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.     

Forensic Evaluation in Alleged Sibling Incest Against Children

Sibling incest is a serious form of intrafamilial sexual abuse with health, social, and legal relevance. A retrospective study was conducted through the analysis of forensic medical reports of the alleged sibling incest of victims under 18 years old (n = 68) from 2004 to 2011 as well as the respective judicial outcomes. Results demonstrated that sibling’s sexual abuse is associated with several circumstances that might exacerbate its severity such as vaginal, anal, and/or oral penetration. Moreover, the victim’s young age, the proximity between victim and abuser, and the fact that it is committed at the victim’s and/or abuser’s home and by using physical violence and verbal threats justify a late detection of these cases.     

Cross‐examination,sexual abuse and child witness identity

This paper presents extracts from cross‐examinations with child witnesses who are alleged victims of child sexual abuse. The manner in which cross‐examination may present a challenge to the child's identity as child, victim and witness is discussed. Specifically, the child may be portrayed as ‘unchildlike’, for example in their experience of sexual relationships or in their sexual knowledge. They may be portrayed as less than innocent, through references to previous contacts with social services or to other behaviours such as delinquency. Child witnesses may be depicted as instigators rather than victims, seducing the adult or seeking revenge through sexual allegations. Finally, children are easily accused of being poor witnesses, as being confused, untruthful and having fallible memories. The paper considers the dynamics and potential impact of such cross‐examination practice within Finkelhor's framework of four traumagenics of sexual abuse: traumatic sexualization, betrayal, powerlessness and stigmatization. The potential for poorly conducted cross‐examinations to create further problems for child witnesses, particularly in the area of identity, is highlighted, and it is suggested traumagenic factors in such cross‐examinations may resemble those of abuse. The paper discusses practice implications for cross‐examination, judicial intervention and witness support following implementation of the Youth Justice and Criminal Evidence Act 1999 in England and Wales. Copyright © 2002 John Wiley & Sons, Ltd.     

Victims’ Retrospective Explanations of Sibling Sexual Violence

ABSTRACT

While sibling sexual abuse may be the most common form of sexual violence within the family, relatively few studies have been conducted on this topic. The current study addresses this gap in the literature through analyses of thematic categories in narratives gathered from an online survey of sibling sexual violence. Survivors were asked to report why they believed their siblings had become sexually abusive toward them. Participants believed that their abusers had learned to be abusive due to their own victimization or exposure to pornography, were abusive to establish dominance over them, or had some undisclosed mental illness. While the study does not claim to test these explanations or include abusers’ own narratives, it offers insight as to how sibling sexual violence survivors make sense of their experiences and assign blame to abusers and their families. It also offers insights into future inquiries about sibling sexual abuse.     

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.     

Family Responses to Young People Who have Sexually Abused: Anger,Ambivalence and Acceptance

Data on 117 British young people who had sexually abused others were examined in order to investigate the nature and impact of family responses on the management of young sexual abusers. Parental responses were varied, ranging from being entirely supportive of the child, through to ambivalence and uncertainty and, at the other end of the continuum, to outright rejection. Parents were more likely to be supportive when their child's victims were extra‐familial and condemnatory when the victims were intra‐familial. Sibling responses were complex and strongly influenced by whether that sibling was the victim of the young person's abuse or not. Policy and practice implications are discussed.     

Study of Cases of Child Sexual Abuse Referred for Medico-Legal Examination in Cairo and Giza,Egypt,2007–2011

ABSTRACT

Child sexual abuse is a complex problem that results in detrimental effects on its victims. This study aimed to investigate the pattern of child sexual abuse in cases referred for medico-legal examination in Cairo and Giza governorates in the period between 2007–2011. The study included 813 cases of child sexual abuse. Female gender was more predominant than male gender (52.8%, 4.29 cases), and adolescents were the most frequent age group identified as victims of sexual abuse (43.8%, 356 cases). All perpetrators were male and most of them were persons outside the victims’ families (89.9%, 731 cases). It was recommended to teach and encourage children to tell their caregivers if they have been assaulted and to educate parents and caregivers on how to respond when the child discloses sexual abuse.     

