How children tell: the process of disclosure in child sexual abuse

In an analysis of the disclosure by a large number of children from three to 17 years of age of having been sexually abused, and who were eventually confirmed as credible victims, the large majority at first denied the abuse. The authors describe disclosure as a process with definable phases and characteristics--seldom the single entity that typical investigations consider disclosure to be, thereby setting the stage for ensuring injustices and harm to the children.     

Impact of child sexual abuse disclosure on the health of nonoffending parents: A longitudinal perspective

The impact of child sexual abuse (CSA) disclosure on parents’ psychological health has been documented among samples of nonoffending parents. Much less is known about the parents’ physical health. This study assesses the longitudinal impact of CSA disclosure on both the mental and physical health of parents and explores potential gender differences. Interviews with 92 mothers and 32 fathers were completed approximately 12 months and 18 months following disclosure. Generalized as well as mixed model analyses revealed that mothers reported more psychological distress, Posttraumatic Stress Disorder (PTSD) symptoms and activity limitation than fathers. With the exception of PTSD symptoms which showed a significant reduction over time, all other psychological and physical symptoms persisted. The findings highlight the importance of ensuring services for an extended period for the small proportion of parents who display especially high vulnerability.     

The association of maternal depressive symptoms with child externalizing problems: the role of maternal support following child sexual abuse

This study examines the role of abuse-specific maternal support in the association between parent depressive symptoms and child externalizing problems in a sample of children with a history of sexual abuse. In total, 106 mother-child dyads were studied. The association between maternal depressive symptoms and child delinquency behaviors was found to partially operate through abuse-specific maternal support, which was assessed via parent report. Implications of the findings for parenting programs are discussed, and future research directions are considered.     

Relationships between maternal adult attachment security, child perceptions of maternal support, and maternal perceptions of child responses to sexual abuse

This study assessed the relationships between maternal adult attachment style, children's perceptions of maternal support following disclosure of sexual abuse, and maternal perceptions of children's behavioral and emotional responses to sexual abuse among African-American child sexual abuse victims aged 4 to 12 (n=96) and a comparison group of non-abused subjects (n=100). Mothers with insecure attachment styles reported significantly higher rates of internalizing behaviors in their sexually abused children than did securely attached mothers. Among mothers of non-abused children, those with insecure adult attachment styles reported significantly higher rates of externalizing behaviors shown by their children in comparison with mothers with a secure adult attachment style. Mothers with insecure adult attachment styles also reported higher rates of overall behavior problems in their non-abused children that approached statistical significance. Sexually abused children's perceptions of maternal support were not related to maternal attachment style nor to child functioning. Contrary to our prediction, mothers of sexually abused children did not show lower rates of secure attachments when compared to mothers of non-sexually abused children. Our findings indicate that fostering parent- child attachment is important in order to decrease the risk for behavior problems and symptomatology in sexually abused children.     

Cultural and religious influences in maternal response to intrafamilial child sexual abuse:charting new territory for research and treatment

The role of culture when providing services for families in the wake of child sexual abuse disclosure is a charged issue although surprisingly little attention has been given in the research literature to this. This article reports the findings of a grounded theory study exploring facets of maternal response, and aspects of more and less supportive responses, to children who were sexually abused by the mother's intimate partner. Ten mothers, chosen on the basis of theoretical sampling, provided information through in-depth interviews to understand how they responded emotionally and behaviourally to their child's disclosure. As well, three service providers were interviewed as key informants. The research revealed cultural and religious influences as affecting how mothers made meaning of the sexual abuse and the actions they took. Mothers from cultural backgrounds that adhere to rigid patriarchal norms identified themes of intense value conflicts regarding family preservation, loyalty binds between the perpetrating partner and child victim, and anxieties around being alienated from their extended family and ethnic community. They also reported that their cultural belief systems were not well understood by service providers. In parallel, helping professionals identified cultural issues as presenting barriers for engaging with some clients. Practice implications and research directions are discussed.     

