Identification of red flag child sexual grooming behaviors

BACKGROUND

Sexual Grooming is the deceptive process wherein a would-be perpetrator prepares a child for sexual abuse (CSA) and prevents disclosure and detection. It is often difficult to detect sexual grooming because some grooming behaviors resemble normal adult-child interactions. To prevent CSA, it is vital to identify sexual grooming behaviors that can be considered "red flag" behaviors.

OBJECTIVE

This study compared reported sexual grooming behaviors between adults who experienced CSA and those with no CSA history to identify which behaviors differed between the two groups. Further we explored whether the relationship to the adult male in the Non-CSA group impacted reported behaviors.

PARTICIPANTS AND SETTING

Participants were recruited online through Prolific and included adults who experienced CSA (n = 411) and those with no CSA history (n = 502).

METHODS

Participants who reported CSA completed the Sexual Grooming Scale - Victim Version (SGS-V) about their CSA experience. Those with no CSA history were randomly assigned to one of three conditions (family member/non-family member/community member) and completed a modified version of the SGS-V about an adult male with whom they had the most interpersonal contact before age 18.

RESULTS

Numerous sexual grooming behaviors that differentiated the behaviors of adults who engaged in CSA and those who did not were identified. The relationship to the adult was an important consideration.

CONCLUSIONS

Red flag sexual grooming behaviors, specifically those related to desensitizing the child to physical contact and sexual content, can be identified in cases of CSA and have an important role in prevention.

Violence and sexual abuse rates before and during the Covid-19 pandemic: A prospective population-based study on Norwegian youth

BACKGROUND

Considerable concern is raised as to whether the pandemic has led to an increase in violence and sexual abuse against children.

OBJECTIVE

The present study objective is to provide rates of violence and sexual abuse against adolescents the year before the pandemic compared to one year into the pandemic.

PARTICIPANTS AND SETTING

Two samples of Norwegian 12-16-year-olds were approached. A representative pre-pandemic sample of 9240 adolescents (M age (SD) = 14.11(0.88), and a sample recruited one year into the pandemic resulting in 3540 responses (M age (SD) = 14.5 (0.96)).

METHODS

An online survey was administered during school hours including established measures of violence and sexual abuse exposure. Sociodemographic characteristics were assessed.

RESULTS

There was 1.4 percentage point increase in sexual abuse by an adult, and a 3.9 percentage point decrease in psychological violence by a parent during the pandemic compared to the year before the pandemic. Otherwise, violence and sexual abuse rates remained stable across these two time periods. Risk factors for violence and sexual abuse were amplified during the pandemic.

CONCLUSION

Norway, a high-income welfare state, imposed measures to counteract the burden of the pandemic mitigation actions for adolescents. This might partly explain the absence of the feared increase in violence towards adolescents. The disproportionate risk for violence and sexual abuse for some groups of adolescents is however concerning, and should be followed up over time.

Intergenerational Continuity of Child Sexual Abuse: Comparison of Mother and Emerging Adult Dyads

Sexual abuse trauma can have long-term implications for individuals in terms of psychological functioning, relationships, and socio-environmental circumstances, all of which are elements that could explain the CSA intergenerational continuity phenomenon. There are few empirical studies drawing comparisons between families to identify factors associated with the intergenerational (dis)continuity of CSA. The objectives of this study are to compare mother and emerging adult dyads to determine differences between cycle maintainers, cycle breakers, cycle initiators, and a control group in terms of maternal maltreatment histories, mental health, attachment, and socio-environmental characteristics. A sample of 186 dyads was recruited across Canada to participate in an online study. The study represents a cross-sectional design and bivariate and multivariate analyses were used. The results support prior research that there is a higher risk of CSA in dyads where the mother experienced CSA (OR = 1.38). Compared to cycle initiators, maintainers reported greater psychological distress (M = 27.23; 35.18), and lower mother-rated parent-child attachment (M = 115.83; 111.43). Maintainers reported more post-traumatic stress symptoms only in comparison to the control group (M = 24.82; 10.13). Mothers in cycle maintaining dyads were exposed to more acts of domestic violence than those in cycle breaking dyads (OR = 2.43). No group differences were observed for intimate partner attachment. Findings should be replicated using robust methodological designs (e.g., longitudinal, mixed methods). Preventative efforts should target at-risk families to reduce the chance of intergenerational CSA.

