Adolescent Victims Of Sexual Abuse Research Articles

Intelligence Is Associated With Voluntary Disclosure in Child Sexual Abuse Victims

PurposeThe purpose of this study was (1) to determine whether intelligence level is associated with the pattern of the disclosure and (2) to elucidate which, between the verbal and performance intelligence, better reflect the pattern of disclosure in child and adolescent sexual abuse victims. MethodsData were collected on 162 participants who visited a public center for sexually abused children and adolescents between January 2013 and December 2014. Demographic information, case characteristics, and disclosure pattern as well as intelligence quotients (IQs) of subjects were gathered. Intelligence was analyzed as level, full scale IQ, and the verbal and performance IQ. ResultsEighty-one subjects (50.0%) voluntarily disclosed that they have been sexually abused. In regression analysis, intellectual level, age, and the number of perpetrators were associated with disclosure pattern. Full scale IQ was associated with the disclosure pattern (odds ratio = .983, 95% confidence interval = .968–.997, p = .017). When intelligence was divided into verbal and performance IQ, verbal IQ affected the pattern of disclosure (odds ratio = .973, 95% confidence interval = .956–.991, p = .003) with linear correlation (p = .001). ConclusionsWe found that IQ was associated with the disclosure pattern. The intelligence, especially in verbal domain, is linearly correlated with the probability of voluntary disclosure. We suggest that special legal assistance and social concern are required for children and adolescent victims below normal intelligence to make them disclose the sexual abuse.

SURVIVING SEXUAL ABUSE IN EVERYDAY LIFE: FORMS OF RESISTANCE USED BY CHILDREN AND ADOLESCENTS

ABSTRACT Objective: to understand the forms of resistance used by children and adolescent victims of sexual abuse in the everyday family routine. Method: qualitative research developed at an Assistance Center to Women in Situations of Violence in the semi-arid region of Pernambuco, with data collected between June and November of 2014 through interviews with nine women. The analysis process was based on notions of Comprehensive Sociology and Everyday Life, with data organized by affinity, interpreted and categorized. Results: the emerged categories: ritualization of sexual abuse of children and adolescents in the family routine: acceptance of destiny through passivity; Camouflage to survive the experience of sexual abuse: silence, astuteness and acting/pretending in order to escape abuse, Between hidden sexual abuse and The revelation of sexual abuse. It can be seen that episodes of abuse occurred in secret and under the threat of abusers through intimidating gestures or words. Victims did not confront them or call attention or ask for help, they used tricks like metaphors, laughs and ironic words, as well as ridiculing them with excuses, hiding, pretending to be asleep or fleeing to the street. Conclusion: the underground centrality present in sexual abuse triggered forms of resistance in opposition to the oppression generated by the abuser in which, in accepting that way of life, the participants developed different survival mechanisms, as well as participating in voluntary work, music and sports, these vents alleviate the burden of concealing the abuse.

Disequilibrium and Loss of Narrative Coherence in Identity Construction: A Piagetian Perspective on Trauma in Adolescent Victims of Sexual Abuse

Previous authors have presented contradictory views of trauma as either the over- or under-elaboration of experience. This article provides a new theoretical perspective on trauma by incorporating Piagetian constructivism. On a theoretical level, it argues that both forms of narrative disruption following a traumatic episode are not contradictory. Rather, both over- and under-elaboration indicate disequilibrium and loss of narrative coherence in the construction of personal identity. Results are presented from an empirical study of the autobiographies of 15 adolescent victims (between the ages of 12 and 17) of sexual assault. Participants were enrolled in the initial stage of a psychotherapeutic treatment program for abuse in Santiago, Chile, at the time of study. Analysis of participant autobiographies reveals multiple forms of disorganization. The majority of adolescent narratives referred to predominance of traumatic experiences, whereas a small number of cases excluded traumatic experiences altogether. Discussion of study results shows that both forms of narrative disorganization indicate disequilibrium and loss of narrative coherence. Piagetian constructivist theory provides insight into this phenomenon by supporting and advancing understandings of trauma from a constructivist perspective. Implications for therapeutic treatment of sexual abuse, which may help generate clinical guidelines, are presented.

