were resolved through discussion.

Data Analysis and Synthesis

A narrative thematic synthesis approach was used to collate findings across heterogeneous study designs. Extracted data were grouped into preliminary thematic categories and refined through iterative discussion among authors. The purpose of synthesis was not to produce meta-analytic estimates but to map patterns, concepts, and gaps within the existing evidence base.

This approach aligns with scoping review methodology, which emphasises breadth of coverage, conceptual mapping, and identification of research gaps.

Results

This section presents the outcomes of the study selection process, the characteristics of the included studies, and the thematic synthesis developed from the extracted data. A PRISMA flow diagram is provided to illustrate the screening and selection of studies (Figure 1).

PRISMA Flowchart and Study Selection

The database searches yielded a total of 52 records, including 38 records from Ovid MEDLINE, 11 from Ovid PsycINFO, and 3 from CINAHL (Supplemental Appendix B). No duplicates were identified.

During initial screening, 33 records were excluded based on title and abstract review. Nineteen full-text articles were retrieved and assessed for eligibility. Of these, 10 studies were excluded:

6 for not meeting the inclusion criteria, and

4 for reporting outcomes irrelevant to the review’s objectives.

A final set of nine studies met all inclusion criteria and were included in the analysis.

Figure 1.

PRISMA 2020 flow diagram.

Data Analysis and Presentation

Data from the included studies, such as authorship, study design, sample characteristics, conceptualisations of CSA, and key findings, were extracted independently by two reviewers and organised in an Excel spreadsheet. This enabled comparison of methodological approaches and outcome patterns across studies.

Thematic synthesis was used to examine how CSA experiences among South Asian women were represented within the literature. Preliminary codes were generated through repeated reading of extracted data and grouped into broader categories. These categories were refined iteratively to construct overarching themes that captured cross-study patterns.

Figure 2 (Thematic Map) summarises the key themes identified in this review, including individual, cultural, familial, and structural factors that contribute to the experience and impact of CSA in South Asian contexts.

Figure 2.

Thematic map depicting contributing factors and barriers related to childhood sexual abuse in South Asian contexts.

Thematic Analyses

Factors Contributing to Childhood Sexual Abuse

Shame, Blame, Silencing, and Familial Harmony Dilemmas in Disclosure

This review advanced the proposition that childhood sexual abuse in South Asian communities is heightened by shame, blame, and silencing to uphold familial harmony, creating challenges in disclosure. Research in cultural, socio-psychological, and anthropological fields has identified a strong honour orientation in societies across the Mediterranean, the Middle East, Pakistan, India, and the southern United States (Cihangir, 2013). As the potential for familial disgrace becomes salient, individuals who have experienced sexual abuse grapple with a profound sense of shame, perceiving it as a blemish on the family’s honour (Cowburn et al., 2014). The implied consequence of this shame is the instigation of fear among victims, rooted in the looming prospect of familial disgrace. In India, cultural dynamics converge with attribution of blame and the imposition of shame, particularly within familial structures. Families, deeply vested in the preservation of their societal reputation, frequently undertake extensive measures to shield themselves from potential dishonour (Baradha 2006; Choudhury 2006, as cited by Carson et al., 2013).

It is not uncommon for children to bear the burden of responsibility for their own abuse, given the prevailing precedence of adult authority over those of children (Carson et al., 2013). Furthermore, considering the intimate connection between a child's identity and their family's standing within the community, any action that might cast a shadow on the family's good name is typically shrouded in secrecy, sometimes even from immediate or extended family members (Carson et al., 2013). This web of cultural dynamics underscores the urgency of examining the profound interplay of shame, responsibility, and family dynamics in the context of childhood sexual abuse. This practice of maintaining secrecy mainly protects the perpetrator of sexual abuse and allows the cycle of abuse to persist (Carson et al., 2013). In a study of sexually abused girls and their families in Western Madhya Pradesh, Sahay (2010) found that despite legal actions against abusers, many victims were pressured by their families to keep the abuse secret. Families often urged the girls to forget the abuse and forgive the offenders for the sake of family honour. Sahay (2010) also noted that these girls were discouraged from seeking counselling or medical help, even when they showed significant mental and emotional distress. This reflects that when parents or caregivers refuse to believe the child victim's account of sexual abuse or attempt to conceal it, both further intensify the child's distress, known as betrayal trauma, and hinders their access to therapeutic assistance when needed (Carson et al., 2013).

