Child sexual abuse: seven years in practice

The lifetime prevalence of child sexual abuse assessed in young adults in Lithuania

OBJECTIVE

We examined the prevalence of different types of childhood sexual abuse (CSA) in Lithuania focusing on how these experiences were related to victim's age and relationship to the perpetrator.

METHODS

The participants came from a representative household survey of youth aged 18-29 and the sample consisted of 2000 participants (47.7 % women) with a mean age of 23.9 years (SD = 3.6). The ISPCAN Child Abuse Screening Tool Retrospective version (ICAST-R, Dunne et al., 2009) for young adults was used to investigate childhood exposure to CSA. Both current sociodemographic information and information on circumstances during childhood (e.g., number of siblings, family members with whom the participant lived between 7 and 12 year of age) were collected.

RESULTS

The prevalence of any CSA experience before the age of 18 was 15.9 %, with higher rates for women (13.5 % and 18.5 % for men and women, respectively). Being spoken to in a sexual way or sexual things being written about the person was the most prevalent form of CSA. In contrast, number of victims that reported sexual intercourse was much lower. The most common type of perpetrator was another young person. Intrafamilial CSA was rare with higher risk in step-relationships.

CONCLUSIONS

Our study provides representative prevalence estimates of the CSA in a region for which such estimates were not previously available. These Lithuanian estimates correspond well with previous literature. Importantly, the findings point to peers being an important perpetrator group in CSA cases. This and other findings can inform the planning of relevant policy measures and actions to both prevent CSA and investigate cases effectively.

Examining the Awareness Levels of Parents on Child Sexual Abuse

Introduction:

Child sexual abuse (CSA) is defined as all kinds of actions that an adult uses a child for sexual purposes. The studies concluded that parents have incomplete or incorrect information and the protection of children against abuse is the fundamental duty of parents. This study analyses the CSA awareness levels of parents.

Methods:

Descriptive survey model is performed. The research sample covers 455 parents. The Child Sexual Abuse Awareness Scale for Parents and a demographical information form was used for research data collection and analyzed on SPSS 21.0 software.

Results:

A statistically significant difference was found between parents’ CSA awareness levels and age, gender, marital status, duration of marriage, education level, and number of children. The results showed that parents who were married for up to 10 years had a university degree, had only 1 child, and had higher awareness of sexual abuse myths. Contrary to expectations, no significant results were obtained regarding the signs of sexual abuse scores of groups with high awareness of myths of sexual abuse.

Implications for Research and Practice:

Contrary to the literature, the awareness levels of fathers about CSA are lower than the awareness levels of mothers, and the awareness levels of parents decrease as they get older. There is a need for further comprehensive and more scientific studies to identify the CSA problem in North Cyprus and propose solutions, and consequently prevention programs should be developed for professional groups that are related with child and parents.

Parent-child communication and preventive practices for child sexual abuse among the general population: A community-based study

Objectives

This study was conducted to investigate parent–child communication and preventive practices centred on child sexual abuse among a cohort of Saudi population.

Methods

A cross-sectional descriptive study was carried out at a single primary health care centre (PHC) in Dammam city, KSA. Parent–child communication and preventive practice were measured by a Self-Reporting Questionnaire with binary answers (yes/no). A total of 400 subjects were selected using a stratified random sampling method.

Results

This study found that 82.5% (n = 329) of parents talked with their children about the latter's bodily privacy. With regard to supervision, most parents (91.7%) said that their children were under their direct supervision all the time. Other variables wear wearing appropriate clothes (94.7%), supervision (93.5%), and teaching a child about their bodily privacy (93.2%). A majority of the respondents (76.2%) were achieved a good preventive practice score, while 95 (23.8%) were observed to have poor communication practice. Logistic regression analyses for gender (p < 0.020; odds ratio 3.031; 95% CI), marital status (p < 0.026; odds ratio 0.081; 95% CI), and family size of more than one wife (p < 0.041; odds ratio 0.081; 95% CI) were significantly associated with good preventive practice.

Conclusion

The study showed that parent–child communication practices in KSA seem to be reasonably good. Further parental supervision of children with respect to sexual abuse needs attention. Parents are advised to communicate with their children and to provide them with information and material on the prevention of sexual abuse.