Prevalence and determinants of sexual abuse among adolescent girls during the COVID-19 lockdown and school closures in Ghana: A mixed method study

BACKGROUND

In the wake of the COVID-19 pandemic, concerns have been raised that the pandemic may derail global efforts against child sexual abuse (CSA).

OBJECTIVES

This study examines the prevalence and associated factors of sexual abuse among adolescent girls in the context of the COVID-19 pandemic in Ghana.

PARTICIPANTS AND SETTING

The sample comprised 853 adolescent girls aged 13-19 (16.03 ± 2.04 years) in Ghana.

METHODS

The study employed a concurrent mixed-method design.

RESULTS

Overall, the prevalence of CSA during the COVID-19 lockdown and school closures was 32.5 %. Protective factors for CSA were feeling safe in neighbourhood (AOR = 0.526, 95 % CI = [0.325, 0.850]) and parents often listen to opinions (AOR = 0.446, 95 % CI = [0.241, 0.826]). Risk factors for CSA were physical activity (AOR = 1.649, OR = 1.783, 95 % CI_AOR = [1.093, 2.487, 95 % CI_OR = [1.241, 2.561]), parents sometimes listen to opinions (AOR = 1.199, OR = 1.924, 95 % CI_AOR = [0.504, 2.853], 95 % CI_OR = [1.034, 3.582]), living with another relative (AOR = 2.352, OR = 2.484, 95 % CI_AOR = [0.270, 20.523], 95 % CI_OR = [0.317, 19.475]), Akan ethnicity (AOR = 1.576, OR = 1.437, 95 % CI_AOR = [0.307, 8.091], 95 % CI_OR = [0.316, 6.534]), having no disability (AOR = 1.099, OR = 1.138, 95 % CI_AOR = [0.679, 1.581], 95 % CI_OR = [0.786, 1.649]) and having a close relationship with parents (AOR = 1.334, OR = 1.752, 95 % CI_AOR = [0.746, 2.385], 95 % CI_OR = [1.096, 2.802]).

CONCLUSION

Knowledge of the risk and protective factors identified in this study can guide and inform the development of CSA prevention programmes during disruptive occurrences like school closures and lockdown.

Children's Sexuality and Nudity in Discourse and Images in a Danish Education and Care Journal over 50 Years (1970-2019): The Emergence of "The Child Perpetrator of Sexual Abuse" in an International Perspective

In the late twentieth century, a new view of children as potential sexual abusers emerged. Today, more research addresses children's "problematic sexual behavior" than their natural sexuality, and even young children are stigmatized and criminalized because of species-typical sexual behavior. Despite the importance of this new field of research and view of childhood sexuality, studies of this development, its origins, and consequences are extremely rare. This study analyzed the discourse and images related to childhood sexuality in a Danish education and care journal for childcare professionals, from 1970 to 2019, to examine the emergence of "the child perpetrator of sexual abuse" in Denmark in the late 1990s, and traced the travelling of these ideas back to the United States, where this figure originated in the mid-1980s. The study revealed a radical change in views of childhood sexuality in Denmark from 1970 to 2019: from an extreme liberalism in the early decades-illustrated by a rare collection of photos of children's nudity and sexuality, of which a selection is reprinted in this article-to a view that strongly associates children's sexuality with sexual abuse. The study showed that the significant attention to and fear of child sexual abuse influenced the new view of childhood sexuality, and that this progressively took root in Danish childcare institutions, creating a panic. This article examines the knowledge, narratives, and the question of proportion regarding the cross-cultural view of children as potential sexual abusers, and discusses its consequences, combining a historical study and a dissection of an important, current phenomenon.

Child Sexual Grooming of Catholic Clergy: A Comparison between Victims Allegedly Abused by Clergy with Single versus Multiple Victims

There is evidence that clergy who commit child sexual abuse (CSA) may utilize sexual grooming behaviors in the offense process consistent with a content-validated model (Sexual Grooming Model; SGM). Although research has examined differences in characteristics between clergy with single versus multiple CSA victims, little is known about how sexual grooming behaviors may vary between these groups. The present study utilized a large sample of alleged clergy sexual abuse incidents (n = 10,667) to examine the differences in reported sexual grooming behaviors for victims who experienced abuse by an individual who had a single (V-SVOs) or multiple (V-MVOs) victims. As part of a larger study, files of victim reports of CSA were reviewed from 195 dioceses/eparchies and 140 religious institutes in the United States; these data were analyzed based on behaviors in the SGM for the present study. Overall, the findings showed that the two groups (V-SVOs and V-MVOs) experienced similar tactics throughout the sexual grooming process outlined by the SGM. However, there were some differences for certain tactics within the gaining access and isolation, trust development, and desensitization to sexual contact and physical touch stages of sexual grooming. The implications for prevention, policy, and treatment, as well as future directions of research, are discussed.

