Since stories of molestation by priests and allegations of a cover-up in the Catholic church have drawn intense media coverage in the last three months, child sexual abuse has been pushed into the foreground.

Dr. Daniel Materna, psychologist with Sharon Regional Health System's Behavioral Health Services in Hermitage, said it's important to recognize the signs of sexual abuse in children, and it is even more important for those who have been abused -- even if was years ago -- to get help.

Sexual abuse can be defined in many different ways, including the age difference between the victim and perpetrator, how the victim felt during the encounter, or if any aggression, threats, coercion, manipulation or exploitation was used against the victim.

"How hurtful it is ... it's not a simple act of sex for a child at all," Materna said. "It's a lot to impose on a child."

Between 10 and 30 percent of women and 10 percent of men report sexual abuse every year, but the actual numbers of cases are likely to be much higher because many victims do not report abuse, Materna said.

"One reason it doesn't get reported is there's a lot of shame and guilt a child experiences when sexual abuse occurs," Materna said.

Usually child sexual abuse occurs in a relationship where there is supposed to be trust. When an adult violates that trust, Materna said, a child reacts with confusion and may show behavioral symptoms, such as acting out aggressively or sexually or withdrawing. The child's grades may plummet, they may talk about suicide or hurt themselves.

When a parent learns about a child's sexual abuse, Materna said, it's essential that the parent believes and protects the child.

"When a child is not believed or the situation is minimized, it forces the hurt or shame to go underground," Materna said. "A child will assume he or she must suffer in silence ... if no one believes them, they are left to make sense of something they just can't comprehend."

An abused child may start to act out sexually by touching others or themselves.

"It's important for adults around them to pay attention," Materna said.

Otherwise, that child will still be sexually "ill-at-ease" when entering adolescence.

"For some people, as they become adults, sex becomes the way of relating to people, with sets them up for further problems," Materna said. "It leads to sexual contact with other partners and opens them up to disease."

Sexual abuse can be associated with a wide variety of problems if it is left untreated and can impact victims for their entire lives.

"Really the best thing a person can do, male or female, mature adult or teenager, is to get help for it," Materna said.

Victims of sexual abuse may lose self-confidence and self-esteem. They are also likely to experience anxiety disorders, panic attacks and depression.

A study at the Mayo Clinic in the early 1990s revealed that women who were sexually abused as children had a higher degree of pelvic pain and were more likely to develop pelvic inflammatory disease, bladder infections, yeast infections and obesity. They were also twice as likely to become pregnant before age 18.

Materna said a correlation has also been found between childhood abuse and irritable bowel syndrome.

Even adults who were abused as children should not hesitate to seek help now.

"It's very important for any adult who has been sexually abused not to be afraid to seek treatment as an adult," Materna said. "Your health improves, emotional problems improve. Following successful treatment can dramatically improve an adult's functions across many areas of their life."