Graphic interventions on child sexual abuse: the case of Indian narratives

The development of primary prevention efforts to reduce child sexual abuse before it occurs has been inhibited by a lack of research into the attitudes and beliefs associated with child abuse and maltreatment. This article presents findings from 4,918 men pooled from nationally representative surveys of men in Australia, the United Kingdom and the United States, and presents a latent class analysis of men's attitudes to technology-facilitated child sexual exploitation and abuse, and its relationship with sexual interest in children and/or sexual offending against children. This study identified and described three latent classes of attitudes towards technology-facilitated child sexual exploitation and abuse, identifying significant and meaningful behavioural and demographic differences between the three groups of men. An important finding of this study is that the shift from "normalisation/blame diffusion" (associated with the belief that technology-facilitated child sexual exploitation and abuse is normal and acceptable behaviour) to "denial of abusiveness: and restrictive stereotypes" (associated with denying that abuse is harmful and desired by the child) was associated with greater odds of acting on sexual interest in children. The finding suggests that the moral or ethical quandary posed by sexual interest in children, and the consensus that child sexual abuse is morally wrong, has an important role to play in the prevention of technology-facilitated child sexual exploitation and abuse. Interventions that seek to reinforce attitudes that child sexual abuse is harmful, and the fault of the perpetrator, may prevent at-risk men from offending. From the perspective of secondary prevention, targeting men who hold normalisation and blame diffusion beliefs may assist agencies in identifying offenders earlier in their offending trajectory. The findings also underscore the critically important role of the media and other sources of cultural influence, including the technology sector and entertainment industry, in reinforcing the moral wrong of child sexual abuse.

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...

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

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.

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.

Father-Daughter Incest

This study examined the relationship between self-reported childhood physical and sexual abuse, romantic relationship quality, possible gender differences, and clinical implications. Three hundred thirty-eight women and 296 men who sought services at a university mental health clinic in the northeast region of the United States completed a 30-minute self-report assessment questionnaire before their first therapy session. Among the items in the questionnaire were measures of childhood physical and sexual abuse, relationship stability, problem areas in the relationship, and other demographic information. Results from structural equation modeling indicated that childhood physical abuse influenced relationship quality for both men and women whereas childhood sexual abuse did not have a significant impact on relationship quality for either gender. The results of the study indicated that there may be more gender similarities than differences in experiences of childhood abuse and relationship quality than previous research has shown. Key Words: child abuse, marital quality, physical abuse, sexual abuse. The National Incidence Study IV (Sedlak et al., 2010) reported that an estimated 323,000 children were physically abused and 135,300 children were sexually abused between 2005 and 2006. Over the past few decades, numerous studies have been conducted on both the short-term and long-term negative effects that child abuse can have on the victim (Alpher & France, 1993; Braver, Bumberry, Green, & Rawson, 1992; Futa, Nash, Hansen, & Garbin, 2003; Springer, Sheridan, Kuo, & Cames, 2007). Most studies, however, have focused on the potential that the victim has for becoming a perpetrator as an adult (Wilcox, Richards, & O'Keeffe, 2004), for entering abusive romantic relationships (Griffing et al., 2005; Van Benschoten, 1995), or for abusing their own children (Hall, Sachs, & Rayens, 1998; Lawson, 2001). Within the existing research, multiple studies examined the relationship between childhood abuse and sexual satisfaction in marriage (Finkelhor, Hotaling, Lewis, & Smith, 1989; Leonard, Iverson, & Follette, 2008; Loeb et al., 2002), but few have examined the relationship between childhood abuse and the overall quality of the adult's committed romantic relationships (Alpert, Brown, & Courtois, 1998; Finkelhor et al., 1989). Additionally, few studies have focused on how gender impacts those long-term effects. The purpose of this study was to examine the relationship between the frequency of childhood physical and sexual abuse and relationship quality, with a focus on possible gender differences and the clinical implications of any gender differences. Age and length of relationship were controlled to take into account the developmental stage of the relationship and recognize that a young married couple may be different from an old married couple. LITERATURE REVIEW Childhood Physical Abuse and the Psychosocial Consequences in Adulthood Childhood physical abuse has been found to have negative effects on adult mental and psychological functioning (Arata, Langhinrichsen-Rohling, Bowers, & O'Farrill-Swails, 2005; Springer et al., 2007; Styron & Janoff-Bulman, 1997; Swenson & Kolko, 2000). Individuals who experienced physical abuse in childhood were more likely to report physical illness, depression, anger, and anxiety than nonabused individuals (Springer et al., 2007). Childhood Sexual Abuse and the Psychosocial Consequences in Adulthood Childhood sexual abuse has also been associated with psychological and relational impairment in adult life (Alpert et al., 1998; Jesness, 2009; Sypeck, 2005; Wilcox et al., 2004). Research suggested that many adult survivors of sexual abuse had gone on to experience difficulty forming healthy relationships. These victims often blamed themselves for the abuse, which made it difficult to come to terms with the psychological, emotional, and social consequences ofthat type of violation. …

