Predictors of Intrusive Sexual Behaviors in Preschool-Aged Children

Children with sexual behavior problems: Ties to child maltreatment, family functioning, and help-seeking

Although the literature on children's sexual behavior problems (SBPs) has indicated that maltreatment and family dysfunction are linked to SBPs, several facets of these factors have remained unexamined. Prior research has largely focused on SBPs more broadly, though interpersonal SBPs (ISBPs) are likely a distinct, more severe SBP subtype. The aim of the current study was to examine potentially relevant, unexplored factors, including the number of types of and total allegations of maltreatment as well as familial characteristics (i.e., parenting attitudes and behaviors, discipline methods, family functioning, and help-seeking) in relation to SBPs and ISBPs. The present study included 8-year-old children (N = 1,011, 51.1% female, 53.8% Black) and their caregivers from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) study. In the model for SBPs, externalizing symptoms, the number of types of maltreatment allegations, maladaptive discipline methods, and help-seeking were associated with SBPs, whereas child's gender, race/ethnicity, internalizing symptoms, total maltreatment allegations, income, family functioning, and parenting attitudes were unrelated, r2 = .23. When ISBPs were examined, only child's gender and externalizing symptoms were tied to ISBPs, r2 = .09. However, child's race/ethnicity and internalizing symptoms, as well as maltreatment experiences, family factors, and help-seeking, were not associated with ISBPs. These findings highlight the importance of broader externalizing symptoms for both SBPs and ISBPs as well as the role of multiple types of maltreatment, parenting behavior, and help-seeking in the context of general SBPs.

Factors Related to General Sexual Behavior of Children Under 10 Years Old in Korea

The risk factors for intrusive or problematic sexual behavior in a specific population, including abused or clinically referred children, have been occasionally explored. However, sexual behaviors broadly in the general population have not been investigated. This study aimed to determine whether child characteristics, exposure to trauma, family factors, and exposure to sexuality, which were proposed as predictors of sexual behavior problems in previous studies, significantly affected the general sexual behaviors of children under 10 years in the Korean population. The parents of 652 children aged 3-9 years in a Korean community completed questionnaires, including the Child Sexual Behavior Inventory, the Korean version of the Child Behavior Checklist, Trauma Symptom for Young Children, the Korean version of the Family Inventory of Life and Change, the Dysfunctional Parenting Scale, and exposure to trauma and sexuality. Regression analysis indicated that children's age, externalizing behavior problems, post-traumatic symptoms, exposure to trauma, and exposure to sexuality were significant predictors of overall sexual behaviors. Therefore, it may be helpful to explore trauma and exposure to sexuality even to understand a child's general sexual behavior. In addition, psychoeducation can help parents monitor and reset family boundaries and sexual exposure that can affect children's sexual behavior.

Scoping Review of the Definitions Used to Describe and Understand Harmful Sexual Behaviors in Children and Young People

There is a growing body of evidence that adolescents, and other children, are responsible for a significant proportion of sexual abuse against children. However, there are substantial differences in how this phenomenon is defined and conceptualized between and within sectors. This scoping review explored the current definitions of harmful sexual behaviors (HSB), and other similar terms, used across a range of stakeholder groups. In all, 141 papers were reviewed from both empirical and gray literature sources, including key policy and practice documents. Included papers needed to list a clear definition for the behavior of interest. There was disagreement and inconsistency across the included papers in their conceptualization of harmful, abusive, or problematic sexual behavior (PSB) in children and adolescents. Although the term HSB has been adopted as an umbrella term or continuum in many policy, practice, and research settings, there is a large variance in behaviors, treatment needs, etiology, and harms present across different types of sexual behavior. Relying solely on one term to describe a wide range of sexual behaviors in children and young people may limit the understanding of this issue and imply similarities between groups that are not present. We suggest that clearly defined subsets of HSB, such as sexual abuse, technology-assisted HSB, and PSB, may give more context to the behavior of concern and may be helpful in informing further research, prevention, and best practice approaches.