"I Am A Living Testimony to the Human Spirit": A Thematic Analysis of Middle Aged and Older Adults' Resilience after Child Sexual Abuse

Despite extensive documentation of the adverse impacts of child sexual abuse (CSA), less is known about long-term effects of CSA, that is, the impact in middle and late adulthood, when one is further removed from the CSA. This study describes coping strategies and positive outcomes reported by adult female survivors of child sexual abuse ages 50+ (n = 58). Responses came from an anonymous online survey of adult survivors of CSA. We conducted a qualitative "RADaR" rapid analysis on the survey's open-ended questions. Survivors employed both internal attitudes and specific activities to cope with their childhood CSA. Most (n = 55) reported positive outcomes from CSA: self, others, and relational and/or emotive strengths. Due to survey limitations, we were unable to identify factors that contributed to survivors reporting positive outcomes and survivors who reported negative or no positive outcomes. This study suggests CSA survivors in middle and late adulthood may feel stronger as a result of abuse. More research is needed to identify factors that contribute to resilience.

The Longitudinal Effects of Second Step Child Protection Unit on Children: Gender as a Moderator

We investigated the longitudinal effects of the Second Step Child Protection Unit (CPU; Committee for Children) on student outcomes through a randomized controlled trial. Eight schools with a total sample including 2,031 students were assigned randomly to the CPU intervention or the wait-list control condition. We employed a multi-process latent growth model using a structural equation modeling framework which simultaneously analyzed student outcome growth via the effects of the intervention. The moderating effect of gender was also included. Over four data collection waves (pretest, posttest, follow-up [6 months] and follow-up [12-months]), the intervention group students were better able to recognize appropriate requests in CSA scenarios than control group students over time. Teacher-student relations improved for the students in the intervention schools but worsened for the students in the control schools over time. Despite concerns that CSA prevention programs may result in the unintended consequence of making children more fearful, children in both conditions did not show increased fears over time. The longitudinal effect on CSA recognition was more pronounced among girls, who suffer from higher CSA prevalence, compared with boys. Implications for prevention, policy, and directions for future research are discussed.

One-year Cohort Follow-up on the Diagnosis and Posttraumatic Symptoms in Child Sexual Assault Victims in Korea

OBJECTIVE

The victims and their families of child sexual abuse (CSA) may confront persistent psychological sequela. We aimed to investigate the psychological symptoms, diagnosis, and family functions in children and adolescents with CSA.

METHODS

We assessed the symptom scales at 6-month intervals, and conducted diagnostic re-assessments at 1-year intervals. Trauma Symptom Checklist for Children (TSCC), Trauma Symptom Checklist for Young Children (TSCYC), Family Adaptability and Cohesion Evaluation Scales IV (FACES-IV), and Family Communication Scale (FCS) scores were reported by children or parents.

RESULTS

We found in parent-reported TSCYC, that posttraumatic stress symptoms domain scores significantly decreased with time progression. The scores decreased more in the evidence-based treatment group over time in anxiety and posttraumatic stress symptom domains of TSCC. In FACES-IV and FCS scores, indices of family function have been gradually increasing both after 6 months and after 1 year compared to the initial evaluation. Further, about 64% of the children diagnosed with psychiatric diseases, including posttraumatic stress disorder (PTSD) at the initial assessment maintained the same diagnosis at follow-up.

CONCLUSION

We observed changes in psychological symptoms and family functioning in sexually abused children with time progression during 1 year. It is postulated that PTSD may be a persistent major mental illness in the victims of CSA.