The objective of this cross-sectional study was to investigate childhood physical and sexual abuse as factors associated with arthritis among adults from selected states in the United States. Data for this study came from the 2019 Behavioral Risk Factor Surveillance System survey. An analytic sample of 75,717 adults 18-75years old (49.7% female) was analyzed using log-binomial regression. The outcome variable investigated in this study was arthritis, and the main explanatory variables were childhood physical and sexual abuse. Of the 75,717 respondents examined, 20,938 (representing 27.6%) had arthritis. A little over one in four respondents (25.5%) experienced childhood physical abuse and 5.6% experienced childhood sexual abuse by age 18. In the multivariable regression, respondents who experienced childhood physical abuse had 1.36 times the risk of having arthritis when compared to respondents who did not experience childhood physical abuse (ARR=1.36, p<.001, 95% CI=1.28-1.46). Respondents who experienced childhood sexual abuse had 1.60 times the risk of having arthritis when compared to respondents who did not experience childhood sexual abuse (ARR=1.74, p<.001, 95% CI=1.54-1.97). The findings of this study demonstrate that childhood physical and sexual abuse are associated with arthritis later in adulthood. The associations persisted even after adjusting for demographic, socioeconomic status, body mass index (BMI), current smoking status, and self-perceived physical health. The findings of this study add to the burgeoning number of studies demonstrating the adverse impact of childhood physical and sexual abuse on chronic health outcomes among adults.

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 purpose of this study was to examine the relationship of childhood physical and sexual abuse to subsequent lifetime alcohol or drug use disorders among American Indians (AIs) by using cross-sectional and retrospective data collected from a structured epidemiological interview. A sample of 3,084 AIs from two tribal populations-Southwest and Northern Plains--participated in a large-scale, community-based study. Participants were asked about traumatic events and family history and were administered standard diagnostic measures of substance use disorders. Prevalence of childhood physical abuse was approximately 7% for both tribes, and childhood sexual abuse was 4%-5%, much higher for females. The Northern Plains tribe had higher prevalences of substance use disorders. Childhood physical abuse had a significant main effect in bivariate models of substance dependence, but remained significant only in the multivariate models of substance dependence for the Northern Plains tribe. Correlates of disorder were psychiatric and medical comorbidity, parental alcohol problems and adult experience of physical attacks. Childhood physical abuse had a stronger effect than childhood sexual abuse on lifetime substance dependence. Childhood sexual abuse, on the other hand, was more associated with lifetime substance abuse. Females more commonly experienced childhood abuse but were less likely than males to develop substance use disorders. Although additional covariates reduced the main effect on disorder, results provide clinical guidance to constellations of risk factors and expand the population at risk to include males.

Child sexual abuse (CSA) is a global problem that affects children across cultures, nationalities and economic status. Under reporting of CSA is common. CSA remains a taboo issue that is sensitive to discuss, this often leads to stigma and shame. There are significant gaps in knowledge on the occurrence of CSA in Indonesia and this is reflected in fragmented and inconsistent responses. This can be seen in the literature review conducted for this thesis that found the contradictions in definitions of children within the laws have contributed to how and whether CSA cases are correctly recognised in Indonesia. These were based on the age of the child and their marital status; often this construction was especially discriminating against girls. Cultural practices can add to these difficulties as well as perpetuate myths or inaccuracies about the occurrence of CSA. As a result, there are challenges in understanding its prevalence. Indonesia has begun to recognise CSA as a significant problem requiring effective intervention and prevention. The national government has a strong national policy on child protection and commitment to addressing violence against children. This is consistent with the United Nations New Sustainable Development Goals which urge member countries to eliminate child violence, including CSA (World Health Organisation et al., 2016). This thesis specifically aims (i) to understand how CSA is perceived within current policy and law, and in doing so to elucidate the context and complexities of CSA, and (ii) to explore the various perspectives that stakeholders hold regarding CSA, and how the issues are addressed at the local level. In order to achieve the abovementioned aims, the thesis adopted a critical discourse analysis method. In particular, Bacchi’s WPR (What’s the Problem Represented to be) methodology was chosen due to the exploratory and conceptual gaps in understanding how CSA in Indonesia is conceived. This approach is particularly suitable for facilitating a better understanding regarding the assumptions and evidence used to construct Indonesian policy and law on CSA. The critical discourse analysis was comprised of two parts. First, it critically explored how CSA issues in Indonesia have been constructed and represented. Six government documents were analysed, namely two laws and four national policies, which are related to child protection. Second, the analysis investigated the problematisation of CSA among stakeholders, including their perspectives on the national policy and law on CSA prevention and intervention, and challenges in program implementation at the local level. Semi-structured interviews were conducted with 16 stakeholders (7 people in Central Java Province, and 9 people in Surakarta City). These participants included local policy makers, public servants, health professionals, and relevant Non-Government Organisation representatives. The thesis identified five key findings. Firstly, main CSA problematisations were identified: children are a vulnerable, at risk and disempowered group; there is a lack of access and coordination on integrated services for children; and there is a lack of agreement and clarity across laws and policy in child protection. Perspectives across stakeholders at the local level confirmed these problematisations and their consequences. Second, the assumptions of power relations that feature in society, and across government institutions, contributed to the construction of CSA problematisations in Indonesia. These assumptions were related to cultural practices, and structural power created by the laws and policies. Third, the historic influence of Dutch colonial law within the current Indonesian child protection laws and policies, was identified. Fourth, the government texts were silent on discussing the issue of CSA due to the influence of cultural and religious beliefs, including the concept of taboo. Fifth, the silence about CSA in Indonesian policy discourse influenced the design and strategy of CSA prevention and intervention in the country. Given the limited adequate access to justice, protection, and services, children in Indonesia are at high risk and are vulnerable to sexual abuse. The issue of CSA might be thought about differently if dominant discourses are replaced. This thesis offers a way to replace the relevant aspects of the dominant discourse with alternative representations and conceptual frameworks that would likely have a less harmful effect. In summary, the policy and legal discourses on CSA have a significant potential to be transformed to construct and develop a more effective response to CSA prevention and intervention in Indonesia.