Eliciting Accounts of Alleged Child Sexual Abuse: How Do Children Report Touch?

Investigative interviewers frequently question alleged victims of child sexual abuse about any touching or bodily contact that might have occurred. In the present study of forensic interviews with 192 alleged sexual abuse victims, between 4 and 13 years of age, we examined the frequency with which alleged victims reported bodily contact as “touch” and the types of prompts associated with “touch” reports. Even young alleged victims of sexual abuse reported bodily contact as “touch,” and they used the word “touch” more frequently in response to recall than recognition prompts. Regardless of age, children typically referred to “touch” before interviewers used this term, suggesting that even young children are able to report “touch” without being cued by interviewers.     

The Cognitive Impact of Sexual Abuse and PTSD in Children: A Neuropsychological Study

Sexual abuse is known to have an impact on both child and adult mental health, but the neuropsychological basis of this effect is still largely unknown. This study compared neuropsychological test results from a group of 76 children, 13 of them sexual abuse victims with symptoms of post-traumatic stress disorder, 26 victims of sexual abuse who showed no symptoms post-traumatic stress disorder, and 37 controls. The groups were matched by age, sex, socioeconomic status, and educational level. Child sexual abuse was associated with reduced ability to inhibit automatic responses measured by the Stroop test regardless of post-traumatic stress disorder status. These findings indicate possible attentional inhibition difficulties in child victims of sexual abuse, which may help explain psychopathology associated with the experience.     

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.     

Theoretical Perspectives of Male Sexual Abuse: Conceptualization of a Case Study

The purpose of this article is to demonstrate the traumatic impact that sexual abuse can have on a young male's development by addressing mediating dispositions that can render a child vulnerable to the effects of sexual abuse. Consideration is given to three different theoretical perspectives that are not exclusive to male victims but shed light on the impact that sexual abuse can have on the development of a young boy. These perspectives include early family relationships and attachment theory, developmental psychopathology, and trauma theory. These theoretical lenses provide a conceptual understanding into why some victims are vulnerable to the effects of sexual abuse. Each theoretical view is applied to a case study of an adolescent male with a history of early trauma and sexual abuse. Clinical implications are discussed.     

Theoretical perspectives of male sexual abuse: conceptualization of a case study

The purpose of this article is to demonstrate the traumatic impact that sexual abuse can have on a young male's development by addressing mediating dispositions that can render a child vulnerable to the effects of sexual abuse. Consideration is given to three different theoretical perspectives that are not exclusive to male victims but shed light on the impact that sexual abuse can have on the development of a young boy. These perspectives include early family relationships and attachment theory, developmental psychopathology, and trauma theory. These theoretical lenses provide a conceptual understanding into why some victims are vulnerable to the effects of sexual abuse. Each theoretical view is applied to a case study of an adolescent male with a history of early trauma and sexual abuse. Clinical implications are discussed.     

The ultimate deception: childhood sexual abuse in the church

Childhood sexual abuse is a serious problem. Significant evidence exists that victims experience both short-term and long-term emotional and psychological problems related to the abuse. Childhood sexual abuse committed by clergy or other adults affiliated with the church may have additional ramifications because of deep violations of trust, honesty, and love. In addition, it can create spiritual distress in victims. Child and adolescent mental health nurses need to actively promote risk-reduction strategies to help prevent the abuse from occurring in their communities.     