Risk Factors for Sexual Revictimization and Dating Violence in Young Adults with a History of Child Sexual Abuse

Interpersonal revictimization, through sexual violence and psychological or physical dating violence, is one of the many consequences of childhood sexual abuse (CSA). This study examined how childhood maltreatment, sociodemographic characteristics, mental health, relational factors, and community factors are associated with 1) sexual revictimization 2) psychological dating violence victimization, and 3) physical dating violence victimization in a sample of young adults reporting a history of CSA. A sample of 190 young adults (18-25 y.o.) with self-reported experiences of CSA completed an online survey measuring childhood maltreatment (e.g. neglect, physical abuse, witness to domestic violence), sociodemographic characteristics (e.g. material deprivation, education), mental health (dissociation, posttraumatic stress symptoms), relational factors (e.g. insecure attachment style), and community factors (e.g. neighborhood disadvantage). Hierarchical logistic regressions indicated that once all risk factors were entered in the models, PTSD was positively associated with psychological dating violence, while dissociation was positively associated with physical dating violence. Physical abuse in childhood was positively associated with sexual revictimization. The present study shows the importance of simultaneously considering the impact of multiple characteristics surrounding CSA survivors when evaluating risks of revictimization. Additionally, it highlights the importance of providing CSA survivors with adequate mental health support for trauma-related disorders, as it may be crucial to prevent revictimization.

Child abuse prevention education policies increase reports of child sexual abuse

BACKGROUND

It is well supported that engaging in prevention education increases a child's awareness of child sexual abuse. However, due to methodological limitations, prior research has yet to determine whether this knowledge leads to increases in reporting or substantiation of child sexual abuse.

OBJECTIVE

We examined whether state mandates for school-based prevention education correlate to changes in reports of child sexual abuse.

METHODS

We used a quasi-experimental design to investigate the association between child sexual abuse report rates from 2005 to 2019 and presence of state legislation mandating school-based child sexual abuse prevention curricula. Child sexual abuse report data were obtained from the National Child Abuse and Neglect Data System child files. We focused on reports for school-aged children ages 5-17. Data on state laws on prevention curricula were extracted from enoughabuse.org, Prevent Child Abuse America, ErinsLaw.org, and directly from published legislation.

RESULTS

State education mandates were associated with an increase in the incidence of child sexual abuse reports made by education personnel (IRR = 1.22, 95 % CI, 1.01-1.48). Policies were not associated with increases in incidence of child sexual abuse reports made by non-education personnel (IRR = 1.08, 95 % CI, 0.95-1.22) or decreases in likelihood that any given report was confirmed (OR = 1.00; 95 % CI, 0.90-1.12).

CONCLUSIONS

There is moderate evidence that adopting state mandates for child sexual abuse prevention education may increase disclosures and reporting of child sexual abuse by school-based sources. There is no evidence that mandates decrease the validity of child sexual abuse reporting by school-based sources.

Patterns of disclosure and perceived societal responses after child sexual abuse

BACKGROUND

Disclosure of child sexual abuse (CSA) is key for abused children to access help and to protect them and other children.

OBJECTIVE

The aim of this study was to investigate patterns of disclosure of child sexual abuse and how children perceived responses from people they disclosed to.

PARTICIPANTS AND SETTING

Data were collected online in classrooms and during home studies in a national probability-based sample of 3282 third-year students in Swedish high schools in 2020-2021 (the age of the students varied between 16 and 23 years (M = 18,2)).

METHODS

Results are presented with frequencies (n) and percentages (%). Pearson's chi-squared test was used for comparisons between groups.

RESULTS

First, a substantial share of abused girls and most abused boys had not yet told anyone about the abuse, leaving them unable to access protection or rehabilitation. Second, participants who had disclosed sexual abuse had most often turned to a peer, more rarely to an adult, and seldom to a professional or volunteer. Third, although the societal responses that the participants perceived were mixed, more severe abuse was associated with more negative societal responses. Fourth, most participants stated that they did not need any professional support. Fifth, among the minority who had sought help, half were satisfied and a third dissatisfied.

CONCLUSIONS

Results showed that most children with experience of CSA did not have access to the protection, support, and rehabilitation that they have a right to. Preventive measures need to target children and young people, while societal responses after CSA, especially severe CSA, need to be improved.

