Assessment Of Child Sexual Abuse Research Articles

Assessment of Child Sexual Abuse in Victimized Women

Child sexual abuse (CSA) is a frequent phenomenon, and women who report it are at a higher risk of mental disorders and sexual dysfunction. The application of a brief questionnaire could help gynecologists assessment of CSA history in women. This study was carried out including women (n = 593) who had been victims of CSA before the age of 18 years. We used the Early Trauma Inventory Self Report–Short Form (ETISR-SF) Part 4, the Female Sexual Function Index (FSFI), the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7), the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), and a semi-structured instrument to assess CSA. Among the 593 women included, 77 agreed to answer the questionnaires, 62(80.5%) had traumatic sexual events, 53(68.8%) had a total FSFI score ≤ 26.55, and 64(84.2%) considered themselves victims of CSA. There was an association regarding the belief that CSA influenced their sex life and their being at risk for GAD (p = 0.001), PTSD (p = 0.02), and sexual abuse by a family member (p = 0.01). The risk factors were the presence of risk for GAD (OR = 5.88[1.3–27.03]) and CSA by a family member (OR = 5.78[1.57–21.28]). This methodology can assist gynecologists in assessing a patient’s history of CSA.

Kluczowa rola niezwłocznie podjętych badań kryminalistycznych w dochodzeniach dotyczących przestępstw przeciwko integralności seksualnej małoletnich. Studium przypadku systemu analizy kryminalistycznej w Kazachstanie

Timely appointment of forensic examinations in the prosecution of crimes against the sexual integrity of minors is the key not only to their rapid and complete investigation, but also the most important means of proving the guilt of suspects. In most cases, apart from the victim’s testimony and the results of identification, the guilt of the criminal is confirmed only with the help of forensic expert opinions, and a delay in the implementation of forensic analysis can lead to the irreparable loss of traces of a criminal offense. The role of forensic expertise in the fight against crimes against the sexual integrity of minors in modern realities is massively increasing, as it directs investigations and provides evidence to combat the changing face of crime. In recent years, the Republic of Kazakhstan has experienced a qualitative development of the forensic analysis system, which is reflected in numerous adopted legislative initiatives. Proper organisation of criminal investigation and high-quality interaction of intelligence and investigative services in collecting and recording evidence, as well as strict compliance with the requirements of the Criminal Procedural Code of the Republic of Kazakhstan during forensic analysis, allow identifying crimes against the sexual integrity of minors and bringing the perpetrators to criminal responsibility. Strict adherence to protocols and procedures that ensure the integrity of medical records, documentation and all collected clinical and forensic evidence can only increase the value of a medical assessment of child sexual abuse during a forensic analysis.

Regional variation in sentences for child sexual abuse: An empirical study with Finnish court data

While sentencing consistency is a major principle of most of the justice systems, some features of sentencing disparities remain understudied. The purpose of the current study is to examine regional variation in aggravation assessment of child sexual abuse (CSA). We use data of CSA convictions given in Finnish district courts (n = 909). Multilevel regression modeling is used as the analytic method to assess whether the variation persists even after controlling for the offense characteristics.The descriptive results show that there are remarkable differences between courts. The results from the multilevel regression analysis suggest that the between-court variation in convictions is not fully explained by the observed offense characteristics, as the variation persists even after controlling for these. While the current results are suggestive of between-court sentencing disparities, the source for this variation remains speculative. More research is needed on data allowing for both between- and within-court analyses.

Hindsight bias in assessing child sexual abuse

ABSTRACT Two studies using large samples of jury-eligible adults tested whether hindsight influences perceptions of potential grooming behaviours. In study 1, participants (n = 371) were presented with vignettes describing five different interactions between an adult and children and rated the likelihood that these behaviours were indicative of sexual abuse in foresight and in hindsight. In hindsight, the ratings of the behaviours doubled in size, evidence of hindsight bias. This finding held even for participants who had received training on how to identify possible sexual abuse. Study 2 used the same stimuli but randomly assigned participants (n = 159) to a hindsight or not condition; estimates of the likelihood that the adult is a child molester were double the size in the former group compared to the latter group. These findings have implications for civil lawsuits occasioned by sexual abuse that occurs within youth-serving organisations.

A Standardized Peer Review Program Improves Assessment and Documentation of Child Sexual Abuse.

