Organized sexualized and ritual violence: Results from two representative German samples

BACKGROUND

Organized sexualized and ritual abuse (ORA), a contentious issue since the 1980s, remains a polarizing topic. Although there is much debate about the existence of this phenomenon, a differentiated perspective is lacking, and no representative study has yet addressed the frequency.

OBJECTIVE

This paper aims to investigate the frequency of ORA in Germany using two representative datasets.

PARTICIPANTS AND SETTING

Data were collected from representative samples of the German population (N = 2522, N = 2515). Participants aged 16 to 96 years (50 and 53 % female) were recruited. They were selected by a random route procedure and asked to fill out a paper-pencil-questionnaire.

METHODS

The four aspects of ORA (severe sexual violence, perpetrator networks, commercial exploitation, ideology) were assessed based on the definition provided by an expert group. Additionally, in the second survey, a direct yes/no question about the experience of ORA as well as details on perpetrators and offense characteristics were surveyed.

RESULTS

Frequency of ORA was low. The direct question on ORA was affirmed by 0.5 % (n = 13), while according to the criteria of the definition, only 0.2 % or less of individuals experienced organized sexualized abuse, and <0.1 % experienced ritual abuse.

CONCLUSION

Although ORA is discussed thoroughly, frequencies in the German population are low. This may be due to inconsistent terminology and operationalization of definitions with lack of precision. However, an intersection of conspiracy beliefs and the topic of ritual violence sheds another light on this issue that should receive more attention.

A web-based psychological support program for caregivers of children with rare chronic diseases: a randomized controlled trial

BACKGROUND

Approximately 50% of rare diseases have symptom onset during childhood. A high level of nursing care and an often uncertain prognosis put caregivers of the affected children at high risk for psychological distress. At the same time, their caregivers have limited access to appropriate psychological care. The aim of this study was to evaluate a web-based psychological support program for caregivers of children with chronic rare diseases (WEP-CARE).

METHODS

German-speaking parents (recruited between May 2016 and March 2018) caring for children aged 0-25 years with a rare disease showing clinically relevant anxiety symptoms, were assigned to either the WEP-CARE (n = 38) or treatment as usual (n = 36) condition within a randomized controlled trial. The primary outcome measure was parental anxiety, assessed with the Generalized Anxiety Disorder Questionnaire (GAD-7). Secondary outcomes were fear of disease progression, depression, coping, quality of life and user satisfaction. The group differences were tested through repeated-measures analyses of variance. The WEP-CARE group was additionally followed up three months after the treatment.

RESULTS

A significant time-group interaction was found for anxiety (F (1,35) = 6.13, p = .016), fear of disease progression (F (1,331) = 18.23, p < .001), depression (F (1,74) = 10.79, p = .002) and coping (F (1,233) = 7.02, p = .010), suggesting superiority of the WEP-CARE group. Sustainability of the treatment gains regarding anxiety, fear of disease progression and coping was confirmed at the 6-month follow-up assessment (p < .01). A significant interaction effect could not be found for quality of life (F(1,2) = 0.016; p = .899). Both participating parents and therapists were satisfied with WEP-CARE.

CONCLUSIONS

Our results underline the efficacy and feasibility of WEP-CARE for parents of children with various rare diseases.

Long-term mental health consequences of female- versus male-perpetrated child sexual abuse

BACKGROUND

Research on child sexual abuse increasingly focuses on sexually offending females; however, there is a lack of research that focuses on the individuals being affected. Studies have suggested that the consequences for those affected by sexually offending males and females are comparable.

OBJECTIVE

The aim is to compare mental health consequences of sexual abuse perpetrated by women versus men in quantity and type.

PARTICIPANTS AND SETTING

Data was anonymously retrieved from the German-wide contact point "help line sexual abuse" from 2016 to 2021. Details of abuse cases, gender of the offending individuals, and reported mental disorders of the person affected were analyzed. The sample consisted of N = 3351 callers with experiences of child sexual abuse.

METHOD

The relationship between gender of the perpetrating person and mental disorders of the victimized person was computed using logistic regression models. To account for rare events data, Firth's logistics regression model was used.

RESULTS

The consequences were similar in quantity, albeit different in type. Callers with experiences of female-perpetrated abuse were more likely to report suicidality, non-suicidal self-injury behavior, personality disorders, dissociative identity disorders, alcohol/ drug addiction, and schizophrenia, while people with experiences of male-perpetrated abuse rather reported post-traumatic stress disorder, affective disorders, anxiety disorders, dissociative disorders, eating disorders, externalized disorders, and psychosomatic disorders.

