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Mwangi MW, Kellogg TA, Brookmeyer K, Buluma R, Chiang L, Otieno-Nyunya B, Chesang K. Perpetrators and context of child sexual abuse in Kenya. CHILD ABUSE & NEGLECT 2015; 44:46-55. [PMID: 25882669 PMCID: PMC4826906 DOI: 10.1016/j.chiabu.2015.03.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 03/03/2015] [Accepted: 03/16/2015] [Indexed: 05/05/2023]
Abstract
Child sexual abuse (CSA) interventions draw from a better understanding of the context of CSA. A survey on violence before age 18 was conducted among respondents aged 13-17 and 18-24 years. Among females (13-17), the key perpetrators of unwanted sexual touching (UST) were friends/classmates (27.0%) and among males, intimate partners (IP) (35.9%). The first incident of UST among females occurred while traveling on foot (33.0%) and among males, in the respondent's home (29.1%). Among females (13-17), the key perpetrators of unwanted attempted sex (UAS) were relatives (28.9%) and among males, friends/classmates (31.0%). Among females, UAS occurred mainly while traveling on foot (42.2%) and among males, in school (40.8%). Among females and males (18-24 years), the main perpetrators of UST were IP (32.1% and 43.9%) and the first incident occurred mainly in school (24.9% and 26.0%), respectively. The main perpetrators of UAS among females and males (18-24 years) were IP (33.3% and 40.6%, respectively). Among females, UAS occurred while traveling on foot (32.7%), and among males, in the respondent's home (38.8%); UAS occurred mostly in the evening (females 60.7%; males 41.4%) or afternoon (females 27.8%; males 37.9%). Among females (18-24 years), the main perpetrators of pressured/forced sex were IP and the first incidents occurred in the perpetrator's home. Prevention interventions need to consider perpetrators and context of CSA to increase their effectiveness. In Kenya, effective CSA prevention interventions that target intimate relationships among young people, the home and school settings are needed.
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477
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Eg MB, Hansen LA, Sabroe S, Charles AV. Hymenal lesions and legal outcome in sexually abused girls with a history of vaginal penetration. Forensic Sci Int 2015; 252:163-7. [PMID: 26005856 DOI: 10.1016/j.forsciint.2015.04.031] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 07/04/2014] [Accepted: 04/22/2015] [Indexed: 12/01/2022]
Abstract
PURPOSE In many cultures, it is commonly accepted that the hymen remains unchanged throughout childhood, until it is torn at the first episode of sexual intercourse. Therefore, the definition of virginity is directly linked to a normal hymen. However, most girls referred for medical forensic colposcopic examination have normal or nonspecific findings, the prevalence of abnormal findings in girls with a history of genital penetration being only 4-6%. The aim of this study was to investigate the relation between hymenal findings seen at the colposcopic examination and the legal outcome: prosecution in court and conviction in court. RESULTS During the 80-month period of our study, 426 girls with a median age of 9 years (range 0-15 years) were included. A history of at least one vaginal penetration was given in 226 of the girls with a median age of 12 years (range 2-14 years). The hymenal findings were described as normal in 125 of the 226 cases (55%). In 50 cases (22%), hymenal clefts were found, 17 (34%) of which were complete and 33 (66%) incomplete. The finding of hymenal clefts increased with age. Of the 226 cases of girls being sexually assaulted with vaginal penetration, 119 cases (53%) were prosecuted in court, 102 of which (86%) resulted in conviction. Thirty-five (70%) of the cases with hymenal clefts and 100 (57%) of the cases without hymenal clefts were prosecuted in court, showing a correlation between hymenal clefts and conviction; however, the correlation was not significant (χ(2) test=2.1 and P=0.14). In total, 29 (58%) of the cases with hymenal clefts and 88 (50%) of the cases without hymenal clefts were convicted in court, which shows no significance (χ(2) test=1.0 and P=0.33). CONCLUSIONS The single most important feature for conviction in court is the child's testimony and not hymenal findings seen at the colposcopic examination. Especially the testimony of the older children leads to conviction, raising the question whether the videotaped testimonies are aimed at the court proceedings, or whether hearing the child's testimony directly in court has a more powerful effect. Overall, it is crucial that the videotaped police questioning of the younger children is performed by specialized personnel, with the aim of presenting the testimony in a detailed and credible manner in court, giving children of all ages a fair trial.
