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.     

Forensic Interviews for Child Sexual Abuse Allegations: An Investigation into the Effects of Animal-Assisted Intervention on Stress Biomarkers

The use of therapy animals during forensic interviews for child sexual abuse allegations is a recommendation by the Therapy Animals Supporting Kids Program to help ease children’s discomfort during the forensic interview process. Based on this recommendation, this study incorporated a certified therapy canine into the forensic interview process for child sexual abuse allegations. This study investigated changes in salivary cortisol, immunoglobulin A, blood pressure, and heart rate as a result of forensic interview phenomenon (e.g., outcry) incorporating animal-assisted intervention versus a control condition in children (N = 42) interviewed for alleged child sexual abuse. The results supported significantly greater heart rate values for the control group (n = 23) who experienced sexual contact and/or indecency than the experience of aggravated sexual assault compared to no difference in HR for the intervention group (n = 19). The results suggest that the presence of the canine in the forensic interview may have acted as a buffer or safeguard for the children when disclosing details of sexual abuse. In the intervention group, children’s HR was lower at the start of the forensic interview compared to the control group. Finding an effect of having a certified handler–canine team available during the forensic interview on physiological measures of stress has real-world value for children, child welfare personnel, and clinical therapists. It is suggested that animal-assisted intervention be expanded to children facing other types of trauma and to treatment programs for child survivors of sexual abuse.     

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.     

Judgments regarding parental alienation when parental hostility or child sexual abuse is alleged

Abstract

Allegations of Parental Alienation (PA), the systematic disparaging of one parent by the other parent aimed at alienating their child’s affections, as a basis for child custody decisions are highly controversial. Claims of parental hostility or allegations of child sexual abuse in custody cases may trigger concerns about PA. Family court professionals (N?=?280) rated young children’s accuracy of report (e.g., suggestibility, honesty) in general and also read three custody scenarios varying as to whether or not they included allegations of parental hostility or child sexual abuse, or no such allegations. For each scenario, the alleged alienating parent’s gender was experimentally varied between subjects. Participants rated the likelihood that each case involved PA. For the scenario that included allegations of child sexual abuse, professionals who viewed young children as more inaccurate reporters or who read about the mother (rather than a father) as the alleged alienator were more likely to rate the scenario as involving PA. For the scenario that described parental hostility but no child sexual abuse allegations, professionals who were older or female were more likely to judge the scenario as involving parental alienation when a mother (rather than a father) was the alleged alienator, whereas there were no significant predictors of responses to the no-allegation scenarios. Findings are discussed in relation to the difficult task of evaluating custody cases for PA when parental hostility or child sexual abuse is alleged.     

Multidisciplinary Team Involvement and Prosecutorial Decisions in Child Sexual Abuse Cases

This study examines the impact of multidisciplinary teams (MDTs) coordinated by Children’s Advocacy Centers (CACs) on the prosecutorial decision to accept or reject cases of child sexual abuse (CSA). This analysis is part of an examination of the utility of CACs as it relates to prosecutorial decisions. Case specific information was obtained on all cases with both child protective services (CPS) law enforcement involvement processed through one Texas CAC, serving multiple counties, from 2010 to 2013. For the purposes of this study one county is listed as rural and one is listed as urban. The study site also unofficially serves several more rural counties. The urban county accounts for approximately 75% of all cases processed through the CAC. The final analyses included 553 cases of alleged CSA. Logistic regression was used to evaluate the utility of MDTs and case coordination among law enforcement and CPS as they relate to prosecutorial decisions. The number of participants at MDT meetings was correlated with an increase in prosecutorial acceptance rates by approximately 30%. Prosecutor presence at MDT meetings was correlated with an increase in acceptance rates by approximately 80%. Official case coordination between law enforcement and CPS was not statistically significant. Results of this study suggest that the MDT model provides a useful tool for prosecutors when determining whether to accept or reject cases of CSA, while official coordination may be less impactful.     

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.     

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.     

Impact of Perpetrator Type on Attributions of Mother Fault in Child Sexual Abuse

Blaming nonoffending mothers for child sexual abuse has substantial negative consequences for both the mother and child victim. Although perpetrator type has been shown to influence how much blame and responsibility is placed on nonoffending mothers in child sexual abuse cases, research to date has focused primarily on perpetrators who are strangers to the child or the child’s biological father, ignoring the effect of other father-figure perpetrators. The current study examined how differences in perpetrator’s relationship to the mother impacted blame, responsibility, cause, and prevention as separate constructs. One hundred and eight participants from an online community sample were randomly assigned to read a vignette describing a child sexual abuse situation with a female victim and one of two perpetrators: the victim’s biological father or the mother’s boyfriend. Participants assigned significantly higher levels of fault for CSA to the mother when the perpetrator was the mother’s boyfriend. Implications and future directions are discussed.     

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.     

