From behind the shadows: a profile of the sexual abuse of older men residing in nursing homes

Previous research on the sexual abuse of older adults has revealed few cases of the sexual abuse of older men. The first national study of the sexual abuse of vulnerable adults in facilities, reported in this article, collected data on alleged, investigated, and substantiated cases of sexual abuse. This study revealed 26 cases reported and screened in for investigation concerning the alleged sexual abuse of older men (aged 50 and older) residing in nursing homes. Cases occurred in five states within a six month time period. Of these cases, six were confirmed upon investigation by Adult Protective Services or other regulatory agencies. Victims tended to be predominantly white males with cognitive and physical deficits that limited their ability for self care. The most typical sexual abuse alleged and substantiated was fondling. Residents were more often substantiated as the abuser than other perpetrators. Sexual abuse of older men in nursing homes crosses traditional gender, cultural, and role boundaries for both victims and perpetrators.     

Childhood Sexual Abuse,Adult Psychiatric Morbidity,and Criminal Outcomes in Women Assessed by Medium Secure Forensic Service

There is little literature on childhood sexual abuse in women seen by forensic services. A cohort of 225 cases of women seen by forensic services in a medium secure unit in the UK were examined, and childhood sexual abuse and non–childhood sexual abuse cases were compared. Over half the sample had a history of childhood sexual abuse, and 5.6% of this group were victims of a subsequent sexual assault in adulthood. The perpetrators were all male. The majority of intrafamilial cases resulted in victims being raised in environments outside the family home. Childhood sexual abuse was associated with later relationship, educational, and occupational difficulties. Significant associations were also seen with personality disorder, self-harm, and substance misuse. Treating services need to recognize the potential importance of childhood sexual abuse in their models of care given the complexity of the association between childhood sexual abuse and psychosocial needs and its impact on successful rehabilitation.     

Problems of Research in Male Child Sexual Abuse

The focus of the present paper is the main problems found in the study of male child sexual abuse. Aspects of child sexual abuse of males reviewed here include (a) definitions, (b) prevalence rates and under-reporting, (c) effects, (d) possible mechanisms of how sexual abuse affects male victims, (e) gender related risks, (f) types of abuse, (g) perpetrators of abuse, and (h) the victim/perpetrator cycle. We conclude that while much research is urgently required in this area, some tentative conclusions are warranted and some important trends are beginning to emerge for future research directions.     

Correlates of Sexual Abuse in a Sample of Adolescent Girls Admitted to Psychiatric Inpatient Care

We examined correlations of child sexual abuse among 300 adolescent girls in psychiatric inpatient treatment. Diagnostic and Statistical Manual of Mental Disorders (4th ed.)-based psychiatric diagnoses were obtained from the Schedule for Affective Disorder and Schizophrenia for School-Age Children—Present and Lifetime and from data on family and behavioral characteristics from the European Addiction Severity Index (EuropASI). A total of 79 girls (26.3%) had experienced child sexual abuse during their lifetime. Child sexual abuse was associated with an adolescent’s home environment, sibling status, smoking, posttraumatic stress disorder diagnosis, self-mutilating behavior, and suicidal behavior. At least 62% of the perpetrators were acquaintances of the victims. Correlates of child sexual abuse can be used to identify child sexual abuse victims and persons at heightened risk for child sexual abuse.     

Bullying,sexual harassment and happiness in residential children's homes

Much is now known about bullying and, to some extent, sexual harassment in settings such as schools. In residential children's homes, however, the two remain disturbing features of institutional life. This is a particular cause for concern as many of the residents in these homes, given their troubled backgrounds, are at greater risk of becoming victims of perpetrators. This article looks at the incidence and effects of these related maladies within the context of a wider study involving 223 children in 48 residential homes in five local authorities. The study found that fellow residents, rather than staff, were the main sources of physical and sexual abuse. Both bullying and harassment (actual and attempted) were strongly associated with the widespread misery reported by many residents. Copyright © 2000 John Wiley & Sons, Ltd.     

