Adolescent Sexual Abuse Research Articles

The Use of Therapeutic Stories in Counseling Child and Adolescent Sexual Abuse Survivors

Counselors will regularly counsel children and adolescents with histories of sexual abuse and be challenged with providing supportive and empowering interventions that serve to move the client from victim to survivor status. Therapeutic stories are a creative counseling technique that can be used when counseling child and adolescent sexual abuse survivors. Theoretical support and guidelines for using therapeutic stories when counseling sexual abuse survivors are presented. In this article, case examples, sample therapeutic stories, and applications of therapeutic stories are provided.

Child and adolescent sexual abuse and violence in India: a review

In recent years, there has been an increasing attention to sexual coercive experiences of young people in developing countries, including India. Research done in this newer area is generating new...

Comparison by crime type of juvenile delinquents on pornography exposure

Previous literature on pornography indicates that pornography use for men at risk for aggression may result in sexually aggressive behavior, but very little research has been reported on juvenile sexual abusers' exposure to pornography. The current study compared pornography exposure between male adolescent sexual abusers (n=283) and male nonsexually offending delinquent youth (n=170). Sexual abusers reported more pre- and post-10 (years of age) exposure to pornography than nonsexual abusers. Yet, for the sexual abusers, exposure is not correlated to the age at which the abusers started abusing, to their reported number of victims, or to sexual offense severity. The pre-10 exposure subscale was not related to the number of children the group sexually abused, and the forceful exposure subscale was not correlated with either arousal to rape or degree of force used by the youth. Finally, exposure was significantly correlated with all of the nonsexual crime scores in the study. Implications for forensic nursing are discussed.

Adolescent school-based sexual victimization: Exploring the role of opportunity in a gender-specific multilevel analysis

Purpose Most research on school-based adolescent sexual victimization has lacked an explicit theoretical focus. This study examined whether an opportunity framework is appropriate for understanding adolescent school-based sexual harassment and sexual assault victimization using gender-specific multilevel analysis. Methods Using a sample of middle and high school adolescents, we examined the effects of individual-level indicators of opportunity on school-based sexual harassment and sexual assault victimization. In addition, we explored the relative influence of school factors on student sexual victimization, including the potential moderating influence the school environment may have on the effects of individual-level indicators of opportunity. Finally, we examined the potential differences in the correlates of sexual victimization across male and female adolescents. Results Several individual-level indicators of opportunity were associated with school-based sexual harassment and sexual assault for both males and females, though several important gender differences were observed. In addition, school factors directly and indirectly influenced sexual victimization. Conclusions Findings suggest that an opportunity framework is appropriate for understanding school-based sexual harassment and sexual assault victimization, and that important gender differences do exist. The implications of these results and directions for future research are discussed.

Risk Reduction for Substance Use and Trauma-Related Psychopathology in Adolescent Sexual Assault Victims: Findings From an Open Trial

Limited attention has been paid to the development and evaluation of interventions that reduce risk for substance use, while also targeting trauma-related psychopathology among maltreated adolescents. Risk Reduction through Family Therapy (RRFT) is a multicomponent treatment that integrates principles and interventions from existing empirically supported treatments. The purpose of the current study was to evaluate the feasibility of implementation and initial efficacy of RRFT through an open pilot trial involving a small sample (N = 10) of female adolescents (aged 13-17 years) who had experienced at least one memorable sexual assault in their lifetime. Measures of substance use and substance use risk factors (e.g., family functioning), posttraumatic stress disorder (PTSD), and depression symptoms were assessed pre- and posttreatment as well as at 3-month and 6-month posttreatment follow-up assessments. Results demonstrated reductions in multiple areas, including substance use and related risk factors, PTSD, and depression symptoms, which were maintained through follow-up. Clinical implications and future directions with this line of research are discussed.