The Levels of Cortisol and Oxidative Stress and DNA Damage in Child and Adolescent Victims of Sexual Abuse with or without Post-Traumatic Stress Disorder.

ObjectiveThe aim of this study was to investigate whether cortisol and oxidative stress levels and DNA damage differ between individuals who developed PTSD or not following a sexual trauma.MethodsThe study included 61 children aged between 5 and 17 years who sustained sexual abuse (M/F: 18/43). The patients were divided into two groups: patients with PTSD and patients without PTSD based, based on the results of a structured psychiatric interview (K-SADS-PL and CAPS-CA). Cortisol, glutathione peroxidase (GPx), superoxide dismutase (SOD), coenzyme Q, 8-Hydroxy-2-Deoxyguanosine (8-OHdG) were all evaluated by the ELISA method.ResultsOur evaluation revealed a diagnosis of PTSD in 51% (n=31) of victims. There was no significant difference between the groups with or without PTSD in terms of cortisol, GPx, SOD, coenzyme Q, and 8-OHdG levels. There was no correlation between CAPS scores and GPx, SOD, coenzyme Q, and 8-OHdG levels between patients with or without PTSD. In patients with PTSD, both cortisol and 8-OHdG levels decreased with increasing time after trauma, and there was no significant correlation with cortisol and 8-OHdG levels in patients without PTSD.ConclusionAlthough the present study did not find any difference between the groups in terms of 8-OHdG concentrations, the decreases in both cortisol and 8-OHdG levels with increasing time after trauma is considered to indicate a relationship between cortisol and DNA damage.

“NOBODY DESERVES THIS”: ADOLESCENT SEXUAL ASSAULT VICTIMS’ PERCEPTIONS OF DISBELIEF AND VICTIM BLAME FROM POLICE

Prior research reveals that many police engage in victim blaming, skeptical reactions to adult sexual assault survivors. However, little is known about adolescent survivors’ experiences with police. To address this gap, qualitative interviews were conducted with 20 adolescent rape survivors to understand adolescents’ perceptions of their interactions with the police (specifically the messages the officers conveyed about the assault and the victims themselves). Positive perceptions occurred when the adolescents perceived police behavior as indications of believing their story, validating their decision to report, and refraining from judgment of their behavior. On the other hand, negative perceptions were associated with behaviors that were viewed as indications of skepticism, blame, or judgment. Specific behaviors that were associated with each of these themes are discussed. Interactions with the police influenced survivors’ emotional well-being and their hope for their case's success. Implications for improving interactions between police and adolescent sexual assault victims are discussed.

Testing and Prophylaxis for Adolescent Victims of Sexual Assault in Pediatric EDs

For adolescent victims of sexual assault, the American Academy of Pediatrics and the CDC recommend testing for chlamydia and gonorrhea; prophylaxis for chlamydia, gonorrhea, and trichomonas; pregnancy testing; and emergency contraception for female victims presenting within 120 hours of assault. In a retrospective study, investigators reviewed testing and prophylaxis practices for 12,687 adolescent victims (age, …

Research With Adolescent Victims of Child Sexual Abuse: Evaluation of Emotional Impact on Participants

The aim of this study was to evaluate the emotional impact on adolescent victims of sexual abuse from participating in a study addressing the consequences of their abuse. A total of 114 adolescents between 12 and 17 years old participated (54 sexually abused adolescents and 60 nonabused students). Both groups responded to a battery of scales to determine their coping strategies and some psychological consequences linked to stressful experiences and two questions about the emotional impact of participating in the study. Sexually abused adolescents reported fewer unpleasant emotions after participating than did nonvictim students (mean difference = .45, t[109] = −2.934; p < .01). Adolescents who had more symptoms reported more discomfort (rS scores between .35 and .49; p < .01). These results suggest that when ethical guidelines are followed, it is possible to survey adolescent victims of sexual abuse on aspects related to their experience without causing them significant distress.

