Social reactions to child sexual abuse disclosures: a critical review

Recent studies have examined disclosure of child sexual abuse to determine the correlates and consequences of telling others about this form of victimization. The present article reviews the current empirical literature on disclosure and reactions to adult survivors to assess what is known about the process of disclosure and whether telling others is therapeutic and leads to positive outcomes. Most studies assessing social reactions in detail have concerned adult survivors retrospectively reporting on their disclosures of child sexual abuse. Few empirical studies have been conducted in this area but research suggests that few victims tell anyone about child sexual abuse as children, and that the type of reactions to disclosure vary according to when disclosure occurs (childhood or adulthood), the extent and nature of the disclosure, and the person to whom one discloses. Clear evidence shows that negative social reactions are harmful to survivors' well-being, but better assessment of specific reactions and their effects are needed in theoretically-based studies to evaluate how these responses affect survivors' recovery in the context of other variables. Suggestions for future research on social reactions of others to adult survivors disclosing child sexual abuse are presented.     

The Relationship between Knowledge and Child and Caregiver Distress during the Medical Examination for Child Sexual Abuse

When child sexual abuse is suspected, a child sexual abuse–related medical examination is recommended to ensure the child's well-being. While the extant research has sought to identify factors influencing child distress during this examination, only recently have studies began examining variables that may be directly associated with the child or with the medical setting. Knowledge of the child sexual abuse–related medical examination is one medical-related variable that has been implicated in child and caregiver distress during the examination. The current study contributes to the existing literature by investigating associations among examination knowledge in relation to caregiver and child anxiety at the time of a child sexual abuse–related medical examination, taking into account ethnicity, past child abuse, injury to child as result of abuse, and caregiver response to disclosure. Sixty-eight children and their nonoffending caregiver were assessed. Results indicated that understanding of the examination and caregiver response to disclosure were significantly associated with caregiver and child anxiety.     

Boys Abused in a Community Setting: An Analysis of Gender,Relationship, and Delayed Prosecutions in Cases of Child Sexual Abuse

ABSTRACT

Previous research on gender differences and delay of disclosure of child sexual abuse is inconclusive; some research has found that male victims are more likely to delay disclosure than female victims, while other studies have found no gender difference. The present archival study investigated this inconsistency by examining factors that interact with delay. Judicial outcomes of child sexual abuse cases were coded (N = 4237) for variables related to the offense, the complainant-accused relationship, and court proceedings. Males and females differed with respect to delay only when the relationship between the complainant and the accused was established in the community (e.g., sports coach) or was a stranger to the child. When the accused was a parent, other relative, or a non-relative connected to the child through the family, there was no difference in delay between males and females. Further, males were more vulnerable in the community, as evidenced by a higher proportion of accused community members with male than female complainants, even though males represented fewer than 25% of cases in the database. These findings may help explain inconsistencies in gender differences in delayed disclosure. Implications regarding education about child sexual abuse are discussed, with a focus on male victims.     

Sexual Abuse in Malawi: Patterns of Disclosure

Potential human immunodeficiency virus transmission makes prompt disclosure of child sexual abuse in Africa critical. The pattern of disclosure of 133 children presenting to the largest hospital in Malawi were analyzed. Eighty percent presented early enough for effective use of HIV postexposure prophylaxis. Seventy-five percent of children made a disclosure of child sexual abuse; 29% spontaneously and 47% after prompting. Disclosures were most commonly made to a parent, and age did not affect the pattern of disclosure. The number of children reporting child sexual abuse is increasing, possibly because of increasing awareness, availability of services, and fear of HIV. Although prompt disclosure rates were relatively high, facilitating easier disclosure of child sexual abuse by a free telephone help-line and better training of teachers may be helpful.     

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.     