Children's response to the medical visit for allegations of sexual abuse: maternal perceptions and predicting variables

This study examined maternal perceptions of their child's response to the medical evaluation for alleged sexual abuse. A total of 50 mothers were interviewed 6 months after a visit to a Child Protection Clinic for a medical evaluation of alleged sexual abuse. The mothers answered a questionnaire on their child's reactions to the medical visit. More than 60% of children were perceived as being reassured about physical integrity. The degree of psychological distress was independent of perpetrator's identity and severity of the abuse. Mothers considered that a hypothetical second visit would generate in their child a level of anxiety that increased with perceived intensity of fear of the examination and decreased with perceived kindness of the physician. These results suggest that the physician's behaviour during the medical evaluation for alleged sexual abuse has an influence on the child's degree of distress that is independent of type and severity of abuse. Copyright © 2001 John Wiley & Sons, Ltd.     

Relationship to perpetrator, disclosure, social reactions, and PTSD symptoms in child sexual abuse survivors

This research examined victim relationship to the perpetrator, disclosure characteristics, social reactions, and PTSD in adult survivors' of child sexual abuse (CSA) identified in a convenience sample of 733 college students. Results indicated that relationship to the perpetrator was related to CSA characteristics and outcomes. More negative reactions such as disbelief were observed for those victimized by relatives compared with acquaintance and stranger victims, especially for those disclosing in childhood. Victims of relatives had more PTSD symptoms if they delayed disclosure, received more negative reactions in childhood, and engaged in self-blame at the time of the abuse. Results are discussed in the context of Freyd's (1996) betrayal trauma theory, in order to better understand the traumatic impact of CSA.     

The impact of child, family, and child protective services factors on reports of child sexual abuse recurrence

This study identified selected child factors (e.g., age, gender, race/ethnicity, disabilities, prior victimization, and relationship to perpetrator of abuse), family risk factors (e.g., substance abuse, domestic violence, inadequate housing, and financial problems), and services provided by child protective services that likely increased reports of child sexual abuse recurrence by type of reporter. Survival analysis was conducted using the National Child Abuse and Neglect Data System data set of 2002-2004. Child disability, being a prior victim, having a perpetrator as a caregiver, family financial problems, and receiving family supportive services increased the likelihood for reports of child sexual abuse by mandated reporters. Being Hispanic, having a disability, having a perpetrator as a caregiver, financial problems, and receiving family preservation services statistically decreased the likelihood for reports of child sexual abuse recurrence.     

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.     

Experiences of disclosure of childhood sexual abuse and psychopathology

Reported child sexual abuse is associated with the development of anorexia and bulimia nervosa overall, but the mediating factors that determine whether such abuse is relevant in individual cases are not adequately understood. This study considers the importance of the experience of initial disclosure as a mediator in a case series of eating-disordered women. The extent of psychopathology (particularly the frequency of vomiting and the presence of the symptoms of borderline personality disorder) was associated with the nature of the perceived response to an attempted disclosure. A perceived lack of response or a negative, hostile response was associated with specific patterns of symptomatology. Further research is suggested to extend these conclusions, and the clinical implications of these findings are discussed.     

Disclosing sexual abuse: the impact of developmental variables

Despite increasing evidence that even a young child can be a competent witness in a court of law, there is one factor that is often used to impeach the credibility of a child in a sexual abuse case, and that is the nature and timing of the child's disclosure of the sexual victimization. This paper examines the impact of developmental variables on that disclosure and suggests that when those variables are recognized, the credibility of the young child as a witness increases.     

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.     

To tell or not to tell: the impact of disclosure on sexual assault survivors' recovery

There is a growing body of research examining the disclosure of sexual assault. But the focus on time to first disclosure does not capture the whole picture. Survivors also differ in how long they continue to disclose, to whom they disclose, and the types of reactions received during disclosure. To provide a more comprehensive view of disclosure, this study sought to identify patterns of disclosure among a sample of 103 female sexual assault survivors recruited from the community. This study also sought to identify characteristics of each disclosure pattern, differences in how each disclosure pattern tends to unfold (e.g., who is told and how they react), and differences in how these disclosure patterns are related to physical and mental health outcomes. Results revealed four distinct disclosure patterns: nondisclosers, slow starters, crisis disclosers, and ongoing disclosers. Assault characteristics and rape acknowledgment distinguished nondisclosers and slow starters from the other two disclosure groups. Slow starters were also less likely to disclose to police and medical personnel and received negative reactions less frequently while nondisclosers experienced more symptoms of depression and posttraumatic stress than other groups. Implications of these findings for future research and practice are discussed.     