Abuso sexual na infância e adolescência: perfil das vítimas e agressores em município do sul do Brasil

Estudo descritivo e de corte transversal que objetivou conhecer as características do abuso sexual em crianças e adolescentes de zero a 14 anos, a partir dos casos registrados nos Conselhos Tutelares e programas de atendimento do município de Londrina-PR, em 2006. Os dados foram coletados por meio de formulário e posteriormente analisados por frequência (absoluta e relativa) e proporção. Dos 186 casos, as vítimas foram predominantemente do sexo feminino (74,2%) e o risco de incidência foi maior na idade de 10 anos entre as meninas (coeficiente de cinco por 1.000); 97,3% dos agressores eram do sexo masculino; maior parte dos abusos ocorreu na residência das vítimas (52,7%) e durou menos de seis meses (57%). Houve lesão corporal em 90,3% dos casos, com seqüela física e psicológica em 97,8%. O abuso sexual entre crianças e adolescentes constitui-se um problema de saúde pública, além da estreita interface com as questões policiais e jurídicas.

Pretreatment and outcome correlates of past sexual and physical trauma in 118 bipolar I disorder patients with a first episode of psychotic mania

To assess the prevalence and correlates of childhood and adolescent sexual and/or physical abuse (SPA) in bipolar I disorder (BDI) patients treated for a first episode of psychotic mania. The Early Psychosis Prevention and Intervention Centre admitted 786 first-episode psychosis patients between 1998 and 2000. Data were collected from patients' files using a standardized questionnaire. A total of 704 files were available; 43 were excluded because of a nonpsychotic diagnosis at endpoint and 3 due to missing data regarding past stressful events. Among 658 patients with available data, 118 received a final diagnosis of BDI and were entered in this study. A total of 80% of patients had been exposed to stressful life events during childhood and adolescence and 24.9% to SPA; in particular, 29.8% of female patients had been exposed to sexual abuse. Patients who were exposed to SPA had poorer premorbid functioning, higher rates of forensic history, were less likely to live with family during treatment period, and were more likely to disengage from treatment. SPA is highly prevalent in BDI patients presenting with a first episode of psychotic mania; exposed patients have lower premorbid functional levels and poorer engagement with treatment. The context in which such traumas occur must be explored in order to determine whether early intervention strategies may contribute to diminish their prevalence. Specific psychological interventions must also be developed.

Sexual Self-Schemas of Female Child Sexual Abuse Survivors: Relationships with Risky Sexual Behavior and Sexual Assault in Adolescence

Childhood sexual trauma has been demonstrated to increase survivors' risk for engaging in unrestricted sexual behaviors and experiencing adolescent sexual assault. The current study used the sexual self-schema construct to examine cognitive representations of sexuality that might drive these behavioral patterns. In Study 1 (N=774), we attempted to improve the content validity of the Sexual Self Schema Scale for child sexual abuse (CSA) survivors, introducing a fourth sexual self-schema factor titled the "immoral/irresponsible" factor. In Study 2 (N=1150), the potential differences in sexual self-views, as assessed by the four sexual self-schema factors, between CSA survivors and non-victims were explored. In addition, Study 2 evaluated how these sexual self-schema differences may contribute to participation in unrestricted sexual behaviors and risk for sexual assault in adolescence. Results indicated that a history of CSA impacted the way women viewed themselves as a sexual person on each of the four factors. CSA survivors were found to view themselves as more open and possessing more immoral/irresponsible cognitions about sexuality as compared to women who did not have a CSA history. In addition, the CSA survivors endorsed less embarrassment and passionate/romantic views of their sexual selves. The interaction of CSA severity and the sexual self-schemas explained variance in adolescent sexual assault experiences above and beyond the severity of CSA history and participation in risky sexual behaviors. The findings suggest that sexual self-views may serve to moderate the relationship between CSA and adolescent sexual assault. Implications of these findings and directions for future research are discussed.