An Overview of a Hospital-Based Child Advocacy Center's Experience from Turkey

The purpose of the present study was to investigate sociodemographic variables, features of sexual abuse (SA), and first psychiatric evaluation results of abused children, and to analyze the relation of the psychiatric evaluation results to the children's age and gender, type and duration of abuse, abuser-child relationship, and marital status of the children's parents, at one of the most experienced Child Advocacy Centers (CACs) in Turkey. All data were obtained from reports prepared by child and adolescent psychiatrists. The sample of this study consists of 436 child sexual abuse (CSA) cases who admitted İzmir CAC between April 2014 and November 2015. The statistical analyses yielded significant relations between psychiatric symptoms and chronic abuse, the gender of the children, and type of abuse. Suicidal ideation and behaviors due to sexual abuse (SA) were also examined. According to our results, it is fair to say that children exposed to SA benefit from immediate psychiatric help because of their vulnerability for psychiatric disorders due to abuse. In this context, CACs are very important multidisciplinary establishments to determine children's multiple needs to ease their trauma with collaborative teamwork. Psychiatric evaluation should be part of this multidisciplinary context.

The Effect of Sexual Abuse on Deviant Behaviors Among Turkish Adolescents: The Mediating Role of Emotions

Drawing from Robert Agnew's General Strain Theory, the purpose of this study is to examine the effect of sexual abuse on deviant behaviors, such as suicide, smoking, drinking, drug use, violent crime, and property crime, among Turkish adolescents. The article also aims to understand the mediating role of negative emotions, including depression and anger, as well as gender differences in this relationship. Findings from a series of analyses demonstrate that the experience of sexual abuse is significantly related to the likelihood of engaging in most of the deviant behaviors. In addition, the mediating role of negative emotions, particularly anger, was highlighted in the findings. Furthermore, the effect of sexual abuse on deviant behaviors was relatively greater for Turkish males compared with Turkish females. The current study contributes to the literature on the consequences of sexual abuse by considering them within the unique Islamic-Western cultural context of Turkey. Overall, findings suggest that this particular form of strain has a substantial impact on deviant behaviors among Turkish adolescents.

Evaluation of Bikers Against Child Abuse (BACA) program: A community intervention for child abuse victims

Children who have experienced physical abuse benefit from a multitude of community interventions including support programs to address emotional and behavioral stability. This pilot study evaluated the services of Bikers Against Child Abuse (BACA), a community of bikers lending intervention to abused children, using a pre/post exploratory design. Participants (N=154) were children who had been referred by parents/guardians for current or past physical and/or sexual abuse. Parents/guardians of children were interviewed four times over a course of one year. Results indicated children demonstrated substantial improvements in their overall levels of emotional distress, conduct concerns, hyperactivity, and behavioral and emotional functioning. Overall, results support the premise that services provided by BACA may serve as a unique intervention for children who have experienced abuse.

A Nonrandom Sample of 55 Sexual Abuse Cases in Sivas

BACKGROUND Sexual abuse in childhood is a significant public health problem because of the destructive results both to the individual and to the community. The aim of this study was to examine the sociodemographic characteristics of children who were victims of sexual abuse, the relationship of the victim and abuser, and the findings of sexual abuse. MATERIAL AND METHODS An examination was made of the results of forensic medicine and psychiatric evaluations of child victims of sexual abuse. The sociodemographic characteristics of the cases and the characteristics of the incidents of sexual abuse were evaluated at the Forensic Medicine Department of Cumhuriyet University between 2013 and 2016. RESULTS A total of 55 cases were included in the study, comprising eight males (14.5%) and 47 females (85.5%) in the age range of 5-17 years. The vast majority of the cases were high school students. The place of the abuse incident was the home of the victim or the perpetrator in 29 cases (52.7%). The sexual abuse was determined to be bodily penetration in 32 cases (58.1%). In 32 cases (58.1%), the perpetrator was known to the victim. CONCLUSIONS The study findings that the perpetrator of the sexual abuse was known to the child, that predominantly female children were attacked, and the low sociocultural level of the cases were consistent with other studies reported in the literature. To prevent sexual abuse of children, to make an early diagnosis, and to provide rehabilitation for the abused children, it is essential that the evaluations of these cases are made using a professional multidisciplinary approach.