CONCLUSIONS

The differences may be due to stigmatization leading to dysfunctional coping mechanisms. Societal gender stereotypes must be reduced, especially within the professional helping system to ensure support for people who have experienced sexual abuse, regardless of gender.

Basic knowledge in child protection– evaluation of an online-course for webbased transfer of interprofessional basic knowledge in child protection

Introduction

Insufficient or faulty cooperation between the various child protection professions can have an extremly negative impact on the well-being of the concerned children. Communication problems that were revealed when dealing with cases of child abuse show the importance of adequate cooperation and common language of the involved professions in child protection.

Objectives

An online-course adressing medical-therapeutic professionals, youth welfare as well as judiciary and police was developed to impart skills and knowledge in child protection to create interdisciplinary understanding and improve cooperation between the involved professions.

Methods

The acquisition of competencies, the transfer of learning content into everyday work and the quality of the online-course are determined using an online-survey before starting (t1) and after completing (t2) the course. T1-assessment is currently being evaluated with 1034 datasets, t2-assessment will take place 03/2022.

Results

Intended target groups could be accessed and participated in the online-course, although the ratio of medical-therapeutic participants was greater than of judiciary professionals. Specific results of T1- and T2- assesssment and comparing analyses are expected in March 2022 and will be presented.

Conclusions

Based on existing online-courses developed by the Universityhospital Ulm, the suitability of online-education for training professionals in the field of child protection could be proven. If comparable effects can be shown for this online-course, there is an increase in evaluated offers of high quality. These enable comprehensive and low-threshold access to the subject of interdisciplinary communication and cooperation in child protection for involved professionals.

Disclosure

No significant relationships.

The Predictors of Awareness of Sexual Abuse and Sexual Violence in the Media and the Influence on Actions of the Individuals

Introduction: The number of reportings on sexual abuse (SA), sexual violence (SV) cases covered in the media has risen a significant amount with most cases involving women and children. The aim of the study is to explore the questions: Are people aware of sexual abuse and sexual violence in the media? What are the predictors of awareness of sexual abuse and sexual violence? Does the awareness of sexual abuse and sexual violence in the media affect the actions of the individuals? Methods: A representative survey of the German-speaking resident population (2020) on physical and mental well-being was used. The participants (N = 2,503: females = 50.9%) were between the ages of 14 and 97 (M = 49.81). The German version of the Adverse Childhood Experiences Questionnaire, The General Habitual Well-Being Questionnaire and questions about own experiences of sexual harassment on the internet, experiences of domestic sexual abuse and different socio-economic variables were used. The outcome variables regarding the awareness of SA and SV in the media, different types of scandals (church, pedophile, USA), #MeToo-debate and the change in actions were used. Frequency analyses and binary regressions were conducted. Results: One thousand five hundred and fifty-five (62.6%) respondents answered yes to being aware of SA and SV in the media. The results show that females, aging, number of children in household, Protestant and Catholic religion, school graduation, own experience(s) of sexual harassment on the internet, own experience(s) of SA in childhood, and Adverse Childhood Experiences have a significant higher association to the awareness of SA and SV in the media. German nationality and Muslim religion have a significant lower association. The variables that most commonly affected the awareness of SA and SV, scandals, debate and the individual actions were age, own experiences of sexual harassment on the internet and the Protestant religion. Conclusion: Advertising more support centers, hotlines and linking this information to sexual abuse cases covered in the media should be considered. Media bystander interventions could be helpful to train people to react appropriately. Further investigation that considers the different types of media and its influence on the awareness of SA and SV is needed.

