Providing sexual education to victims of child sexual abuse:what is a clinician to do?

Despite the large body of research on childhood sexual abuse, virtually no one has examined the coverage of sexual education in treatment. Agencies from across the United States that specialize in treating child and adolescent victims of sexual abuse were surveyed. The results indicate that sexual education is covered in treatment with children of all ages, with male and female clients, and in both individual and group therapy. There was a statistically significant difference in the coverage of sexual education based on clients' age, but not based on gender or treatment modality. Parents are often included in treatment; however, the amount of parental involvement varies. Published materials, such as children's books and videos, are frequently used. Participants (i.e., clinicians) are satisfied with their coverage of sexual education in treatment even though clients often experience negative reactions. Results suggest that covering sexual education in treatment helps decrease some of the negative effects of sexual abuse. This study also serves as a test of Dillman's Total Design Method of conducting mail surveys.     

Extended evaluations in cases of child sexual abuse: how many sessions are sufficient?

This article provides new findings from a national study involving 18 forensic interview sites of 137 children who were randomly assigned to a four or eight session extended evaluation. Cases assigned to the eight session protocol were significantly more likely to be classified "credible disclosure" of sexual abuse (56.6%) than cases assigned to the four session protocol (29.5%) and significantly less likely to be classified "credible nondisclosure" of sexual abuse (9.2%) than cases in the four session protocol (24.6%). When four versus eight sessions, demographic variables, and case characteristics were entered into a regression, variables that predicted likelihood of sexual abuse were eight session protocol, older victim age, and caretaker belief the child had been sexually abused. When new disclosures were examined by session in the eight session protocol, 95% of new disclosures occurred by the sixth session.     

Reliability of professional judgments in forensic child sexual abuse evaluations: unsettled or unsettling science?

In the absence of photographic or DNA evidence, a credible eyewitness, or perpetrator confession, forensic evaluators in cases of alleged child sexual abuse must rely on psychosocial or "soft" evidence, often requiring substantial professional judgment for case determination. This article offers a three-part rebuttal to Herman's (2009 ) argument that forensic decisions based on psychosocial evidence are fundamentally unreliable and that this conclusion represents settled science. The article also discusses the potentially adverse consequences of Herman's proposed reforms to forensic practice on child protection and prosecution efforts.     

Mandatory reporting of childhood sexual abuse in Israel: what happens after the report?

While the professional literature deals to some degree with the difficult dilemmas faced by professionals regarding the question of reporting or not reporting child abuse as mandated by law, there is a glaring insufficiency of studies looking at the impact of reporting on the victims and their families. This paper presents six cases of suspected sexual abuse to demonstrate some of the inconsistency in responses to reports within the Israeli system. The authors recommend amendments to the Israeli mandatory reporting law so that the law is not only a societal decree of the absolute prohibition against the sexual exploitation of minors and others incapable of giving informed consent, but also a basis for consistent and skillful professional intervention.     

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.     

"Speaking of mothers. . ."How does the literature portray mothers who have a history of child sexual abuse?

The tendency to cast mothers in a negative light has featured in much of the literature researching child sexual abuse. More recently however, this trend has become increasingly evident in any number of empirical discussions focusing on mothers who themselves have a history of child sexual abuse. This article presents a detailed thematic analysis of the ways in which the literature presents these mothers, particularly concentrating on research examining their parenting post disclosure of their child's sexual abuse. A critical reading of the literature supports commentary on methodological problems in research design as well as assumptions made about mothering, the nature of support, and the focus on the effects of childhood sexual abuse to the exclusion of the influence of other childhood experiences and difficulties.     