Caregiver Needs Following Disclosure of Child Sexual Abuse

Caregiver support is vital in improving outcomes for child sexual abuse victims; however, the disclosure can significantly affect caregivers, thus impacting their ability to meet their children’s needs. To maximize the support from caregivers, their own needs following disclosure need to be met. This study investigated the impact of child sexual abuse disclosure and associated needs as identified by caregivers. Sixty needs assessment forms were collected from families who accessed a parenting support pilot program run in New Zealand. These forms were completed by nonoffending caregivers during an assessment session with their counselor and consisted of both open-ended and Likert scale questions focusing on both the needs of the child and the family. Caregivers identified a range of impacts of the disclosure on their children, themselves, and other families members and the related support that may be needed. In particular, caregivers identified that they needed support with child behavior management and with their own coping. The findings suggest that interventions with caregivers following disclosure of child sexual abuse may be a valuable adjunct to therapy provided directly to the child.     

Factors Associated with Adolescents’ Disclosure of Sexual Abuse Experiences in Hong Kong

This research project is the first study conducted in Hong Kong using adolescent subjects to explore predictors of child sexual abuse disclosure. Eight-hundred male and female adolescents aged 13 to 16 years were recruited from the community while another 30 adolescents joined the study from a clinical setting. One hundred and seventy-seven adolescents acknowledged having a child sexual abuse experience. Results showed that the severity of sexual abuse activities and parent attachment were associated with disclosure in the clinical setting, while abuser’s gender and the adolescents’ disclosure tendency were associated with disclosure among participants in the community setting. Among the 104 participants who had disclosed their childhood sexual abuse, 70% of them had disclosed it within one month and 63% of them had disclosed to 2 to 5 people. The majority of the disclosers (81%) shared their child sexual abuse experience(s) with their friends. Participants from the clinical setting tended to reveal the experience more to adults than those from the community. The study suggested that when choosing a potential confidant, adolescents paid more attention to confidant characteristics than to anticipated confidant responses to their disclosure. Limitations and practical implications for increasing child sexual abuse disclosure rates are discussed.     

The effects of interviewer race and child race on sexual abuse disclosures in forensic interviews

This study examined the impact of interviewer race and child race on disclosures by alleged child sexual abuse victims during forensic interviews. Despite findings that supportiveness of caretaker, gender of interviewer, gender of child, and age of child affect disclosure, previous studies have failed to examine race as a variable impacting disclosure in a real-world setting. The study examined 220 cases from an archive of reports generated from forensic interviews in an urban setting. The reports were reviewed and coded for degree of disclosure, focusing on African American and Caucasian children and interviewers. The results indicate that child race and the interaction of child race and interviewer race reliably distinguished between no disclosure, tentative disclosure, and disclosure with detailed account of activity, while interviewer race alone failed to serve as a significant predictor. The interaction between child race and interviewer race was not in the predicted direction, with cross-race dyads disclosing more than same-race dyads. Results are discussed in the context of real-world applications versus the previous analogue child sexual abuse literature.     

The Relationship Between Perceptions of Response to Disclosure of Childhood Sexual Abuse and Later Outcomes

This study assessed whether perceptions of others’ reactions to disclosure are related to psychological and physical outcomes among individuals with a history of child sexual abuse. Eighty-six female undergraduates completed a series of questionnaires assessing child sexual abuse, nonsexual trauma, depression, anxiety, posttraumatic stress disorder, somatic symptoms, disclosure, and social reactions to disclosure. Those who reported child sexual abuse endorsed higher levels of psychological and physical symptoms than those who reported a nonsexual traumatic event. Child sexual abuse survivors who reported more hurtful responses to disclosure had higher levels of posttraumatic stress disorder, anxiety, and physical symptoms than nonsexual trauma survivors. These findings suggest that many survivors of CSA may need psychological services, and an important focus of treatment may be assessing and strengthening social support.     