Ecological momentary intervention to reduce suicide risk among adolescents (EMIRA)

Suicide is among the leading causes of death among adolescents and suicide risk is particularly high after discharge from psychiatric inpatient care. Therefore, interventions to reduce suicidal thoughts and behaviours (STBs) among adolescents discharged from psychiatric inpatient care are integral for successful suicide prevention among this group. However, such interventions are scarce. EMIRA aims to close this important gap in mental health services by developing an ecological momentary intervention (i.e., intervention delivered in real-time and within one's natural setting) consisting of a personalized, automatically triggered crisis support smartphone app to reduce STBs after discharge from psychiatric inpatient care among adolescents aged 14-21 years at risk for suicide. First, we will conduct qualitative interviews with adolescents aged 14-21 years who previously experienced STBs, their parents and health care providers to identify their intervention needs and safety concerns regarding ecological momentary assessment (EMA). Next, we will investigate the short-term variability of STBs and their cognitive and physiological risk factors among adolescents aged 14-21 years using EMA (app-based self-report + wrist worn device). Based on our results and past research we will develop a personalized crisis support smartphone app (mobile safety planning) that is not only self-accessible but starts automatically based on the presence of pre-identified STB risk factors. Finally, we will conduct two consecutive studies to test the feasibility, efficacy and cost-effectiveness of the developed ecological momentary intervention in reducing STBs after discharge from psychiatric inpatient care among adolescents aged 14-21 years at risk for suicide. EMIRA has great potential to close a crucial gap in adolescent mental health services and significantly improve suicide prevention among this group.

Häufigkeiten von Übergriffen auf Kinder und Jugendliche durch Angehörige der Heil- und Pflegeberufe

Zusammenfassung. Theoretischer Hintergrund: Kindesmisshandlung, -missbrauch und Vernachlässigung stellen ein gesamtgesellschaftliches Entwicklungsrisiko für Kinder in Deutschland dar. Zweithäufigster Kontext des Geschehens nach dem familiären Umfeld sind Institutionen. Fragestellung: Der vorliegende Artikel gibt eine Übersicht zu Häufigkeiten von Übergriffen durch Angehörige der Heil- und Pflegeberufe mit Schwerpunkt auf dem kinder- und jugendpsychiatrischen/-psychotherapeutischen Bereich. Methode: Mittels Literaturrecherche wird der Forschungsstand zum Thema dargestellt. Ergebnisse: Neben Auswertungen zu Zwangsmaßnahmen, welche von Betroffenen häufig als viktimisierend erlebt werden, existieren für Deutschland zwei repräsentative retrospektive Befragungen zum medizinischen Bereich. Hier ergaben sich Prävalenzen zwischen einem Fünftel und einem Drittel der Befragten, die mindestens eine Form von Gewalt oder Vernachlässigung bejahten. Diskussion und Schlussfolgerung: Neben alarmierenden Zahlen zeigt sich der große Bedarf an weiterer Forschung zum Thema.

Mothers as perpetrators and bystanders of child sexual abuse

BACKGROUND

In research and literature, little attention has been paid to the role of women, especially mothers, in child sexual abuse.

OBJECTIVE

In order to estimate prevalences on mothers as perpetrators and bystanders, data was collected in a German nationwide representative survey.

PARTICIPANTS AND SETTING

A total of 2,531 participants (53.3 % female, 14-94 years) were selected by a random route procedure and questioned with a paper-pencil-questionnaire.

METHODS

The survey included the Childhood Trauma Questionnaire as well as questions on the perpetrator-victim relationship, bystanders and the awareness within society on the topic of female-perpetrated child sexual abuse. Prevalences were calculated.

RESULTS

The prevalence of child sexual abuse (6.6 %) as well as the proportion of female perpetrators (6.6 %) determined in the current survey were low compared to the findings of previous studies. Within the group of female perpetrators, biological mothers accounted for a larger share than biological fathers in the group of male perpetrators. Among the bystanders, the biological mother was named most frequently (24.6 %).

CONCLUSION

The general population underestimates the involvement of biological mothers in child sexual abuse. The results confirm that female perpetrators account for a rather small but substantial proportion of the perpetrators of child sexual abuse. Furthermore, the results indicate that mothers play a role in sexual abuse - either as perpetrators or as bystanders - that has been underestimated so far. It is therefore necessary to sensitize professionals and the public to the topic of female perpetrators and especially to the role of mothers in child sexual abuse.

Evaluation of two family-based intervention programs for children affected by rare disease and their families - research network (CARE-FAM-NET): study protocol for a rater-blinded, randomized, controlled, multicenter trial in a 2x2 factorial design

Background

Families of children with rare diseases (i.e., not more than 5 out of 10,000 people are affected) are often highly burdened with fears, insecurities and concerns regarding the affected child and its siblings. Although families caring for children with rare diseases are known to be at risk for mental disorders, the evaluation of special programs under high methodological standards has not been conducted so far. Moreover, the implementation of interventions for this group into regular care has not yet been accomplished in Germany. The efficacy and cost-effectiveness of a family-based intervention will be assessed.

