Childhood Neurotic Disorders with a Sexual Content Need Not Imply Child Sexual Abuse*

Two cases are described of childhood obsessional states in which the content of the symptomatology led parents and professionals to suspect child sexual abuse. Following assessment it was felt, on the balance of probabilities, unlikely that child sexual abuse had occurred in either case. Both children had previously engaged in “sex play” with peers. Maternal attitudes to sexuality were felt to have influenced their daughters’ views about sexual behaviour and to have contributed to the children’s guilt feelings. Response to appropriate treatment was rapid and has been sustained in the short-term. The importance of avoiding lengthy and possibly damaging assessment procedures in such cases is discussed.