아동청소년 성폭력 피해자의 피해사실 폭로에 영향을 미치는 요인

Objectives : The purpose of this study was to analyze the factors related to the disclosure patterns of sexual abuse in children and adolescent victims. Methods : A sample of 153 children and adolescents who visited the Sunflower children's Center (Incheon) between January 1, 2011 and December 31, 2012 were analyzed. The medical records of the victims were reviewed retrospectively. Results : Ninety (58.8%) subjects made a disclosure of sexual abuse voluntarily. The revelation was most commonly made to a parent. The severity and duration of sexual abuse were related to the disclosure patterns. In addition, the group that displayed below average intelligence, particularly subjects in the group with borderline intellectual functioning, tended to disclose their history of abuse less voluntarily than the subjects with normal intelligence. Conclusion : The current study provides insight into the factors that affect disclosure patterns in children and adolescent sexual abuse victims. To prevent sexual abuse, we suggest that special legal assistance and social concern be required for children and adolescents with borderline intellectual functioning.

Sexual Assault: Acute Care and Beyond

Sexual assault, which encompasses any nonconsensual sexual contact, is, unfortunately, common. It results in considerable costs to society, including intangible costs such as loss of quality of life among victims. This review covers the approach to the patient and definitive treatment, disposition, and outcomes for adult and adolescent victims of sexual assault. Figures show female anatomy and common areas for genital injury after rape, a Centers for Disease Control and Prevention algorithm for evaluation of possible nonoccupational HIV exposures and nonoccupational post-exposure prophylaxis, a questionnaire for determining additional key aspects of the history of the assault to be completed and explored in detail by the sexual assault examiner, and the components and steps of the Massachusetts Sexual Assault Evidence Collection Kit. Tables list characteristics that define rape, key aspects of the history, recommended treatment to prevent sexually transmitted infections and pregnancy, calculated risks of acquiring HIV from an isolated sexual contact with a known HIV-positive person, and trauma-informed care. This review contains 5 highly rendered figures, 5 tables, 95 references, and a list of helpful Web sites.

Decreased dehydroepiandrosterone sulphate levels in adolescents with post-traumatic stress disorder after single sexual trauma

Background: Recent evidence shows that the hypothalamic–pituitary–adrenal (HPA) axis can be dysregulated in chronic sexual abuse victims with post-traumatic stress disorder (PTSD). We hypothesized that PTSD in adolescents exposed to a single sexual trauma may function as a chronic stressor leading to HPA-axis dysregulation. Aims: The objective of this study was to assess dehydroepiandrosterone sulphate (DHEA-S) and cortisol levels in female adolescents |with single sexual trauma-related PTSD compared to healthy controls. Method: We assessed 20 female adolescent (age 12–18) single sexual trauma victims with PTSD from the Ondokuz Mayis University Department of Child and Adolescent Psychiatry between December 2013 and December 2014. PTSD symptoms were assessed using the Child Depression Inventory (CDI) and Child Posttraumatic Stress Reaction Index (CPSRI). Blood cortisol and DHEA-S were measured in 20 female adolescent sexual abuse victims with PTSD and 20 healthy adolescents after 12-h fasting using the chemiluminescence method. Results: Compared to age-matched controls, female adolescent sexual abuse victims with PTSD had significantly lower DHEA-S levels (U = 70.00, Z = − 3.517, p = 0.01, r = 0.55). There was also a significant negative correlation between DHEA-S and CDI scores (Spearman r = − 0.522, p < 0.01). Conclusions: Decreased DHEA-S levels and correlation with depressive symptoms are evidence for a dysregulated HPA-axis in female adolescent single sexual trauma victims with PTSD. Further research is now recommended with large patient groups in order to maximize generalizations.