Exposure to sexual content and problematic sexual behaviors in children and adolescents: A systematic review and meta-analysis

BACKGROUND

Exposure to sexual content, such as online pornography or live sexual content, has been posited in the literature as a risk factor for problematic sexual behaviors (PSBs) in children and adolescents, and has been identified as an important avenue for research and intervention, particularly given the ubiquitous access to technology among children.

OBJECTIVE

To examine the association between live/violent and non-violent sexual content exposure and PSB among children and adolescents. Objectives also include informing future research on sexual content exposure as a risk factor for PSB, and providing clinical recommendations related to prevention and intervention.

PARTICIPANTS AND SETTING

Results are based on 16,200 participants (28.65 % female; Mage = 14.26; range = 4.74-17.92) and 27 studies conducted in North America, Europe, Asia, and Africa.

METHODS

A systematic review was conducted of available literature published up to September 2021. Abstract and full-text review were conducted to assess whether studies met inclusion criteria. Random-effects meta-analyses were conducted on included studies.

RESULTS

Significant associations were found between exposure to non-violent sexual content and likelihood of engaging in PSB (OR = 1.82; p < .001; 95 % CI: 1.50-2.21), and between exposure to violent/live sexual content and PSB (OR = 2.52; p < .001; 95 % CI: 1.75-3.61). Sex emerged as a moderator of the association between exposure to non-violent sexual content and PSB, such that the association was stronger in studies with a greater proportion of females.

CONCLUSIONS

Results support the need for future research on risk factors and mechanisms implicated in PSB. Prevention and intervention programs for children with PSB and their families could benefit from incorporating education on sexual content exposure.

Psychometric evaluation of a single-item screening tool for the presence of problematic sexual behavior among preteen children

BACKGROUND

Preteen children with problematic sexual behavior (PSB) are increasingly coming to the attention of mental health professionals. However, efforts to provide clinical care to these children are hampered by the limited dissemination and implementation of effective screening procedures.

OBJECTIVE

A single-item screening tool designed for implementation in mental health settings was developed and tested for psychometric quality.

PARTICIPANTS

Participants included caregivers of children receiving clinical services as a result of displaying PSB and/or subsequent to disclosure of child maltreatment (n = 341).

METHODS

Caregivers completed the single-item tool at the onset of services and approximately 15 days later. In addition, caregivers completed the Child Sexual Behavior Inventory, the Strengths and Difficulties Questionnaire, and the Child Stress Disorder Checklist-Short Form at the initial assessment.

RESULTS

Analyses demonstrated acceptable test-retest reliability of the tool (phi = 0.70-0.74, p < .001). Validity was established by showing that caregivers providing a positive response on the single-item tool scored children significantly higher on a full-length measure assessing PSB than caregivers denying such concerns on the single-item tool (t = 7.28-9.8, p < .001). However, scores on measures of internalizing concerns and posttraumatic stress symptoms were not distinguished by caregiver responses to the single item tool.

CONCLUSIONS

The newly developed single-item tool appears to offer an efficient, reliable, and valid method of screening preteen children for the presence of PSB.

Etiological Pathways to the Emergence of Preteen Problematic Sexual Behavior: An Exploratory Mediational Model

Studies examining the etiology of problematic sexual behavior (PSB) among pre-teen children often rely on identifying correlational relationships without examining potential causal mechanisms. This study describes an exploratory analysis of a potential mediational model where child sexual abuse (CSA) and child physical abuse (CPA) predict the onset of PSB through their impact on the emergence of posttraumatic stress (PTS) symptoms and self-dysregulation. The caregivers of 189 children between the ages of 3 and 11 years presenting for mental health treatment in the United States completed a battery of measures designed to assess each of the variables in the model. Cross-sectional, regression-based mediational analyses showed that the overall model performed adequately (R = 0.33, R² = 0.11, F = 3.07, p = .004). CSA exerted a direct effect on PSB that was not mediated through either PTS or self-dysregulation. However, no direct effect for CPA was found. Rather, CPA exerted a significant effect on the display of self-dysregulation, which in turn was associated with PSB. These results are discussed in light of clinical implications and directions for further research.

