Übersichtsarbeiten / Review Articles. Versorgungsstrukturen zur Abklärung, Diagnostik und Therapie bei Fällen von sexualisierter Gewalt im Kindes-und Jugendalter / Care Structures for the Assessment, Diagnostic and Treatment in Cases of Sexual Abuse in Childhood and Adolescence

Father-Daughter Incest

<p>This report presents the findings of a gap analysis of specialized services for victims and survivors of online child sexual exploitation and abuse (CSEA) in Canada. The analysis took place between March and July 2019 and was conducted to identify existing specialized support services for victims of CSEA, their families, and adult survivors of CSEA, as well as gaps in the availability of such services, any promising practices in Canada or elsewhere, and challenges to providing specialized supports for these victims and their families.</p> <p>Very few support services and treatment practices are specifically related to online CSEA in Canada. Overall, the most promising practices currently offered in Canada are those that address child victims (children and youth up to the age of 18 years) of crime more generally, especially the services provided by the Child and Youth Advocacy Centre network that is expanding across the country, as well as those provided by the longstanding network of service providers that responds to victims of sexual assault. These networks have great potential to provide specialized supports for online CSEA victims and their families. However, they currently lack expertise in online CSEA, and need evidence-based guidance on how to best support these victims; methods demonstrated to be effective for sexual crime victims in general might not be effective or may even be harmful to victims of online crimes.</p> <p>What is needed is investment in creating the evidence base – that is, data evaluating and verifying the appropriateness and effectiveness of specific support services and approaches to treatment for online CSEA – that would then inform best practices. These best practices could then be conveyed in training for service providers, and integrated into supervision and mentorship structures within organizations. Many of the individuals interviewed for this report are experts in the field of child sexual abuse. Other participants are well versed in providing referrals for clients needing specialized supports for child victims of sexual abuse. However, they did not believe that they had expertise specific to working with victims of online CSEA, and generally did not know of specialized services to which they could refer victims. The extensive and well-established networks of experts in the fields of sexual abuse and child sexual abuse should be mobilized to participate in, and contribute to, research in this area in order to develop evidence-based effective responses for victims of online CSEA.</p>

<p>This report presents the findings of a gap analysis of specialized services for victims and survivors of online child sexual exploitation and abuse (CSEA) in Canada. The analysis took place between March and July 2019 and was conducted to identify existing specialized support services for victims of CSEA, their families, and adult survivors of CSEA, as well as gaps in the availability of such services, any promising practices in Canada or elsewhere, and challenges to providing specialized supports for these victims and their families.</p> <p>Very few support services and treatment practices are specifically related to online CSEA in Canada. Overall, the most promising practices currently offered in Canada are those that address child victims (children and youth up to the age of 18 years) of crime more generally, especially the services provided by the Child and Youth Advocacy Centre network that is expanding across the country, as well as those provided by the longstanding network of service providers that responds to victims of sexual assault. These networks have great potential to provide specialized supports for online CSEA victims and their families. However, they currently lack expertise in online CSEA, and need evidence-based guidance on how to best support these victims; methods demonstrated to be effective for sexual crime victims in general might not be effective or may even be harmful to victims of online crimes.</p> <p>What is needed is investment in creating the evidence base – that is, data evaluating and verifying the appropriateness and effectiveness of specific support services and approaches to treatment for online CSEA – that would then inform best practices. These best practices could then be conveyed in training for service providers, and integrated into supervision and mentorship structures within organizations. Many of the individuals interviewed for this report are experts in the field of child sexual abuse. Other participants are well versed in providing referrals for clients needing specialized supports for child victims of sexual abuse. However, they did not believe that they had expertise specific to working with victims of online CSEA, and generally did not know of specialized services to which they could refer victims. The extensive and well-established networks of experts in the fields of sexual abuse and child sexual abuse should be mobilized to participate in, and contribute to, research in this area in order to develop evidence-based effective responses for victims of online CSEA.</p>

Objective: To examine the association between sexual abuse in childhood and adult depression in women.Design: Two stage, case detection and case identification design, using the 30-item general health questionnaire and...

Sexual Abuse in Childhood and Adolescence and the Risk of Early Pregnancy Among Women Ages 18–22

The Council of Europe Convention on the Protection of Children against Sexual Exploitation and Sexual Abuse stipulates the obligation of member states to adopt the necessary legislative and other measures to combat all forms of sexual exploitation and sexual abuse of children and to protect children. In addition to a series of measures related to the prevention and raising awareness of citizens about the unacceptability of any behavior aimed at the sexual exploitation and abuse of children, measures to criminalize such behavior and protect and support victims of violence, the convention also stipulates the obligation of states to establish records of perpetrators of criminal acts of sexual abuse and exploitation of children. Bosnia and Herzegovina, as a signatory to this convention, has undertaken the obligation to implement its provisions into its legal system. However, due to the shared-parallel jurisdiction in the field of criminal legislation between the state and its entities, the protection of human sexual integrity falls within the jurisdiction of the entities, and the obligation to implement the Lanzarote Convention falls on the entities.