Methods/design

The study is a 2x2 factorial randomized controlled multicenter trial conducted at 17 study centers throughout Germany. Participants are families with children and adolescents affected by a rare disease aged 0 to 21 years. Families in the face-to-face intervention CARE-FAM, online intervention WEP-CARE or the combination of both will be treated over a period of roughly 6 months. Topics discussed in the interventions include coping, family relations, and social support. Families in the control condition will receive treatment as usual. The primary efficacy outcome is parental mental health, measured by the Structured Clinical Interview for DSM-IV (SCID-I) by blinded external raters. Further outcomes will be assessed from the parents’ as well as the children’s perspective. Participants are investigated at baseline, 6, 12 and 18 months after randomization. In addition to the assessment of various psychosocial outcomes, a comprehensive health-economic evaluation will be performed.

Discussion

This paper describes the implementation and evaluation of two family-based intervention programs for Children Affected by Rare Disease and their Family’s Network (CARE-FAM-NET) in German standard care. A methodologically challenging study design is used to reflect the complexity of the actual medical care situation. This trial could be an important contribution to the improvement of care for this highly burdened group.

Trial registration

German Clinical Trials Register: DRKS00015859 (registered 18 December 2018) and ClinicalTrials.gov: NCT04339465 (registered 8 April 2020).

Protocol Version: 15 August 2020 (Version 6.1).

Trial status: Recruitment started on 1 January 2019 and will be completed on 31 March 2021.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12875-020-01312-9.

Female-Perpetrated Child Sexual Abuse: Prevalence Rates in Germany

Research on female-perpetrated child sexual abuse, especially maternal sexual abuse, is scarce. Prevalences are assumed to be lower compared to male-perpetrated abuse; however, representative studies including female perpetrators are rare. Experiences of male- and female-perpetrated child sexual abuse were examined in a representative German sample. Questions included experiences of hands-on and penetrative sexual abuse. The perpetrator-victim relationship was assessed to calculate prevalences of maternal sexual abuse. A total of 2516 participants (54.53% female, 14-91 years) were questioned and prevalences, as well as group differences between victims of male perpetrators compared to female perpetrators, were calculated. Overall, 10.5% of all participants reported experiences of child sexual abuse. Female perpetrators were involved in 9.9% of the cases, i.e. 1.0% of all participants. Victims of female perpetrators were significantly more often male. A quarter of the adult female perpetrators were the mother figure of the child. The findings suggest that the share of female perpetrators in cases of child sexual abuse is rather small; concurrently, female perpetration is insufficiently recognized. Especially male victims seem to be at risk for sexual abuse by female perpetrators. Contacts for children especially within the professional support system need to be aware of the existence of female perpetrators.

Possibilities of dissemination of specialist knowledge and acting capacity in the field of child protection in medicine: a qualitative survey

Objective: The shortage of skilled workers and overloaded schedules make further training of health professionals difficult. In addition, child protection is not a systematic part of medical studies. The evaluation of an online course on child protection in medicine reveals positive feedback but also that the main reason for participants aborting the course is lack of time. Dissemination, as an active, targeted spreading of knowledge, can help to further spread knowledge about child protection in the target group. The aim of this article is to investigate whether and how the contents of the online course can be disseminated by professionals who have completed the online course. Methodology: The data were collected through a quantitative online evaluation and qualitative telephone interviews with doctors who had completed the online course and evaluated it using an interpretive-reductive analysis. Results: The respondents consider the need for further training and dissemination measures on the topic of child protection in medicine to be high. However, lack of time and insufficient relevance of the topic would present obstacles in the implementation of such measures. Meaningfulness and time off work or remuneration would in turn create incentives for implementation. Participants in dissemination measures could be motivated for example by further education points. In addition we were able to identify possible approaches for the implementation of such measures. Conclusion: Various parameters influence the motivation of doctors regarding the implementation/perception of dissemination measures. Based on these, recommendations for action are given for different areas of the health care system, such as supplementing the training curricula and providing ready-made materials for dissemination.