Etiological Perspectives on Problematic Sexual Behavior of Preteen Children: Implications for Treatment

Problematic sexual behavior (PSB) among preteen children is a poorly understood clinical phenomenon that may leave even the most skilled and knowledgeable of clinicians at a loss when attempting to develop an evidence-based treatment approach. Much of this lack of practical direction can be credited to the relatively scarce clinical trial research examining this outcome. Nonetheless, the etiological research on PSB provides clearer directions and suggests the implementation of already well-established interventions may be effective. This paper reviews the current state of the etiological research pertaining to PSB and places these findings within developmental psychopathology, social learning theory, and post-traumatic stress disorder symptomatology frameworks. Specific treatment directives derived from these three viewpoints are then reviewed, including a review of the current evidence base for the treatment of PSB. Finally, a treatment planning algorithm is specified to help clinicians identify the most beneficial approach to treating PSB in a given case.

Sexual Behavior Problems Among Sexually Abused Children: Associations With Co-Occurring Symptoms

Sexual behavior problems (SBPs) and interpersonal SBPs (ISBPs) among sexually abused children often occur alongside a variety of other clinical difficulties, such as externalizing problems, attentional difficulties, social concerns, and posttraumatic stress symptoms (PTSS). Yet, as few studies have examined these links in a multivariate manner, it is unclear which symptoms are most strongly related to SBPs and ISBPs. Research regarding children's reports of their difficulties and SBPs and ISBPs is also very limited. The current study investigated the relations between both caregiver- and child-reported trauma-related symptoms and SBPs and ISBPs among 248 treatment-seeking sexually abused children (ages 6-12; M = 8.06, SD = 2.52; 64.5% female; 55.6% white). Children's caregiver-reported trauma-related sexual concerns and anger were associated with SBPs. For ISBPs, only caregiver-reported sexual concerns were related to ISBPs. Surprisingly, none of the child-reported symptoms were associated with either SBPs or ISBPs. Trauma-related sexual concerns and anger may be tied to SBPs, whereas other clinical difficulties may be less strongly implicated. Trauma-related sexual concerns may be most important in understanding interpersonally focused SBPs. Children's self-reported difficulties may be unrelated to caregiver-reported SBPs, or these results may be a function of a low degree of caregiver and child symptom concordance.

Children who engaged in interpersonal problematic sexual behaviors

BACKGROUND

Over one-third of inappropriate sexual contact experienced by children is initiated by other children. Many studies examined child initiators (CIs) of interpersonal problematic sexual behaviors (IPSBs). This study uniquely links CI information with types of sexual contact as described by children they engaged in IPSBs.

OBJECTIVE

Describe CIs' characteristics and types of sexual acts they initiated.

PARTICIPANTS/SETTING

Medical charts of CIs and children they engaged in IPSBs. Examinations occurred between 2002 and 2013.

METHODS

Retrospective chart review.

RESULTS

Most CIs were male (83%) and related to the child they engaged in IPSBs (75%); mean age was 10 years (range 4-17); 58% reported viewing sexually explicit media; 47% experienced sexual abuse. Most CIs (68%) engaged in multiple types of IPSBs. Children who experienced IPSBs initiated by males reported engagement in greater numbers of invasive acts (t(216) = 2.03, p = .043). Older CIs were more likely than younger CIs to report viewing sexually explicit media (χ²(1) = 7.81, p = .007) and those who did were more likely to initiate more invasive acts (t(169) = 2.52, p = .013) compared to CIs who did not.

CONCLUSIONS

In this study, most CIs were young and experienced multiple adverse events; the most common types of IPSBs were invasive; and over half the CIs had been exposed to sexually explicit media, which was associated with initiating invasive sexual acts. These findings suggest aiming prevention efforts at young children to help them manage exposure to sexually explicit media and redress victimization experiences.