Culture significantly shapes how women perceive and respond to sexual violence. In South Asian communities where Hindi and Urdu are spoken (e.g., parts of India, Pakistan, and Bangladesh), the prevalent term for describing shame followed by sexual abuse roughly translates to “I couldn’t stop them from robbing my dignity”(“meri izzat lut gayi”). This euphemistic discourse serves to reinforce deeply ingrained traditional values and notions of honour and shame within the prevailing power structures of these communities. Linguistically, it implies a narrative in which a man transgresses upon a woman's honour through sexual abuse, effectively deflecting accountability from the perpetrator (Cowburn et al., 2014). Notably, within popular cinema in these regions, the recurring euphemism “loss of honour” linguistically suggests a connection between honour and female reproductive anatomy, portraying it as susceptible to violation and insinuating a degree of responsibility upon the victim. Consequently, survivors often contend with enduring consequences such as disgrace, social isolation, coerced marriages, or even acts of violence as retribution for allegedly tarnishing their family's reputation (Cowburn et al., 2014).

In South Asian communities, the pursuit of “izzat” (honour) and the avoidance of “sharam” (shame, Urdu/Hindi/Punjabi) hold significant importance. The notion of sharam acts as a cultural barrier, discouraging individuals from openly addressing incidents of sexual violence. The prevalent prioritisation of izzat over the well-being of children is widespread, and individuals perceived as jeopardising family honour or causing shame risk facing social exclusion from their community. For instance, a participant in Cowburn and Harrison’s (2014) study disclosed that she only reported being a victim of sexual abuse after distancing herself from the community where it occurred. When asked about the possibility of reporting it while still part of that community, she explained that the fear of potential repercussions, including social ostracism and physical harm, would have deterred her, ultimately contributing to the protection of the abuser.

Socially and culturally constructed concepts of shame often leave South Asian women feeling compelled to endure abusive situations or relationships to avoid tarnishing their family’s reputation. These notions of izzat and sharam perpetuate gender violence and oppression and discourage women from seeking support or challenging such injustices (Cowburn et al., 2014). Speaking about sexual violence not only brings shame upon victims but also upon their families and communities. Subsequently, male perpetrators, benefiting from patriarchal privilege, remain silent about their crimes to safeguard their social standing.

In Pakistan, a nation steeped in conservatism and primarily adherent to the Muslim faith, there exists an anticipated regulation of sexual impulses and conduct among the youth (Nadeem et al., 2020). As a consequence, existing societal norms act as a formidable barrier, dissuading individuals from reporting instances of abuse both within familial spheres, and to healthcare professionals and authorities. The pervasive influence of these cultural dynamics introduces considerable impediments to the open acknowledgement and reporting of sexual abuse cases. Here, the underreporting of sexual abuse, particularly concerning minors, notably girls, is a prevailing issue. This phenomenon is influenced by various contributing factors, encompassing the enduring stigma and apprehension of enduring lifelong shame associated with the victim and her family (Nadeem et al., 2020).

Furthermore, families are apprehensive that the revelation of abuse within the community could irrevocably impair the future marriage prospects not only for the victim but also for her sisters. Unfortunately, the prevailing societal emphasis on marriage as a significant goal for young girls exacerbates this concern. As a result, an ethos of silence is predominantly endorsed to avert such consequences. Ironically, in an ostensibly supportive yet misguided approach, families may erroneously assume that the path forward involves simply moving past the trauma without engaging in open discussions, adopting a facade of normalcy as if the traumatic event never transpired (Nadeem et al., 2020). In their discussion on potential treatment approaches, Nadeem et al. (2020) propose that while trauma-focused cognitive-behavioural therapy (TF-CBT) is a therapeutic method centred on families, the dynamics within collectivistic societies diverge from those in individualistic societies. As elucidated earlier, various facets of collective shame within the families necessitate specific attention and consideration.

The importance of shame following sexual abuse is also highlighted by Daral et al. (2016). They examined the barriers to disclosure of abuse among school going girls in Delhi, India, and found that out of 1060 participants, 282 (26.6%) had experienced sexual abuse. For these 282 participants, the prevailing cause for not disclosing abuse was a sense of shame or embarrassment, noted in 65% of cases involving sexual abuse during specific situations and 80% of cases of severe sexual abuse.

Likewise, in her 2019 study, Verma employed qualitative case studies to delve into the dynamics of sexual abuse. The qualitative focus centred on understanding the “concept” and “phenomenon of shame” by eliciting personal reflections, particularly narratives emphasising shame. The unanimous finding highlighted that silence surrounding such incidents was predominantly rooted in feelings of shame and, to some extent, fear. These emotions were internalised due to societal constructs and the pervasive belief that disclosure would stigmatise the family.