Human rights and health go hand-in-hand. An interview with Savitri Goonesekere

Q: On 20 November 2009, it was 20th anniversary of United Nations Convention on Rights of Child (CRC). Sri Lanka is often cited as a model for its work in reducing child and maternal mortality and in improving literacy. How has CRC contributed to this? A: Sri Lanka has a good record of achievement with regard to children. In my country, have had visionary policies on health and education, meaning that every child has had right to go to school and right to basic health and that has been reflected in very good social indicators for even before CRC. In a sense, politicians had put in place through these policies but they weren't written into 1978 Constitution's Bill of Rights. Q: What changes followed CRC in Sri Lanka? A: Before convention, did not consider rights were necessary for all children, and child abuse was addressed only from point of view that they are children in difficult situations. The convention linked concept of good governance and state accountability. Giving access to health and education for all children, recognizing gaps in coverage and need to prevent disparities in health delivery are now state obligations. Protecting from abuse and exploitation must also receive high priority. The CRC is a powerful accountability measure for ensuring an effective public health system. Q: Is CRC really necessary for a country with sound laws and policies? A: Implementing all standards on child in CRC is not an easy task. An ideal situation does not prevail in any country, not even developed countries. Some argue that if the health policies are in place, why do need to put them in constitution and other laws? The reason is clear. Political systems are very fragile. All it takes is a change in a health minister. If someone comes in with a different attitude, everything can change. If a right is not in place in a law or constitution, it's very easy to pull it back. Q: Is there cynicism about what human can achieve? A: There is a cynicism about and what they can do, especially in developing countries. This just encourages states not to implement treaties they have signed. Human laws create a culture of support for implementing health policies by helping community to monitor state's actions and programmes. They can't get away with saying we can't help this situation. Even in a country such as ours, which has some fairly sound laws and policies on health systems and a fairly good administrative system for health delivery, there are gaps and weaknesses. Examples are regional variations in health and education services and child abuse. Q: You have completed an assessment of adolescents' of access to reproductive and sexual health information and services in Sri Lanka. What did you find? A: We found that Sri Lanka's focus on child protection has benefited in younger age group, but has largely neglected young people. The problem is that group adolescents as either or young people but their needs are quite specific. Adolescents' health problems are becoming more complex. Health providers need to acknowledge adolescents have a right to basic health services in some neglected areas such as reproductive health based on access to information and right of choice. Over years, problems have emerged including exploitation of children, particularly young girls who work in domestic service when they should be in school, sexual abuse of adolescents within family and in community. Teenage pregnancy is an emerging problem. Q: Sri Lanka has an exceptionally good record in region for its attempts to eliminate child marriages. Why do they still occur? A: Our laws and policies on access to education helped in implementation of minimum age laws. …

Book Review: Plach, T. (2008). Investigating Allegations of Child and Adolescent Sexual Abuse: An Overview for Professionals. Springfield, IL: Charles C. Thomas 192 pp

Book Review: Plach, T. (2008). Investigating Allegations of Child and Adolescent Sexual Abuse: An Overview for Professionals. Springfield, IL: Charles C. Thomas 192 pp

Sexual revictimization in a clinical sample of women reporting childhood sexual abuse

Background: Child and adolescent sexual abuse (CSA) increases the risk for adult sexual assault (ASA), and psychological vulnerability as well as aspects of CSA and upbringing might influence the risk. Aims: The aims of this study were to investigate whether women who reported both CSA and ASA: 1) have been exposed to more severe CSA and 2) have greater psychological distress and vulnerability than women who were not revictimized. Methods: The study was a cross-sectional study of 161 adult women with a reported history of intrafamilial CSA. Thirty-six per cent of the women stated they had been exposed to ASA. The severity of CSA, psychological distress (Symptoms Checklist-90-R) and Cognitive Distortion were assessed. Five factors of Cognitive Distortion (fearful, scared, shy, mistrust and vulnerable) were identified by factor analysis of Symptoms Checklist-90-R sub-scale. Results: The CSA was significantly more severe (penetration: 77%/60%; multiple offenders: 67%/25%) in women exposed to ASA compared with their counterparts, as was the rate of suicide attempts (47%/30%). Also, the psychological distress and the factors: fearful, scared, shy and mistrust were significant higher. Conclusion: The results showed an increased psychological vulnerability among women with ASA, but whether the results are cause or effect of sexual revictimization or can be generalized to other clinical samples are not clear. Interventions targeting the increased risk of ASA should be developed, implemented and tested in prevention as well treatment programmes.