Sexual Revictimization in Adult Women: Examining Factors Associated with Their Childhood and Adulthood Experiences

Using data collected from a sample of adult women (n = 234), this study examined the relationship between the experience and disclosure of childhood sexual abuse and subsequent adult sexual violence. Multivariate analyses revealed that physical force during the childhood sexual abuse experience was significant in both children's decisions to disclose as well as in adult revictimization experiences. Furthermore, childhood disclosures were significantly associated with adulthood disclosures about revictimization, but only when there was no action following the childhood disclosure. The implications for enhancing training and education about understanding and responding to children and women's disclosures about sexual violence are discussed.     

The Continuum of Disclosure: Exploring Factors Predicting Tentative Disclosure of Child Sexual Abuse Allegations During Forensic Interviews and the Implications for Practice,Policy, and Future Research

When a child sexual abuse investigation ensues, many children do not disclose readily to professionals. Defining disclosure beyond the disclosure versus nondisclosure dichotomy is essential, yet little research exists on factors associated with a continuum of disclosure, including active and tentative disclosure. Through the coding of 196 forensic interviews using content analysis and subsequent regression analysis, findings suggest that children of color, children abused by adults, unintentional initial disclosure, and those lacking family support were more likely to tentatively disclose in this study. Implications include a need to understand tentative disclosure as part of a normal continuum of disclosure within court proceedings and investigations of abuse allegations.     

The Effect of Severe Child Sexual Abuse and Disclosure on Mental Health during Adulthood

This study examined the relationship among severe child sexual abuse, disclosure, and mental health symptoms during adulthood. The sample consisted of 172 adults who were sexually abused in childhood. The multivariate model showed that respondents in their 30s and 40s who were abused by more than one abuser, who were injured by their abusers, who were abused by a biological relative, who told someone about the abuse when it occurred, and who did not discuss their abuse in depth within one year of the abuse had a greater number of mental health symptoms. Abuse severity and disclosure history should be assessed by professionals to identify clients who are at higher risk of mental health symptoms and to focus therapy.     

Children’s Knowledge of Genital Anatomy and Its Relationship With Children’s Use of the Word “Inside” During Questioning About Possible Sexual Abuse

ABSTRACT

This study was designed to examine the relationship between children’s understanding of their genital anatomy and their use of the word “inside” in response to questions about genital touch during a forensic medical examination. This study involved a secondary data analysis of 674 records of children at a sexual abuse clinic in a large city in a southern state. Data were analyzed using contingency table, binary logistic, and multinomial logistic regression analysis methods. An association between children’s understanding of genital anatomy and their use of the word “inside” to describe genital touch was found. Children’s age and development contributes to their overall understanding of genital anatomy, and their knowledge of genital anatomy appears to influence how they answer questions regarding genital touch. This finding could play an important role in sexual abuse cases in states where the definition of rape includes penetration of any bodily opening, including labial penetration.     

Ritual,and child sexual abuse,but not ritual child sexual abuse

Central to the controversy over ritual (satanic) child sexual abuse have been claims concerning agency ‘diagnoses’ of cases. Specifically, it has been alleged that agency findings of ritual abuse have been erroneous and are the product of poor practice. There is, though, little systematic information regarding agency assessment of suspected ritual abuse cases. This paper presents two cases where there was evidence both of child sexual abuse and ‘ritual’ but where agencies adjudged that these aspects occurred independently of one another and were not indicative of ritual child sexual abuse. The existence of these cases underlines the need for a broader and more balanced debate in respect of ritual abuse in general and the agency handling of these cases in particular. Copyright © 2000 John Wiley & Sons, Ltd.     

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.     

A Psychosocial Understanding of Child Sexual Abuse Disclosure Among Female Children in South Africa

Child sexual abuse is endemic in South Africa, driven by high levels of gender-based violence and underscored by structural and social factors. This article aims to develop an understanding of the process of disclosure in a sample of female children and their caregivers. In-depth semistructured interviews were conducted with 31 female children aged 8–17 years and their caregivers at 3 intervals after presentation to a sexual assault treatment center. Nearly half of the children failed to disclose the sexual abuse immediately, fearing caregivers’ reaction. Most children purposefully disclosed to a confidant through a process of identifying an intermediary to tell caregivers on their behalf. The process of disclosure was influenced by multiple factors, such as a fear of the caregiver’s reaction and disbelief, which is related to parental style. Disclosure was found to be a dynamic process that unfolds and not a single or static event and influenced by multiple factors which all impact on recovery. Our findings highlight the need to address social norms on sexual abuse in order to improve responses to disclosure to facilitate post-sexual-abuse adjustment for the child and the family.     

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.     

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.     

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.     

The Seven Pillars of Quality Care in a Statewide Pediatric Sexual Assault Nurse Examiner Program

This article describes a systematic approach used by a statewide pediatric sexual assault nurse examiner program to ensure the quality of forensic medical examinations it provides in child sexual abuse investigations. Seven strategies for enhancing quality are described: (a) hiring experienced professionals, (b) effective training, (c) comprehensive protocols, (d) ample support for pediatric sexual assault nurses, (e) management oversight, (f) a clinical coordinator to provide ongoing training and technical assistance, and (g) a quality assurance process in which expert child abuse pediatricians review each statewide pediatric sexual assault nurse examination. To show the evolution of quality care over time, the program's experience from 2004 to 2010 is reviewed, and quality assurance data are analyzed.