The Characteristics of Child Sexual Abuse in the School Environment in Turkey

School may represent a protective factor, boosting the mental health of the student body, while also representing a risk factor that heightens the potential for mental health problems. The present study aims to identify the individual and familial characteristics associated with the incidents of child sexual abuse (CSA) in Turkey’s school environment. The incidents involving school-related CSA constituted 5.6% (N = 125) of 2,238 cases. The following was discovered: an adult committed the majority (64%) of CSA in the school environment; most adult perpetrators were teachers (62.5%). This study determined that the perpetrators manipulated the victims via methods that included physical abuse (11.2%), threats (19.2%), tricks/deception (15.2%), and taking photographs/videos with sexual content (3.2%); and CSA incidents involved intercourse (15.2%); and almost three-quarter of the victims of CSA in the school environment reported the incident late. This study indicates that peer perpetrators abuse younger victims and a greater proportion of male victims relative to adult perpetrators. In light of these findings, school security must be improved, especially in public schools, and trainings aimed at preventing bullying and sexual abuse (SA) should be given to all school staff, students, and parents.     

Childhood victimization and subsequent adult revictimization assessed in a nationally representative sample of women and men

The purpose of this study was to identify whether experiences of childhood physical and/or sexual victimization would increase women's and men's risk for victimization in adulthood by different perpetrators (any perpetrator regardless of the relationship to the victim; intimate partner perpetrator; non-intimate perpetrator) using a nationally representative sample. Results of hierarchical logistic regression analyses indicated that childhood victimization increased the risk for adulthood victimization by any perpetrator for men and women, and by an intimate partner for women but not men. Female and male victims of physical and/or sexual child abuse are at higher risk for adult victimization by non-intimate perpetrators. These results suggest the appropriateness of interventions among adults or young adults who have been victims of child abuse, to prevent any future victimization in adulthood. To guide the development of such prevention programs, research is needed to identify factors that affect the probability of adulthood victimization among child abuse victims.     

Sexual Abuse Prevention: A Training Program for Developmental Disabilities Service Providers

Persons with developmental disabilities are at an increased risk for becoming victims of sexual abuse. Research has revealed that the largest group of identified perpetrators of sexual abuse is developmental disability service providers. The purpose of the present study was to develop, implement, and evaluate the effectiveness of a sexual abuse prevention training program. Participants were administered a survey assessing knowledge and attitudes before and after the training workshop. Small improvements in knowledge and attitudes about sexual abuse and the sexuality of persons with developmental disabilities were found; however, ge-neral attitudes about individuals with developmental disabilities did not change. Suggestions for future directions in this area are provided.     

Parent-Child Relationships of Victims and Siblings in Incest Families

Clinical accounts suggest that families in which sexual abuse occurs are characterized by poor parent-child relationships. However, there have been no empirical studies utilizing standardized measures to assess the quality of such relationships. In this study, information on parent-child relationships was obtained for 36 child victims and 41 nonabused siblings in families in which father-child sexual abuse had been acknowledged by the father/perpetrator. Results indicated that child victims reported greater relationship problems with father/perpetrators than with mothers. In addition, victims reported greater relationship difficulties with father/perpetrators than did siblings. There were no differences between father/perpetrator and mother reports of relationship quality for victims and siblings. Victims' self-reported depression and anxiety were associated with father/perpetrators' views of father-child relationships, whereas nonabused siblings' self-reported depression and anxiety were associated with father/perpetrators' views of father-child relationships, whereas nonabused siblings' self-reported depression and anxiety were associated with mothers' views of mother-child relationships.     

The Levels of Cortisol,Oxidative Stress,and DNA Damage in the Victims of Childhood Sexual Abuse: A Preliminary Study

In this study we aimed to investigate serum cortisol, oxidative stress, and DNA damage in children who are sexual abuse victims. The study included 38 children who sustained child sexual abuse and 38 age- and gender-matched children who did not have a history of trauma. Cortisol levels reflecting the status of the hypothalamic-pituitary-adrenal axis, anti-oxidant enzymes glutathione peroxidase, superoxide dismutase, natural anti-oxidant coenzyme Q, and 8-hydroxy-2-deoxyguanosine as the indicator of DNA damage were analyzed in serum samples using the enzyme linked immunosorbent assay method. Cortisol levels were significantly higher in the child sexual abuse group compared to the control group. There were no significant differences between the groups in terms of oxidative stress and DNA damage. Cortisol and 8-hydroxy-2-deoxyguanosine levels decreased as the time elapsed since the sexual abuse increased. Coenzyme Q level was lower in victims who sustained multiple assaults than in the victims of a single assault. Cortisol and superoxide dismutase levels were lower in the victims of familial sexual abuse. Decreases in cortisol and 8-hydroxy-2-deoxyguanosine levels as time elapsed may be an adaptation to the toxic effects of high cortisol levels over a prolonged period of time. Child sexual abuse did not result in oxidative stress and DNA damage; however, some features of sexual abuse raised the level of oxidative stress.     