Authority as coercion:when authority figures abuse their positions to perpetrate child sexual abuse

ABSTRACT. This article discusses child sexual abuse by a person in a position of authority, such as the child's teacher, guardian, relative, sports coach, or other person with authority over a child because of his/her particular position. The article tracks the recent trend toward recognizing position of authority in both state legislation and judicial precedent. Understanding the confusion and intimidation surrounding a child's experiences as a result of being sexually abused by a person in a position of authority often explains why children often fail to report or delay in reporting such abuse. Thus, existence of a perpetrator's position of authority in a particular case of child sexual abuse should influence a court's rulings on the elements of sexual abuse or assault in particular state statutes, as well as what evidence should be admissible. Ultimately, the author concludes that all states should recognize position of authority in their child abuse statutes, that such statutes should be interpreted broadly by the courts, and, finally, that evidence of the defendant's prior acts of sexual abuse should almost always be admissible at trial.     

Parental knowledge of child sexual abuse symptoms

The purpose of this study was to investigate parental knowledge of symptoms of child sexual abuse (CSA), and to determine the factors associated with that knowledge. A total of 150 parents listed symptoms of CSA in the following areas: physical/medical, emotional, sexual behavior, and behavior towards others. Results suggest that, although most parents are familiar with some of the symptoms of CSA, they are more likely to know emotional or behavioral reactions which could be suggestive of many other life stressors. Parents with higher socioeconomic status listed more symptoms, but race and parenting experience were not significant factors. Results suggest the need to inform parents of more indicative physical or sexual symptoms, and to target parents of lower SES background in awareness efforts. doi:10.1300/ J070v15n04_01.     

An integrated treatment approach to child sexual abuse in the family

SUMMARY. In responding to the increasing professional recognition of child sexual abuse within the family, this paper, relating data from a clinical sample to epidemiological studies, is the first of a number devoted to experimental approaches being taken to identify and treat this problem. The author goes on to describe the multi-disciplinary approach taken at the Tavistock Clinic and other treatment centres. The need for close cooperation and coordination of all professionals concerned and for the involvement of all family members in different forms of treatment is particularly emphasised. This paper was given at the 11th International Congress of the International Association for Child and Adolescent Psychiatry and Allied Professions, Paris, July 1986     

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.     

Medical evaluation of suspected child sexual abuse: 2011 update

The medical evaluation of children with suspected sexual abuse includes more than just the physical examination of the child. The importance of taking a detailed medical history from the parents and a history from the child about physical sensations following sexual contact has been emphasized in other articles in the medical literature. The examination is important, however, and medical providers who examine children need to be aware of published research on findings in nonabused children, studies of healing of injuries, and studies documenting the association between sexual contact and the diagnosis of sexually transmissible infections in children. This article reviews the current approach to interpreting findings in children who may have been sexually abused and why additional research is needed.     

Videotaped interviews in child sexual abuse cases: the Texas example

Suchrara writes [1977: 296] that "a child's right to humane treatment must be considered not an option on the part of adults, but an obligation." The use of videotaped interviews as admissible judicial evidence is an important step toward Suchrara's goal; videotaped testimony attempts to balance the emotional, psychological, and developmental needs of the child with the civil liberties afforded to alleged perpetrators. The Texas State Legislature, with the passage of Senate Bill 836, broadened the civil rights of children to include the notion of humane treatment in civil and criminal investigations and proceedings. The Texas law establishes explicit guidelines to enhance the child's dignity in a traumatic and personal experience. Furthermore, the law protects the civil rights of the accused guaranteed by the sixth and fourteenth amendments to the U.S. Constitution. The successful implementation of the videotape law, however, depends on the skills and expertise of the social worker. The practitioner must possess specialized training in the dynamics of child sexual abuse and an extensive understanding of related law and legal processes. This expertise is built on a foundation of knowledge and skills required for effective interviewing, counseling, and an exhaustive understanding of human behavior theory. Given the complexity and interplay of law, rights, and human behavior, the social worker requires ongoing training in these areas in order that the interests of all concerned parties be protected. The Texas State Legislature provides an opportunity for the social welfare and legal communities to determine jointly how and to what extent the rights of a victim and an alleged perpetrator may be protected. The law is in hand; the success of its implementation now rests with the practitioners.