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478
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Lewy J, Cyr M, Dion J. Impact of interviewers' supportive comments and children's reluctance to cooperate during sexual abuse disclosure. CHILD ABUSE & NEGLECT 2015; 43:112-22. [PMID: 25816755 DOI: 10.1016/j.chiabu.2015.03.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 02/27/2015] [Accepted: 03/03/2015] [Indexed: 05/11/2023]
Abstract
In the field of child sexual abuse (CSA) disclosure, many studies have been conducted on the impact of interviewers' questioning style, but few have examined the impact of interviewers' supportive comments on children's cooperative and reluctant disclosure of substantive details. This field study used a sample of children ranging from 4 to 13 years of age who have all disclosed CSA. The first objective was to examine if the interviewer's and the child's comments during CSA interviews would vary as a function of the use of the National Institute of Child Health and Human Development (NICHD) Protocol. The second objective was to identify the strongest correlates of the proportion of details disclosed by the children during forensic interviews. A total of 90 matched NICHD Protocol and non-Protocol interviews done by the same interviewers were audio-taped, transcribed, and coded using verbal subscales. The goal was to explore if differences exist between the interviewers' supportive and non-supportive comments as well as children's cooperative and reluctant statements during investigative interviews conducted prior to or after the NICHD Protocol training. Results of a MANCOVA showed that the use of the NICHD Protocol had no influence on interviewers' and children's demeanors. A hierarchical multiple regression analysis controlling for relevant variables (e.g., child's age and NICHD Protocol) showed that children's reluctance and interviewers' non-support were associated with a lesser proportion of details. Overall, these results indicate that in order to promote detailed disclosure of CSA, interviewers should decrease their non-supportive comments and learn to deal more effectively with children's reluctance during forensic interviews. As such, protocols and training should encourage investigative interviewers to devote more time identifying early signs of children's verbal reluctance and to understand the negative impact of non-supportive comments on the disclosure of substantive details.
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479
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Collin-Vézina D, De La Sablonnière-Griffin M, Palmer AM, Milne L. A preliminary mapping of individual, relational, and social factors that impede disclosure of childhood sexual abuse. CHILD ABUSE & NEGLECT 2015; 43:123-34. [PMID: 25846196 DOI: 10.1016/j.chiabu.2015.03.010] [Citation(s) in RCA: 116] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Revised: 03/10/2015] [Accepted: 03/16/2015] [Indexed: 05/08/2023]
Abstract
Uncovering the pathways to disclosures of child sexual abuse (CSA) and the factors influencing the willingness of victims to talk about the abuse is paramount to the development of powerful practice and policy initiatives. Framed as a long interview method utilizing a grounded theory approach to analyze data, the objective of the current study was to provide a preliminary mapping of the barriers to CSA disclosures through an ecological systemic lens, from a sample of 67 male and female CSA adult survivors, all of whom had recently received counselling services. The current project led to the identification of three broad categories of barriers that were each comprised of several subthemes, namely: Barriers from Within (internalized victim-blaming, mechanisms to protect oneself, and immature development at time of abuse); Barriers in Relation to Others (violence and dysfunction in the family, power dynamics, awareness of the impact of telling, and fragile social network); and Barriers in Relation to the Social World (labelling, taboo of sexuality, lack of services available, and culture or time period). This study points to the importance of using a broad ecological framework to understand the factors that inhibit disclosure of CSA, as barriers to disclosure do not constrain solely the victims. Results are discussed in light of their implications for research, prevention and intervention programs, and social policies and media campaigns, as the burden is on the larger community to create a climate of safety and transparency that makes the telling of CSA possible.
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480
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Leclerc B, Wortley R. Predictors of victim disclosure in child sexual abuse: Additional evidence from a sample of incarcerated adult sex offenders. CHILD ABUSE & NEGLECT 2015; 43:104-11. [PMID: 25812798 DOI: 10.1016/j.chiabu.2015.03.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 02/25/2015] [Accepted: 03/03/2015] [Indexed: 05/18/2023]
Abstract
The under-reporting of child sexual abuse by victims is a serious problem that may prolong the suffering of victims and leave perpetrators free to continue offending. Yet empirical evidence indicates that victim disclosure rates are low. In this study, we perform regression analysis with a sample of 369 adult child sexual offenders to examine potential predictors of victim disclosure. Specifically, we extend the range of previously examined potential predictors of victim disclosure and investigate interaction effects in order to better capture under which circumstances victim disclosure is more likely. The current study differs from previous studies in that it examines the impact of victim and offense variables on victim disclosure from the perspective of the offender. In line with previous studies, we found that disclosure increased with the age of the victim and if penetration had occurred. In addition, we found that disclosure increased when the victim came from a non-dysfunctional family and resisted the abuse. The presence of an interaction effect highlighted the impact of the situation on victim disclosure. This effect indicated that as victims get older, they are more likely to disclose the abuse when they are not living with the offender at the time of abuse, but less likely to do so when they are living with the offender at the time of abuse. These findings are discussed in relation to previous studies and the need to facilitate victim disclosure.
