Disclosure Of Child Sexual Abuse Research Articles

Detecting child sexual abuse in child and adolescent psychiatry: a survey study of healthcare professionals' assessment practice.

Research shows that only around half of all survivors of child sexual abuse (CSA) disclose the abuse during childhood and adolescence. This is worrying, as CSA is related to substantial suffering later in life. The proportion of children and adolescents who have been exposed to CSA is significantly higher in Child and Adolescent Psychiatry (CAP) than in the general population. Healthcare professionals report that uncovering CSA is a complex and challenging task. However, we know little about how they proceed when uncovering CSA. More knowledge of healthcare personnel's experience is therefore necessary to facilitate and increase CSA disclosure. The study aims to explore how CAP healthcare professionals in Norway proceed when assessing and detecting CSA, how they experience this work, and what hinders or facilitates their efforts. The study employed a mixed method approach. Data was collected through an anonymous online survey, generating both quantitative and qualitative data. The sample consisted of 111 healthcare professionals in CAP, of whom 84% were women, with a mean age of 40.7 years (range 24-72; sd = 10.8). Mean years of CAP clinical experience were 8.3 years (range 0-41; sd = 7.5). The quantitative data was analysed using descriptive statistics, correlations, and independent sample t-tests, while the qualitative data was analysed using a team-based qualitative content analysis. The results showed that detection of CSA was viewed as an important, but complex task in CAP, and the existing procedures were deemed to be insufficient. The therapists mostly felt confident about how to proceed when they suspected or detected CSA, yet they seldom detected CSA. In their initial assessment they applied standardised procedures, but if their suspicion of possible CSA persisted, they seemed to rely more on clinical judgement. Specific challenges and facilitators for CSA detection were identified, both in the individual and in the organisation. The study highlights the challenges and complexities healthcare professionals and the CAP system face when assessing CSA, which may account for the low detection rate. The results show that healthcare professionals believe room for clinical autonomy and targeted competence development may improve CSA detection. Additionally, the findings suggest a need for CAP to define roles and responsibilities within and between agencies.

Female-Perpetrated Child Sexual Abuse: A Vignette Study Investigating Professionals' Gender-Related Perception Bias and the Influence of an E-Learning Course

AbstractThe attitude of professionals towards victims’ disclosures of child sexual abuse has a decisive influence on the well-being of the victims. However, both vignette studies as well as victim surveys suggest that professionals’ perception on sexual abuse is influenced, among other factors, by the perpetrators’ gender. The present analysis investigates whether professionals’ perception of sexual abuse is influenced by the perpetrators’ gender, the professionals’ gender as well as their experience and field of profession. Additionally, the effect of an e-learning course was examined. As part of an e-learning course on child sexual abuse, N = 1925 German professionals (social work, educational, medical-therapeutic, legal professionals) were presented with pre- and post-editing vignettes differing in the perpetrators’ gender and the ambiguity of the situation. The professionals had to rate the situations in terms of sexual abusiveness. The findings revealed that the same situation would be more likely classified as abusive when the perpetrator was male, particularly in ambiguous situations. Moreover, work experience, personal experiences with sexual abuse, and awareness of sexual abuse had significant positive relationships with the professionals’ rating of the abusiveness of a situation. An effect of training was identified, with situations being more likely rated as abusive after the course, specifically in cases with female perpetrators. Victims of female-perpetrated sexual abuse are still often disbelieved, and their experiences trivialized because professionals perceive violence by women differently due to gender stereotypes and a lack of knowledge on female-perpetrated violence. This study highlights the important effect of training. Both science and professional practice need to increase knowledge about female-perpetrated child sexual abuse, as it remains a taboo topic.

International researchers and child protection service workers beliefs about child sexual abuse disclosure and statement validity

International researchers and child protection service workers beliefs about child sexual abuse disclosure and statement validity

Twelve barriers preventing child sexual abuse disclosures

Twelve barriers that prevent young people from disclosing sexual abuse and four factors that help them have been identified by researchers. Pete Henshaw explains

Factors associated with delayed disclosure of child sexual abuse: A focus on the victim's having been led to perform sexual acts on the perpetrator