The Prevalence of Sexual Abuse in Institutions: Results From a Representative Population-Based Sample in Germany

The lifetime prevalence of sexual abuse in institutional settings in Germany was examined in a sample representative of the general adult population (N = 2,437). Participants completed a survey on whether they had ever experienced such abuse, its nature (contact, noncontact, forced sexual, intercourse), the type of institution (e.g. school, club), and the relationship of perpetrator to victim (peer, caregiver, staff member). Overall, 3.1% of adult respondents (women: 4.8%, men: 0.8%) reported having experienced some type of sexual abuse in institutions. Adult women reported higher rates of all types than did men, with rates of 3.9% versus 0.8% for contact sexual abuse, 1.2% versus 0.3% for noncontact sexual abuse, and 1.7% versus 0.2% for forced sexual intercourse. We conclude that a remarkable proportion of the general population experiences sexual abuse in institutions, underscoring the need for development of protective strategies. Especially, schools seem to represent good starting points for primary prevention strategies.

Psychosocial interventions for children and adolescents after man-made and natural disasters: a meta-analysis and systematic review

Children and adolescents are a vulnerable group to develop post-traumatic stress symptoms after natural or man-made disasters. In the light of increasing numbers of refugees under the age of 18 years worldwide, there is a significant need for effective treatments. This meta-analytic review investigates specific psychosocial treatments for children and adolescents after man-made and natural disasters. In a systematic literature search using MEDLINE, EMBASE and PsycINFO, as well as hand-searching existing reviews and contacting professional associations, 36 studies were identified. Random- and mixed-effects models were applied to test for average effect sizes and moderating variables. Overall, treatments showed high effect sizes in pre-post comparisons (Hedges' g = 1.34) and medium effect sizes as compared with control conditions (Hedges' g = 0.43). Treatments investigated by at least two studies were cognitive-behavioural therapy (CBT), eye movement desensitization and reprocessing (EMDR), narrative exposure therapy for children (KIDNET) and classroom-based interventions, which showed similar effect sizes. However, studies were very heterogenic with regard to their outcomes. Effects were moderated by type of profession (higher level of training leading to higher effect sizes). A number of effective psychosocial treatments for child and adolescent survivors of disasters exist. CBT, EMDR, KIDNET and classroom-based interventions can be equally recommended. Although disasters require immediate reactions and improvisation, future studies with larger sample sizes and rigorous methodology are needed.

The Prevalence of Sexual Violence

BACKGROUND

Sexual violence can cause severe mental and bodily harm. This is the first study of a population-based sample in Germany to assess both the frequency of the subjects' having experienced sexual violence and the frequency of their having manifested sexually aggressive behavior themselves.

METHODS

2513 persons (of whom 2422 were over age 18 and 91 were aged 14 to 18) were asked about their experiences with sexual violence in the past 12 months, either as the person committing sexual violence or as the victim of sexual violence at the hands of other adults or similarly aged adolescents.

RESULTS

0.6% (n = 6) of the men and 1.2% (n = 16) of the women surveyed, and ca. 5% (n = 4) of the adolescents surveyed, reported having been the victim of some kind of sexual violence. 1.5% (n = 15) of the men and 1.0% (n = 13) of the women reported that they themselves had manifested sexually aggressive behavior. Women were overrepresented and adolescents underrepresented in the sample, in comparison with the overall population.

CONCLUSION

These findings suggest that the prevalences of experiences of sexual violence and of sexually aggressive behavior are markedly underestimated in official crime statistics, particularly with respect to events in which women commit sexual violence and men are victims of it. Prevalences were assessed in this study from selfreported information; the findings may thus have been distorted by a tendency on the part of the informants to give answers they thought would be socially acceptable, particularly with respect to their own sexually aggressive behavior. Moreover, the small overall number of events complicates the interpretation of the findings.

[Trauma-focused Cognitive-behavioral Therapy with children and adolescents: Practice, evidence base, and future directions]

Trauma-focused cognitive behavioral therapy (Tf-CBT) is an evidence-based trauma therapy for children and adolescents aged 3–17 years with posttraumatic stress disorder (PTSD). One supportive caregiver is regularly included in the therapeutic process. Tf-CBT consists of eight components and can be summarized by the acronym P.R.A.C.T.I.C.E: Psychoeducation and Parenting skills, Relaxation skills, Affective modulation skills, Cognitive coping skills, Trauma narrative and cognitive processing of the traumatic event(s), In vivo mastery of trauma reminders, Conjoint child-parent sessions, and Enhancing safety and future developmental trajectory. Based on a total of 13 randomized controlled trials, several meta-analyses and systematic reviews confirm the efficacy of Tf-CBT, which received evidence level Ia in several international guidelines and is therefore recommended as first-line treatment for children and adolescents with PTSD.