More harm than good? Diagnostic codes for child and adult abuse

This study sought to understand the reasons for the lack of use of ICD diagnostic codes for child and adult abuse. New Jersey professionals were recruited to participate in three focus groups on child abuse, adult or primarily woman abuse, and elder abuse. Participants included health care providers, advocates from the community, and representatives of state agencies and the insurance industry. Concerns about coding abuse included further jeopardizing victims/patients, diagnostic uncertainty, and lack of resources. Members of the child abuse group were somewhat more receptive to coding abuse. Reasons to code, such as for documentation and reimbursement were discussed and rebutted. Most participants concluded that use of the abuse codes should be judicious because they have the potential to do more harm than good. More research is needed on the implications of coding for victims/patients along with medical education in the identification of abuse in general and coding abuse in particular.     

How aware of child sexual abuse (CSA) are ethnic minority communities? A literature review and suggestions for raising awareness in Australia

A systematic literature review was conducted to help address the gap in national and international knowledge about child sexual abuse (CSA) and ethnic minority communities. This paper reports the findings of that review in relation to the theme of community awareness. The results suggest that awareness of CSA may be low in ethnic minority communities due to misperceptions that it is ‘a Western problem’. This in turn may be associated with norms in the country of origin which are asserted to transfer after migration, such as CSA being seen as a private family matter that does not invite systematic intervention from the state, low media and research attention, widespread acceptance of myths about CSA, and prohibitive norms on discussing matters to do with sex including abuse. Such trends are seen to be the result of, but also then further protect and preserve, collectivist and patriarchal structures. They also make it challenging for raising community awareness. Nevertheless, genuine community engagement through outreach/educational/preventative programs that empower minorities through co-delivery, are high on cultural competency, tailored to specific groups, and use a feminist framework where appropriate, are seen as necessary; they represent investment in minority communities and child safety of children from minority communities. Overall, realistic goals about the effectiveness of outreach educational programs, combined with value for culturally meaningful constructions of child safety, are seen as key toward the success of awareness-raising programs.     

Child sexual abuse and attachment theory:are we rushing headlong into another controversy?

The child sexual abuse knowledge base has developed within a highly charged political and social context. As such, early theories of sexual abuse were susceptible to biases that reflected the larger sociocultural context. The purpose of this paper is to consider whether attachment theory as it is applied to child sexual abuse might also be susceptible to such biases. Although this paper concludes that attachment theory can potentially add an important dimension to the conceptualization of child sexual abuse and its dynamics, it is also suggested that attachment theory may remain at risk for becoming a vehicle for transmitting political and ideological agendas.     

Parent–child gender matching and child psychological adjustment after divorce

The present study aimed to determine whether a parent–child gender match would influence child psychological adjustment after divorce. Participants included 69 parents (36 mothers) in active family law litigation to resolve issues related to postdissolution of marriage or time-sharing matters. Participants provided demographic information and completed the Child Behavior Checklist (CBCL; Achenbach, 1991 Achenbach, T. M. (1991). Manual for the child behavior checklist/4–18 and 1991 profile. Burlington, VT: Department of Psychiatry, University of Vermont. [Google Scholar]) to assess their perceptions of their child’s internalizing and externalizing behavior problems. Results demonstrated that internalizing and externalizing behaviors were not affected by whether children spent more time with the same gender parent, opposite gender parent, or split their time equally between both. Comparisons and contradictions between the results in this study and existing research are discussed, as well as practical implications.     

Programming for preventing sexual abuse and abduction: what does it mean when it works?

Many kinds of educational programs and other approaches to teaching children about the dangers of sexual abuse and abduction by strangers can have the "side effect" of creating new anxieties in the children. The program described in this article is effective without introducing negative, anxiety-producing stories, examples, and other warnings.     

Will it never end? The narratives of incest victims on the termination of sexual abuse

The aim of this study is to investigate how child sexual abuse is terminated. This study attempts to gain insight into how people exposed to incest narrate the termination of the incest relationship. Seven women and one man were recruited from the Incest Support Centre and from snowballing for a 1-2-hour-long in-depth interview using a narrative approach. The subjects' narratives varied according to how they perceived their own role in the termination process, their relationship with the offender, and how well they remembered the stage of termination. A common feature of the narratives was that the feeling of being a victim lasted after the abuse stopped. In this respect, the lack of support from family, friends, and healthcare personnel and the psychological power exercised by the offender were important issues in the narratives. It is suggested that the termination process is affected by the victims' ability to regulate influence and mentalization. Furthermore, a transfer of cultural meanings from the social environment to the individual must have taken place. Future research should focus on the significance of the termination process in terms of psychological functioning and the construction of self and identity.     