These internalised emotions, rooted in societal constructs and the pervasive belief that disclosure would stigmatise the family, are also featured in the multi-dimensional scale to measure trauma associated with child sexual abuse (MSCSA) (Choudhary et al., 2018). This scale comprehensively assesses symptoms across six domains (behaviour, emotions, cognitive functioning, psychopathology, biological functioning, and social functioning), including 48 culture-specific sub-constructs. Unlike existing scales, it considered not only individual body shame but also incorporated culturally specific elements like family shame. In India, where sexual abuse is associated with shame and loss of respect (Gilligan & Akhtar, 2006 as cited by Choudhary et al., 2018), reporting and managing cases hinge on factors such as expressed emotion, stigma, and discrimination, contributing to underreporting, persistent trauma symptoms in children, and the manifestation of psychological disorders into adulthood. Choudhary et al. (2018) recommended that while quantitative research has established the detrimental effects of CSA, a more nuanced exploration of these effects and variations is crucial, warranting the application of qualitative research methodology.

Low SES, Poverty, Lack of Education, Overpopulation, and Complex Legal System

This review further explores the proposition that childhood sexual abuse in South Asian communities is exacerbated by systemic issues such as low socioeconomic status (SES), poverty, lack of education, overpopulation, and a complex legal system. Carson et al. (2013) highlight that addressing various forms of child abuse and neglect (CAN) in India is significantly hindered by challenges such as overpopulation, which leads to inadequate interventions and services for children and families, as well as factors like poverty, illiteracy, child abandonment, underreporting of CAN cases, and cultural norms related to parental rights and practices. Kacker and Kumar (2008) note that the tightly knit patriarchal family system rarely sees children as individuals with their own rights. Although the Indian Constitution guarantees many fundamental rights to children, these are more needs-based than rights-based, presenting the government with the challenge of implementing these provisions effectively.

Deb and Mukherjee (2011) conducted a study in West Bengal, India, revealing that among 120 girls who experienced childhood sexual abuse, 93% belonged to rural, economically disadvantaged families with low educational attainment, predominantly living in nuclear households. A significant majority (73.3%) of trafficked girls were enticed with promises of employment opportunities, marriage, and improved living conditions. Additionally, over half of the victims reported being deceived with prospects of a better future, only to be trafficked into brothels. These findings underscore how systemic factors such as low socioeconomic status contribute significantly to the prevalence of childhood sexual abuse in South Asia. Poverty and educational disadvantages increase vulnerability, as evidenced by the high proportion of abused girls from rural, economically disadvantaged backgrounds lacking adequate support structures.

It is essential to recognise that childhood sexual abuse (CSA) in India differs from that in other countries due to various factors such as poverty, overcrowded living conditions in many households, extended family setups, shared caregiving responsibilities, children living on the streets, as well as inconsistent enforcement of child labour laws in some regions. Several factors related to child sexual abuse, including the child's familial and socio-cultural context, play a crucial role in determining the nature and magnitude of trauma experienced. These include low socio-economic status (Ministry of Women and Child Development, Government of India, 2007) and the complexities of legal proceedings required for justice (Deb & Walsh, 2012; Gilligan & Akhtar, 2006).

Considering the existing legal frameworks, their inaccessibility, and lack of public trust in them, Deb and Mukherjee (2011) observed in their study that among the 120 participants, only two cases of sexual abuse were reported to the police, resulting in security measures and legal actions for the victims. The researchers noted a widespread discomfort and fear among India's impoverished communities towards law enforcement agencies and the police in general.

Legal obstacles for victims of abuse are also revealed by Nadeem et al. (2020). They demonstrated that sexual abuse of minors, particularly girls, is typically under-reported in Pakistan due to several factors. These include the stigma and fear of enduring lifelong shame for the victim and her family, societal tendencies to blame or disbelieve victims, but especially the inefficiencies of the legal system marked by prolonged, costly, and traumatic proceedings that often result in unjust outcomes. Accounting for economic and legal dependency, Nadeem et al. (2020) highlight the critical situation for healthcare professionals in Pakistan when the father is the perpetrator, and the mother is financially reliant on him. Proposing direct confrontation of the abuser as a necessary step to prevent further harm, practical measures such as securing the child's room or restricting interactions with the abuser within the home are sometimes suggested. The absence of a formal legal reporting system or crisis intervention exacerbates these challenges, leading families to seek help from healthcare facilities where addressing familial anxieties and overcoming socio-cultural barriers regarding the stigma of abuse and psychiatric care emerge as crucial areas for intervention.

Legal barriers are also present in the case of commercial sexual exploitation of children through trafficking, Singh and Kometiani (2020)emphasises that while legal recourse can offer restitution to survivors, it is typically a protracted and complex endeavour. Prosecuting trafficking cases often spans years, causing frustration for survivors (Nichols & Heil, 2015). The flawed legal handling of sex trafficking cases stems from challenges in reporting, filing charges, witness testimony, prolonged legal proceedings, and mistreatment of survivors.