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481
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Pelisoli C, Herman S, Dell'Aglio DD. Child sexual abuse research knowledge among child abuse professionals and laypersons. CHILD ABUSE & NEGLECT 2015; 40:36-47. [PMID: 25192960 DOI: 10.1016/j.chiabu.2014.08.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2014] [Revised: 06/09/2014] [Accepted: 08/11/2014] [Indexed: 06/03/2023]
Abstract
The purposes of this study were to: (1) Assess child abuse professionals' and nonprofessionals' knowledge of scientific research findings that are relevant to forensic child sexual abuse (CSA) evaluations and (2) describe associations between child abuse professionals' levels of research knowledge and their education and experience. An 18-item multiple-choice test was administered to 188 child abuse professionals and 457 nonprofessionals (undergraduate college students) in Brazil and the United States. The nonprofessionals' average percent correct, M=44%, was not significantly different than what would be expected for random guessing (45%). The professionals' average percent correct, M=55%, was higher than that of nonprofessionals and random guessing (both ps<.001). The average percent correct score for the US-sample psychologists, M=76%, was higher than the average score of the other professionals, M=51%, p<.001. Professionals' educational level, as measured by the highest academic degree obtained, was positively associated with percent correct scores, Spearman's ρ=.46, p<.001. Controlling for educational attainment, professional experience, as measured by the total number of CSA evaluations performed, was weakly associated with percent correct scores, partial r=.15, p=.04. Percent correct scores were low for both nonprofessionals and professionals. Most of the participants in this study were uninformed or misinformed about scientific research findings that are important for conducting optimal forensic CSA evaluations and for making accurate judgments about the validity of sexual abuse allegations.
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482
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Rassenhofer M, Zimmer A, Spröber N, Fegert JM. Child sexual abuse in the Roman Catholic Church in Germany: comparison of victim-impact data collected through church-sponsored and government-sponsored programs. CHILD ABUSE & NEGLECT 2015; 40:60-67. [PMID: 25528952 DOI: 10.1016/j.chiabu.2014.11.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 11/17/2014] [Accepted: 11/21/2014] [Indexed: 06/04/2023]
Abstract
At around the same time in 2010, the German government and the Roman Catholic Church in Germany each set up a critical incident reporting system (CIRS) to gather information on child sexual abuse that had taken place within the Church. The objective in both cases was to solicit stories from victims and former victims and allow them to have input into a review process. The existence of these two similar systems, one initiated by the institution involved in the abuse and the other by an independent entity, provided an opportunity to compare the background and motivation of victims who chose to communicate through one channel or the other. Data were obtained on a total of 927 individuals, 571 through the church CIRS and 356 through the government CIRS, who had reported that they had experienced childhood sexual abuse within the Roman Catholic Church. Some differences were found between the two groups in terms of gender, the reported frequency of abuse, and the desire for compensation. These differences highlight the need for an effective complaint management system to offer not just one but complementary channels of communication. In addition, the findings confirm the feasibility and value of a CIRS approach and the use of so-called 'citizen science' in politically driven review processes.
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483
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Parent-Boursier C, Hébert M. Security in Father-child Relationship and Behavior Problems in Sexually Abused Children. JOURNAL OF FAMILY VIOLENCE 2015; 30:113-122. [PMID: 29321696 PMCID: PMC5758341 DOI: 10.1007/s10896-014-9653-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
While the influence of mother-child relationships on children's recovery following sexual abuse has been documented, less is known about the possible contribution of father-child relationships on outcomes. The present study explored the contribution of children's perception of security in their relationship to the father on internalizing and externalizing behavior problems, while controlling for sociodemographic variables and variables associated with the mother-child relationship. Participants were 142 children who disclosed sexual abuse involving a perpetrator other than the biological father. Regression analyses indicated that children's perception of security to fathers contributed to the prediction of parental reports of children's behavior problems, even after controlling for maternal psychological distress and perception of security to mothers.
