Prevalence, contexts, and correlates of child sexual abuse in Cyprus

Estimating the economic burden attributable to online only child sexual abuse offenders: implications for police strategy

Evidence is beginning to emerge of the serious negative effects online only child sexual abuse (OOCSA) can have on victims. Establishing the scale and nature of the problem could assist police in prioritizing suspects. In study 1, scoping review identified eleven studies that examined OOCSA's impact on victims. Five themes emerged from narrative review; definitional issues, a new normal, OOCSA grooming processes, comparisons with offline CSA, mechanisms between OOCSA and harm. In study 2, OOCSA national prevalence was estimated by applying 2.9% rate of OOCSA observed from original police data to a lower bound ("sexual communication with a child" crimes recorded by the police), middle (scaling up to estimate undetected offenses) and upper bound estimate of the national offender pool (self-reported sexual solicitation offenders). Recent UK Home Office figures were adapted to establish economic costs. Lifetime costs estimates attributable to OOCSA are £7.4 million (police reports), £59.6 million (including undetected offenders) and £1.4 billion (national prevalence estimates). Over 75% of this is non-financial costs borne by victims in terms of emotional harm and lost output. Government bears around 20% of the cost burden, mostly non-financial costs for police forces. Findings are discussed in relation to evidence-led recommendations for prioritization and wider police actions that can be taken to avoid the considerable economic and social burden associated with OOCSA offenses.

Commercial Sexual Exploitation of Children and Adolescents in Europe: A Systematic Review

OBJECTIVES

The objective of this review is to provide a systematic and critical summary of findings regarding empirical studies conducted on commercial sexual exploitation of children (CSEC) in Europe. The purpose is to gain an understanding of the characteristics and main topics addressed in European research on CSEC, identify gaps, and give suggestions for future studies.

METHOD

The review was guided by the "Preferred Reporting Items for Systematic Review and Meta-Analysis-Protocols". A comprehensive search on several databases was conducted to identify published and unpublished empirical research on CSEC in Europe, revealing 3,846 documents. In total, 56 research papers that focused specifically on CSEC in European samples were included.

SYNTHESIS

Research concerning European studies of CSEC and trafficking for purposes of sexual exploitation has developed significantly over the last 20 years but is still rather limited and mainly focused on the UK and Sweden. Most of the studies reviewed suffer from important methodological flaws such as an inaccurate definition of the phenomenon analyzed, small and convenience samples, and nonvalidated and nonspecific instruments.

CONCLUSIONS

Findings from this study demonstrate the need for greater exploration and research around a number of areas of sexual exploitation of children in Europe. Further work is necessary in terms of capacity building, training, and awareness-raising for society as a whole and, specifically, professionals providing direct support to children and young people at risk of exploitation.

Cinsel Saldırı - İstismar Olguları Üzerine Retrospektif Bir Çalışma

Objective: In this study; it is aimed to analyze the sexual attack-abuse cases that occurred in Bolu province and were judged by the High Criminal Court. Methods: A total of 148 cases of sexual assault - abuse decided by the Bolu High Criminal Court between 2007 and 2016 were analyzed retrospectively. Results: This study included 148 cases: 131 (88.5%) cases were female and 17 (11.5%) were male. The mean age was 18.6 ± 11.6 (min:4, max:83). The highest number of cases was in the 13-15 age group (n=52, 35.2%). Sexual abuse most frequently occurred through vaginal penetration (n=72: 48.6%). The most common psychiatric diagnosis was acute stress disorder (n:12, 10.8%) and post-traumatic stress disorder (n:12, 10.8%). Physical violence was found to be statistically effective (p = 0.008) in the occurrence of mental disorders after the event. The victim recognized 81.8% of the attacker. Conclusion: We think that more effective sexual attack-abuse prevention strategies can be developed at the national level by determining the risk factors of sexual assault-abuse in our country through wider research to be conducted across the country.

Current of Child Sexual Abuse in Asia: A Systematic Review of Prevalence, Impact, Age of First Exposure, Perpetrators, and Place of Offence