Outcry Consistency and Prosecutorial Decisions in Child Sexual Abuse Cases

This study examines the correlation between the consistency in a child’s sexual abuse outcry and the prosecutorial decision to accept or reject cases of child sexual abuse. Case-specific information was obtained from one Texas Children’s Advocacy Center on all cases from 2010 to 2013. After the needed deletion, the total number of cases included in the analysis was 309. An outcry was defined as a sexual abuse disclosure. Consistency was measured at both the forensic interview and the sexual assault exam. Logistic regression was used to evaluate whether a correlation existed between disclosure and prosecutorial decisions. Disclosure was statistically significant. Partial disclosure (disclosure at one point in time and denial at another) versus full disclosure (disclosure at two points in time) had a statistically significant odds ratio of 4.801. Implications are discussed, specifically, how the different disciplines involved in child protection should take advantage of the expertise of both forensic interviewers and forensic nurses to inform their decisions.     

Judicial Decision-Making and Juvenile Offenders: Effects of Medical Evidence and Victim Age

ABSTRACT

A growing body of evidence suggests that jurors place greater weight on DNA or other types of forensic evidence than non-forensic evidence (Cole & Dioso-Villa, 2009). For cases involving child sexual abuse, certain types of evidence, including forensic medical evidence, may be viewed as more important or indicative of abuse than other types of evidence, such as victim statements or disclosure. The present study evaluated perceptions of juvenile offenders and victim credibility across four vignettes that systematically manipulated variables related to victim age and physical indicators of abuse. A sample of 636 participants read vignettes and answered questions pertaining to the vignette. Participants also provided demographic information and responded to a series of items assessing participants’ judicial decision-making strategies and outcomes. Broadly, the presence of medical evidence significantly influenced participants’ decision-making across a variety of variables, including verdict outcome, verdict confidence, confidence that the victim was truthful, and determinations involving sex offender registration and notification requirements. The influence of medical evidence and victim age on perceptions and sentencing of juvenile sex offenders across these and additional outcome variables will be discussed.     

Recent Supreme Court Rulings on Child Testimony in Sexual Abuse Cases

Three recent United States Surpreme Court decisions concerning court testimony in cases involving sexually abused children are discussed. Two of the decisions establish criteria for allowing courtroom procedures (such as televised testimony) that enable a child witness to testify without a direct face-to-face encounter with the alleged abuser. The third decision establishes some criteria for the admissibility of incriminating hearsay statements made by very young children during the course of professional evaluation for reported sexual abuse. Implications of these criterai for decisions about courtroom procedures for obtaining children's testimony and for interviewing children in cases of alleged sexual abuse are also discussed.     

The role of disclosing child sexual abuse on adolescent adjustment and revictimization

The role of disclosing child sexual abuse on adolescent survivors' symptomatology and the presence of additional unwanted sexual experiences was investigated in a subsample of 111 adolescents from the National Survey of Adolescents who reported child sexual abuse. Results indicated that prompt disclosure of sexual abuse to an adult moderated the influence of penetration during the abuse on the number of symptoms at assessment. Thus, prompt disclosure buffered the influence of more severe abuse. Disclosure also had a main effect on the likelihood of further victimization. Participants who told an adult promptly after the abuse were less likely to report additional unwanted sexual experiences.     

Disclosure of Child Sexual Abuse as a Life‐Long Process: Implications for Health Professionals

One of the aims of this research project was to develop a fuller understanding of the process of disclosure of child sexual abuse. Face‐to‐face in‐depth interviews were conducted with 22 men and women aged 25 to 70 years old, who had an early sexual experience at the age of 15 or under with someone of 18 or over. Narrative inquiry methodology was used and data was analysed using Rosenthal and Fischer‐Rosenthal's (2004) process of data analysis. Disclosure can be conceptualised as a complex and life‐long process, and most participants did not make a selective disclosure until adulthood. The findings extend Alaggia's (2004) model of disclosure to include the life stage and the person to whom the disclosure is being made. The main barriers to disclosure and possible gender differences are discussed. Family therapists need to manage the challenges inherent in disclosure of child sexual abuse at any age.     