Prevalence and psychological sequelae of self-reported childhood physical and sexual abuse in a general population sample of men and women

The goal of this study was to retrospectively estimate the prevalence of childhood physical abuse (CPA) and childhood sexual abuse (CSA) in relation to experience of adult violence, poor mental health, addictive behaviour and sexual risk behaviour among university students from 24 countries in Africa, the Americas and Asia. In a cross-sectional survey, data were collected from 18 404 undergraduate university students (mean age 20.7, SD = 2.9, age range of 16–30 years) from 24 countries. Overall, 5.0%, 2.6% and 1.2% of the students reported childhood physical abuse, childhood sexual abuse and childhood physical and sexual abuse, respectively. In the logistic regression models, adjusting for age, sex, study year, family wealth, and country, having experienced CPA and CSA was associated with increased odds of having any adult violence (physical and sexual partner violence victimisation. Having been in a physical fight, and weapon carrying), any poor mental health (post-traumatic stress disorder, depression symptoms and sleeping problems), addictive behaviour (tobacco use, binge drinking, frequent gambling and obesity) and sexual risk-taking was higher with a self-reported history of CPA and CSA.

This study reports on the relationship of childhood sexual and physical abuse in adult outpatients of an anxiety disorders clinic. A total of 205 consecutive patients admitted to two anxiety disorders clinics in Hamilton, Ontario, Canada, were given the Child Maltreatment History-Self-Report to elicit a history of childhood sexual or physical abuse. Childhood sexual abuse was reported by 23.4% and childhood physical abuse by 44.9%. Patients with a history of childhood sexual or physical abuse had significantly higher Beck depression scores and concurrent major depression, as well as more significant impairment in social functioning. They also demonstrated significantly higher state and trait anxiety scores. The occurrence of sexual or physical abuse was not associated with the presence of any particular primary anxiety disorder diagnosis. However, childhood sexual and/or physical abuse may affect the severity of the anxiety disorder as well as the presence of concurrent major depression.

Victims of child sexual abuse (CSA) are at greater risk of developing psychopathology in adulthood. Most research on CSA has focused on female survivors, while the experiences of male survivors have been comparatively understudied. Consequently, factors that contribute to the mental health outcomes of male CSA survivors require further investigation. The current study examined how greater endorsement of conformity to masculine norms (Winning, Emotional Control, Risk-Taking, Violence, Playboy, Self-Reliance, Primacy of Work, Power Over Women, and Heterosexual Self-Presentation) mediated the relation between CSA severity and depression, anxiety, and posttraumatic stress symptoms (PTSS). Data were collected from 649 adult males, 25.2% of whom reported experiencing child or adolescent sexual abuse (mean age = 29.7). The sample was recruited from a college sample and through Amazon MTurk. Mediation analyses confirmed significant direct effects between CSA and depression and anxiety symptoms, but not PTSS. Masculinity subscales, Playboy and Self-Reliance, mediated the relation between CSA and depression and anxiety. None of the masculinity subscales had a significant mediating effect between CSA and PTSS. Findings demonstrated that adherence to masculine norms influence long-term mental health outcomes in men. Clinicians working with male CSA survivors may operationalize these findings to tailor treatment by restructuring clients’ views of masculinity to improve symptoms of depression and anxiety.