Gender: How Patriarchal Norms Fester Female Inferiority in South Asia

As highlighted before, in South Asian communities, a child’s disclosure of abuse by a male family member, a respected community leader, or a family friend inherently challenges patriarchal ideologies that portray the family as a secure environment, protected by male authority figures (Cowburn et al., 2014). For Indian women, this patriarchal framework heavily regulates women's sexual desires, agency, and bodies, treating female family members as property and symbols of familial honour, commodifying them as vessels of this honour (Harvey, 2014). Despite the crucial role of women's honour in maintaining family standing, their personal status often remains low (Cowburn et al., 2015), contributing to ongoing violence, including child sexual exploitation (Gill & Brah, 2014).

In the case of Bangladesh, patriarchy remains a significant barrier to women’s advancement, despite constitutional recognition of women's equality (Constitution of the People’s Republic of Bangladesh, 1972, Art. 19, § 3; Art. 28, § 2). Patriarchal structures frequently coerce women into providing sexual services, force them into prostitution, and use rape and the threat of rape to control their sexuality, leading to shame and dishonour. In Pakistan, gender-based discrimination and limited awareness of child sexual abuse often lead families to confine girls to their homes for protection from outsiders, inadvertently exposing them to intrafamilial risks of CSA (Rahim et al., 2021). Therefore, in South Asian cultures across India, Pakistan, and Bangladesh, men are conditioned as “controllers of women’s sexuality,” tasked with enforcing societal norms under the guise of safeguarding familial honour (Abraham, 1999, p. 597).

Barriers: Hindrances to Victims’ Help-Seeking and Obstacles in Treatment Provision

In this scoping review, we identified that the barriers to help-seeking among victims were found to overlap with the obstacles to treatment provision encountered by professionals, such as counsellors and psychologists. This section elaborates on the themes addressing the challenges posed by cultural incompetence among mental health workers and the impact of societal taboos related to sex on therapeutic communication. In the subsequent section, we discuss how victims' diminished expectations for support and assistance lead to delays in treatment, negatively impacting their psychosocial experiences. These factors ultimately contribute to re-victimisation on an individual level and re-traumatisation at a societal level.

Ensuring the physical and psychological safety of victims of CSA is crucial in all treatment approaches. Choudhary et al. (2024) emphasise the importance of systematically designing, developing, and evaluating methodologically sound interventions for children who have experienced CSA. However, in the absence of effective, formal protective systems, it becomes necessary to explore innovative protective measures. Deb and Mukherjee (2011, as cited in Carson et al., 2013) noted that while most of the one-hundred twenty (120) female adolescents (n = 120) in their study reported significant benefits from counselling, not all counsellors were equally competent in addressing the trauma the participants had experienced.

Overlapping Barriers for Victims Seeking Help and Professionals Providing Treatment

Cultural differences within victims and between victims and professionals significantly impact the reporting and treatment of sexual abuse. Nadeem et al. (2020) define culturally informed care as “the capacity for health care professionals to effectively provide trauma-informed assessment and treatment that respects and integrates patients’ and families’ cultural values, beliefs, and practices” (p. 2). In Asian cultures, where traditional treatment methods are still widely used, the relevance of Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) is often questioned (Damra et al., 2014). Singh and Komeitiani (2020) highlight that the lack of professional trauma training in Kolkata, India, necessitated the use of client-centred therapy and cognitive behaviour therapy (CBT). Working with child sexual assault and trafficking victims from India, Nepal, and Bangladesh, Singh and Komeitiani (2020) initially believed that Trauma-Focused CBT, which integrates trauma-sensitive interventions with CBT, would be effective for these children and adolescents (National Child Traumatic Stress Network, 2012).

However, Singh and Komeitiani (2020) found that a CBT-based approach was not universally effective. Cultural taboos about discussing sex made many victims uncomfortable verbalising their feelings, while trauma-related difficulties prevented others from understanding abstract CBT concepts, such as identifying cognitive errors, connecting emotions to thoughts and actions, and cognitive restructuring. In India, there is a notable scarcity of research that integrates the unique socio-cultural dimensions of CSA and its interventions (Choudhary et al., 2024). Choudhary et al. (2024) also raise concerns about the global applicability of TF-CBT, as highlighted in a Cochrane systematic review. This review points to a weaker evidence base for TF-CBT, largely due to the high risk of bias stemming from inadequate reporting on blinding procedures. Additionally, while trauma-focused therapies like TF-CBT are family-oriented, family dynamics in collectivistic societies differ significantly from those in individualistic societies.

In today’s multicultural societies, characterised by increasing immigration and expanding migrant communities, lessons learned from South Asian countries (e.g., India, Pakistan, Bangladesh) hold relevance for the Western world. These insights can help mental health professionals provide culturally informed trauma care, thereby enhancing the likelihood of positive outcomes for victims and preventing re-traumatisation (Nadeem et al., 2019). The following section discusses the cultural factors in Pakistan and India that contribute to the underreporting of CSA by victims.