"I do not remember… You are reminding me now!": Children's difficult experiences during forensic interviews about online sexual solicitation

BACKGROUND

Forensic interviews for children who have undergone online sexual solicitation (OSS) constitute a unique setting compared to other forms of child sexual abuse (CSA). In these cases, the interviewer holds concrete evidence of the abuse in the form of pictures or texts. During the interview, interviewers use these materials to advance the data collection regarding the abuse, a practice that may significantly influence the child's wellbeing.

OBJECTIVE

The current study aims to explore children's experiences during forensic interviews concerning OSS.

PARTICIPANTS AND SETTING

The sample included 20 Jewish children in Israel who were referred to and participated in a forensic investigation.

METHODS

A thematic qualitative methodology was used to analyze the children's narratives.

RESULTS

The findings demonstrate the children's difficulties when confronted with materials related to the abuse. The children detailed the different ways the interview challenged their wellbeing, including visualizing and verbalizing the abuse, new insights, and being videotaped.

CONCLUSIONS

The findings in the current study emphasized the intrinsic challenges that children face in OSS forensic interviews resulting from the tension between the interviewer's need to collect details about the abuse and the child's desire to forget it. Practical ramifications pertaining to these threats to the child's wellbeing, future recommendations, and limitations of the study will be discussed.

Effects of internet-delivered cognitive behavioral therapy on use of child sexual abuse material: A randomized placebo-controlled trial on the Darknet

INTRODUCTION

The use of child sexual abuse material (CSAM) is an international public health and child protection challenge.

OBJECTIVE

To investigate whether Prevent It, a therapist-supported, internet-delivered, eight-week, cognitive behavioral therapy, reduces CSAM viewing among users.

METHODS

We conducted a global online single-blind (participants), parallel-group, superiority, randomized, psychological placebo-controlled trial with a one-month follow-up, 2019-2021 (ISRCTN76841676). We recruited anonymous participants, mainly from Darknet forums. Inclusion criteria: age 18+ years, past week CSAM use, and sufficient English language skills; exclusion criteria: severe psychiatric illness or non-serious intent to participate. The main outcome was change in self-reported, weekly viewing time from pre- to post-treatment, according to the Sexual Child Molestation Risk Assessment+.

RESULTS

A total of 160 participants (157 male, 2 non-binary, and 1 not reporting gender) from all world regions (age intervals [%]: 18-29 [49]; 30-39 [30]; 40-49 [15]; 50-59 [6]) were randomized (1:1) to Prevent It (N = 80) or Placebo (N = 80). Between-group, intention-to-treat analyses suggested a significantly larger decrease in viewing time in Prevent It participants vs. controls pre- to post-treatment (Prevent It: N = 76, Placebo: N = 78, estimate -0.25, 95 % CI, -0.46 to -0.04, p = .017, Cohen's d 0.18). Negative side effects from treatment were fewer in Prevent It compared to control participants and neither group reported severe adverse events.

CONCLUSION

We provide initial support for the feasibility, efficacy, and safety of Prevent It to reduce CSAM viewing among motivated users. Further research is needed to validate these findings.

Exploration of factors influencing court outcomes in cases involving minors as victims in Ghana

BACKGROUND

The factors that influence positive court outcomes for cases of child sexual abuse (CSA) have been studied in other contexts but very few such studies exist for Sub-Saharan countries. Knowledge of how such cases fare in these court systems is, however, important for a global assessment of such outcomes.

OBJECTIVE

The study explored the predictive effect of the victim, complainant; offender and offence characteristics, and length of the trial on case disposition and dropout.

METHODS, PARTICIPANTS AND SETTING

Three hundred and eighty-nine (389) closed court files related to child sexual abuse in Ghana were reviewed and analyzed.

RESULTS

The findings show that the number of court sittings (length of trial) and complainant characteristics predict negative outcomes for CSA cases in Ghana. Specifically, convictions were less likely to occur where caregivers were the complainants (OR = 0.45), and when there were longer court sittings (OR = 0.95). Victim, offender, and offence characteristics, however, did not influence case outcomes.

CONCLUSIONS

This study is one of the first studies using actual court data to predict the outcome of cases in CSA in Ghana, and makes recommendations for the support of children and caregivers through the court process.

The Swedish social services' police reporting and children's access to protection and support in child abuse cases: A quantitative content analysis

BACKGROUND

The UN Convention on the Rights of the Child prohibits all forms of violence against children. Sweden was early in introducing a ban on disciplinary violence; however, difficulties have been noted in identifying children in need of protection and providing help for children exposed to violence.