Introduction:The objective was to assess the impact of interventions associated with ongoing expert peer review on the quality of child abuse medical providers’ written and photograph documentation in child sexual abuse cases.Methods:Pediatricians participated in a HIPAA compliant blind peer review process on a web platform developed to provide the American Board of Pediatrics maintenance of certification. Participants submit sequential photograph and written documentation of child sexual abuse examinations over 1 year. Documentation includes genital examination descriptions and interpretation of findings. Reviewers evaluate the photographic quality and written documentation of examination findings utilizing a numerical rating system. Each case cycle is reviewed by one of four experts in child abuse who received training in a uniform evaluation process. Reviewers follow each case throughout three cycles of documentation, selecting from several interventions that have been customized to address the quality issues noted. The third and final cycle includes summary comments from the reviewer.Results:Forty-one participants completed the program at the time these data were collected. A paired t test analysis of the combined scores of the three measures, such as Image Quality, Quality of Written Documentation, and Accuracy of Exam Interpretation, showed a statistically significant improvement (P < 0.001) between the first and last sets. In addition, each of the individual measures was statistically significant between the first and last case sets with a P value of <0.05 for each.Conclusion:Peer review with interventions customized to address quality issues improved the quality of the assessment and documentation of child sexual abuse evaluations.

Breaking the silence: Development of a qualitative measure for inquiry of child sexual abuse (CSA) awareness and perceived barriers to CSA disclosure.

The present study aimed to develop a qualitative measure for assessment of child sexual abuse (CSA) awareness and perceived barriers to CSA disclosure based on adolescents' perspectives and expert consensus. Focus group discussions (FGD) were conducted with the adolescents (n = 10) and the Delphi method was used to gain expert consensus (n = 5). The FGDs were audio recorded and Delphi method was conducted via email. Salient domains and themes were identified through manual thematic analysis of the qualitative data obtained from both the methods. Data validity and authentication was obtained through data and researcher triangulation. The qualitative measure for assessment of CSA awareness and perceived barriers to CSA disclosure consisting of 13 qualitative questions was developed based on these domains and expert opinion. The test-version was administered to a pilot sample of 20 adolescents meeting the inclusion criteria for this study. Based on their feedback on ease of understanding and clarity, questions were modified and rearranged. Participation rate was found to be high amongst adolescents as they readily agreed to engage in the study. Findings further indicated that the ambit of CSA awareness includes knowledge of multiple aspects like forms of sexual abuse, characteristics associated with people at risk for perpetration and at risk for victimisation, prevalent beliefs about CSA, prevention strategies and CSA legislation in India. Perceived barriers to CSA disclosure were identified in the context of self, others and the society. Implications for research, and the need for preventive frameworks for CSA in Indian context are discussed.

Beliefs of helping professionals within the context of child sexual abuse assessment

Beliefs of helping professionals within the context of child sexual abuse assessment

Audit tool for assessing child sexual abuse prevention content in school policy and curriculum

Although audit and feedback has not been well-used in social research, it is a useful method by which to answer research questions concerned with the notion of “best practice”, for example, whether a policy or program meets a required standard or benchmark. This paper draws on educational research conducted for a 5-year nation-wide public inquiry: the Australian Royal Commission into Institutional Child Sexual Abuse. The research comprised an audit of the strength and comprehensiveness of child sexual abuse prevention education policy and curriculum in 32 Australian school systems. The paper describes the development of the audit tool including its conceptual background, step-by-step process for identifying and synthesising evidence to generate the audit criteria and descriptors, and an explanation of how the tool was used. It also presents a succinct protocol for the research method, and critical commentary on the strengths and weaknesses of audit and feedback for social research.

Psychological and Behavioral Indicators in the Forensic Assessment of Child Sexual Abuse

Psychological and Behavioral Indicators in the Forensic Assessment of Child Sexual Abuse

Child sexual abuse: From diagnosis to formulation

Aim:To demonstrate the need to replace the diagnosis of child sexual abuse with psycho-social formulations.Method:The literature on the limitations of diagnosis is reviewed and the methodological challenge of assessing child sexual abuse both at the individual and population level examined.Findings:The case for continuing with a diagnostic approach to child sexual abuse cannot be sustained. The complexity of this socio-legal matter requires methodological sophistication in both individual case work and research about the topic.Conclusion:A digital medical logic of present/absent and the search for single diagnostic procedures are ill-suited for a picture of multi-factorial complexity and competing personal accounts. Formulation is better suited for the task of investigating CSA, though the risk of psychological reductionism also attends this improved shift from medical diagnosis.

A Bayesian Decision-Support Tool for Child Sexual Abuse Assessment and Investigation.