Research in Child Protection Against Abuse and Neglect: at the crossroads of analysis, strategy, and policy

Using objective measures, the authors found a high rate of childhood sexual and physical abuse in a sample of 66 female psychiatric inpatients. Childhood abuse experiences were correlated with severity of adult psychiatric symptoms. The authors explore the usefulness of adult psychological symptoms, diagnoses, and prescribed medications as factors in the identification of patients who have histories of early sexual and physical abuse.

Child Sexual Abuse: Ethics and Evidence

Relationship of childhood sexual, physical, and combined sexual and physical abuse to adult victimization and posttraumatic stress disorder

Previous research has documented a relationship between child sexual abuse and alcohol dependence. This paper extends that work by providing a comprehensive description of past year and lifetime alcohol consumption patterns, consequences, and dependence among women reporting either physical and sexual abuse in a national sample. This study used survey data from 3,680 women who participated in the 2005 U.S. National Alcohol Survey. Information on physical and sexual child abuse and its characteristics were assessed in relation to 8 past year and lifetime alcohol consumption measures. Child physical or sexual abuse was significantly associated with past year and lifetime alcohol consumption measures. In multivariate analyses, controlling for age, marital status, employment status, education, ethnicity, and parental alcoholism or problem drinking, women reporting child sexual abuse vs. no abuse were more likely to report past year heavy episodic drinking (OR(adj) = 1.7; 95% CI 1.0 to 2.9), alcohol dependence (OR(adj) = 7.2; 95% CI 3.2 to 16.5), and alcohol consequences (OR(adj) = 3.6; 95% CI 1.8 to 7.3). Sexual abuse (vs. no abuse) was associated with a greater number of past year drinks (124 vs. 74 drinks, respectively, p = 0.002). Sexual child abuse was also associated with lifetime alcohol-related consequences (OR(adj) = 3.5; 95% CI 2.6 to 4.8) and dependence (OR(adj) = 3.7; 95% CI 2.6 to 5.3). Physical child abuse was associated with 4 of 8 alcohol measures in multivariate models. Both physical and sexual child abuse were associated with getting into fights, health, legal, work, and family alcohol-related consequences. Alcohol-related consequences and dependence were more common for women reporting sexual abuse compared to physical abuse, 2 or more physical abuse perpetrators, nonparental and nonfamily physical abuse perpetrators, and women reporting injury related to the abuse. Both child physical and sexual abuse were associated with many alcohol outcomes in adult women, even when controlling for parental alcohol problems. The study results point to the need to screen for and treat underlying issues related to child abuse, particularly in an alcohol treatment setting.

The aim of this study was to investigate the association of recalled childhood sexual and physical abuse with current sexual functioning in mid-life. The sample was participants in the longitudinal population-based cohort of mid-aged women, The Melbourne Women's Midlife Health Project. Three hundred sixty two of the women (92% of the available cohort) were administered the Violence Questionnaire in the sixth year of follow-up. This included questions on physical abuse and sexual abuse experienced in childhood. We used the Short Personal Experiences Questionnaire (Dennerstein, Anderson-Hunt, & Dudley, 2002) to assess current sexual functioning. Forty eight percent of the women had no experience of childhood sexual abuse, 42% had experienced noncontact sexual abuse, 36% had experienced contact sexual abuse, and 7% had experienced penetrative sexual abuse. Nine percent of the women had experienced physical abuse in childhood. Women who had experienced penetrative childhood sexual abuse were significantly more likely to have fewer children (median 2) than women who had not experienced penetrative childhood sexual abuse (median 3) (P < 0.05). The only area of sexual or relational functioning significantly affected by childhood sexual abuse was that of feelings for partner (P < 0.05). Those who experienced penetrative childhood sexual abuse had, on average, significantly shorter current relationships (P < 0.05). Women who had experienced both childhood sexual and physical abuse reported a lower frequency of current sexual activities (P < 0.05). This study of mid-aged women found that the major impact of childhood sexual abuse is on the quality of relationship with the partner.