OBJECTIVES

The purpose of this study was to explore the social services' police reporting and children's access to protection and support in cases of physical and sexual child abuse.

METHODS

The sample consisted of 291 child welfare reports from three Swedish municipalities. Data were collected from child welfare reports, investigations, and child social records and analyzed using quantitative content analysis.

RESULTS

A majority of the cases, including cases with a high indication for police reporting, were not reported to the police by the social services. Although the child in 60.1 % of cases provided information about violence, 70.7 % of all child welfare investigations were completed without support measures, and only 8.2 % led to protection or support linked to violence. Children's participation was limited, suggesting inadequate conditions for children's access to protection and support.

CONCLUSIONS

Children's right to protection against violence requires the recognition of children as active participants with access to safe participation. Failure to report suspected crimes against children risks minimizing acts of violence or making violence invisible. Difficulties in handling conflicts of interest between children and parents risk neither protection nor support being provided for the child.

Brief Report: Child Sexual Abuse and Somatic Symptoms in Older Adulthood for Men

Somatic symptom disorders are often misdiagnosed or minimized among men, especially in middle and older adulthood. Previous research investigating links between somatic disorders and early trauma, such as childhood sexual abuse (CSA), have mostly been based on small, non-representative, female samples using cross-sectional designs. The current study used data from the Wisconsin Longitudinal Study to assess associations between CSA and somatic symptom severity among men in middle- and late-adulthood (mid-50s to early 70s) with histories of CSA (n = 129) and a matched, non-abused comparison group (n = 2,322). Childhood (e.g., co-occurring adversities and parental education) and demographic background variables (e.g., marital status, self-rated health, and income) were controlled. Growth curve modeling was used to explore trajectories of somatic symptoms over time. Results indicated that the CSA group had higher somatic symptom severity than the non-abused group (γ01 = .10, p < .05); symptoms decreased over time for both groups with no significant differences in the rate of change. Healthcare providers should include CSA in assessments for men. Because contemporary somatic symptoms may represent unresolved early life course trauma, mental health support services should be expanded for this population. Future research should explore gender-appropriate treatment modalities for older men with histories of CSA.

Impact of Child Sexual Abuse on Socioeconomic Attainment in Adulthood

PURPOSE

While child sexual abuse (CSA) victimization is linked to adverse mental and behavioral health outcomes, few studies have examined the association between CSA and socioeconomic attainment in adulthood, particularly for men. This study assesses the impacts of CSA victimization on socioeconomic outcomes in adulthood, separately for men and women.

METHODS

Analyses are based on the National Longitudinal Study of Adolescent to Adult Health restricted use dataset. Adolescent to Adult Health is a nationally representative cohort of teenagers in grades 7-12 (1994-1995; N = 20,000) followed to ages 33-44 (2016-2018; N = 12,300). These analyses were based on N = 10,119 participants. We used propensity score weighting to equate on observed confounders of those who experienced CSA victimization with those who had not. All analyses were conducted in the R statistical software.

RESULTS

In this analytical sample, 25.2% of women and 9.8% of men reported of having been sexually abused as a child. Results from propensity score weighted models showed that by their late 30s, men and women who experienced CSA had lower educational attainment, lower odds of being financially stable, and a decrease in household income compared to their peers. CSA was associated with lower odds of being employed among women only.

DISCUSSION

Findings from this study suggest that men and women who survive CSA, experience socioeconomic disadvantages in adulthood relative to peers who did not experience CSA. Preventive programs and treatment and other services for survivors of CSA could positively impact individuals' economic productivity over the life course, reducing the individual and societal costs associated with CSA victimization.

Taking a School-Based Child Sexual Abuse Prevention Program to Scale: a Cost Analysis

Cost analyses are used to determine overall costs of implementing evidence-based programming and may help decision makers determine how best to allocate finite resources. Child sexual abuse (CSA), regularly viewed as a human rights violation, is also a public health concern estimated to impact 27% of females and 5% of males by age 18. Universal, school-based CSA programs are one prevailing prevention strategy. However, there are no known cost analyses of school-based CSA prevention programming, thereby limiting potential scalability. Using the ingredients method, this cost analysis presents the findings of implementing Safe Touches, an evidence-based universal prevention program, across four sites (i.e., counties) in one mid-Atlantic state. Reaching a total of 14,235 s grade students, results indicate an average cost of $43 per student, an average classroom cost of $859, an average district cost of $10,637, and an average site cost of $154,243. There was a noted decrease in costs when more students were reached, suggesting a need to focus efforts on bolstering the reach of implementation efforts. Sensitivity analyses explored variations in implementation constraints such as personnel and facilities suggesting a range of per-student costs (lower-bound per-student cost = $34; upper-bound per-student cost = $64). Findings presented herein may be used to inform future universal CSA prevention efforts by providing detailed information about the costs of large-scale implementation of an evidence-based program among elementary-aged children.