BackgroundContextual variables associated with children's willingness to disclose sexual abuse have been identified in previous studies, but further investigation is needed to better understand delayed disclosure of child sexual abuse (CSA). ObjectivesThis study aimed to examine the factors associated with the risk of delayed disclosure of CSA. More specifically, it focused on a factor that has rarely, if ever, been looked into: the fact that some victims are led to perform sexual acts on the perpetrator. Participants and settingA content analysis was performed on 68 transcripts of investigative interviews with CSA victims aged 4 to 12 years old. MethodsBased on our content analysis, the time between the first abuse and the first disclosure was determined for each victim. The age and gender of the victim, the victim's relationship with the perpetrator, the age of the perpetrator, the frequency and severity of the abuse, and whether or not the victim mentioned having performed sexual acts on the perpetrator were also coded. ResultsChi-square analyses showed that the risk of delayed disclosure was associated with the victim's having performed, or not performed, sexual acts on the perpetrator (χ2 = 16.327, p < 0.001), the victim's relationship with the perpetrator (χ2 = 10.013, p = 0.002), and the frequency of the abuse (χ2 = 11.617, p < 0.001). ConclusionOur study is the first to demonstrate that having been led to sexually touch the perpetrator is associated with delayed disclosure of CSA.

Adult disclosures of non-recent child sexual abuse: is there a role for restorative justice?

This article examines the views of 29 victim survivors (who were part of a larger study) who retrospectively disclosed non-recent child sexual abuse regarding their reasons for disclosure, the child protection and criminal justice responses to them, and the possible ways for improving system responses to address their needs and interests. The reasons for disclosure centred on a desire to pass the burden of the abuse to someone else, to achieve a subjectively defined form of justice and to regain power and control over their lives. Following disclosure, victim survivors often found themselves involved in two forms of investigation: child protection and criminal justice. The findings suggest that criminal justice systems do not adequately address victims’ needs in these circumstances. They often feel marginal to child protection investigations and feel used instrumentally in those proceedings. However, having social workers ‘rattle the cage’ of perpetrators provided comfort for some victim survivors who failed to get justice through criminal justice mechanisms. Based on the research presented in this study, it is suggested that restorative justice may have something to offer as part of the response to non-recent disclosures of child sexual abuse as part of both criminal justice and child protection investigations and processes.

Abused Children: Psychotherapist from behind the Screen: The Case Study of Incest in the Arab Sector in Israel

We know that child sexual abuse (CSA) and incest does not occur in isolation, but often in conjunction with emotional and physical abuse, neglect, and domestic violence within the family (Tener, et al., 2021). The more types of child maltreatment experienced, the greater the negative impact on abused children mental health. The family situation greatly affects the mother's ability to respond positively toward the disclosure of CSA. A recent cluster analysis of 35 psychotherapists from behind the screen in Israel in dealing with incest in the Arab sector has been discussed in this study. This study used a qualitative methodology based on interviews with 35 psychotherapists who work from behind the screen with sexually abused children based on the case study of incest in the Arab region. Interviews were utilized to gather qualitative information regarding the abuse in the Arab sector in Israel. These abused Arab youngsters had undergone counselling and psychological treatment before the interviews. The last themes that emerged were: characteristics of the therapist that support behind the screen therapeutic connection, narrative therapy, turning points, and counsel for therapists working with abused children in the Arab sector in Israel. The factor that affected the participants the most was confidence in the therapeutic alliance based on precise boundaries between the therapist and the abused child presented themes offered helpful therapeutic ideas and tactics that aided in speeding up the healing process.

Men’s Experiences of Self-Conscious Emotions Following Childhood Sexual Abuse

ABSTRACT Rates of detection and disclosure of childhood sexual abuse (CSA) are believed to be lower in males due to gender socialization fears. The experience of CSA is thought to increase negative self-conscious emotions (shame, guilt, embarrassment, anger, and fear). Such self-conscious emotions have been associated with a range of mental and public health issues. As there has been no research to date that has explored the experience of shame and guilt within the wider context of self-conscious emotional states for males, this research aimed to explore men’s experiences of self-conscious emotions following CSA. Nine semi-structured interviews with males were completed. Interpretative Phenomenological Analysis identified three themes: “Invisible In This World” captures participants’ isolating circumstances surrounding their CSA, and how this impacted their perception of not being protected or able to speak out; “The Emotional Fallout” describes the overwhelming emotions experienced as a result of the CSA and how such emotions have impacted participants lives, and “Learning To Live With The Wound That May Never Heal” addresses how participants have spent their lives living with the abuse and how it’s a process to learn how to adapt and live with the abuse. Findings suggest there is a clear need to recognize the role and power of self-conscious emotions in male CSA, especially for healthcare professionals and services supporting males with CSA. Without addressing such self-conscious emotions, males who have experienced CSA are at risk of enduring the emotional fallout throughout their lives.

