Linda LaFlower had several of those worst-case circumstances in her childhood abuse. The abuser was her grandfather, and the assaults involved forced intercourse over about seven years, she said. Beginning when she was 6, he would often take her to his garage, or a quiet room in his large house, she said. And he would rape her.

She has been in therapy on and off for 20 years, and she said she still isn't faring well. For nearly four decades, through motherhood, a failed marriage, other relationships and several jobs, the trauma has been a constant, unwanted companion. "Every day when I see a little girl with a man, I cringe."

She is trained as a licensed nursing assistant, but said she has had trouble holding jobs, partly because of medications she's been on, and partly because she can't focus on tasks very well. She also can't bring herself to help male patients with dressing and other aspects of personal care. She said she's been treated for significant mental health disorders, including dissociative identity disorder, or what used to be called multiple personalities.

Her grandfather died 20 years ago, she said. Her last experience with him, several years before he died, was nearly as traumatic as the childhood abuse.

She was married and in her 20s, and the family was at a church service in Claremont. Something about the priest's message led her to feel that she was at least partly at fault for what had happened, so she approached her grandfather afterward and told him she was sorry. He responded by inviting her back to his house, she said. There, in a moment when her husband was looking away, he put a hand on her breast and said, "I'm glad you're on my side."

In Megan Fallon's case, the abuser wasn't a family member, and the assaults took place over the course of months, not years. But if she seems to be managing well, she nevertheless doesn't assume she's put the matter behind her. Talking about the incidents can still bring tears and anger, and her decision to talk publicly has her concerned about how people will react.

"I put on a great front," she said. "I always have this thing in the back of my mind — am I doing enough? Because if I'm perfect, they won't ever wonder if something's wrong."

She worries that more serious consequences of the abuse could be lying just below the surface of her so-far-successful life. She never dealt with the abuse as a child, she said. Her parents learned of the molestations a few years after they stopped, when her sister revealed the secret. They tried to talk with her and suggested therapy, but she refused to open up.

She now thinks it's almost time to plumb the depths of her childhood experience. "I would say yes, now that I'm more grounded. I'm probably going to be here (in the Upper Valley) for a long time — you know, provided this article doesn't make me skip town. I see myself getting therapy."

Some of the more dangerous effects of childhood sexual abuse don't take decades to surface. VA researcher Schnurr and others report that young victims frequently engage in high-risk behavior as teenagers, including promiscuity and drug and alcohol use.

"If kids start drinking and drugging as a result of their abuse," Schnurr said, "it can set them on a pathway toward revictimization and other health effects." Those could range from sexually transmitted diseases to marrying an abusive spouse. "Intimate partner violence," studies have shown, is common among adult survivors of childhood abuse.

"I didn't have normal relationships" as a teen, said Fallon. "At 14 I had sex for the first time. Drunk." She experimented extensively with drugs. That risky behavior continued for a couple of years, until her parents got her into ice hockey, which proved to be the healthy outlet she was lacking. "My aggression came out in my ice hockey."

Last month, she was home in New York for the funeral of a 21-year-old friend from her teen years, who had died of a drug overdose. She knows she was on that path herself. "I went out to dinner with my parents, and I said 'I can't thank you enough.'"