Child sexual abuse: the suffering untold

Addressing sexual assault in Pakistan: Insights from an analysis of female survivors at Lahore General Hospital

BACKGROUND & OBJECTIVE

Rape is a severe kind of sexual violence that represents a significant violation of human rights. The objective was to investigate the demographic and clinical features of female survivors of sexual assault in Lahore, Pakistan.

METHOD

A retrospective study was conducted at the Department of Forensic Medicine of Lahore General Hospital, analysing records of female sexual assault survivors investigated by affiliated police stations from November 2020 to November 2022. Data were collected from medicolegal certificates and medical notes and analysed using SPSS software.

RESULT

282 female survivors reported to Lahore General Hospital's Forensic Medicine Department, aged 5-55 years, with a mean age of 22.74 ± 8.30. A significant proportion (50.4%) were aged 16-25 years. Most survivors were examined between 6 and 24 h (34%) and 2-7 days (37.9%) after the assault, with the majority (95%) exhibiting well-developed secondary sexual characteristics. Sexual assault and physical abuse were both reported in 56.4% of cases. In 77% of cases, the perpetrator was known, and in 36.5% of cases, a weapon was used. No external body injury was observed in 74.8% of cases, and 2.8% showed signs of fresh hymen rupture. The study identified 92.2% of cases lost to follow-up.

CONCLUSION

This study highlights the pressing need to implement effective measures to prevent and address rape in Pakistan. The findings emphasise the need for education, improved forensic infrastructure and policy reforms to address sexual assault effectively.

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.

Trapped in a Maze: Arab Teachers in Israel Facing Child Sexual Abuse Among Their Pupils

Cultural contexts are formative of and fundamental to how individuals understand, conceptualize, and act within a context of violence. Conceptually and methodologically, however, research from a culturally informed perspective on the experiences of teachers contending with the violence of child sexual abuse (CSA) in particular is broadly limited. As educators frequently confront cases of CSA in their everyday work, their ability to promote detection, disclosure intervention, and especially prevention gives them the potential to be agents of social change; however, while their responsibilities are critical, they are simultaneously members of their communities and cultures, and their interactions are bound by these dynamics. The purpose of the study is to analyze the experiences of Arab teachers in Israel who confront CSA in their everyday work. The findings are based on qualitative thematic analysis of semi-structured interviews conducted with 30 female Arab teachers working within the Arab school system in Israel. Results indicate that when facing CSA, the teachers experience an ongoing conflict between their cultural and professional codes, trapping them in a maze of intertwining and oppositional demands. On the one hand, they are constrained by the norm of protecting the honor and maintaining the status and reputation of those involved, including themselves; on the other hand, as empathetic professionals, they desire to aid their pupils. While the participants do not accept the status quo, they are effectively at a loss as to how to change it. In order find a way out of their entrapment in coping with CSA among their pupils, the only currently available path is to act as a lone hero; there is, however, the potential to foster the development of a secondary culture within the school to inaugurate cultural change in coping with CSA. Implications for future research, policy, and practice are discussed.

Diverse psychiatric presentation associated with child sexual abuse: Case series

Child sexual abuse (CSA) occurs when a person involves the child in sexual activities for his/her sexual gratification, commercial gain, or both. We report a series of 12 cases of CSA, who presented to the psychiatry department with diverse psychiatric presentations associated with CSA. In most of these cases, the perpetrator was unmarried and known to the child. The presentation was varied with patients being diagnosed with obsessive-compulsive disorder, schizophrenia, acute and transient psychotic disorder, dysthymic disorder, recurrent depressive disorder, acute stress reaction, conversion disorder, borderline personality disorder, and moderate depressive episode with somatic symptoms. Individual and family counseling was an important part of management of these cases along with pharmacotherapy. More vigilance about CSA and mental health in all categories of health-care personnel would help in early detection and timely management of these cases.

Randomized controlled trial of the Child Protection Unit: Grade and gender as moderators of CSA prevention concepts in elementary students

BACKGROUND

Despite the importance of child sexual abuse (CSA) prevention, there are few recent randomized controlled trials of school-based CSA prevention programs.

OBJECTIVES

(1) To evaluate the effects of the Second Step Child Protection Unit (CPU) on students' CSA prevention concept knowledge, ability to recognize, report, and refuse unsafe touches, and perceptions of teacher-student relations and (2) investigate the moderating role of age and gender on program effectiveness.

PARTICIPANTS AND SETTING

Eight elementary schools in a large suburban school district in the northeast United States were randomly assigned to the intervention or control condition, with analyses conducted on a total of 2172 students.

METHODS

Students in intervention schools received the 6-week CPU and those in the control schools were exposed to business as usual. Students were administered assessments at baseline and then at post-test.

RESULTS

Univariate Analyses of Covariance revealed that students in the intervention schools had significantly higher scores on all outcomes than students in the control schools at post-test, even after controlling for baseline scores. Children in younger grades made greater gains from the program, and girls scored higher than boys in CSA knowledge and ability to recognize, refuse, and report unsafe touches, but both boys and girls made significant gains.

CONCLUSIONS

Results support the importance of beginning early with school-based CSA prevention efforts. Although boys are still at a relative disadvantage in terms of their knowledge and ability in this area, they are able to make gains at the same rate as girls.

Teacher Outcomes from the Second Step Child Protection Unit: Moderating Roles of Prior Preparedness, and Treatment Acceptability

Teachers play a critical role in child sexual abuse (CSA) prevention and intervention efforts. We examined the impact of the Second Step Child Protection Unit (CPU) on improving teacher awareness, attitudes, and teacher-student relations for 161 teachers. Teacher baseline scores and treatment acceptability were examined as moderators. Structural equation modeling (SEM) revealed a significant effect of the CPU on teachers' awareness, attitudes, and teacher-student relations, particularly for teachers with lower prior knowledge, attitudes, and student relationships. Teachers' acceptability of the CPU also moderated outcomes, where a higher level of acceptability of CSA interventions was associated with an increase in outcomes.