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484
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Miron LR, Orcutt HK. Pathways from childhood abuse to prospective revictimization: depression, sex to reduce negative affect, and forecasted sexual behavior. CHILD ABUSE & NEGLECT 2014; 38:1848-59. [PMID: 25455965 PMCID: PMC4254559 DOI: 10.1016/j.chiabu.2014.10.004] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Revised: 09/23/2014] [Accepted: 10/06/2014] [Indexed: 05/28/2023]
Abstract
Research suggests that adverse events in childhood, such as childhood physical, sexual, and emotional abuse, confer risk for later sexual assault. Psychological distress, coping strategies, and sexual behavior may help explain the path from childhood abuse to revictimization. The present study explored how the use of sex to regulate negative affect (SRNA) operates independently, and in combination with other psychosocial factors to increase college women's (N=541) risk of experiencing prospective adult sexual assault (ASA). Sequential multiple mediator models in Mplus were used to assess the effect of three different forms of childhood abuse on prospective ASA, both independently and while controlling for other forms of childhood abuse. The indirect effect of adolescent sexual assault (AdolSA), depressive symptoms, SRNA, and participants' response to a sex-related vignette was tested using bias-corrected bootstrapping. In the full path model, childhood emotional abuse and AdolSA predicted ASA, while childhood physical and sexual abuse were directly associated with AdolSA, but not ASA. Additionally, depressive symptoms and participants' estimate of their likely behavior in a sex-related vignette directly predicted prospective ASA. Results using bootstrapping revealed that a history of childhood abuse predicted prospective ASA via diverse direct and indirect paths, as well as through a similar multiple mediator path. Overall, findings suggest that a combination of affective, coping, and sexual expectancy factors contribute to risk for revictimization in adult survivors of childhood abuse. Future research directions and targets for risk-reduction programming are discussed.
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485
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Castelli P, Goodman GS. Children's perceived emotional behavior at disclosure and prosecutors' evaluations. CHILD ABUSE & NEGLECT 2014; 38:1521-1532. [PMID: 24674647 DOI: 10.1016/j.chiabu.2014.02.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Revised: 02/20/2014] [Accepted: 02/24/2014] [Indexed: 06/03/2023]
Abstract
The present study investigated the perceived emotional behavior of alleged child victims when disclosing sexual abuse in a forensic interview. It also addressed whether the perceived emotional behavior influenced prosecutors' evaluations of children's potential as witnesses and prosecutors' recommendations to press charges. Ninety-eight videotapes of forensic interviews with alleged child sexual abuse victims (4- to 17-year-olds) were coded for behavioral indicators of emotions. Case file information and district attorney evaluations were also coded. Results indicated that children were not generally perceived as being emotional (e.g., sad) during disclosure. However, the perceived intensity of expressed emotions was greater when children disclosed the alleged abuse compared to when they discussed more neutral topics in rapport building. Greater perceived emotional withdrawal by children at disclosure was associated with more negative evaluations of child witnesses by prosecutors. Moreover, children's emotional behaviors, as noted by prosecutors, were among the predictors of prosecutors' recommendations to file charges. Practical implications are discussed.
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486
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Badejoko OO, Anyabolu HC, Badejoko BO, Ijarotimi AO, Kuti O, Adejuyigbe EA. Sexual assault in Ile-Ife, Nigeria. Niger Med J 2014; 55:254-9. [PMID: 25013260 PMCID: PMC4089057 DOI: 10.4103/0300-1652.132065] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: Sexual assault (SA) is a shattering malevolence against women. This study determined the burden, periodicity, presentation and management of SA in Ile-Ife, Nigeria. Materials and Methods: Retrospective analysis of the hospital records of 76 SA survivors managed over a 5-year period (2007-2011) in Obafemi Awolowo University Teaching Hospitals complex (OAUTHC), Ile-Ife. Results: Sexual assault accounted for 0.69% of all female and 5.2% of all gynaecological emergencies in OAUTHC, Ile-Ife. The survivors’ ages ranged from 4 to 50 years (mean = 17.7 ± 8.8years) and adolescents made up for 48%. The peak prevalence of SA was in February and December and among adults and under-16-year-old survivors, respectively. Daytime and weekday SA were significantly more common among the under-16-year-old survivors (P = 0.008). Majority of the survivors (62%) knew their assailant(s). Neighbours were the commonest perpetrators identified (28.2%) and the assailants’ house was the commonest location (39.4%). Weapons were involved in 29.6% of cases and various injuries were identified in 28.2% of the survivors. Hospital presentation was within 24 hours in majority (76.1%) of the survivors, but rape kit examinations were not performed as the kits were not available. Although appropriate medical management was routinely commenced, only 12.7% of survivors returned for follow-up. Conclusions: Seasonal and diurnal patterns exist in the prevalence of SA in Ile-Ife and most survivors that reported in the hospital presented early. Rape kit examinations were, however, not executed, due to non-availability. Personnel training, protocol development, provision of rape kits and free treatment of SA survivors are, therefore, recommended. Public enlightenment on preventive strategies based on the observed periodicity and age patterns is also suggested.