Trauma-focused cognitive behavioral therapy with unaccompanied refugee minors: a case series

BACKGROUND

Unaccompanied refugee minors (URMs) are a group who are vulnerable to developing posttraumatic stress symptoms (PTSS). However, they rarely receive the treatment that is indicated and there are no treatment studies focusing exclusively on this group of adolescents. This case study evaluates the feasibility of trauma-focused cognitive behavioral therapy (TF-CBT) for URMs with PTSS.

METHOD

A health care utilization sample of N = 6 was assessed prior to and after treatment with TF-CBT. Therapists were asked to report differences in treatment application and content in comparison to TF-CBT standard protocol.

RESULTS

We found moderate to high levels of PTSS at baseline and a clinically significant decrease in symptoms at posttest. Some modifications to the TF-CBT protocol were made with regard to affective modulation which required more sessions than usual whereas fewer caregiver sessions were conducted.

CONCLUSION

TF-CBT is feasible in reducing PTSS in severely traumatized URMs. Further research with controlled trials is necessary.

TRIAL REGISTRATION

The trial registration: ClinicalTrials.gov Identifier NCT01516827. Registered 13 December 2011.

Hilfebedarf und Hilfsangebote in der Versorgung von unbegleiteten minderjährigen Flüchtlingen

Zusammenfassung. In den letzten Jahren kommt es zu einer deutlichen Zunahme der Zahl unbegleiteter minderjähriger Flüchtlinge (UMF) in Deutschland. Dies stellt nicht zuletzt die klinische Versorgung vor neue Fragestellungen, da es sich um eine hoch vulnerable Gruppe handelt. In der vorliegenden Übersichtsarbeit sollen die psychischen Auffälligkeiten und deren längerfristiger Verlauf beschrieben werden, um den Hilfebedarf darzustellen. In einem weiteren Schritt werden die Hilfsangebote anhand der Rückmeldungen von UMF erfasst. Das klinische Bild wurde vorrangig von einer posttraumatischen Stresssymptomatik geprägt, wobei sich im Langzeitverlauf eine hohe Stabilität psychischer Belastungen zeigte. Daneben existiert jedoch auch ein erheblicher Anteil resilienter UMF. Mehrfach wurde von den UMF der Wunsch nach Schulbildung und rascher sprachlicher Integration geäußert.

Child sexual abuse in the Roman Catholic Church in Germany: comparison of victim-impact data collected through church-sponsored and government-sponsored programs

At around the same time in 2010, the German government and the Roman Catholic Church in Germany each set up a critical incident reporting system (CIRS) to gather information on child sexual abuse that had taken place within the Church. The objective in both cases was to solicit stories from victims and former victims and allow them to have input into a review process. The existence of these two similar systems, one initiated by the institution involved in the abuse and the other by an independent entity, provided an opportunity to compare the background and motivation of victims who chose to communicate through one channel or the other. Data were obtained on a total of 927 individuals, 571 through the church CIRS and 356 through the government CIRS, who had reported that they had experienced childhood sexual abuse within the Roman Catholic Church. Some differences were found between the two groups in terms of gender, the reported frequency of abuse, and the desire for compensation. These differences highlight the need for an effective complaint management system to offer not just one but complementary channels of communication. In addition, the findings confirm the feasibility and value of a CIRS approach and the use of so-called 'citizen science' in politically driven review processes.

Child sexual abuse in religiously affiliated and secular institutions: a retrospective descriptive analysis of data provided by victims in a government-sponsored reappraisal program in Germany

Background

The disclosure of widespread sexual abuse committed by professional educators and clergymen in institutions in Germany ignited a national political debate, in which special attention was paid to church-run institutions. We wanted to find out whether the nature of the abuse and its effect on victims differed depending on whether the abuse had been experienced in religiously affiliated versus secular institutions.

Methods

In 2010, the German government established a hotline that victims could contact anonymously to describe their experiences of sexual abuse. The information provided by callers was documented and categorized. Our analysis looked at a subset of the data collected, in order to compare the nature of the abuse experienced at three types of institutions: Roman Catholic, Protestant, and non–religiously affiliated. Non-parametric tests were used to compare frequency distributions, and qualitative data were analyzed descriptively.

