Child sexual abuse in clinical and forensic psychiatry: a review of recent literature

Men's sexual interest in children: one-year incidence and correlates in a population-based sample of Finnish male twins

In a study of 1,310 Finnish adult male twins we found that sexual interest in children aged 12 or younger was reported by 0.2% of the sample. Sexual interest in children aged 15 or younger was reported by 3.3%. Participants reporting sexual interest in children aged 15 or younger were younger, reported stronger sexual desire, and had experienced more childhood sexual and nonsexual abuse. The present study is the first to give a population-based estimate of the incidence of sexual interest in children among adult men. The 12-month incidence of sexual interest in children below the age of 16 years is roughly comparable to the one-year incidence of major depression or the lifetime prevalence of transvestitic fetishism.

The influence of medical and behavioral evidence on conviction rates in cases of child sexual abuse

Child sexual abuse cases have one of the lowest conviction rates across all charges. While research has investigated the impact of attitudes and beliefs in judicial decision makers, little is known about the influence of medical evidence. The aim of this study was to examine how the presence or absence of evidence impacts on conviction. A sample of 113 child sexual abuse cases from Australia were coded for the types of evidence that were presented as well as other relevant descriptive data. The most significant predictor of verdict was the behavior of the child rather than the presence of medical evidence. This finding suggests that greater attention might be given to the collection and reporting of this evidence in future trials.

The role of PTSD in adjudicating violent crimes

PTSD was formalized as a diagnosis by the American Psychiatric Association in 1980 with the publication of the Diagnostic and Statistical Manual of Mental Disorders (DSM), 3rd edition. Since that time, the diagnosis has been widely utilized in the courts including the use in criminal proceedings. PTSD may play a role in the assessment of violent crimes both as a possible contributing factor in the perpetrators as well as a consequence in the victims. There are a number of ethical and clinical considerations in the use of this diagnosis. Importantly, the diagnostic criteria have changed to a degree with subsequent editions of the DSM. This may have an impact on the interpretation of past legal judgments. Moreover, extensive psychiatric comorbidity may complicate the clinical picture, e.g., mood disorders, substance use disorders, or psychosis. The diagnosis of PTSD is still based on clinical, largely subjective criteria, e.g., biological markers are not yet utilized. As such, there may not be consistent agreement about the diagnosis among experts. This paper summarizes some of these relevant issues in adjudicating violent crimes.

Perícia psicológica no abuso sexual de crianças e adolescentes

Ao mesmo tempo em que denúncias de abuso sexual contra crianças e adolescentes são frequentes, implicando em medidas protetivas urgentes para as vítimas e punições para os perpetradores, também são crescentes os casos de falsas denúncias. Este artigo tem como principal objetivo revisar, com base na literatura nacional e internacional recente, o papel da perícia psicológica no abuso sexual infantojuvenil. Na comum inexistência de vestígios físicos, uma avaliação psicológica abrangente demonstra-se imprescindível, devendo integrar diferentes fontes de informação e indicadores, já que alguns destes são contraditórios e inespecíficos. O perito deve possuir formação na área de atuação e conhecimentos sobre a legislação vigente, além de assegurar que a avaliação não se torne um elemento abusivo para o periciado.

Non-verbal behavior of children who disclose or do not disclose child abuse in investigative interviews

OBJECTIVE

The study focused on children's nonverbal behavior in investigative interviews exploring suspicions of child abuse. The key aims were to determine whether non-verbal behavior in the pre-substantive phases of the interview predicted whether or not children would disclose the alleged abuse later in the interview and to identify differences in the nonverbal behaviors of disclosing and non-disclosing children.

METHOD

We studied DVD-recorded interviews of 40 alleged victims of child abuse. In all cases, there was external evidence strongly suggesting that abuse had occurred. However, half of the children disclosed abuse when interviewed using the NICHD Investigative Interview Protocol, whereas the other half did not. Two raters, unaware whether or not the children disclosed, independently coded the videotapes for nonverbal indices of positive and negative emotions, stress, and physical disengagement in each 15-second unit of the introductory, rapport building, and substantive interview phases.

RESULTS

Indicators of stress and physical disengagement increased as the interviews progressed while indices of positive emotions decreased. Non-disclosers showed proportionately more physical disengagement than disclosers in both the introductory and substantive phases.

CONCLUSIONS

Awareness of non-verbal behavior may help investigators identify reluctant children early in forensic interviews.

PRACTICE IMPLICATIONS

There is substantial evidence that, when questioned by investigators, many children do not disclose that they have been abused. The early detection of reluctance to disclose may allow interviewers to alter their behavior, helping the children overcome their reluctance by providing non-suggestive support before the possibility of abuse is discussed. Of course, nonverbal behavior alone should not be used to assess children in investigative interviews. However, nonverbal cues may nonetheless provide additional information to interviewers and assist them in identifying reluctant children.