BACKGROUND: Child sexual abuse (CSA) is a serious global problem and challenge for all people because it increases the risk of various issues. AIM: This study investigated the CSA in Asian countries focusing on prevalence rates, impact, victim’s age of first exposure, type of CSA, perpetrator, and places of CSA offence. METHODS: We searched PubMed, Medline, ProQuest, ScienceDirect, CINAHL, Academic Search Complete, ClinicalKey, PsycINFO, Google Scholar, and manual search for studies published between January 2011 and November 2020. Only articles related to CSA in Asia were included in this review. RESULTS: The results showed that prevalence of CSA ranged from 2.2% - 94% for girls and 1.7% - 49.5% for boys. The prevalence rates for non-contact abuse were 12.6% - 56.5% for girls and 0.7% - 68.7% for boys; contact abuse was 5.3% - 67.2% for girls and 2.2% - 53.3% for boys; penetrating abuse was 0.5% - 88.24% for girls and 1.7% - 57.1% for boys. The findings reported most victims’ age of first exposure was preteen. The rate of the violation occurring in the victim’s house was 6.1% - 41.9%; most CSA perpetrators are known by victims. This study reported adverse impacts on CSA victims such as psychological, health, and physical disorders, and changes in behavior. In addition, other findings were found, including recovery, perceptions, values, causes, and expectations of victims of CSA. CONCLUSIONS: The incidence of CSA in Asia is still high and the age of the first victims is early adolescence. The majority of victims are women who already know the perpetrator, and taboo cultural factors are thought to play a role in increasing CSA in Asia. The results indicate the need to develop CSA prevention efforts that involve culture.

[Diagnostics and Significance Evaluation in Cases of Suspected Child Sexual Assault - An Analysis of 210 Cases]

BACKGROUND

Child sexual abuse is difficult to diagnose in children and it is a challenging task for all involved medical disciplines of a medical child protection unit. The present study describes the factors that led patients to be presented to a child protection unit under the suspicion of sexual abuse and the diagnostic instruments which were used in order to substantiate or prove suspicious fact.

PATIENTS AND METHOD

This study was conducted retrospectively on the basis of 210 children and adolescents ranged in age between 4 months and 18 years, who were presented to the medical child protection unit of Frankfurt am Main with suspected sexual abuse in the period from 2010 to 2015. 173 cases were analyzed in more detail. The cases were analyzed with the help of standardized documentation sheet and suspicious facts were evaluated with regard to their significance.

RESULTS

A total of 173 patient records were analyzed in more detail containing cases of suspected child sexual abuse. The majority of the children and teenager were female and younger than 10. Often the father was accused of sexual abuse and parents were separated or in custody battle. The patient's statements were crucial for substantiation of suspicious fact in 60% of the cases. The assessment was more certain if the alleged perpetrator was not part of the close family and if other forms of physical violence were associated.

CONCLUSION

The study shows that gynecological respectively anogenital findings do not represent the key evidence for the substantiation of sexual abuse allegations. Instead, it underlines the significance of further diagnostic methods, in particular the psychological and anamnestic evaluation.

Dental care of patients exposed to sexual abuse: Need for alliance between staff and patients

The aim was to explore the experiences of sexually abused individuals as dental patients. Purposively selected were 13 informants (11 women) aged 19-56. All had experienced sexual abuse as children or adults and memories of this abuse had been triggered and expressed during a dental appointment. They were encouraged to relate in their own words their experiences of the dental appointment. The interviews were recorded digitally, transcribed verbatim, and analysed according to Qualitative Content Analysis. The overall theme illustrating the latent content was The dental appointment - a volatile base requiring predictability and a secure working alliance. The first category covering the manifest content was The dental care provider "assumes responsibility," with two subcategories: (i) contradictory disclosure, and (ii) alliance formation - a levelling of power. The second category was The patient is "in focus," with two subcategories: (i) alertness to signs of discomfort, and (ii) attention to obvious but subtle expressions of needs. On an understanding that the patient has been sexually abused, an individually tailored, patient-centered approach to treatment is suggested. Dental care providers may also need to be aware of and reflect on their position of power, in relation to the patient and its possible chairside implications.

Características da violência contra crianças no município de Porto Alegre: análise das notificações obrigatórias

RESUMO Objetivo caracterizar a violência notificada contra crianças no município de Porto Alegre. Método estudo retrospectivo, incluindo 5308 casos de violência contra crianças de zero a doze anos registrados no Sistema de Informação de Agravos de Notificação no município de Porto Alegre. Resultados idade média foi de 5,95 ± 3,86 anos, com predomínio de crianças do sexo feminino (61%). A violência sexual foi a mais notificada (53%). A maioria dos agressores eram do sexo masculino (68%) e 72% dos casos ocorreram no domicílio da vítima. As meninas são mais suscetíveis à violência sexual. Crianças do sexo masculino sofrem mais violência física e negligência. Conclusão e implicações para a prática os resultados demonstram a importância do conhecimento do perfil das violências para intervenção e elaboração de políticas públicas intersetoriais, assim como para a capacitação da equipe multiprofissional para o reconhecimento do problema no momento da assistência e o devido encaminhamento.