Closeness in relationships as a mediator between sexual abuse in childhood or adolescence and psychopathological outcome in adulthood

The risk of adverse psychological outcomes in adult victims of childhood and adolescent sexual abuse (CSA) has been documented; however, research on possible mediating variables is still required, namely with a clinical perspective. The attachment literature suggests that secure interpersonal relationships may represent such a variable. Twenty-eight women who had experienced episodes of CSA, and 16 control women, were interviewed using Bremner's Early Trauma Inventory and the DSM-IV Global Assessment of Functioning; they also responded to Collins' Relationship Scales Questionnaire, evaluating adult attachment representations in terms of Closeness, Dependence and Anxiety. Subjects with an experience of severe abuse reported significantly more interpersonal distance in relationships (low index of Closeness) than other subjects. The index of psychopathological functioning was correlated with both the severity of abuse and attachment (low index of Closeness). Regression analysis on the sample of abused women revealed that attachment predicted psychopathology when abuse was controlled for, whereas abuse did not predict psychopathology when attachment was controlled for. Therefore, preserving a capacity for closeness with attachment figures in adulthood appears to mediate the consequences of CSA on subsequent psychopathological outcome.

Characteristics of sexual violence in adolescents from 10 to 19 years of age, Cali 2001-2003.

Background: In Colombia among violent not fatal injuries the sexual crimes occupy fourth place, being more affected the minors of age. The sexual violence experienced on the infancy or on the adolescence leaves severe consequences. Objectives: To describe the occurrence of sexual violence cases denounced in teenagers from 10 to 19 years, during the 2001-2003 in Cali. Methods: A descriptive study of prevalence of sexual abuse in adolescents from 10 to 19 years assisted in the Institute of Legal Medicine and Forensic Sciences of the Southwest region during the 2001-2003 for clinic and social work evaluation. Prevalence was calculated and the chi2 test was used to explore differences between variables. Results: From 250 cases of accusations of adolescents were included 77.5% of these accusations were filed by women; being the most affected group age between 10 to 14; 96% reported to have any scholarship studies at the moment of the abuse; 46% were doing family-related activities at the moment of the abuse; 31.4% of the victims belonged to monoparental family and 40% to mixed family; 38.2% of the adolescents had records of family domestic violence; 82.6% of the aggressors were a victim’s acquaintance and only the 17% reported to have been attacked by a stranger. The menace and the blackmail were the principal forms used by the aggressor to persuade victim’s silence. Also stands out the presence of accomplices in the moment of the abuse. Finally, the commune (or municipality) 13 and 20 were the ones with a greater number of cases, and the one with the least was the 17 with only one case. Conclusions: A high percentage of victims of sexual violence are women who know his aggressor. The accusations are more prevalent in sectors with socioeconomic disadvantage.

Handbook of social work in child and adolescent sexual abuse

Handbook of social work in child and adolescent sexual abuse

Caring for young adolescent sexual abuse victims in a hospital-based children's advocacy center

Objectives This study compared health care assessments, referrals, treatment, and outcomes for young adolescent sexual assault/sexual abuse victims seen at a hospital-based Child Advocacy Center (CAC), to that provided to similar victims evaluated by other community providers. A second purpose was to document how common DNA evidence is found among such cases. Method A retrospective matched case-comparison design matched index CAC cases diagnosed with extra-familial sexual assault to non-CAC cases referred for prosecution in the same county, matched by age and sex of victim, age and sex of perpetrator, and type of assault ( N = 128 pairs). Since the case-comparison design produces paired data, analyses used paired t-tests, McNemars test, and Wilcoxon signed-rank tests. Health care outcomes included whether victims received a health exam, indicated tests, findings of trauma on genital exams and counseling referrals; legal outcomes included whether cases were prosecuted, verdicts, and length of sentences. Results CAC cases were significantly more likely to receive a physical exam, a genital exam when indicated, and referral for counseling (all p < .001). In the CAC group 26.7% vs. 4.8% had positive genital trauma findings, and only 6.3% of CAC cases failed to get indicated sexually transmitted infection (STI) tests or prophylactic treatment for STIs vs. 80% of the comparisons ( p < .001). There were no differences in decisions to prosecute, convictions, or sentence lengths between the groups. DNA was documented in only 27.3% of acute cases, although evidence kits were completed. Conclusions Young adolescent sexual abuse victims received markedly different health care in a hospital-based CAC compared to elsewhere. DNA is not commonly found in acute cases. Implications for practice Community health care providers and law enforcement should be encouraged to refer victims to hospital-based CACs for specialized examinations and treatment.