Forensic, cultural, and systems issues in child sexual abuse cases--part 1: an introduction

This article introduces the first in a two-part special issue focusing on forensic, cultural, and systems issues in child sexual abuse cases. The five articles contained in this issue include a diversity of perspectives on approaches to extended interviews and evaluations of child sexual abuse suspicions, an exploration of the ways culture affects child sexual abuse disclosure and reporting, considerations relevant to the management of a child's mental health needs while forensic process are ongoing, and the use of anatomical dolls in forensic interviews. We call for attention to several practice areas, including (a) prioritizing a child's mental health needs while minimizing disruption of forensic processes, (b) developing best practices and models of child sexual abuse assessment and evaluation when a one-session forensic interview is insufficient, (c) appropriately evaluating child sexual abuse concerns when they occur without a disclosure and/or in children with communication limitations, and (d) the integration of cultural sensitivity into interviews and evaluations.     

Cultural issues in disclosures of child sexual abuse

Cultural norms affect the likelihood that child sexual abuse will be discovered by an adult or disclosed by a child. Cultural norms also affect whether abused children's families will report child sexual abuse to authorities. This article explores the ways ethnic and religious culture affect child sexual abuse disclosure and reporting, both in the United States and internationally. Guidelines for culturally sensitive child abuse interviewing are provided to facilitate disclosures of abuse from culturally diverse children in formal settings.     

Reclaiming the Mother-daughter Relationship after Sexual Abuse

This paper seeks to provide direction to therapists working with mothers and daughters after a disclosure of father-daughter sexual abuse. The importance of the mother's belief in and support for the child's recovery is highlighted, as are some of the cultural assumptions about mothers and daughters which negatively impact on the relationship. Despite paying lip service to offender responsibility, there continues to be a culture of mother blaming in the child sexual abuse and family therapy literature on incest. Current research findings challenge some of the prevalent myths about mothers’ responses to their children's disclosures. Few clinical sources have addressed this issue, and therapists who reject the mother blaming literature are therefore left with little guidance as to how to work more effectively with mothers and daughters. Consequently they may unwittingly further undermine the relationship. Work with mothers and daughters as they recover from intrafamilial sexual abuse is discussed, and key therapeutic themes and guidelines for practice presented. We explore the significant theme of the rebuilding of trust between mothers and daughters and facilitate a process whereby the woman is able to bear witness to and acknowledge the trauma experienced by her daughter.     

Common Beliefs About Child Sexual Abuse and Disclosure: A College Sample

ABSTRACT

Adults’ common beliefs about child sexual abuse and disclosure were explored. Participants (N = 670) were questioned about key areas of child sexual abuse that could affect decision-making processes of jurors evaluating child sexual abuse cases. These areas included victim and perpetrator characteristics, medical and behavioral indicators of child sexual abuse, memories for the event, and disclosure of the event. The scientific literature pertaining to these same areas are reviewed. While individual beliefs were consistent with some areas of the scientific literature (e.g., victim and perpetrator characteristics), they strongly contrasted the literature in other important areas (e.g., memories for the event, indicators of child sexual abuse, and the likelihood of denial and recantation). Implications, including the option of providing expert testimony to reduce discrepancies, are discussed.     

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.     

Child and Interviewer Race in Forensic Interviewing

The purpose of this study was to examine the potential effect of child race and interviewer race on forensic interviewing outcomes. The results of the regression analysis indicated that child race and interviewer race had a significant effect on interview outcome category (no findings, inconclusive, or findings consistent with sexual abuse). Furthermore, the results indicate that the interaction of child and interviewer race had predictive value for rates of findings consistent with sexual abuse but not in the direction predicted. Cross-race dyads had significantly higher rates of interview outcomes consistent with sexual abuse. These findings suggest that more research into the effect of race on disclosure of child sexual abuse is needed.