Nadeem et al. (2019) emphasise that, specifically in Pakistan where discussing sexual abuse is a strong taboo, the unconditional acceptance of survivors’ feelings and experiences by health professionals is therapeutically beneficial in a conservative, religious society. Establishing a therapeutic alliance not only with the survivor but also with the family is crucial, as the healing process involves the entire family unit. In collectivistic cultures like Pakistan, trauma resulting from abuse is viewed as a 'family trauma,' necessitating support for all household members, which places a significant challenge for mental health practitioners. Although trauma-focused therapies (e.g., Trauma-Focused Cognitive Behavioural Therapy) are family-oriented, family dynamics in collectivistic societies differ from those in individualistic societies. As discussed, various elements of collective shame must be addressed within these families (Nadeem et al., 2019). Nadeem et al. (2019) also note that focusing on a trauma narrative at the beginning of a therapeutic alliance can be counterproductive in the local culture.

In the context of India, in a study conducted by Verma (2021), involving consenting female participants (n = 100) who were victims of CSA, several reasons were identified for their reluctance to disclose their experiences. Specifically, 18% of the respondents reported a lack of support from either their mothers or fathers, which influenced their decision not to confide in anyone. Additionally, 8% indicated that they belonged to dominant families where discussing such matters was not permissible, as speaking about sex was considered taboo. Verma (2021) underscores that Indian society, characterised by a rural-urban divide, is governed by rigid social norms, practices, and both written and unwritten social sanctions that have persisted for generations. Traditional norms in India dictate that discussions about sexuality should be confined to marital relationships and familial spaces, excluding children and restricting open dialogue. This close-knit family structure often conceals sexual abuse of children by family members, leaving it largely untreated and unaddressed. Singh and Komeitiani (2020) highlight that the lack of professional trauma training in Kolkata, India, required the use of client-centred therapy and cognitive behaviour therapy (CBT). Working with child sexual assault and trafficking victims from India, Nepal, and Bangladesh, the team of Singh and Komeitiani (2020) initially believed that Trauma-Focused CBT, which integrates trauma-sensitive interventions with CBT, would be effective for these children and adolescents (National Child Traumatic Stress Network, 2012). However, Singh and Komeitiani (2020) found that a CBT-based approach was not universally effective. Cultural taboos about discussing sex made many victims uncomfortable verbalising their feelings, and trauma-related difficulties prevented others from understanding abstract CBT concepts, such as identifying cognitive errors, connecting emotions to thoughts and actions, and cognitive restructuring.

Lack of Expectations: Pathways to Re-traumatisation and Re-victimisation

Singh and Komeitiani (2020) emphasise the significant psychosocial consequences resulting from delayed intervention with victims of CSA that they work with. They observe that the trauma of sexual abuse often perpetuates across generations, manifesting in these children daily. Even when trauma is addressed, it continues to impact an individual's emotions, thoughts, relationships, immune system, and overall biological functioning (van der Kolk, 2014). Although humans are resilient, traumatic experiences leave enduring traces, both on a large scale—such as cultural—and on a smaller scale within families of origin, which are transmitted intergenerationally (van der Kolk, 2014). Daral et al. (2016) highlight the absence of expectation for support or assistance among victims of sexual abuse. In their study, involving 120 participants who had experienced sexual abuse, while seventy-eight individuals refrained from disclosing owing to feelings of shame, nine individuals did not disclose their abuse because they had no expectation of receiving any form of help. In South Asia, child victims of CSA often have low expectations of receiving help, partly due to the nature of CSA, where trust is a central issue. Many victims fear that the mental health workers will betray their trust, resulting in further harm. Therefore, involving supportive parents or caregivers in the treatment is recommended for children who have experienced sexual abuse, as this can help in building a secure environment. Children often experience ambivalence between the desire to keep the CSA a secret and the need to unburden their story to a safe and caring person (Crenshaw & Hardy, 2007). Therapy, therefore, can only begin with establishing a therapeutic, trusting relationship between the child and the counsellor.

As defined above, re-victimisation refers to experiencing interpersonal trauma (e.g., sexual assault) after experiencing sexual abuse (Messman-Moore & Long, 2000). In examining the relationship between individual-level re-victimisation and treatment provision, it is essential to consider how the silencing of victims acts as a barrier to help-seeking, ultimately leading to the re-experiencing of sexual abuse. The foundational assumption of shame has been shown to significantly predict re-victimisation in adults with a history of childhood sexual victimisation (Kessler & Bieschke, 1999). South Asian women, in particular, often feel compelled to endure abuse due to societal notions of shame (izzat and sharam) legitimising gender violence and stifling discussions on the topic (Gilligan & Akhtar, 2006, p. 1370). In a study by Cowburn et al. (2014), when a participant was asked if they would have disclosed their abuse in childhood, they responded saying, “probably not. Because of the repercussions of what they would do to me. Because I don’t have my parents now that’s why I came forward as well. If they had still been alive then I would not have because of embarrassing them” (Cowburn et al., 2014, p. 8).

