Child sexual abuse is defined as "the use of a child under 18 years of age as an object of gratification for adult sexual needs and desires." Sexual abuse ranges in intensity from exhibitionism and gentle fondling to forcible rape that results in physical injury. Intrafamilial and extrafamilial child sexual abuse are distinguished in the discussion, followed by a review of the prevalence of child sexual abuse. A discussion of the psychodynamics and psychopathology of the incestuous family is followed by descriptions of the psychological sequelae of child sexual abuse. These include paranoid reactions and mistrust, poor self-image, depression and suicidal behavior, hysterical and dissociative symptoms, impaired peer relationships, poor school performance, substance abuse, and disturbances in sexual behavior. An overview of the assessment of child sexual abuse addresses the physical evaluation, the clinical evaluation, and false allegations of child sexual abuse. A case study of an evaluation of alleged incest is presented. A concluding legal commentary addresses issues related to victims, other family members, and offenders, as well as guidance for mental health professionals and practitioners. 49 references