The Protection of Children from Sexual Offences (POCSO) Act 2012 was implemented with the aim of protecting children from sexual offences. Special courts were established for the trial of child sexual abuse matters which was provided by the POCSO Act. But, implementation of this Act has been delayed because of corruption and obsolete legal proceedings. It is therefore has become a heated topic at the present scenariowhen the general public would like to know more about how effective this Act would be inprotecting children from sexual abuse with the help of the Law. The paper discusses the perpetrators of the Sexual abuseand their relationship with the victims. Through the help of the study made by the Women and Child Ministry it is known that a large majority of the victims are girls though boys were also part of it. The research paper discusses the main factors which are responsible for the delay in implementation of this Act. In this context, the paper wishes to say that there should be a serious, careful and continuous study of the obstacles in the implementation of POCSO Act. It is important to understand that how boys and girls face some crucial problems when reporting sexual abuse from people known to them. Most of the victims experiencethe terrific social humiliation and feelings of shame and guilt when they report that they are sexually assaulted. In spite of its loopholes POCSO Act has been amended recently as the Union Cabinet has agreed to strengthen it by charging death penalty for serious sexual assault on childrenin its recent meeting which was held on 10th July 2019. India is facing many social problems today among them isthe issue of Child Sexual Abuse, which is widespread across the country and affecting children of all ages. “Half of the country's children face some form of sexual abuse with 18.3 percent were physically abused and 8.6 percent were sexually abused in 2017.A national estimate of 1,720 children died from abuse and neglect in fiscal year 2017 compared to 1,750 children who died in fiscal year 2016”. (Child Abuse Report, Women and Child Development India, 2019). When a person uses a child for his/her sexual gratification is termed to be known as Child Sexual Abuse. Child Sexual Abuse is mostly committed by someone who happens to be in relation or in a position of trust, or of power and/or authority. Most of Child abuses take place in a relationship, as it is much safer and easier for a person to take advantage of the child's weakness andhelplessness. Child Sexual Abuse may be verbal, visual and physical in nature and it is physical as well as moral violation of the child's body and trust which is against nature and law. “Although the state is required to give wide publicity to the Protection of Children from Sexual Offences Act, the law is relatively unknown even to those who need to apply it” says Anil Malhotra in his article “Strong Provisions and Weak implementation”.According to Malhotra, the importance and provisions are unknown even to the people belong to executive class though they are very much interested in implementing the Act. In spite of its great prevalence, most of the violence done against children are often hidden, unseen or under-reported. In a conventional country like India sexuality is considered as a taboo, so discussing sexuality and sexual abuse is unimaginable. Parents or guardians often do not have the knowledge to safeguard their children either by educating the children about sexual abuse or by being watchful in order to prevent abuse on their children. In such a context, it is the responsibility of our education system to provide the basic knowledge to children about how to identify unsafe touches and situations and also about self-defense. But only has been made by our education system to address it. There are also some studies say that Child Sexual Abuse can have a worst impact on the mental health of the child and if it is not healed at the earlier stage it would even affect at adulthood. In order to prevent all these problems one needs to undergo therapy and counselling. But the major problem is that only a few NGOs are active in counselling, guiding and sheltering the abused children. Whereas, one cannot expect this kind of support either from government offices or from central Ministry as there won't be any resources, proficiency and country-specific research available to guide training. The Protection of Children from Sexual Offences (POCSO) Act 2012 was implemented in order to protect children from sexual exploitation and sexual abuse; and to support them through legal provisions.

Abuse in Childhood and Adolescence As a Predictor of Type 2 Diabetes in Adult Women

Context: Although physical and sexual abuse of girls is widespread and has been associated with increased risks of obesity, hypertension, and diabetes, no study has investigated the extent to which early abuse increases risk of confirmed cardiovascular disease (CVD) events in women. Hypothesis: Child and adolescent abuse has a dose-response association with risk of CVD events. Design, Setting, and Participants: We examined associations of child and adolescent abuse reported in 2001 with confirmed CVD events from 1989-2007 among 67,102 women in the Nurses' Health Study II. Main Outcome Measures: Proportional hazards models were used to estimate hazard ratios and 95% confidence intervals for myocardial infarction (MI, n=263), stroke (n=251), and total CVD events (n=514). Results: Nine percent of participants reported severe physical abuse and 11% reported forced sex during childhood or adolescence. With adjustment for age, race, body type at age five, parental education and family history, the hazards ratio (HR) for cardiovascular events was 0.91 (95% confidence interval: 0.70-1.17) for mild physical abuse, 1.03 (0.83-1.27) for moderate physical abuse, and 1.45 (1.10-1.90) for severe physical abuse compared to no physical abuse in childhood or adolescence. Compared with women reporting no sexual abuse in childhood or adolescence, the HR was 1.10 (0.89-1.36) for unwanted sexual touching, 1.56 (1.14-2.15) for one episode of forced sexual activity, and 1.62 (1.17-2.22) for repeated forced sex in childhood or adolescence. Associations of severe abuse with stroke were somewhat stronger for stroke than for MI. Adult body mass index, smoking, alcohol use, hypertension, and diabetes accounted for 41% (21% - 66%) of the association of severe physical abuse and 37% (22% - 55%) of the association of forced sex with CVD events. Conclusions: Severe physical and sexual abuse in childhood and adolescence are prevalent risk factors for heightened CVD risk in adult women. Mild and moderate abuse were not associated with increased CVD risk. The excess risk associated with severe abuse is mediated by elevated adult CVD risk factors in women with a history of early abuse.