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487
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Elkjaer H, Kristensen E, Mortensen EL, Poulsen S, Lau M. Analytic versus systemic group therapy for women with a history of child sexual abuse: 1-year follow-up of a randomized controlled trial. Psychol Psychother 2014; 87:191-208. [PMID: 24014477 DOI: 10.1111/papt.12011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2011] [Revised: 05/23/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This randomized prospective study examines durability of improvement in general symptomatology, psychosocial functioning and interpersonal problems, and compares the long-term efficacy of analytic and systemic group psychotherapy in women 1 year after completion of treatment for childhood sexual abuse. DESIGN AND METHODS Women (n = 106) randomly assigned to analytic or systemic psychotherapy completed the Symptom Checklist-90-R, Global Assessment of Functioning, Global Life Quality, Registration Chart Questionnaire, and Flashback Registration at pre-treatment, post-treatment, and at a 1-year follow-up. RESULTS Post-treatment gains were significant for both treatment modalities on all measures, but significantly larger after systemic therapy. Significant treatment response was maintained 1-year post-treatment, but different trajectories were observed: 1 year after treatment completion, improvements for analytic therapy were maintained, whereas they decreased after systemic therapy, resulting in no statistically significant difference in gains between the groups at the 1-year follow-up. Despite maintaining significant gains, more than half of the patients remained above cut-off for caseness concerning general symptomatology at post-treatment and at 1-year follow-up. CONCLUSION The findings stress the importance of long-term follow-up data in effect studies. Different trajectories were associated with the two treatments, but improvement in the two treatment groups did not differ significantly at the 1-year follow-up. Implications of the difference in trajectories for treatment planning are discussed. PRACTITIONER POINTS Both analytic and systemic group therapy proved efficient in improving general symptomatology, psychosocial functioning, and interpersonal problems in women with a history of CSA and gains were maintained at a 1-year follow-up. Despite maintaining statistically significant gains at the 1-year follow-up, 54% of the patients remained above the cut-off for caseness with respect to general symptomatology, which may indicate a need for further treatment. Different pre-post follow-up treatment trajectories were observed between the two treatment modalities. Thus, while systemic group therapy showed a significantly better outcome immediately after termination, gains in the systemic treatment group decreased during follow-up, while gains were maintained during follow-up in analytic group therapy.
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488
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Abstract
Transinstitutionalization (ie, the criminalization of those with mental illness) is relevant to individuals committing sexual offenses. Mental illness can affect the treatment and risk management of individuals committing sexual offenses. In this article the current literature on mentally disordered sexual offenders is described, including how psychosis, mood disorders, anxiety disorders, attention-deficit/hyperactivity disorder, and dementing disorders may affect treatment and management.
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489
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Hershkowitz I. Sexually intrusive behavior among alleged CSA male victims: a prospective study. SEXUAL ABUSE : A JOURNAL OF RESEARCH AND TREATMENT 2014; 26:291-305. [PMID: 23698743 DOI: 10.1177/1079063213486937] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Child Sexual Abuse (CSA) is one widely cited risk factor for Sexually Intrusive Behavior (SIB) among boys. To identify variables that moderate the early onset of SIB in a sample of boys, alleged victims of sexual abuse, the current study involved a prospective examination of all investigations of male CSA victims and those of boys aged under 14 who were suspected of committing SIBs on other children in Israel over a 10-year period. Comparing victims with and without SIB records revealed differences on personal and family factors as well as on the characteristics of abuse. A regression model controlling for age and family factors correctly classified over three quarters of the subjects based on reported experiences of abuse. The data help identify characteristics of the abuse that facilitate the early onset of SIB among male victims of CSA.
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490
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Müller S, Walter H, Christen M. When benefitting a patient increases the risk for harm for third persons - the case of treating pedophilic Parkinsonian patients with deep brain stimulation. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2014; 37:295-303. [PMID: 24289863 DOI: 10.1016/j.ijlp.2013.11.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This paper investigates the question whether it is ethically justified to treat Parkinsonian patients with known or suspected pedophilia with deep brain stimulation - given increasing evidence that this treatment might cause impulse control disorders, disinhibition, and hypersexuality. This specific question is not as exotic as it looks at a first glance. First, the same issue is raised for all other types of sexual orientation or behavior which imply a high risk for harming other persons, e.g. sexual sadism. Second, there are also several (psychotropic) drugs as well as legal and illegal leisure drugs which bear severe risks for other persons. We show that Beauchamp and Childress' biomedical ethics fails to derive a veto against medical interventions which produce risks for third persons by making the patients dangerous to others. Therefore, our case discussion reveals a blind spot of the ethics of principles. Although the first intuition might be to forbid the application of deep brain stimulation to pedophilic patients, we argue against such a simple way out, since in some patients the reduction of dopaminergic drugs allowed by deep brain stimulation of the nucleus subthalamicus improves impulsive control disorders, including hypersexuality. Therefore, we propose a strategy consisting of three steps: (1) risk assessment, (2) shared decision-making, and (3) risk management and safeguards.