Examining the levels of BDNF and cortisol in children and adolescent victims of sexual abuse—a preliminary study

BackgroundPrevious reports have suggested the biological and psychological effects of trauma induced by cortisol and brain-derived neurotrophic factor (BDNF). The present study compared the levels of BDNF, cortisol, and adrenocorticotropic hormone (ACTH) in children and adolescent victims of sexual abuse to those without a trauma history. MethodsThe study was conducted in the Department of Child Psychiatry at Dicle University. The study included 44 children (M/F: 12/32) aged between 8 and 17years who experienced sexual abuse with 42 age-and gender-matched children who did not have a history of trauma. Cortisol, ACTH, and BDNF levels were measured using ELISA. ResultsCortisol levels were higher and BDNF levels were significantly lower in the victims of sexual abuse compared to the control group. The mean time that elapsed from the initial sexual abuse occurrence until the date of examination was 22.7±21.7months. The evaluation of the relationship between this time span and cortisol levels revealed that cortisol levels decreased with increasing time after trauma. Cortisol and BDNF levels were lower in the victims who experienced multiple sexual assaults. ConclusionsThe results of the present study suggest that cortisol and BDNF could be biological molecular mediators of the effects of trauma on biological and psychological systems. This is the first report on the effects of cortisol and BDNF induced trauma in child and adolescent victims of sexual abuse.

Pathways to help: adolescent sexual assault victims' disclosure and help-seeking experiences.

In this study, we conducted semistructured interviews with N = 20 adolescent sexual assault victims who sought postassault help from the medical and legal system to understand young survivors' disclosure and help-seeking processes. Results revealed three distinct disclosure patterns and pathways to help-seeking. First, in the voluntary disclosure group, victims told their friends, who encouraged them to tell an adult, who then encouraged--and assisted--the survivors in seeking help. Throughout this process, the survivors' disclosures at each step were within their control and reflected their choices for how to proceed. Second, in the involuntary disclosure pattern, victims also first disclosed to friends, but then those friends told adults about the assault, against the survivors' wishes; the adults made the victims seek help, which was also against the survivors' preferences. Third, in situational disclosures, the survivors were unconscious at the time of the assault, and their friends disclosed and sought help on their behalf. We also examined how these initial disclosure patterns related to victims' continued engagement with these systems.

G146 A systematic review of mental health outcomes in young people following sexual assault

Aims Sexual assault peaks in mid-to late adolescence but its sequelae among this age group are not well understood. This systematic review aimed to describe mental health outcomes in young people following sexual assault. Methods Two reviewers searched Medline, Embase, CINAHL, OpenGrey and PsycINFO databases independently, screening publications from 1990 to 30 th October 2013. Inclusion criteria : longitudinal studies, systematic reviews and meta-analyses in English with ≥50% participants aged 10–24 years; baseline mental health assessment conducted prior to or Results 3,758 titles and abstracts were screened after excluding duplicates, with 494 papers examined in full. Five cohort studies met inclusion criteria (sample size 64–294; mean age 13–26 years; duration of follow-up 3–12 months post-assault). Three studies examined rates of Post-Traumatic Stress Disorder (PTSD), reporting rates of 88%–94% within a month of assault, 47%–71% by 3 months and 10.5%–65% by 12 months post-assault. Only one study measured rates of Depressive Disorder, reporting rates of 35% 6 months post-assault. A study assessing anxiety disorders 6 months post-assault found that 11% had Generalised Anxiety, 16%, Panic Disorder, 44%, Social Phobia, 41%, Specific Phobia and 56%, Agoraphobia. Longitudinal studies evaluating post-traumatic (n = 3), depressive (n = 2) or anxiety symptom scores (n = 1) all reported reduced symptoms over 6–12 months post-assault. Limitations Small sample sizes, and heterogeneity of study populations, measures used and follow-up schedules. Conclusion Psychopathology is common following sexual assault in young people. Most studies reviewed observed reduced rates of mental health disorders and reduced symptom scores over time but there is a paucity of longitudinal research in this area. Large scale, good quality studies are needed to characterise the nature and course of mental health difficulties experienced by adolescent sexual assault victims over time, in order to allow for better targeting of resources for these individuals.

