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Mileva B, Goshev M, Georgieva M, Braynova I, Alexandrov A. Child Sexual Abuse: Forensic Medical Assessment of the Traumatic Injuries Over the Victim's Body. Cureus 2023; 15:e49873. [PMID: 38170050 PMCID: PMC10760938 DOI: 10.7759/cureus.49873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2023] [Indexed: 01/05/2024] Open
Abstract
Child sexual abuse is a public health problem that affects children worldwide in all ethnic, educational, and socioeconomic groups. These assaults are extremely dangerous not only due to their direct physical traumas received at the time of the abuse, but they also have long-term consequences that can worsen the future quality of the victim's life. A retrospective study of all cases related to child sexual abuse for five years was performed by materials of the Clinic of Forensic Medicine and Deontology, Sofia, Bulgaria. Ninety-five cases involve children from both genders. The traumatic injuries were carefully examined and classified according to their localization over the victim's bodies and based on the time that had passed after the reported assaults. In cases of sexual violence, the most informative and pointing at the exact type of violence are the injuries situated in the anogenital area. Too often, there is a lack of physical findings, depending on the type of sexual violence or associated with the prolonged time that passes after the crime. Children are unaware of what they have to do after suffering such traumas, or they are scared to share their experience with different family members, which can lead to late forensic examination and lack of physical and biological findings, which are the most critical traces in the criminal prosecution of the crimes and this can be a possibility for the perpetrator not to be charged for his unlawful actions.
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Affiliation(s)
- Biliana Mileva
- Department of Forensic Medicine and Deontology, Medical University Sofia, Sofia, BGR
| | - Metodi Goshev
- Department of Forensic Medicine and Deontology, Medical University Sofia, Sofia, BGR
| | - Mihaela Georgieva
- Department of Forensic Medicine and Deontology, Medical University Sofia, Sofia, BGR
| | - Ilina Braynova
- Department of Forensic Medicine and Deontology, Medical University Sofia, Sofia, BGR
| | - Alexandar Alexandrov
- Department of Forensic Medicine and Deontology, Medical University Sofia, Sofia, BGR
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Ku J, Koo C, Patel V. Tics of Trauma: Unique Case of Trauma-Associated Psychogenic Tics in an Adolescent Patient. Cureus 2021; 13:e17652. [PMID: 34646698 PMCID: PMC8486369 DOI: 10.7759/cureus.17652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2021] [Indexed: 12/03/2022] Open
Abstract
Tic disorders are a common psychiatric diagnosis in adolescents. While often a primary disorder, there have been few reports of trauma-associated secondary psychogenic tics. In this case, we detail a 16-year-old girl with a history of trauma who initially presented with depression and trauma-related anxiety. During the course of treatment, she also developed verbal and motor tic-like symptoms that worsened with stress and court proceedings. We classify these new symptoms as psychogenic tics secondary to the trauma associated with sexual abuse. We explore the implication of psychiatric comorbidities, socio-legal stressors, and medication changes in the patient’s new-onset motor and vocal tics. This case points toward a need for consideration of this unique psychiatric manifestation of trauma-associated tics in adolescents with a history of sexual abuse and with otherwise normal neurological and physical examinations.
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Affiliation(s)
- Justine Ku
- Psychiatry, University of California Riverside School of Medicine, Riverside, USA
| | - Cassidy Koo
- Psychiatry, University of California Riverside School of Medicine, Riverside, USA
| | - Varsha Patel
- Psychiatry, University of California Riverside School of Medicine, Riverside, USA.,Psychiatry, Riverside University Health System (Corona Wellness Clinic), Riverside, USA
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Pazderka H, Brown MRG, Agyapong VIO, Greenshaw AJ, McDonald-Harker CB, Noble S, Mankowski M, Lee B, Drolet JL, Omeje J, Brett-MacLean P, Kitching DT, Silverstone PH. Collective Trauma and Mental Health in Adolescents: A Retrospective Cohort Study of the Effects of Retraumatization. Front Psychiatry 2021; 12:682041. [PMID: 34248717 PMCID: PMC8267583 DOI: 10.3389/fpsyt.2021.682041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 05/31/2021] [Indexed: 12/18/2022] Open
Abstract
In the wake of the massive Canadian wildfire of May 2016 in the area of Fort McMurray Alberta, we observed increased rates of mental health problems, particularly post-traumatic stress disorder (PTSD), in school-aged adolescents (ages 11-19). Surprisingly, we did not see these rates decline over the 3.5-year follow-up period. Additionally, our research suggested that the impact of this mass incident resulted in other unanticipated effects, including the finding that children who were not present for and relatively unaffected by the wildfire showed a similar PTSD symptom profile to children more directly involved, suggesting some degree of spillover or stress contagion. A potential explanation for these high rates in individuals who were not present could be undiagnosed retraumatization in some of the students. To investigate this possibility, we compared two groups of students: those who reported the wildfire as their most significant trauma (n = 740) and those who had their most significant trauma prior to the wildfire (n = 295). Those with significant pre-existing trauma had significantly higher rates of both depression and PTSD symptoms, although, unexpectedly the groups exhibited no differences in anxiety level. Taken together, this evidence suggests retraumatization is both longer-lasting and more widespread than might be predicted on a case-by-case basis, suggesting the need to reconceptualize the role of past trauma history in present symptomatology. These findings point to the need to recognize that crises instigated by natural disasters are mass phenomena which expose those involved to numerous unanticipated risks. New trauma-informed treatment approaches are required that incorporate sensitivity to the collective impact of mass crises, and recognize the risk of poorer long-term mental health outcomes for those who experienced trauma in the past.
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Affiliation(s)
- Hannah Pazderka
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Matthew R G Brown
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada.,Department of Computing Science, University of Alberta, Edmonton, AB, Canada
| | | | | | | | - Shannon Noble
- Fort McMurray Public School District, Fort McMurray, AB, Canada
| | - Monica Mankowski
- Fort McMurray Catholic School District, Fort McMurray, AB, Canada
| | - Bonnie Lee
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB, Canada
| | - Julie L Drolet
- Faculty of Social Work, University of Calgary, Edmonton, AB, Canada
| | - Joy Omeje
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
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