Results

Of the 1050 victims in our sample, 404 had been in Roman Catholic, 130 in Protestant, and 516 in non-religious institutions. The overall mean age at the time of reporting was 52.2 years. Males (59.8%) outnumbered females. Victims who had been in religiously affiliated institutions were significantly older than those who had been in secular institutions. Almost half the victims had been abused physically as well as sexually, and most victims reported that the abuse had occurred repeatedly and that the assaults had been committed by males. Patterns of abuse (time, type, and extent), and the gender of the offenders did not differ between the three groups. Intercourse was more frequently reported by older victims and by females. Similar percentages of victims in all groups reported current psychiatric diagnoses (depression, anxiety disorders, PTSD). Significantly more victims from Protestant institutions reported having current psychosocial problems.

Conclusion

The results suggest that child sexual abuse in institutions is attributable to the nature of institutional structures and to societal assumptions about the rights of children more than to the attitudes towards sexuality of a specific religion. The exploratory data arising from this study may serve as a starting point for building hypotheses, and may point the way toward improvements in prevention and intervention strategies.

Listening to victims: use of a Critical Incident Reporting System to enable adult victims of childhood sexual abuse to participate in a political reappraisal process in Germany

Recent revelations about the scope and severity of past child sexual abuse in German institutions set off a broad public debate on this issue, and led to the establishment of a politically appointed Round Table committee and an Independent Commissioner whose mandates were to reappraise the issue and develop recommendations for future policies. A media campaign was launched to publicize the establishment of a Critical Incident Reporting System (CIRS) whereby now-adult victims of past abuse could anonymously provide testimonials and let policy makers know what issues were important to them. Respondents could either call a hotline number or communicate by mail or email. The information collected was documented and analyzed by a research team, and the results of interim reports were included in the recommendations of the Independent Commissioner and the Round Table committee. Most of the respondents described severe and repeated occurrences of childhood sexual abuse. For many, priorities were improvements in therapy and counseling services, the abolishment of the statute of limitations on prosecuting offenders, and financial compensation. Based on the recommendations of the Round Table and the Independent Commissioner, two new laws were adopted as well as an action plan and some guidelines. In addition to rules for recompensation of victims in an institutional context a fund for victims of sexual abuse in intrafamilial context was established by the Federal Government. Another effect of this process was raising societal sensitivity to the problem of child sexual abuse. The use of a CIRS enabled those directly affected by childhood sexual abuse to have some input into a political process designed to address this issue. Such an approach could have applicability in other countries or in other domains of public health and other forms of societal conflict as well.

Entwicklung, Implementierung und erste Ergebnisse eines webbasierten Erhebungsrasters für die telefonische Anlaufstelle der Unabhängigen Beauftragten zur Aufarbeitung des sexuellen Kindesmissbrauchs in Deutschland

Im Rahmen der Aufarbeitung des sexuellen Missbrauchs von Kindern wurde durch die Unabhängige Beauftragte eine telefonische Anlaufstelle eingerichtet. Anrufer haben die Möglichkeit, Erfahrungen, Kritik und Anregungen an die Politik zu äußern; diese sollen in die Empfehlungen der Unabhängigen Beauftragten an den Runden Tisch „Sexueller Kindesmissbrauch in Abhängigkeits- und Machtverhältnissen in privaten und öffentlichen Einrichtungen und im familiären Bereich“ und an die Bundesregierung einfließen. Um die Informationen der Betroffenen für die Arbeit der Unabhängigen Beauftragten nutzbar zu machen, wurde ein webbasiertes Dokumentationsraster zur anonymen Erfassung der Anliegen der Anrufenden entwickelt. Von den Ende Mai bis Mitte Juli 2010 eingegangenen Anrufen (N = 962) liegen N = 510 auswertbare Datensätze vor. Neben der Darstellung des Dokumentationsrasters, werden die ersten deskriptiven und qualitativen Ergebnisse vorgestellt und hinsichtlich ihrer Anforderungen an die Politik diskutiert. Das am häufigsten genannte Anliegen der Anrufenden ist eine Verbesserung der Qualität von Traumatherapien und eine Ausweitung der psychotherapeutischen Angebote (z. B. auf ältere Menschen, Männer). Weitere zentrale Themen waren Entschädigung/Strafverfolgung, Fortbildung/Weiterbildung von Fachpersonen, Enttabuisierung/Prävention und das Thema Vertrauen in die Politik.