Negative Responses to Child Sexual Abuse: A Manifestation of Intolerance

Recently, there has been an increased societal focus on the boundaries of sexual behaviours. During a time when victims and survivors of unwanted sexual experiences are encouraged to come forward, it is vital to understand what makes people respond negatively to such disclosures. This study aimed to examine how endorsement of stereotypical ideas of Child Sexual Abuse (CSA) and response to CSA disclosures are related to various forms of attitudinal intolerance (i.e., racism, sexism and sexual prejudice). We used a survey and vignette methodology with a sample (N = 160) of undergraduate students. Results indicated that endorsement of CSA myths was positively related to all other variables of attitudinal intolerance. With regards to a response to a CSA disclosure, belief in the disclosure decreased as attitudinal intolerance increased. Similar to rape myth endorsement, endorsement of CSA myths may represent another form of intolerance, which only partially translates into a negative response to a CSA disclosure. Implications for intervention are discussed.

Finding a voice: Art therapy as a path to disclosure – a South African perspective

This article examines the use of art therapy for facilitating disclosure among those who have experienced childhood sexual abuse (CSA) in South Africa. Disclosure of CSA is a difficult and complex process, and traditional therapeutic approaches are not always effective. Traditional talk therapy approaches in South Africa are often hampered by cultural barriers, a lack of knowledge and resources, and a tendency to view disclosure as a once-off event rather than a process. Art therapy can provide a safe and non-threatening space for survivors to express their emotions, communicate their experiences, and process the complex feelings associated with CSA. This study sheds light on the mechanisms of change in art therapy and is a valuable resource for mental health professionals working with survivors of CSA and researchers interested in the potential of art therapy as a therapeutic intervention. This article argues that art therapy can be a powerful tool to help CSA survivors find their voice to disclose and initiate the healing process.

Stories of childhood sexual abuse (CSA) among older adults living with HIV (OALH) in South Carolina: a qualitative study

ABSTRACT Childhood sexual abuse (CSA) devastatingly impacts an individual’s behavioral, psychological, and social health. Childhood, a developmental stage directly influenced by the home or school environment, leaves a life-long imprint. Compared with the general population, CSA prevalence is doubled among people living with HIV. Thus, the study aimed to explore CSA circumstances among older adults living with HIV (OALH) in South Carolina (SC). We included 24 OALH aged 50 and above who reported CSA. The data were collected at an immunology center in SC. In-depth semi-structured interviews were conducted, audio-recorded, transcribed, and analyzed using a thematic analysis approach. The iterative analytic process included a discussion of initial thoughts and key concepts, identification, and reconciliation of codes, and naming of emergent themes. Six themes emerged: known perpetrators, re-victimization, “nobody believed me”, “cannot live like others”, lack of CSA disclosure, and interconnections with other adverse childhood experiences (ACEs). CSA experiences and non-disclosure were found to be linked with shame, embarrassment, fear, and trust issues. Hence, trauma-focused interventions are required to resolve these issues and improve the quality of life of OALH with past trauma. Counseling or therapy programs should incorporate psychological and behavioral theoretical models to best target OALH who are CSA survivors.

Childhood Sexual Abuse: A Longitudinal Study of Disclosures and Denials.

In legal cases regarding child sexual abuse (CSA), children have various options, such as to disclose or deny maltreatment. When interviewed in adulthood, their accounts may be consistent with their childhood responses. Alternatively, denial in childhood could be followed in adulthood by disclosure ("deferred disclosure"), confirming previous suspicions. Or the adults could possibly recant. We conducted a longitudinal study of CSA disclosures and denials (N = 99; Time 1 [T1], 3- to 16-year-olds). T1 CSA disclosures and denials at a forensic unit were compared to the individuals' responses 20 years later (Time 2 [T2]. 22- to 37-years-old). We found that consistent disclosure was associated with being older at T1 and female. Deferred disclosure was significantly associated with greater T2 trauma-related symptoms. Corroboration and higher CSA severity predicted T2 recantation. Consistent denial was related to less severe CSA. Our findings add to knowledge about CSA disclosures, which affect legal pathways available to child victims.