The Psychiatric Consequences of Child and Adolescent Sexual Abuse

INTRODUCTION

The purpose of this study was to investigate the psychiatric consequences of sexual abuse and its associated factors in children and adolescents referred to our child and adolescent psychiatry clinic from official medico-legal units.

METHODS

All victims of sexual abuse (n=590) aged 1-18 (mean: 13.56±3.38) referred from forensic units to Ondokuz Mayis University Child and Adolescent Psychiatry Clinic over a period of 2 years [boys: 83 (14.1%); girls: 507 (85.9%)] were included. Child and adolescent psychiatry and forensic medicine specialists evaluated all the cases. The Wechsler Intelligence Scale for Children-Revised Form (WISC-R) and the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version-Turkish Version (K-SADS-PL-T) were applied.

RESULTS

Abuse-related psychiatric diagnoses (of which 45.9% were major depressive disorder and 31.7% were post-traumatic stress disorder cases) were made in 75.2% of the cases. In 80.3% of the cases, the perpetrators were known to their victims [incest, n=91 (15.1%)], and intercourse took place in 48.8%. Although gender and age were not significantly associated with the appearance of any psychiatric disorders, severity of abuse (e.g., intercourse; p=.006), additional physical assault (p<.001), and incest (p<.001) had a significant correlation with psychiatric disorders. To explore the predictive value of multiple factors in the appearance of any sexual assault-related psychiatric disorder, a logistic regression model was used to determine the best linear combination of age, gender, abuse severity, incest, involvement of any other victim, additional physical assault, and length of time from first abuse to first psychiatric evaluation. This combination of variables (occurrence of incest, additional physical assault, and a long duration from first abuse to first psychiatric evaluation) significantly predicted the appearance of a psychiatric disorder of any kind (χ²=55.42; df=7; n=522; p<.001).

CONCLUSION

Our findings reveal that the occurrence of incest, additional physical assault, and a long duration from first abuse to first psychiatric evaluation predict higher rates of sexual abuse-related psychiatric disorders.

Gender-related sexual abuse experiences reported by children who were examined in an emergency department

The purpose of this study was to examine the experiences of sexual abuse by 95 children of two gender groups to determine differences in their reported sexual exploits by perpetrators. Significant differences between female and male children were reported. Male child-victims experienced more anal penetration by penis (54.5%, 10.7% respectively) and finger (27.3%, 2.7% respectively), however; female child-victims experienced more mouth contact to their genitalia (22.7%, 10.0% respectively) and body kisses (47.9%, 9.1% respectively). A more gender-specific approach could help to facilitate prevention, and produce better outcomes.

Training Mental Health Professionals in Child Sexual Abuse: Curricular Guidelines

Given the incidence of child sexual abuse in the United States, mental health professionals need training to detect, assess, and treat victims and should possess a clear understanding of the process of victimization. However, many mental health professionals who work with children and families have not been exposed to any training in child sexual abuse during their formal education. This article will examine the need for such training, suggest critical components of child sexual abuse training, and describe various methods of training (e.g., in person, Web-based, and community resources).

Early-married and sexually abused girls differ in their psychiatric outcomes

Early marriage and sexual abuse are the two of the most frequent types of childhood abuse. Although early marriage is also a type of sexual abuse, it is associated with different physical, social, and mental outcomes than sexual abuse alone. The purpose of this study was to compare early-married girls and sexually abused girls who were referred for forensic evaluation in Turkey in terms of their sociodemographic characteristics, mental disorder rates, and mental symptom severity. We included 63 adolescent girls for whom a judicial report had been demanded and who were under 15 years old when they were married but were not yet 18 years old during the evaluation (15.51±0.78) and 72 sexually abused adolescent girls between 14 and 18 years old (15.80±1.10) in this study. Following a psychiatric evaluation, the study participants completed the Child Posttraumatic Stress Disorder Reaction Index (CPTS-RI) and the Brief Symptom Inventory (BSI). We used the Windows SPSS 16.0 software program to assess the results. At least one psychiatric disorder was determined in 44.4% of the early-married and 77.8% of the sexually abused cases (p<0.001). A diagnosis of PTSD or ASD was observed in 11.1% of the early-married cases and in 54.2% of the sexually abused victims (p<0.001). MDD was determined in 33.3% of the early-married cases and 56.9% of the sexually abused cases (p=0.006). The CPTS-RI scores of the sexually abused victims were higher than those of the early-married cases (p<0.001). All of the subscale scores of the BSI were higher in the sexually abused adolescents than in the early-married cases (p<0.001). Although early marriage has severe physical, social and mental outcomes, it is not as severe as sexual abuse in terms of psychiatric disorder rates and the psychiatric symptom severity it causes.