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491
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Katz C, Barnetz Z, Hershkowitz I. The effect of drawing on children's experiences of investigations following alleged child abuse. CHILD ABUSE & NEGLECT 2014; 38:858-867. [PMID: 24534613 DOI: 10.1016/j.chiabu.2014.01.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2013] [Revised: 01/04/2014] [Accepted: 01/13/2014] [Indexed: 06/03/2023]
Abstract
The primary aim of the study was to evaluate investigative interviews from the perspectives of the children, comparing children who drew with children who did not. One hundred twenty-five children, alleged victims of sexual abuse, were asked about their investigative experience. The uniqueness of the study is that all of the interviews were conducted according to the NICHD Protocol and that children were randomly assigned into one of the two research conditions (drawing vs. non-drawing). The results clearly demonstrate the advantage that drawing has on the children's experience of the investigation, with children in the drawing group more often reporting feelings of hope and success. This study provides practical guidelines for practitioners by emphasizing the beneficial effects that drawing can have. The study stresses the importance of integrating into forensic investigations interventions that enhance children's testimonies and ensure that the investigation is an empowering experience that generates feelings of trust, self-worth, and justice.
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492
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Abstract
This article begins by defining sexual abuse, and reviews the literature on the epidemiology of child sexual abuse (CSA). Clinical outcomes of CSA are described, including health and mental health. An outline is given of all the services often involved after an incident of CSA, and the need for coordination among them. Treatment strategies and evidence-based recommendations are reviewed. Challenges around dissemination and implementation, cultural considerations, and familial dynamics are described. Possible future directions are discussed.
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493
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Joki-Erkkilä M, Niemi J, Ellonen N. Child sexual abuse--Medical statement conclusions in criminal legal process. Forensic Sci Int 2014; 239:31-6. [PMID: 24727220 DOI: 10.1016/j.forsciint.2014.03.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 03/04/2014] [Accepted: 03/05/2014] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To evaluate medical statement conclusions in the criminal-legal process in suspected cases of child sexual abuse (CSA). STUDY DESIGN An observational study of a random sample of 130 medically examined, police reported CSA suspected cases during 2001-2009. Medical statements were evaluated and their conclusions were analyzed with an end-point in the legal process. The data consists of official investigation documents from the University Hospital records, the Police, crime laboratories, the State Prosecutor, and the Courts of Law. RESULTS The median age of the children was 5.3 years (range 11 months-17.3 years) at the time of the suspected sexual abuse. In most cases (76.2%, 99/130) medical statement conclusions neither supported nor excluded the suspicion of CSA. Twenty-one (16.2%) medical statements supported and in 10 cases (7.7%) the conclusion did not support the suspected CSA. Of the suspected CSA cases a hundred (76.9%) proceeded to the Prosecutor. The charge filing rate was 41.5% (54/130). The final conviction rate was 30.8% (40/130) and 74% in the charged cases. Medical statements were mentioned as evidence in the Prosecutor's decision to file charges in 18 (33.3%) of suspected CSA cases and in 15 (36%) of verdicts. A child's clear disclosure of CSA (p<0.001) and medical statements (p=0.037) had a significant role in decision making on convictions. CONCLUSION In medical statement conclusions, physical findings with proper documentation and interpretation are needed to avoid misunderstandings in the legal process. The present study supports a routine medical statement peer review to minimize the risk of neglect caused by lack of knowledge among authorities working with sexually abused children.
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Carvalho J, Nobre PJ. Early maladaptive schemas in convicted sexual offenders: preliminary findings. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2014; 37:210-216. [PMID: 24268826 DOI: 10.1016/j.ijlp.2013.11.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Core cognitive schemas may play a role in the vulnerability for sexual offending. Identifying these schemas could help to conceptualize sexual crimes and rehabilitate convicted sexual offenders. The aim of this preliminary study was to explore the relationship between early maladaptive schemas (EMSs) and sexual offending, as well as how rapists and child sex molesters differ in terms of these schemas. Thirty-two men convicted for rape, 33 convicted for child sexual abuse, and 30 non-offenders were evaluated using the Young Schema Questionnaire (YSQ-S3) and the Brief Symptom Inventory (BSI). Results showed that participants convicted for child sexual abuse presented significantly more schemas from the disconnection/rejection, impaired autonomy/performance, other directness, and over vigilance/inhibition domains than non-offenders, whereas rapists presented more schemas from the impaired autonomy/performance domain than non-offenders. Differences between sex offenders showed that child molesters presented more schemas of pessimism than rapists. Preliminary findings suggested that EMSs may impact sex offender's perceptions about themselves and about the world. Schema-focused therapy (Young, 1990, 1999) may thus be an acceptable approach to sex offender's psychological assessment and intervention.