As previously discussed, re-traumatisation involves the re-experiencing of trauma symptoms in clinical and/or social contexts. Re-traumatisation at the societal level aligns with barriers to treatment, largely driven by internalised shame and unprocessed trauma. Sharam (shame) is a significant cultural barrier that prevents individuals from speaking out about sexual violence and abuse. Deb and Modak’s (2007) study in Tripura, India, found that fear of social stigma (52.9%), perceived harassment (35.3%), parents' unwillingness (35.3%), parents' disbelief in police cooperation (23.5%), and fear of threats from the perpetrator (15.7%) are all manifestations of internalised shame and unprocessed trauma, which collectively contribute to the silence and barriers in seeking help. Carson et al. (2013) highlight that the clinical consequences and developmental delays frequently linked with sexual abuse present a significant risk to the well-being of children and youth, as well as to families and communities. These cyclical compounded factors create a perpetuum mobile of disadvantages, where unprocessed trauma and internalised shame continuously reinforce re-traumatisation and hinder recovery at both the individual and societal levels.

Discussion

This scoping review examined how childhood sexual abuse (CSA) shapes adult women’s experiences of shame, and how this culturally mediated shame contributes to re-traumatisation, re-victimisation, and barriers to disclosure and help-seeking across India, Pakistan, and Bangladesh. Across the nine included studies, a consistent pattern emerged: cultural constructs of honour (izzat), shame (sharam), patriarchal family structures, and community expectations profoundly shaped how survivors made sense of abuse and how, or whether, they disclosed their experiences. The findings also show how structural constraints, such as poverty, limited access to justice. The findings also demonstrate how inadequate trauma-informed services compound individual distress and sustain cycles of silence, re-victimisation, and re-traumatisation in adulthood (See Tables 1 and 2).

Table 1.

Summary Table of Critical Findings.

Themes	Key Findings
Cultural Constructs	Honour (izzat) and shame (sharam) operate as culturally embedded mechanisms shaping survivors’ interpretations of CSA, influencing identity, disclosure, and long-term wellbeing.
Barriers to Disclosure	Disclosure is constrained by family expectations, social surveillance, and fears of damaging familial reputation. These collectivist pressures often outweigh survivors’ personal needs for safety or justice.
Impacts of Shame	Shame silences survivors, reinforces self-blame, and contributes to both re-traumatisation (through internal conflict and institutional stigma) and re-victimisation (through lowered expectations of support and difficulty asserting boundaries).
Systemic Factors	Poverty, limited mobility, inadequate legal protections, and lack of culturally competent services exacerbate survivors’ vulnerability. Rural–urban disparities and the marginalisation of caste-oppressed and minority women further restrict access to support.
Re-traumatisation and Re-victimisation	Re-traumatisation occurs when clinical, legal, or community responses replicate feelings of powerlessness from the original abuse. Re-victimisation involves subsequent harm shaped by structural dependence, constrained autonomy, and cultural obligations.
Therapeutic and Policy Gaps	Western-developed trauma models often require adaptation in collectivist contexts. There is a need for culturally grounded approaches that centre survivors’ lived realities, account for family dynamics, and address stigma around CSA.

Table 2.

Summary Table of Implications for Practice, Policy, and Research.

Implications	Details
Practice	Develop culturally grounded and decolonially informed trauma interventions that centre survivors’ lived experiences, address shame as a mechanism of re-traumatisation and re-victimisation, and work with collectivist structures such as family involvement, honour (izzat), and shame (sharam).
Policy	Strengthen trauma-informed and survivor-centred legal and community support systems, including improved access to justice, protection pathways for marginalised groups (e.g., caste-oppressed or rural women), and capacity-building for culturally competent service provision.
Research	Expand research on culturally mediated re-traumatisation, re-victimisation, and help-seeking barriers; include diverse and underrepresented groups (Dalit women, ethnic and religious minorities, rural communities); and examine practitioner responses using qualitative and decolonial methods to better inform context-adapted interventions.

Interpretation of Key Findings

Three key findings emerged across the nine included studies, highlighting how shame operates as a culturally mediated mechanism linking CSA to adult re-traumatisation, re-victimisation, and barriers to help-seeking in South Asia.