Puerto rican drug users’ experiences of physical and sexual abuse: Comparisons based on sexual identities

This study integrates the results of quantitative and qualitative methods to elucidate the association between sexual identity and physical and sexual abuse among Puerto Rican drug users. A structured questionnaire was administered to 800 subjects in New York and 399 in Puerto Rico. A total of 93 subjects (7.9%) self‐identified as homosexual or bisexual. Gay males were significantly more likely than heterosexual males to report first occurrence of physical abuse by a family member in childhood. Both gay and bisexual males were more likely than their heterosexual counterparts to report first experiencing unwanted sex in childhood and intimate partner physical abuse later in life. Lesbians were more likely than female heterosexuals to report unwanted sex in childhood. Qualitative data were collected through in‐depth life histories with 21 subjects and suggest that gay and lesbian subjects perceive antihomosexual prejudice on the part of family members as one cause of childhood physical and sexual abuse.     

Examining the relationship between childhood sexual abuse and borderline personality disorder: does social support matter?

The relationship between childhood sexual abuse and borderline personality disorder is a prominent issue in the etiological research on borderline personality disorder. This study further explored the relationship between childhood sexual abuse and the development of borderline personality features while evaluating the moderating role of a primary social support source in a sample of 290 female undergraduate students enrolled at a major southeastern university. Consistent with previous research, retrospective self-reports of childhood sexual abuse and low social support were both positively correlated with current borderline personality features. It was hypothesized that the presence of a supportive relationship at the time the childhood sexual abuse occurred would moderate the relationship between childhood sexual abuse and borderline personality features. This moderation hypothesis was not supported in the current study, but post-hoc analyses reveal the need to further examine how we define social support following childhood sexual abuse. This research is a stepping stone toward the prevention of borderline personality disorder following childhood sexual abuse.     

Have child maltreatment and child placement rates declined?

It is argued that the actual incidence of child maltreatment remains elusive and is, in fact, indeterminate. Factors that might be reflected in variations in child maltreatment rates, other than child harm or endangerment at least partially attributable to caretakers, are explored. But since most children residing in foster care in the United States have been placed there for the alleged reasons of child abuse and neglect, we might expect trends over time in the rate of alleged maltreatment to have some bearing on the out-of-home placement population rate. On the contrary, it is shown that the child placement population rate has risen in recent years, even though the overall child maltreatment rate has not. Based on existing data, the child placement population in the United States is calculated to have been nearly one million children on any given day in 2011, higher than at any point throughout the previous century. Brief comparisons are made with child maltreatment and child placement trends in other countries.     

Hidden dangers among circuit parties—A systematic review of HIV prevalence,sexual behaviors and drug abuse during the biggest gay events

ABSTRACT

Circuit parties (CP) are extended celebrations, lasting from a day to a week, primarily attended by gay and bisexual men in their thirties and forties. The increasing popularity of circuit parties may play a significant role in the epidemiology of HIV and other sexually transmitted diseases. We performed a systematic literature search in MEDLINE, without any temporal limit, using the term “circuit party”. Only articles reporting cross-sectional studies were analyzed. Ten articles, published in the period from 2001 to 2015 were included in our systematic review and reported data on samples ranging from 173 to 13,883 gay/bisexual men. The HIV prevalence among men who attended the CPs was very high, ranging from 6% to 40.8%. Sexual risk behaviors (e.g. unsafe sex or multiple partners) and drug use were particularly frequent. It wo'uld be useful to promote efficient strategies with the cooperation of party planners, catching the participants before nightlife activities in order to prevent HIV transmission and the use of recreational drugs.