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495
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Child sexual abuse revisited: a population-based cross-sectional study among Swiss adolescents. J Adolesc Health 2014; 54:304-311.e1. [PMID: 24182941 DOI: 10.1016/j.jadohealth.2013.08.020] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Revised: 08/29/2013] [Accepted: 08/29/2013] [Indexed: 11/23/2022]
Abstract
PURPOSE Child sexual abuse (CSA) is one of the most serious public health problems among children and adolescents, owing to its widespread prevalence and serious health consequences. The present study aimed to assess the prevalence of, and characteristics and circumstances associated with, CSA. METHODS An epidemiological survey was conducted on a nationally representative sample of 6,787 ninth-grade students (15.5 ± .66 years of age) in Switzerland. Self-reported computer-assisted questionnaires were administered between September 2009 and May 2010. Various forms of sexual victimization were assessed using the newly developed Child Sexual Abuse Questionnaire. RESULTS Overall, 40.2% and 17.2% of girls and boys, respectively, reported having experienced at least one type of CSA event. Lifetime prevalence rates were 35.1% and 14.9%, respectively, for CSA without physical contact, 14.9% and 4.8% for CSA with physical contact without penetration, and 2.5% and .6% for CSA with penetration among girls and boys. The most frequently experienced event was sexual harassment via the Internet. More than half of female victims and more than 70% of male victims reported having been abused by juvenile perpetrators. Depending on the specific event, only 44.4%-58.4% of female victims and 5.8%-38% of male victims disclosed CSA, mostly to peers. CONCLUSIONS The present study confirms the widespread prevalence of CSA. The high prevalence of CSA via the Internet and the frequent reports of juvenile perpetrators suggest emerging trends in CSA. Low disclosure rates, especially among male victims, and reluctance to disclose events to family members and officials may impede timely intervention.
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496
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Easton SD. Masculine norms, disclosure, and childhood adversities predict long-term mental distress among men with histories of child sexual abuse. CHILD ABUSE & NEGLECT 2014; 38:243-251. [PMID: 24070695 DOI: 10.1016/j.chiabu.2013.08.020] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Revised: 08/20/2013] [Accepted: 08/27/2013] [Indexed: 06/02/2023]
Abstract
Child sexual abuse (CSA) can have a profound effect on the long-term mental health of boys/men. However, not all men with histories of CSA experience psychopathology. To improve prevention and intervention services, more research is needed to understand why some male survivors experience mental health problems and others do not. The purpose of this study was to examine factors related to mental distress among a large, non-clinical sample of men with histories of CSA (N=487). Using a cross-sectional design with purposive sampling from three national survivor organizations, data were collected through an anonymous Internet-based survey. Multivariate analyses found that only one of the four CSA severity variables-use of physical force by the abuser-was related to mental distress. Additional factors that were related to mental distress included the number of other childhood adversities, years until disclosure, overall response to disclosure, and conformity to masculine norms. Overall, the final model predicted 36% of the variance in the number of mental health symptoms. Mental health practitioners should include masculine norms, disclosure history, and childhood adversities in assessments and intervention planning with male survivors. To more fully explicate risk factors for psychopathology in this population, future studies with probability samples of men that focus on mediational processes and use longitudinal designs are needed.
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497
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Brubacher SP, La Rooy D. Witness recall across repeated interviews in a case of repeated abuse. CHILD ABUSE & NEGLECT 2014; 38:202-211. [PMID: 23906673 DOI: 10.1016/j.chiabu.2013.06.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Revised: 06/12/2013] [Accepted: 06/26/2013] [Indexed: 06/02/2023]
Abstract
In this illustrative case study we examine the three forensic interviews of a girl who experienced repeated sexual abuse from ages 7 to 11. She disclosed the abuse after watching a serialized television show that contained a storyline similar to her own experience. This triggered an investigation that ended in successful prosecution of the offender. Because this case involved abuse that was repeated on a weekly basis for 4 years we thus investigated the degree to which the child's narrative reflected specific episodes or generic accounts, and both the interviewer's and child's attempts to elicit and provide, respectively, specific details across the 3 interviews collected in a 1 month period. Across the 3 interviews, the child's account was largely generic, yet on a number of occasions she provided details specific to individual incidents (episodic leads) that could have been probed further. As predicted: earlier interviews were characterized more by episodic than generic prompts and the reverse was true for the third interview; the child often responded using the same style of language (episodic or generic) as the interviewer; and open questions yielded narrative information. We discuss the importance of adopting children's words to specify occurrences, and the potential benefits of permitting generic recall in investigative interviews on children's ability to provide episodic leads. Despite the fact that the testimony was characterized by generic information about what usually happened, rather than specific episodic details about individual occurrences, this case resulted in successful prosecution.