Child abuse and neglect in Turkey: professional, governmental and non-governmental achievements in improving the national child protection system

Since ratification of the United Nations Convention on the Rights of the Child in 1995, significant efforts were made in Turkey to improve protection of children from abuse and neglect. The government took steps to amend relevant laws. Several state departments recognized the need for professional in-service training of relevant governmental agency staff. University hospitals established numerous hospital-based multidisciplinary child protection centres. The government established an Interministerial Higher Council, which has been overseeing the foundation of 13 child advocacy centres for a multidisciplinary and interagency response to child sexual abuse. In addition to undertaking research, non-governmental organizations contributed to this process by instituting professional and public education. These ground-breaking developments in the last decade give promise of even further improvement in the national child protection system from investigative, child protective and rehabilitative perspectives.

Genital trauma in prepubertal girls and adolescents

PURPOSE OF REVIEW

To look critically at recent research articles that pertain to children and adolescents who present with genital injuries.

RECENT FINDINGS

Emerging evidence supports links to long-term psychological sequelae of child sexual abuse. Parents should be educated to instruct their children regarding types of child abuse and prevention. 'Medicalization' of female genital mutilation (FGM) by health providers, including 'cutting or pricking', is condemned by international organizations.

SUMMARY

Genital injuries whether accidental or intentional need to be reported with standardized terminology to allow for comparisons between reported outcomes. Motor vehicle accidents associated with pelvic fractures may result in bladder or urethral trauma. Adverse long-term psychosocial behaviors may be sequelae of child sexual abuse. FGM is willful damage to healthy organs for nontherapeutic reasons, and a form of violence against girls and women. Healthcare providers should counsel women suffering from the consequences of FGM, advise them to seek care, counsel them to resist reinfibulation, and prevent this procedure from being performed on their daughters.

Reported child sexual abuse in Bahrain: 2000-2009

BACKGROUND AND OBJECTIVE

Child sexual abuse (CSA) is a common problem with severe short and long-term consequences to the abused child, the family and to society. The aim of this study was to evaluate the extent of CSA, and demographic and other characteristics of the abused and their families.

DESIGN AND SETTING

Retrospective and descriptive study based on a review of medical records of CSA cases from 2000-2009 at Sulmaniya Medical Complex, the main secondary and tertiary medical care facility in Bahrain.

PATIENTS AND METHODS

The review included demographic data, child and family characteristics, manifestations and interventions.

RESULTS

The 440 children diagnosed with CSA had a mean age of 8 years (range, 9 months to 17 years); 222 were males (50.5%) and 218 were females (49.5%). There was a steady increase in cases from 31 per year in 2000 to 77 cases in 2009. Children disclosed abuse in 26% of cases, while health sector professionals recognized 53% of the cases. Genital touching and fondling (62.5%) were the most common form of CSA, followed by sodomy in 39%. Gonorrhea was documented in 2% of the cases and pregnancy in 4% of the females. The illiteracy rate among the fathers and mothers was 9% and 12%, respectively, which is higher than the rate among the adult general population. Children came from all socio-economic classes. There was referral to police in 56%, public prosecution in 31% of the cases, but only 8% reached the court.

CONCLUSION

During ten years there has been a 2.5% increase in reported cases of CSA. Improving the skill of professionals in identifying CSA indicators and a mandatory reporting law might be needed to improve the rate of recognition and referral of CSA cases. Further general population-based surveys are needed to determine more accurately the scope of CSA and the risk and protective factors in the family and community.