Prevalence of Child Sexual Abuse in the Nordic Countries: A Literature Review

This review examined child sexual abuse in the Nordic countries focusing on prevalence rates and victims’ age and relationship to the perpetrator. The results show a prevalence of child sexual abuse (broadly defined) between 3–23% for boys and 11–36% for girls. The prevalence rates for contact abuse were 1–12% for boys and 6–30% for girls, while 0.3–6.8% of the boys and 1.1–13.5% of the girls reported penetrating abuse. The findings suggest an increased risk of abuse from early adolescence. In adolescence, peers may constitute the largest group of perpetrators. The results highlight the need for preventive efforts also targeting peer abuse. Future research should include cross-national and repeated studies using comparable methodology.     

Resilience and risk factors associated with experiencing childhood sexual abuse

The effects of child sexual abuse are wide‐ranging and impact on children, families and health/social care systems. The authors review this literature, examining the shortcomings of the ‘victim–offender’ model, and consider the complex, multifactorial nature of this question. Factors associated with a progression from victim to perpetrator are explored and the prevalence of abuse in the general population is also discussed. Protective as well as risk factors are considered and the pivotal role of ‘personal reliance’ is considered as it relates to empowering damaged young people to become healthy adults. The authors also discuss implications for the treatment of young people who become abusers. Two case examples are brie?y reported upon and the article concludes with a consideration of ways to helpfully address the needs of children who become sexual perpetrators. Copyright © 2004 John Wiley & Sons, Ltd.     

Adult perpetrator gender asymmetries in child sexual assault victim selection: results from the 2000 National Incident-Based Report System

Data from the 2000 National Incident-Based Reporting System (NIBRS) show that while males make up about nine out of every 10 adult sexual assault perpetrators, totaling about 26,878 incidents within the reporting period, females account for about one out of 10 perpetrators, totaling about 1,162 incidents. Male sexual assault perpetrators offend against child victims about 25% of the time and predominantly choose female child victims, whereas female perpetrators offend against child victims about 40% of the time and choose child victims of both genders equally. Male perpetrators offend against adolescent victims about 40% of the time, and once again tend to choose female adolescent victims. Female perpetrators offend against adolescent victims a comparable amount of time (about 45%), and for forcible offenses (rape, sodomy, sexual assault with an object, and forcible fondling) choose adolescent victims of both genders equally, while for non-forcible offenses (non-forcible incest and statutory rape) they tend to choose predominantly male victims. Finally, adult male sexual assault perpetrators choose adult victims about 36% of the time while female perpetrators choose adult victims only 16% of the time. Implications for professionals are discussed, including recommendations to aid in correct identification of adult perpetrators and child/adolescent victims of sexual assault.     

Sin vergüenza: addressing shame with Latino victims of child sexual abuse and their families

This article explores shame issues for Latino children who have been sexually abused and their families. Latino cultural concerns around shame that are associated with sexual abuse include: attributions for the abuse, fatalism, virginity, sexual taboos, predictions of a shameful future, revictimization, machismo, and fears of homosexuality for boy victims, and the intersection of shame from sexual abuse with societal discrimination. Quotes and case material are drawn from the author's research and clinical work. The article includes clinical suggestions.     

The parallels between undue influence, domestic violence, stalking, and sexual assault

The dynamics of undue influence (UI) have many similarities with domestic violence, stalking, and grooming behavior used by some sexual predators. This article will help practitioners-particularly law enforcement investigators and prosecutors-better recognize UI as a pattern of behaviors, not an isolated incident. Understanding the dynamics of UI will enhance professionals' appreciation of the responses of victims and the manipulative nature of exploiters. Strategies that have been used effectively with domestic violence, stalking, and some sexual abuse cases may provide remedies for victims of UI and criminal justice options for holding perpetrators accountable. Enhanced awareness of these dynamics should lead to improved investigations, more effective strategies when interviewing and working with victims, and more successful prosecutions of perpetrators who use UI to financially exploit an older person.     