First, the review supported that shame was the most salient determinant of survivors’ long-term psychological outcomes. Although shame is widely reported among CSA survivors globally, the form it takes in South Asia is intensified by honour-based expectations that bind women’s identities to their families’ reputations (Cowburn et al., 2014; Gilligan & Akhtar, 2006). This relational shame (izzat and sharam) produces persistent self-blame, anticipatory fear of social consequences, and expectations of concealment. These processes directly contribute to re-traumatisation (through chronic internal conflict, silence, and unresolved distress) and re-victimisation (through lowered expectations of protection or justice and difficulties asserting boundaries).

Second, the review found that family and community dynamics exert disproportionate influence on survivors’ responses to CSA. Families frequently discouraged disclosure, delayed help-seeking, or minimised abuse to protect marriage prospects, social standing, or interfamily relationships (Carson et al., 2013; Sahay, 2010). These collective pressures distinguish the findings of this scoping review from earlier CSA reviews, which typically emphasised individual-level barriers such as personal shame or fear of the perpetrator. Here, collective enforcement of silence was more prominent than individual avoidance.

Third, the review identified significant gaps in institutional and clinical responses. Survivors encountering health, legal, or mental-health services often experienced disbelief or stigma, which reproduced feelings of powerlessness and contributed to system-driven re-traumatisation (Choudhary et al., 2024; Singh & Komeitiani, 2020 ). Unlike prior reviews that focused primarily on prevalence or typologies of CSA, this scoping review demonstrates how inadequate, culturally insensitive responses can perpetuate harm well into adulthood.

Together, these three findings extend existing literature by showing that shame functions as a central organising mechanism, linking trauma, culture, re-traumatisation, and re-victimisation in ways not adequately documented in previous reviews.

Comparison With Existing Literature

This review differs from earlier CSA reviews on South Asia in several important ways. Prior reviews primarily focused on the prevalence, types, or socio-legal dimensions of CSA, with limited attention to survivors’ adult psychological experiences or to the mechanisms linking CSA to later harm. Unlike these earlier reviews, the present synthesis highlights shame as the central pathway through which CSA translates into re-traumatisation, re-victimisation, and help-seeking barriers in adulthood.

Existing global CSA literature recognises shame as a barrier to disclosure, yet these studies rarely examine how shame becomes culturally amplified in collectivist contexts. The findings of this review show that honour-based norms intensify internalised self-blame, increase pressure to remain silent, and reduce survivors’ capacity to access protection or trauma-informed care. This expands earlier models by demonstrating how culturally enforced shame, not only individual emotion, shapes long-term psychological outcomes.

Re-traumatisation and re-victimisation also emerged as distinct, culturally patterned processes. Re-victimisation was often reinforced by structural factors such as economic dependence, mobility restrictions, and family pressure, which limited survivors’ ability to avoid unsafe relationships. Re-traumatisation, by contrast, occurred when survivors encountered stigma or disbelief within clinical or legal systems, echoing the powerlessness of the original abuse. These pathways are underrepresented in previous South Asian CSA reviews, which tended to focus more narrowly on child-protection systems or legal challenges.

Finally, the review adds to global critiques of trauma interventions by demonstrating that Western-developed models often require cultural adaptation to be effective in South Asia. Shame, family involvement, and norms of silence shape whether and how survivors engage with therapy, underscoring the need for culturally specific models of trauma care.

Recent Developments in Literature (2024–2025) Not Included in the Evidence Base

The following studies were published after the scoping review search closed on 13 August 2024 and were therefore not included in the evidence set. They are incorporated here to update contextual framing and respond to reviewer requests.

Emerging literature continues to highlight the importance of relational identity and culturally embedded trauma processes among South Asian women. Studies show that disclosure of abuse is often shaped by obligations to protect family networks (Baloch et al., 2025) and that mental-health trajectories may be co-regulated by spouses and extended kin (Bicknell et al., 2025). Autoethnographic work also illustrates how women navigate cultural and academic identities simultaneously, with these crossings influencing how trauma is interpreted and communicated (Hou et al., 2025). Qualitative clinical research similarly emphasises that ineffective or insensitive practitioner engagement can heighten vulnerability or trigger re-traumatisation (Alyce et al., 2024).

Taken together, these emerging studies reinforce the need for culturally grounded, decolonised approaches to trauma care.

Implications for Practice, Policy, and Research

Clinicians must adopt culturally informed and trauma-sensitive approaches. This includes recognising how izzat/sharam influence disclosure, avoiding assumptions based on Western trauma models, integrating nonverbal or narrative methods when discussing sexual trauma is taboo, and building trust with both survivors and their families where appropriate. Practitioners should receive training in cultural humility, shame-informed care, and recognising re-traumatisation risks in therapy.

Policy frameworks across India, Pakistan, and Bangladesh must prioritise survivor-centred approaches. This includes improving police responsiveness, reducing legal delays, addressing stigma within institutions, and strengthening community-based protective mechanisms. Policies must acknowledge the disproportionate barriers faced by lower-caste, low-income, and rural women.