Raising the Awareness of Students in a Child Development Department regarding the Prevention of Child Sexual Abuse

The purpose of this study was to evaluate the effectiveness of the training given to raise awareness of child sexual abuse among students at a Turkish University. For this study, a quasi-experimental method, the single group pretest posttest model, was used. The data were collected using a questionnaire that was distributed to students in the Department of Child Development before and after relevant training. The study sample consisted of 87 participants. In this study, increased awareness was indicted by the participants' understanding of good and bad touching following the instruction. In addition, the attitudes of the participants regarding the use of correct anatomical names when teaching about the genitals and their knowledge of the special regions of the body increased (p <.05). The findings of the study showed that the "awareness training" was an effective program for increasing sensitivity regarding the prevention of sexual abuse. Consequently, it is recommended that lessons on child abuse should be included in the university educational curriculum, and that programs promoting sensitivity to this issue should be promoted. It is also recommended that similar studies, with larger samples, should be carried out in the fields of educational science and health science.

Child sexual abuse among medical school students: experiences and perceptions

Given that 5-25% of the adult population report child sexual abuse (CSA), most clinicians will care for victims. Data regarding CSA experiences among medical students are limited and the association of medical students' own history of CSA with relevant perceptions has not been previously examined. The aim of this study was to assess CSA perceptions and exposure of medical students, while exploring their associations. For this purpose, a link was created and made available on a site accessed solely by the Athens medical school undergraduates from February 20 to March 20 2019, comprising a 12-item questionnaire to assess the knowledge and past experience of CSA. This was based on a larger published questionnaire, which was translated and adapted. The questionnaire was then transcripted online, and after pilot testing, was disseminated using the Google documents® platform. Out of 261 responses, CSA was reported by 48 participants (18%), of which 39 were women. Thirty five reported contact CSA. Thirty seven victims (77%) reported previous disclosure of the event, but 18 of them were not protected post disclosure. CSA victims were less likely to agree with the perception that most perpetrators are mentally ill or disabled (p = 0.043), and more likely to strongly disagree with the statement that reputable families are protected from sexual abuse (p = 0.019). In agreement with existing data in general populations globally, about one in five medical students had exposure to CSA. In addition, a potential association of their own experiences with shaping perceptions regarding the identity of CSA perpetrators and affected families for medical students is highlighted.

Intervención psicológica del abuso sexual en niños: Revisión sistemática

La literatura ha mostrado terapias para el tratamiento de los síntomas relacionados con situaciones de abuso sexual infantil en adolescentes, jóvenes y adultos. La presente revisión se enfocó en intervenciones para niños víctimas de abuso sexual con edades entre los tres y los doce años. Nos enfocamos en publicaciones en inglés, español, francés y portugués registradas en las bases de datos Science direct, Jstor, Proquest, Redalyc y Scielo. Los resultados mostraron mayor frecuencia de estudio de este tema en poblaciones norteamericanas y europeas, enfocadas en el tratamiento de síntomas o consecuencias en la salud mental tales como baja autoestima, depresión y ansiedad, actitud vital negativa, trastornos alimentarios, estrés postraumático y otras variables relacionadas como bajo rendimiento académico, conductas auto lesivas o suicidas. La terapia cognitivo comportamental individual y grupal y también su modalidad centrada en el trauma, cuenta con una frecuencia mayor de estudios que demuestran su efectividad para el tratamiento. Igualmente se identifican la terapia psicodinámica de juego, la terapia asistida por animales y la terapia de interacción padre-hijo. Se discute el papel que podría jugar las terapias de tercera generación como complementarias para el manejo de los síntomas o consecuencias del abuso sexual en niños.

Development of a screening tool enabling identification of infants and toddlers at risk of family abuse and neglect: a feasibility study from three South European countries

BACKGROUND

Child abuse is a health and social problem, and few screening instruments are available for the detection of risk in primary health care. The aim was to develop a screening instrument to be used by professionals in the public health care sector, thus enabling the detection of infants and toddlers at risk of emotional and physical abuse and neglect, and to provide evidence for the feasibility of the instrument in Cyprus, Greece and Spain.

METHOD

A total of 50 health professionals from paediatric public health-care centres in the three countries were involved in a three-step process for guiding the development of the screening tool and its application.

RESULTS

A nine-item screening tool, consisting of items assessing relational emotional abuse, physical abuse and other risk factors, was developed. The screening tool was applied on a total of 219 families with 0 to 3-year-old children attending public health centres in the three countries. Clinicians reported that they agreed on the inclusion of the questions (86.4-100%) and that they found the questions to be useful for the clinical evaluation of the family (63.2-100%).

CONCLUSION

The screening tool shows considerable face validity and was reported feasible by an international set of clinicians.