Irish child sexual abuse victims attending a specialist centre

We profiled a cohort of CSA cases referred for assessment to a specialist child sexual abuse (CSA) centre in a national paediatric hospital in Ireland. Historical and clinical data were drawn from records of 171 cases. The majority of cases were referred by social workers following purposeful disclosure of CSA. Three quarters of the cases were female with a mean age of 9 years. They were from a wide spectrum of socioeconomic groups and many had suffered a range of family adversities. In most cases, the abuse involved masturbation of the child by the abuser. Almost all of the perpetrators were male with a mean age of 28 years and in 60% of cases extrafamilial abuse had occurred. In 23% of cases, the perpetrator had a history of previous sexual offending. Anxiety was the most common emotional problem before disclosure and after disclosure the most common emotional problem was guilt. Before disclosure school refusal was the most common behavioural problem and after disclosure fighting was the most prevalent behavioural difficulty. The most common factors supporting the credibility of CSA allegations were labile mood, the child's ability to differentiate fact from fantasy and a detailed disclosure of contextual details. More adolescents showed deterioration in schoolwork after disclosure and for more pre school children clinginess following disclosure was a significant emotional problem. More primary school aged children were abused by perpetrators who had abused a number of children. For children abused by such perpetrators, vaginal intercourse was less common. Vaginal intercourse was more common in 6–11‐year‐old victims and those who were abused on a daily basis. The threat that disclosure posed to the integrity of the family structure was more often a factor hindering disclosure in victims abused by father figures and abused very frequently. Copyright © 2003 John Wiley & Sons, Ltd.     

Situating the Notion of “gbɛkɛfɔŋs” in the Discourse of Child Sexual Abuse Among the Ga in Accra,Ghana

Child sexual abuse (CSA) is a prevalent problem in many societies across the globe. There have been several discussions of the subject and attempts have been made to explain its incidence and find ways to prevent and/or control it. However, despite these efforts, the problem seems to persist in developing countries like Ghana with dire consequences for the children and society at large. This paper sought to glean insights about the persistence of the problem by focusing on the discourse surrounding the subject. Using Focus Group Discussions with adult members in the Ga communities in Accra namely La, Teshie, and James Town where the phenomenon is relatively pervasive, the paper sought to understand the reasoning and the implications of accusing children who were sexually abused in the Ga community of seducing the perpetrators and engaging in sex for money. The paper posits that the labeling of victims of CSA as “gb?k?f??s” (children of bad character) disempowers children and perpetuates the abuse of children. Thus, introducing and situating this notion of “gb?k?f??s” in the center of the discourse largely results in a victimization of the victims and a vicious cycle of CSA. The conclusions from this study point to the need for a reorientation of parental and communal roles and an empowering of children to identify and resist sexual abuse.     

No Place is Safe: Sexual Abuse of Children in Rural Bangladesh

During July 2007 to June 2010, BRAC, a nongovernment organization in Bangladesh, reported 713 incidents of rape and attempted rape of children (< 18 years) in rural Bangladesh. This study explores these 713 incidents to identify possible patterns related to the victims, perpetrators, and different dynamics of the incidents. Rape and attempted rape, particularly of young girls, constituted 64% of all reported incidents of violence against children. Children were found to be abused by men from all walks of life, mainly by non-family-members (83%). Similar diversity was seen in the location, time, and context of the incidents. The present study attempts to put forward an overall picture of the depth of the problem of child sexual abuse in rural Bangladesh, linking the incidents with the socially constructed gender relations of power and how it perpetuates sexual abuse of children, especially girls.     

Including siblings in the treatment of child sexual abuse

Siblings are often not included in treatment programs for children who have been sexually abused. This article describes the necessity of including siblings in the treatment of victims of child sexual abuse. Including siblings in treatment permits families to realize the maximum benefits of therapy for the victim as well as each family member. Theoretical and practical reasons to include siblings in treatment are discussed (i.e., preventing future abuse, providing support for siblings, teaching siblings to refrain from victim-blaming). Case examples using a particular intervention approach at The Family Learning Program and results of client satisfaction surveys are described.