G147 Experiences and perspectives of adolescents presenting to sexual assault referral centres

Background Adolescent sexual assault victims are a vulnerable group with a high baseline prevalence of mental health problems and low follow-up rates. Little is known about their experience of services following sexual assault. Aims To evaluate experiences of care among adolescents accessing co-ordinated specialist sexual assault services serving a large UK city. Methods Design : Prospective longitudinal cohort study. Study population : Adolescents aged 13–17 years presenting to a sexual assault referral centre (SARC) within six weeks of assault. Participants evaluated care received from different professionals using a questionnaire adapted from the Commission for Health Improvement Experience of Service Questionnaire (CHI-ESQ). Results 30% consented to take part. Data were analysed for the first 64 study participants, evaluating care received from uniformed police (n = 51), specialist sexual offences investigative techniques (SOIT) officers (n = 58) and clinical staff at the SARCs (doctors and crisis workers, n = 64). 97% were police referrals and 3%, self-referrals. 67% had experienced vaginal rape, 32%, oral rape and 12%, anal rape. 90% underwent a forensic medical examination. Commonly held fears before accessing care were that they would be judged, disbelieved, ‘blamed’ or ‘called a liar’. Many participants were apprehensive that the forensic examination would be painful, embarrassing or reveal health problems such as infections. As shown in Figure 1, care given by clinical staff at SARCs was consistently rated higher than police care. Only 49% found uniformed police easy to talk to and only 64% felt safe in their care. Only 63% felt believed by their SOIT officer and only 59% felt they had been given enough information (Figure 1). Conclusions Many participants described positive experiences of systems of care for victims of sexual assault. However, variable experiences of care between services highlight the need for improvement in specific areas. Anxieties about being blamed or judged may prevent adolescents accessing services following sexual assault.

Calidad de vida, resiliencia e ideación suicida en adolescentes víctimas de abuso sexual [Quality of life, resilience and suicidal ideation in adolescent victims of sexual abuse

The aim of this study was to evaluate the relationship of resilience and suicidal ideation with quality of life in 50 adolescent sexual abuse victims from Bogotá City, Colombia. The design was ex-post-facto correlational and cross-sectional. Participants completed the Adolescent Resilience Scale (ARS), the Positive and Negative Suicide Ideation Inventory (PANSI), and the health and wellbeing scale for children and adolescents KIDSCREEN-52. At a descriptive level, moderate levels of resilience, low quality of life, and high levels of suicidal ideation were found. Correlation analysis showed that resilience was negatively related to suicidal ideation and positively to quality of life, whereas suicidal ideation was negatively related to quality of life. In conclusion, resilience is a variable which protects against suicidal thinking and promotes quality of life in adolescents victims of sexual abuse.

Can a Cognitive-Behavioral Group-Therapy Training Program for the Treatment of Child Sexual Abuse Reduce Levels of Burnout and Job-Strain in Trainees? Initial Evidence of a Brazilian Model

This study evaluated the extent to which a professional training program of an evidence-based intervention for the treatment of child and adolescent victims of sexual abuse could reduce strain and burnout levels in trainees. Participants were 30 psychologists, 19 of whom composed the experimental group (G1) and 11 the comparison group (G2). Data collection occurred before and after the training. The results showed that the ‘work demand’ increased for G1 and remained stable for G2, whereas the ‘control at work’ remained stable for G1 while decreasing for G2. Regarding burnout levels, there was a decrease in depersonalization and stabilization in the levels of emotional exhaustion and reduced professional efficacy for G1, whereas for G2, all the burnout indicators significantly increased. These results partially support the perspective that the training program would have an indirect protective effect on the occupational psychopathology levels of the trainees.