When Disclosure Fails to Substantiate Abuse: Child and Perpetrator Race Predict Child Sexual Abuse Substantiation.

We examined the effects of child race, perpetrator race, and abuse disclosure status (within the context of a formal forensic interview) on abuse substantiation outcomes. Specifically, we coded child sexual abuse disclosure, abuse substantiation, and race of 315 children (80% girls, M age = 10, age range = 2-17; 75% White, 9% Black, 12% Biracial, 3% Hispanic, 1% Asian) who underwent a child forensic interview in a Midwestern child advocacy center. Supporting hypotheses, abuse substantiation was more likely in cases involving (a) abuse disclosure (vs. no disclosure), (b) White children (vs. children of color), and (c) perpetrators of color (vs. White perpetrators). Also supporting hypotheses, the effect of abuse disclosure on increased abuse substantiation was greater for White children than for children of color. This research suggests that even when children of color disclose their experiences of sexual abuse, they nonetheless face barriers to abuse substantiation.

Women Receive More Positive Reactions to Childhood Sexual Abuse Disclosure and Negative Reactions are Associated With Mental Health Symptoms in Adulthood for Men and Women.

Although disclosure of sexual abuse has become more socially acceptable for both men and women in recent years, there is much yet to be understood about differences in the disclosure process and associated pathology between men and women. The current study aimed to (a) investigate differences in aspects of the childhood sexual abuse (CSA) disclosure process between adult men and women and (b) explore how timing of disclosure, perceived parental style, and negative social reactions to disclosure relate to various mental health symptoms. Using a cross-sectional, quasi-experimental design, adult men and women in the United States recruited through Amazon's Mechanical Turk (N = 299) completed self-report surveys. Women reported disclosing to a significantly greater number of people than men, and were more likely to disclose to parents, while men were more likely to tell friends. Results revealed that women reported receiving significantly more positive responses and emotionally supportive responses to their CSA disclosures than men. Negative reactions to disclosure were positively associated with internalizing symptoms and externalizing symptoms, while both negative reactions to disclosure and perceived parental dysfunction were positively associated with substance use symptoms. Results signify a need for resources to aid individuals in supporting survivors of CSA, as reactions have the potential to impact recovery trajectory and for clinicians to consider how disclosure experiences impact survivor cognitions and symptom exacerbation.

Paths of disclosure – The process of sharing experiences of child sexual abuse

AbstractThe objective was to explore how children and young people retrospectively described disclosure of child sexual abuse in relation to their own agency. Data consists of semi‐structured interviews with 14 participants that had disclosed sexual abuse during childhood. Interviews were audio recorded, transcribed and analysed with thematical analysis. Participants' descriptions of their own agency in relation to disclosure of child sexual abuse, shows that both silence and disclosure can be active choices. By offering children choices trusting them to make decisions for themselves, their sense of control can be increased.

Old crimes reported in new bottles: the disclosure of child sexual abuse on Twitter through the case #MeTooInceste

Movements such as #MeToo have shown how an online trend can become the vehicle for collectively sharing personal experiences of sexual victimisation that often remains unreported to the criminal justice system. These social media trends offer new opportunities to social scientists who investigate complex phenomena that, despite existing since time immemorial, are still taboo and difficult to access. They also bring technical difficulties, as the challenge to identify reports of victimisation, and new questions about the characteristic of the events, the role that victimisation testimonies play and the capacity to detect them by analysing their characteristics. To address these issues, we collected 91,501 tweets under the hashtag #MeTooInceste, posted from the 20 to 27 January 2021. A model was fitted using Latent Dirichlet Allocation that detected 1688 tweets disclosing experiences of child sexual abuse, with an accuracy of 91.3% [± 3%] and a recall of 93.1% [± 5%]. We performed Conjunctive Analysis of Case Configurations on the tweets identified as disclosures of victimisation and found that long tweets posted by users with small accounts, without URL or picture, were more likely to be related to disclosure of child sexual abuse. We discuss the possibilities of these trends and techniques offer for research and practice.