A study on child sexual abuse reported by urban indian college students

Background and Objectives

The prevalence of child sexual abuse (CSA) in India is 18-50% depending on the population studied. To devise strategies for prevention of CSA at the primary care level, we studied the prevalence of CSA amongst college students aged 17-25 years.

Methods

A group of medical students and their friends were sent, an anonymous questionnaire validated by experts via WhatsApp. The questionnaire assessed demography, occurrence of prior CSA and details of the sexual abuse.

Results

About 574 students participated in the study. The majority of respondents were female (380, 66.2%). About 467 (81.2%) of participants were from South India. Of the 380 women and 194 men who consented to participate in the study, 218 (57.3%) and 65 (33.5%), respectively, said that they had been sexually abused in the past (p < 0.00001). The event commonly occurred at 12-14 years (22.6%), but about 53% of victims were <12 years of age. The perpetrator was usually male (93.2%), less than 30 years of age (54%) and a stranger (42.7%). The most common form of CSA from 348 instances in 283 respondents was some form of "bad touch or caresses" (56.6%). About 25.8% of those abused did not speak to anyone about the event. Only 249 respondents (43%) were counselled regarding CSA by their parents.

Conclusions

The prevalence of CSA amongst South Indian college students is 49.3%. The victims were mainly girls <12 years of age and the perpetrators were mainly male (93.2%). Primary Care Physicians can play a greater role in the early detection and prevention of CSA.

"Explode into small pieces": Suicidal ideation among child sexual abuse survivors

BACKGROUND

Child sexual abuse (CSA) has been acknowledged as predisposing survivors to an increased risk of suicidal ideation and attempts. Despite this risk being widely recognized, the study of suicidality has mainly focused on psychopathology, while less attention has been given to survivors' experiences and perceptions.

OBJECTIVE

This study aims to uncover the experiences and perceptions of suicidality among adult CSA survivors.

PARTICIPANTS AND SETTINGS

The sample consisted of 41 adult CSA survivors' written narratives of abuse that included references to suicide.

METHODS

Written narratives of CSA experiences were collected from 41 adult participants as part of the Israeli Independent Public Inquiry on CSA to change public policy. An inductive thematic analysis guided the exploration of the stories.

RESULTS

The findings portrayed several main themes regarding the survivors' experiences before, during and after suicidal thoughts and behaviors. These themes elucidated their motivations leading to suicidal attempts, including the wish to end one's self and suffering, self-blame, communicate the abuse and the request for recognition. Additionally, the survivors' stories illuminated their experiences following the suicidal attempts, depicting inadequate treatment and difficulties with the psychiatric labeling of a mental health disorder.

CONCLUSIONS

The findings of this study uncover new insights regarding the link between trauma, posttraumatic suffering, and suicidality within a social interaction context. Furthermore, these findings call medical and psychosocial health practitioners to view post-CSA suffering as trauma-related rather than personal psychopathology and to adjust practices to adapt to survivors' experiences and needs.

A contemporary case file analysis of child sexual abuse in institutional settings in England and Wales

BACKGROUND

Despite increased institutional safeguards and regularly updated statutory guidance that stresses safeguarding is 'everybody's responsibility', children continue to be sexually abused in institutional contexts in England and Wales. There also remains a lack of contemporary knowledge about institutions' responses to concerns about [risk of] CSA.

OBJECTIVE

Reviewing Disclosure and Barring Service (DBS) discretionary-decision case files, as a detailed source of information about CSA in institutions occurring in the last 5 years, the aim of this paper was to understand what institutions knew about CSA and inappropriate behaviours that indicated children could be at risk of harm prior to formal disclosures to the DBS and how institutions did, or did not, respond to this knowledge.