In assessments of child sexual abuse (CSA) allegations, informative background information is often overlooked or not used properly. We therefore created and tested an instrument that uses accessible background information to calculate the probability of a child being a CSA victim that can be used as a starting point in the following investigation. Studying 903 demographic and socioeconomic variables from over 11,000 Finnish children, we identified 42 features related to CSA. Using Bayesian logic to calculate the probability of abuse, our instrument-the Finnish Investigative Instrument of Child Sexual Abuse (FICSA)-has two separate profiles for boys and girls. A cross-validation procedure suggested excellent diagnostic utility (area under the curve [AUC] = 0.97 for boys and AUC = 0.88 for girls). We conclude that the presented method can be useful in forensic assessments of CSA allegations by adding a reliable statistical approach to considering background information, and to support clinical decision making and guide investigative efforts.

Spatial language, question type, and young children's ability to describe clothing: Legal and developmental implications.

Children's descriptions of clothing placement and touching with respect to clothing are central to assessing child sexual abuse allegations. This study examined children's ability to answer the types of questions attorneys and interviewers typically ask about clothing, using the most common spatial terms (on/off, outside/inside, over/under). Ninety-seven 3- to 6-year-olds were asked yes/no (e.g., "Is the shirt on?"), forced-choice (e.g., "Is the shirt on or off?"), open-choice (e.g., "Is the shirt on or off or something else?"), or where questions (e.g., "Where is the shirt?") about clothing using a human figurine, clothing, and stickers. Across question types, children generally did well with simple clothing or sticker placement (e.g., pants completely on), except for yes/no questions about "over," suggesting children had an underinclusive understanding of the word. When clothing or sticker placement was intermediate (e.g., pants around ankles, and therefore neither completely on nor off), children performed poorly except when asked where questions. A similar task using only stickers and boxes, analogous to forensic interviewers' assessments of children's understanding, was only weakly predictive of children's ability to describe clothing. The results suggest that common methods of questioning young children about clothing may lead to substantial misinterpretation. (PsycINFO Database Record

The Relationship Between Perceptions of Response to Disclosure of Childhood Sexual Abuse and Later Outcomes

This study assessed whether perceptions of others’ reactions to disclosure are related to psychological and physical outcomes among individuals with a history of child sexual abuse. Eighty-six female undergraduates completed a series of questionnaires assessing child sexual abuse, nonsexual trauma, depression, anxiety, posttraumatic stress disorder, somatic symptoms, disclosure, and social reactions to disclosure. Those who reported child sexual abuse endorsed higher levels of psychological and physical symptoms than those who reported a nonsexual traumatic event. Child sexual abuse survivors who reported more hurtful responses to disclosure had higher levels of posttraumatic stress disorder, anxiety, and physical symptoms than nonsexual trauma survivors. These findings suggest that many survivors of CSA may need psychological services, and an important focus of treatment may be assessing and strengthening social support.

The Neurobiology and Psychology of Pedophilia: Recent Advances and Challenges.

A pedophilic disorder is recognized for its impairment to the individual and for the harm it may cause to others. Pedophilia is often considered a side issue and research into the nature of pedophilia is delayed in comparison to research into other psychiatric disorders. However, with the increasing use of neuroimaging techniques, such as functional and structural magnetic resonance imaging (sMRI, fMRI), together with neuropsychological studies, we are increasing our knowledge of predisposing and accompanying factors contributing to pedophilia development. At the same time, we are faced with methodological challenges, such as group differences between studies, including age, intelligence, and comorbidities, together with a lack of careful assessment and control of child sexual abuse. Having this in mind, this review highlights the most important studies investigating pedophilia, with a strong emphasis on (neuro-) biological studies, combined with a brief explanation of research into normal human sexuality. We focus on some of the recent theories on the etiology of pedophilia such as the concept of a general neurodevelopmental disorder and/or alterations of structure and function in frontal, temporal, and limbic brain areas. With this approach, we aim to not only provide an update and overview but also a framework for future research and to address one of the most significant questions of how pedophilia may be explained by neurobiological and developmental alterations.

“Who Can You Tell?” Features of Arab Culture That Influence Conceptualization and Treatment of Childhood Sexual Abuse

The literature on child sexual abuse reflects growing recognition of the manner in which culture impacts the conceptualization, experience, and treatment of such cases. Despite heightened visibility of Arab Americans within the United States, population due to recent media attention, little empirical research exists on the occurrence of child sexual abuse within this population. Arab culture is often characterized by an emphasis on collectivism and familial obligations, and such features may prove to either facilitate or impede assessment and treatment of child sexual abuse, depending on how they are manifested. In terms of reporting child sexual abuse, cultural values pertaining to shame and honor as well as the stigma attached to mental health problems may influence the response to abuse. As such, enhancing the cultural competence of the therapist is key to facilitating effective cultural practice. Empirical research is required to investigate and substantiate these concepts as they relate to child sexual abuse in Arab-American populations.