The Legacy of Shame following Childhood Sexual Abuse Disclosures

ABSTRACT Shame has been recognized as a barrier to child sexual abuse (CSA) disclosures, but there has been less focus on the impact of shame on post-disclosure. This study explores how shame is experienced by CSA survivors following disclosure. Semi-structured interviews were conducted with eleven CSA survivors aged 14–25 years on their CSA disclosure experiences. Thematic analysis of the transcripts produced four themes that highlight the various impacts of shame post-disclosure: 1) struggles with identifying as a sexual abuse survivor; 2) manifestations of shame; 3) shaming responses to disclosures; and 4) strategies to overcome shame. Clinical implications are presented using a social ecological perspective.

Personal narratives, public risk: using Foucault’s ‘confessional’ to examine adult retrospective disclosures of childhood abuse

Disclosure of childhood sexual abuse is a process that is often laden with boundary testing, decision-making and, at times, risk. Disclosures tend to be delayed, often into adulthood and later life, with disclosures to authorities remaining relatively low. In the Republic of Ireland adults who disclose experiences of childhood sexual abuse are directed towards child protection services due to an interplay between jurisprudence, child protection policy design, and mandatory reporting obligations, requiring social work practitioners to balance the social and the legal. This article compares Foucault’s concept of the confessional to current social work practices of engaging with adult victims and survivors of abuse. It is argued that thinking about these interactions as a confessional-like system highlights a process of knowledge creation that is taking place when a personal narrative of abuse is shared, willingly or via mandated reporting, with a child protection agency under the auspices of a modern state. This ‘confessional-lens’ helps us identify a tipping of the balance in this area of social work practice, away from provision of care and person-centredness, across a boundary, to legalistic practice. Narratives of childhood abuse are transformed into knowledge deemed necessary to assess current risk to children. A process that places the adult on the periphery, leading to a potential for harm and re-traumatisation.

Patterns of disclosure and perceived societal responses after child sexual abuse

BackgroundDisclosure of child sexual abuse (CSA) is key for abused children to access help and to protect them and other children. ObjectiveThe aim of this study was to investigate patterns of disclosure of child sexual abuse and how children perceived responses from people they disclosed to. Participants and settingData were collected online in classrooms and during home studies in a national probability-based sample of 3282 third-year students in Swedish high schools in 2020–2021 (the age of the students varied between 16 and 23 years (M = 18,2)). MethodsResults are presented with frequencies (n) and percentages (%). Pearson's chi-squared test was used for comparisons between groups. ResultsFirst, a substantial share of abused girls and most abused boys had not yet told anyone about the abuse, leaving them unable to access protection or rehabilitation. Second, participants who had disclosed sexual abuse had most often turned to a peer, more rarely to an adult, and seldom to a professional or volunteer. Third, although the societal responses that the participants perceived were mixed, more severe abuse was associated with more negative societal responses. Fourth, most participants stated that they did not need any professional support. Fifth, among the minority who had sought help, half were satisfied and a third dissatisfied. ConclusionsResults showed that most children with experience of CSA did not have access to the protection, support, and rehabilitation that they have a right to. Preventive measures need to target children and young people, while societal responses after CSA, especially severe CSA, need to be improved.

Pervasiveness of child sexual abuse in Kisii county during the Covid-19 pandemic

Child sexual abuse (CSA) is both a social and public health concern locally and globally. A mutual mistaken belief on child sexual abuse is that, it is uncommon occurrence committed against girls by male strangers in both rural and urban areas in Kenya. Notwithstanding myriad research on CSA, little is known about its Pervasiveness. It occurs at all levels of the society affecting not only girls but also boys. The purpose of this study therefore was to investigate the pervasiveness rate of child sexual abuse among pupils during the COVID-19 pandemic. The COVID-19 plague is a international historic incident that will remain to affect approximately every facet of ordinary life, including affecting our economic, political, and healthcare eco-systems. The study was informed by the Attachment Theory which suggests that children’s lives are centered initially on their parents, the family environment being their primary agent of socialization. Systematic random sampling was used to select the respondents to ensure that the sample was a representative. The study utilized descriptive survey design. The study population was 700 pupils out of which a sample size of 100 (14 percent) pupils was selected. The study used questionnaires administered to each respondent. The researcher administered the questionnaires individually to all respondents. The study found out that threats from perpetrators were preventing the disclosure of child sexual abuse. The research recommends that research, programs and policies should focus on child protection. The patriarchal narrative of manhood needs to change and boys should read from a different script on their roles and place in the society.