Incest,paedophilia, pornography and prostitution: making familial males more visible as the abusers

In this paper I return to the survivor case study and sex offender data I used in my paper on conceptual models of the relationship between pornography and child sexual abuse in Child Abuse Review in 1997. Here I use them to show how paedophile typologies and sex offender classifications contribute to constructing the invisibility of the normal, ordinary, heterosexual family men who sexually abuse their own and other people's children on a very substantial scale. I also use it as the basis for developing a typology which constructs the connections between incest, paedophilia, pornography and prostitution in the form of a ‘Continuum typology of child sexual abuse and the characteristics of child sexual abusers’, and captures the crossover of victims and perpetrators and the overlap of intrafamilial and extrafamilial child sexual abuse and exploitation. This, in turn, becomes the basis for constructing a ‘Nosology of child sexual abuse classification’ which genders the abusers and takes account of both the overlap and the dominant discourse currently of policing and policy, in which ‘paedophilia’ and ‘child sex offending’ have become synonymous, and incest abusers are invisible. Copyright © 2001 John Wiley & Sons, Ltd.     

Childhood Coping Strategies of Intrafamilial and Extrafamilial Female Sexual Abuse Victims

A sample of 66 college women's retrospective reports of childhood sexual abuse was examined in order to identify the coping strategies implemented by victims of intrafamilial and extrafamilial sexual abuse at the time of their victimization Results indicated that both intrafamilial and extrafamilial victims reported attempts to regulate their distress (with emotion-focused coping strategies) and to impact the actual abuse situation (using problem-focused coping strategies). However, intrafamilial victims reported employing more of both types of coping as compared to extrafamilial victims. With regard to more specific types of emotion-focused coping, intrafamilial victims reported using more wishful thinking, detachment self-blame, and self-isolation. Differences between the two groups are also examined on a strategy-by-strategy basis. The implications of these results are discussed with regard lo clinical interventions for victims.     

Disabled Women Sexually Abused in Childhood: Treatment Considerations

There is a dearth of literature addressing the issues presented in the treatment of adult disabled women who were victims of childhood sexual abuse. This article focuses on the pertinent issues involved in clinically treating this population, such as the meaning of the traumatic event of sexual abuse for the individual, the disability and how it may have impacted her in terms of dependence, body integrity, and sexuality. Coping strategies and case examples are presented and possible countertransferential reactions are examined.     

Sibling Incest Dynamics: Therapeutic Themes and Clinical Challenges

Increasing empirical evidence points to the prevalence and devastating effects of sibling incest. The dynamics of incestuous sibling relationships are complex and typically embedded in severely dysfunctional families. Often confused and/or distressed by their incestuous experiences, many victims fail to disclose the abuse. Left undisclosed and untreated, unresolved issues of mutuality and consequent shame and guilt can lead to life-long emotional problems and dysfunctional behavioral patterns that are difficult to repair. Two cases illustrate common therapeutic themes, the importance of timely disclosure and coordinated, multi-dimensional treatment approaches, as well as the therapeutic challenges of assisting sibling incest victims who present for treatment as adults.     

Male victims of child sexual abuse

Despite the increased attention the subject of child sexual abuse has received in recent years, rarely has much consideration been given to the boys and adolescent males who are the victims of such abuse. That young girls are consistently the clear majority of sexual abuse victims is not disputed, however the extent to which they are the majority is in question. A review of existing literature has indicated that one of the leading factors for this inadvertent negligence in presenting a truer picture of the magnitude of the problem for male victims concerns the area of under-reporting of the incidence of abuse of young males. Under-reporting has served to give a false sense of the scope of child sexual abuse, particularly for male children. Many societal and methodological factors contribute to under-reporting. Reasons for the discrepancy in reporting abuse will be presented and implications for practice will be discussed.     

How Qualitative Research Can Inform Clinical Interventions in Families Recovering From Sibling Sexual Abuse

The impact of sibling sexual abuse (SSA) has been culturally and therapeutically minimised and has received scant research attention. Furthermore, prior research has focused upon the separate experiences of the victim or the offender, or upon seeking family dysfunction explanations. In contrast, this qualitative study attempts to understand the experiences of all family members (victims, offenders, parents and other siblings) when SSA is disclosed. The pathway to recovery for each family member is identified. A systemic analysis of these (often conflicted) pathways of recovery provides some surprising findings and contributes to an understanding of the difficulties facing families in this situation, the constraints on family support and connectedness, validation for the victim and offender accountability.