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498
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Godbout N, Briere J, Sabourin S, Lussier Y. Child sexual abuse and subsequent relational and personal functioning: the role of parental support. CHILD ABUSE & NEGLECT 2014; 38:317-25. [PMID: 24199753 DOI: 10.1016/j.chiabu.2013.10.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Revised: 09/18/2013] [Accepted: 10/01/2013] [Indexed: 05/03/2023]
Abstract
This study examined the role of nonoffending parental support in the relationship between child sexual abuse (CSA) and later romantic attachment, psychiatric symptoms, and couple adjustment. Of 348 adults engaged in stable romantic relationship, 59 (17%) reported sexual abuse. In this subgroup, 14% (n=8) reported parental intervention after the abuse was disclosed (i.e., support), 15% (n=9) reported a lack of parental intervention after abuse disclosure (i.e., nonsupport), and 71% (n=42) reported that their nonabusive parent(s) was(were) unaware of their abuse. Results indicated that, compared to other groups, CSA survivors with nonsupportive parents reported higher levels of anxious attachment, psychological symptoms, and dyadic maladjustment. In contrast, CSA survivors with supportive parent(s) expressed psychological and couple adjustment equivalent to non-abused participants, and lower attachment avoidance, relative to all other groups. Path analysis revealed that insecure attachment completely mediated the relationship between perceived parental support after CSA and later psychosocial outcomes. An actor-partner interdependence model showed different patterns for men and women and highlighted the importance of considering relational dynamics in dyads of CSA survivors. Overall, the results suggest that perceived parental support serves as a protective factor among those exposed to CSA.
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499
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Anderson GD. Child sexual abuse prevention policy: an analysis of Erin's law. SOCIAL WORK IN PUBLIC HEALTH 2014; 29:196-206. [PMID: 24802215 DOI: 10.1080/19371918.2013.776321] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Child sexual abuse affects thousands of children in the United States and is vastly underreported. Tertiary prevention policies, primarily in the form of sex offender registries and community notification programs, have received the most attention and funding. Few policies have focused on school-based prevention. One recently passed law in Illinois mandates all K-5 public schools to implement sexual abuse prevention programs. The law was championed by a young social worker, Erin Merryn. Through the multiple streams framework, this article examines the unique set of political circumstances, united with Merryn's advocacy, which created the opportunity for the law to pass.
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500
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Are crimes by online predators different from crimes by sex offenders who know youth in-person? J Adolesc Health 2013; 53:736-41. [PMID: 23890773 DOI: 10.1016/j.jadohealth.2013.06.010] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Revised: 06/08/2013] [Accepted: 06/10/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE We examined cases in which sex offenders arrested for Internet-related crimes used the Internet for sexual communications with minors, comparing crimes by offenders who met victims online to those by offenders who knew victims in-person prior to the offense. METHODS We collected data from a national sample of law enforcement agencies (n = 2,653) about arrests in 2009 for Internet-related sex crimes against minors, conducting detailed telephone interviews with investigators about individual cases. This paper examines a subset of arrest cases that included the use of online sexual communications (online-meeting offenders, n = 143; know-in-person/online offenders, n = 139). RESULTS AND CONCLUSIONS Compared with know-in-person/online offenders, online-meeting offenders were less likely to have criminal backgrounds and more likely to use online communications to deceive victims. However, deception was a factor in a minority of cases and was also used by some know-in-person/online offenders. The majority of cases in both groups involved statutory rape (i.e., nonforcible illegal sexual activity with underage youth) or noncontact offenses such as child pornography production or sexual solicitation of a minor. We conclude that crimes by online-meeting offenders should not be treated as different or more dangerous than those by know-in-person/online offenders who use online sexual communications. Rather, prevention efforts should educate about the nature of statutory rape and related noncontact offenses. The primary message should be that it is criminal for adults to make sexual overtures to minors, online or offline, no matter what their relationship to the youth.
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