Post Traumatic Stress Disorder/PTSD in adolescent victims of sexual abuse: resilience and social support as protection factors

This analysis examined the contribution of personal, family (maternal and paternal support; sibling support) and extra-familiar (peer support; other adults) resilience to the prediction of clinical levels of PTSD symptoms in adolescents reporting sexual abuse. Controls were established for abuse-related variables (type of abuse, severity and multiple abuse) in a representative sample of high schools students in the province of Quebec. A total of 15.2% of adolescent females and 4.4% adolescent males in high school reported a history of sexual abuse in childhood. Sexually abused adolescent females (27.8%) were more likely than adolescent males (14.9%) to achieve scores with high clinical levels of PTSD. Hierarchical logistic regression revealed that over and above the characteristics of the sexual abuse experienced, resilience factors (maternal and peer support) contributed to the prediction of symptoms of PTSD attaining the clinical threshold. Alternative intervention and prevention practices geared to adolescent victims of sexual assault are discussed.

Cold or caring? Adolescent sexual assault victims' perceptions of their interactions with the police.

One-third of sexual assault cases that are reported to the police involve adolescent victims (Snyder, 2000), yet little is known about adolescent victims' interactions with law enforcement. Through semistructured interviews with 20 adolescent sexual assault victims, this study sought to understand--from the perspectives of the adolescents--how the police interacted with them on an interpersonal level and the impact this had on the adolescents' emotional well-being and engagement in the criminal justice system. Findings revealed that when the police engaged in behaviors that the victims perceived as caring, compassionate, and personable (vs. behaviors that were perceived as uncaring, insensitive, and intimidating), there was a positive impact on victims' emotional well-being and criminal justice system engagement. Implications for improving adolescents' help-seeking experiences are discussed.

Developing Recruitment Methods for Vulnerable, Traumatized Adolescents

This article describes the process by which we created a recruitment protocol for engaging adolescent sexual assault victims in a qualitative evaluation study. Working in collaboration with forensic nurses, rape victim advocates, adolescent rape survivors, and our institutional review board (IRB), we created a prospective recruitment method whereby adolescent victims were given information about the evaluation project at the time of postassault treatment services, but data collection was deferred until the trauma of the assault had a chance to diminish. In-person qualitative interviews were conducted with 25 clients at the treatment programs approximately 10 weeks after the assault. Although we recruited only a small number of youth (21% of the eligible sample), the methods were sufficient to achieve saturation, and comparisons to the agencies’ quantitative records suggest that the interview sample was not different from program population norms. We examine why some teens chose not to participate and provide recommendations for recruiting hard-to-find, vulnerable, and/or traumatized adolescent populations.

Adolescent Sexual Assault Victims and the Legal System: Building Community Relationships to Improve Prosecution Rates

Adolescents are at high risk for sexual assault, but few of these crimes are reported to the police and prosecuted by the criminal justice system. To address this problem, communities throughout the United States have implemented multidisciplinary interventions to improve post-assault care for victims and increase prosecution rates. The two most commonly implemented interventions are Sexual Assault Nurse Examiner (SANE) Programs and Sexual Assault Response Teams (SARTs). The purpose of this study was to determine whether community-level context (i.e., stakeholder engagement and collaboration) was predictive of adolescent legal case outcomes, after accounting for "standard" factors that affect prosecution success (i.e., victim, assault, and evidence characteristics). Overall, 40% of the adolescent cases from these two SANE-SART programs (over a 10-year period) were successfully prosecuted. Cases were more likely to be prosecuted for younger victims, those with disabilities, those who knew their offenders, and instances in which the rape evidence collection kit was submitted by police for analysis. After accounting for these influences, multi-level modeling results revealed that in one site decreased allocation of community resources to adolescent sexual assault cases had a significant negative effect on prosecution case outcomes. Results are explained in terms of Wolff's (Am J Community Psychol 29:173-191, 2001) concept of "over-coalitioned" communities and Kelly's (1968) ecological principles.