Sexual Abuse Images in Cyberspace: Expanding the Ecology of the Child

Cyberspace has added a new dimension to the ecology of children made the subjects of sexual abuse images distributed online. These images cannot be permanently removed and can continue to circulate in cyberspace forever. A review of the current literature suggests that helping professionals are not consistently aware of or do not probe possibilities of online sexual victimization in the investigation, assessment, and treatment of child sexual abuse. Nor is this issue adequately addressed in their education and training. There are gaps in the literature regarding how to identify and provide treatment for these children. New assessment and treatment targets are needed to enhance existing practice approaches. A contemporary ecological model that incorporates an explicit consideration of the cybersystem is provided as a starting point for practitioners to be aware of the possibility that images of child sexual abuse were recorded and distributed online.

Inter-rater reliability in child sexual abuse diagnosis among expert reviewers

ObjectivesTo determine how well experts agree when assessing child sexual abuse cases. MethodsA total of twelve physician subjects were recruited and voluntarily enrolled from an existing peer review network. Experts from the network had been chosen for their experience in the field and their affiliation with children's advocacy centers. Each expert submitted three cases of prepubertal female genital examinations clearly demonstrable of the case findings. Submitted cases included demographics, history, physical and genital exam findings, photodocumentation, and diagnosis. Experts reviewed each submitted case and labeled the case negative for physical finding(s), positive for physical finding(s), or indeterminate. Cases were analyzed to determine the level of agreement. ResultsThirty-six cases were submitted for use in this study; one case was excluded prior to starting the review process. After all experts completed their reviews the authors reviewed the cases and results. Two additional cases were excluded, one due to poor quality photodocumentation and one for not meeting the study criteria. Thirty-three cases were used for data analysis.All 12 expert reviewers agreed in 15 of the cases. Overall, in 22 of 33 (67%) cases at least 11 of the 12 reviewers agreed with the original diagnosis. Six of 33 (18%) cases had variable agreement (8–10 reviewers agreed with original diagnosis) among reviewers; 5 of 33 (15%) cases had poor or mixed agreement (7 or less reviewers agreed with original diagnosis). ConclusionsExperts exhibit consensus in cases where the findings clearly are normal and abnormal, but demonstrate much more variability in cases where the diagnostic decisions are less obvious. Most of the diagnostic variability is due to interpretation of the findings as normal, abnormal or indeterminate, not on the perception of the examination findings themselves. More research should be done to develop a national consensus on the accurate interpretation of anogenital examination findings. Photographic image quality plays an important role in this quality review process and universally needs to be improved.

Assessing child sexual abuse allegations: An exploratory study on psychological reports

This study examines several psychological reports to verify whether consultant psychologists use scientifically based procedures during clinical assessment of sexually abused children. To address our aims, first we propose a methodological premise on mixed-method approaches and on the methodological appropriateness paradigm. We then provide a content analysis (run using the T-LAB software) of psychological reports produced by a sample of Italian consultant psychologists. Results show a biased use of some word associations that may lead to confirmatory interpretations.

Assessing Alleged Child Sexual Abusers in Noncriminal Contexts: Proposed Guidelines for Practice

Assessing child sexual abuse allegations is a challenging task for any child protection or mental health professional given that the secretive nature of sexual abuse is often associated with limited medical evidence and a lack of independent corroborative information. In addition to the scant evidence available to help decide the case, there are controversies surrounding the legal standard of proof and immense pressure to act quickly to ensure the safety of the children who are allegedly abused. Unfortunately, there is currently a lack of literature pertaining to the assessment of alleged child sexual abusers. This article examines the standard of proof and legal conundrum pertaining to alleged child sexual abuse cases. More importantly, it proposes guidelines for mental health professionals conducting an assessment of such persons. Assessments, if conducted effectively, can assist the court and child protection services in managing the risk of future inappropriate sexual behaviors.

The Enough Abuse Campaign: Building the Movement to Prevent Child Sexual Abuse in Massachusetts

This case study describes the Enough Abuse Campaign, a multidisciplinary, statewide effort to prevent child sexual abuse in Massachusetts. The study uses the Institute of Medicine's Framework for Collaborative Community Action on Health to provide a systematic description of the campaign's process of implementation, which includes: (a) developing a state-level infrastructure for child sexual abuse prevention, (b) assessing child sexual abuse perceptions and public opinion, (c) developing local infrastructures in three communities and implementing training programs focused on preventing perpetration of child sexual abuse, (d) facilitating changes in local communities to child-sexual-abuse-related systems, and (e) inviting Massachusetts residents to join an advocacy-based movement to prevent child sexual abuse. This case study concludes with future directions for the campaign and topics for future research related to child sexual abuse.