Future research should expand beyond urban, accessible populations and incorporate culturally grounded methodologies. Longitudinal studies are needed to examine long-term trauma trajectories, especially the interplay of shame and re-traumatisation. Studies should also evaluate culturally adapted therapeutic approaches, assess the efficacy of survivor-led interventions, and include marginalised groups such as Dalit women, ethnic minorities, and LGBTQ+ survivors, who remain nearly absent from the current evidence base.

Limitations

This scoping review has several limitations. First, the review was restricted to English-language publications, which may have excluded relevant regional scholarship and vernacular analyses. Second, the search window closed on 13 August 2024; therefore, studies published after this date were not included in the formal evidence base. Third, only nine studies met the inclusion criteria, reflecting the limited empirical research on CSA among adult women in South Asia. Fourth, consistent with scoping-review methodology, no formal quality appraisal was conducted, and the included studies varied in methodological design and depth. Fifth, although this review focused on India, Pakistan, and Bangladesh to provide conceptual coherence, the findings may not generalise to other South Asian or collectivist contexts.

Finally, the representation within the reviewed studies was uneven. Few studies explicitly examined the experiences of women from structurally marginalised communities, such as Dalit women in India or ethnic minority groups in Bangladesh, despite evidence suggesting they face heightened vulnerability and systemic barriers. Rural–urban differences were also rarely explored, even though rural women may experience more constrained mobility, stronger adherence to honour-based norms, and reduced access to trauma-support services. These gaps highlight the need for future research that includes more diverse populations and attends to intersectional differences within South Asian societies.

Conclusion

This scoping review underscores the profound impact of cultural norms, such as sharam (shame), izzat (honour), and patriarchal structures, on the disclosure, help-seeking behaviours, and trauma experiences of childhood sexual abuse survivors in South Asia. Systemic issues, including poverty, limited education, and complex legal systems, exacerbate barriers to support and justice for victims.

Addressing CSA in South Asian communities requires culturally informed care that draws on both Western and non-Western perspectives. As discussed in the Introduction, decolonial approaches highlight how trauma support must account for the cultural, structural, and historical contexts that shape survivors’ experiences. Applying these principles involves centring survivors’ lived realities, recognising the influence of honour, shame, and family dynamics, and adapting therapeutic models to local cultural norms. Future efforts should focus on dismantling harmful social expectations, strengthening trauma-informed services, and developing contextually responsive interventions that reflect the everyday realities faced by South Asian women.

By acknowledging these multifaceted challenges and prioritising culturally sensitive interventions, there is potential to improve support for victims, reduce CSA prevalence, and address its long-term consequences. This work is a step toward fostering more inclusive and effective approaches to understanding and treating CSA in South Asia.

Supplemental Material

sj-docx-1-sgo-10.1177_21582440261442258 – Supplemental material for Understanding Childhood Sexual Abuse and its Association With Psychological Traumatisation, Re-traumatisation, and Shame in Adult South Asian Women: A Scoping Review

Supplemental material, sj-docx-1-sgo-10.1177_21582440261442258 for Understanding Childhood Sexual Abuse and its Association With Psychological Traumatisation, Re-traumatisation, and Shame in Adult South Asian Women: A Scoping Review by Manisha Massey, Mariette Berndsen and Helen McLaren in SAGE Open

Supplemental Material

sj-docx-2-sgo-10.1177_21582440261442258 – Supplemental material for Understanding Childhood Sexual Abuse and its Association With Psychological Traumatisation, Re-traumatisation, and Shame in Adult South Asian Women: A Scoping Review

Supplemental material, sj-docx-2-sgo-10.1177_21582440261442258 for Understanding Childhood Sexual Abuse and its Association With Psychological Traumatisation, Re-traumatisation, and Shame in Adult South Asian Women: A Scoping Review by Manisha Massey, Mariette Berndsen and Helen McLaren in SAGE Open

Footnotes

Acknowledgements

We acknowledge the support of the research team, colleagues, and the College of Education, Psychology and Social Work at Flinders University for their guidance and resources throughout this project.

ORCID iD

Manisha Massey

Ethical Considerations

This scoping review synthesised published, de-identified data and did not involve direct human participants; therefore, institutional ethics approval was not required.

Consent to Participate

As no human participants were directly involved in this scoping review, informed consent was not required.

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was conducted as part of the lead author’s PhD in Clinical Psychology at Flinders University. The lead author is a recipient of the Australian Government Research Training Program (AGRTP) Scholarship.

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Data Availability Statement

Data sharing not applicable to this article as no datasets were generated or analysed during the current study.

Supplemental Material

Supplemental material for this article is available online.

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