Relevance and application of TEACH-VIP: perspective from a developing nation – India

TEACH-VIP (Training, Educating and Advancing Collaboration in Health on Violence and Injury Prevention) was developed by the World Health Organization in response to the need for formal training materials and curriculum relating to violent injuries. The course is meant for utilization in diverse settings and by different nations to raise awareness among professionals about this public health issue. TEACH-VIP is designed so that the content can be customized to local scenarios and needs, to make it more locally relevant. This article examines the relevance and application of the course within the Indian setting. It focuses on three violence issues covered in TEACH-VIP: gender-based violence, child and adolescent sexual abuse and self-inflicted harm, reviewing evidence from local research studies, suggesting points for adaptation and highlighting the multiple stakeholder responses. Such local adaptations would serve the major objective of TEACH-VIP by facilitating the prevention of violence and injury through the training of a variety of personnel.

Guidelines for medical care of children evaluated for suspected sexual abuse: an update for 2008

Child sexual abuse is a common problem in our society and medical professionals who provide evaluations of children who may have been abused need to be updated as to recent research findings and recommendations for conducting examinations and interpreting results. Research studies have provided important new information regarding the qualifications of examiners, the recovery of forensic evidence in children, the frequency of abnormal findings in children and adolescents, the healing of genital injuries, and the interpretation of medical findings and sexually transmissible infections with respect to abuse. The recommendations for the timing and type of examinations for prepubertal children, in contrast to adolescent sexual assault victims, may need to be changed. Studies showing that partial tears of the hymen, as well as abrasions and contusions, may heal to leave very little or no sign of previous injury emphasize the importance of urgent evaluations. There is a need for standardization of the training of medical professionals who perform child sexual abuse evaluations to ensure continuing competence.

68: The Forensic Rape Examination: Is Colposcopy Really Necessary?

The use of colposcopy in adolescent and adult sexual assault cases is becoming increasingly more widespread nationally despite lack of rigorous scientific evidence. Drawbacks to its use include the expense and maintenance of equipment, additional provider training, and the psychological trauma to the patient of a genital examination under magnification. This study was undertaken to compare anogenital injuries in sexual assault victims using three different forensic examination techniques: 1) direct visual inspection, 2) nuclear staining using toluidine blue, and 3) colposcopy.

Sexual Functioning and Sexual Satisfaction Among Women Who Report a History of Childhood and/or Adolescent Sexual Abuse

This study examined the relationship between sexual functioning, sexual satisfaction, and predictor variables (experiential avoidance, relationship violence, relationship satisfaction, anger, and psychological distress) in 22 women reporting a history of childhood and/or adolescent sexual abuse. Sexual satisfaction correlated significantly with all predictor variables. Sexual functioning correlated significantly with relationship violence only. Interestingly, sexual satisfaction and sexual functioning were not significantly correlated. Two hierarchical regression equations, using sexual satisfaction and sexual functioning as dependent variables and using the same predictor variables, were tested. Results suggest that different factors may account for sexual satisfaction and sexual functioning and more research is needed to clarify this relationship.

Sexual Abuse, Violence And Hiv Risk Among Adolescents In South Africa

The aim of the study is to investigate sexual abuse, violence and HIV risk among a sample of South African adolescents. The sample included 400 male and 400 female 16 or 17 year-olds; 400 were from rural and 400 from urban areas, and almost all from African descent. Participants were chosen by multi-stage cluster and quota sampling. Results indicate high rates of sexual and physical violence, 17% of the girls reported having been raped, and 26.3% reported to have experienced sexual and/or physical violence. Predictors for having experienced physical and/or sexual violence among girls and boys included socio-economic variables, HIV risk behaviour and substance use. The results of this study have important implications for understanding and preventing adolescent sexual assault, physical violence and HIV risk in South Africa. Keywords: Sexual abuse, violence, HIV risk, substance use, adolescents, South Africa Gender and Behaviour Vol. 6 (1) 2008: pp. 1462-1478