PARTICIPANTS AND SETTING

Cases involved 32 male and 11 female barred persons and 19 male and 51 female sexually abused children.

METHOD

Thematic analysis was applied to 43 files where decisions were made by the DBS to add individuals to the Children's Barred list (which prevents them by law from working with children) between 2017 and 2020.

RESULTS

In 79% of cases there was some level of awareness of concerns relating to inappropriate behaviour or CSA, through rumours and gossip, concerns about professionalism, and observed changes in the behaviour of subsequently barred individuals or victims. There was wide variation in the degree to which institutions responded. In a small number of cases action was taken promptly; however, this was not typical.

CONCLUSIONS

Institutions and professionals failed in their duty of care by not taking any action at all, or responding slowly in ways that did not prevent CSA.

Parenting Stress in Non-Offending Caregivers of Sexually Abused Children

The non-offending caregiver (NOC) population is under studied despite their role in the recovery of child victim-survivors of sexual abuse. Research suggests that NOCs experience significant distress following a child's disclosure of sexual abuse. Trauma has been demonstrated to negatively impact the caregiver-child relationship. This study informs about common NOC stress reactions in response to child sexual abuse (CSA) disclosures and has clinical implications for treating families affected by CSA. Participants included 66 NOCs (age 23-66, M = 41.09, SD = 10.26) who participated in clinical intakes at a CSA treatment program and completed a self-report measure of parenting stress. Depending on the child's age, NOCs were administered either the Parenting Stress Index-fourth edition, Short Form (PSI-4-SF) or the Stress Index for Parents of Adolescents (SIPA). NOCs reported higher than average parenting stress. Statistically significant differences between the clinical and normative samples were found on all PSI-4-SF domains and on majority of SIPA domains. High to Clinically Significant scores were reported by 42% of NOCs for Parent-Child Dysfunctional Interaction. Stress related to their child's social withdrawal was reported by 56% of NOCs. This study provides comparison data for evaluations of NOCs. NOCs may require treatment and family-based approaches are implicated.

Why Didn't They Intervene? Examining the Role of Guardianship in Preventing Institutional Child Sexual Abuse

In recent years, the failings of institutions to safeguard children from sexual abuse have been brought to light through investigations and commissions of inquiries such as Australia's Royal Commission into Institutional Responses to Child Sexual Abuse. The role of adults as guardians, to protect children within these institutions, has been afforded particular scrutiny, highlighting past ineffective and harmful intervention and responses to abuse, and even inaction. Despite this attention, limited research to date has explored the barriers underpinning guardianship behavior in this setting. Enhanced understanding of the potential barriers to guardianship is key for informing improved guardianship behavior in the future. Using data from Australia's Royal Commission, this study applies Reynald's (2010) model of capable guardianship to investigate dimensions of guardianship in youth-serving institutional settings. Three discrete settings were examined: outside school hours care, schools, and sporting institutions. Results support the utility of Reynald's (2010) model for advancing knowledge about guardianship behavior in youth-serving institutions, providing valuable lessons for future policy directions, to enhance safeguarding practices.

Pediatricians' Attitudes Toward Child Sexual Abuse in the Republic of Srpska

Child sexual abuse (CSA) affects all cultures and sociodemographic sections. As health professionals, pediatricians are often the first line of defense when it comes to CSA identification and reporting. Our previous study examined encounters, competence, beliefs, and reporting regarding CSA among pediatricians in countries of the former Yugoslavia, Serbia, and Montenegro. Following up on this work, we expanded our research to another neighboring country, the Republic of Srpska (RS). Sixty pediatricians were surveyed in 2020, comprising 30% of all practicing pediatricians in the Republic of Srpska. Compared to their colleagues from Serbia and Montenegro, RS pediatricians revealed an increased perception that children are often abused by someone they do know well, were more confident in their abilities to detect CSA, reported a higher number of CSA cases, and were more interested in further trainings on the subject of CSA. Despite this, the level of underreporting remained high (40%). To our knowledge, this is the first study to both assess and compare CSA-related attitudes in this part of the world. Key differences between RS, other two neighboring countries as well as from other countries worldwide are likely to stem from the level of pediatricians' training and education, as well as from the socio-cultural and legislation context. Although encouraging, our data indicate a need for further research in the countries of the former Yugoslavia.