Complex Clinical Profile in Adult Female Survivors of Childhood Sexual Abuse: Dissociation, Psychopathology, and Somatic Comorbidity

Background: Childhood sexual abuse (CSA) is associated with long-term psychological and somatic consequences in adulthood. However, detailed clinical characterisations of female survivors remain limited from a public health perspective. Methods: This exploratory cross-sectional study was conducted in Spain (March 2022–June 2023) with 31 adult women (18–58 years) with a history of CSA. Participants were recruited through non-probabilistic sampling from clinical services and a survivors’ association. Sociodemographic and clinical variables were assessed using validated instruments, including the EGS-R, SCL-90-R, DERS, DES, RSE, and PID-5-BF, administered in structured online guided sessions. Descriptive statistics, Pearson correlations, and independent samples t-tests were performed. Results: The sample reported early-onset CSA (mean age = 7.17 years), predominantly intrafamilial, repeated, and prolonged, with high rates of revictimization and low disclosure. Participants reported clinically relevant levels of post-traumatic, psychological, and dissociative symptoms. The mean DES score was 11.89 (SD = 7.75). Women reporting a current somatic illness showed significantly higher levels of post-traumatic symptoms, general psychological distress, and dissociation, together with lower self-esteem. Earlier age of CSA onset and younger current age were associated with several indicators of greater symptom severity. Conclusions: In this exploratory clinical sample, adult female survivors of childhood sexual abuse reported substantial psychological distress, dissociative symptoms, and frequent somatic illness. The observed associations between trauma-related variables and clinical outcomes should be interpreted cautiously and require replication in larger and more diverse samples. Nevertheless, the findings support the potential relevance of trauma-informed and multidisciplinary approaches when working with clinically vulnerable survivors of childhood sexual abuse.