Intrafamilial Child Sexual Abuse Research Articles

The effectiveness and impact of the child protection and criminal justice systems in cases of intrafamilial child sexual abuse

Purpose – The purpose of this paper is to report on the findings from a study commissioned by the Office of the Children’s Commissioner (OCC) in England, concerning intrafamilial child sexual abuse (IFCSA)/incest. Specifically, it aims to explore the evidence about child protection and criminal justice responses to victims of IFCSA in the UK and where the gaps in these approaches lie. Design/methodology/approach – A Rapid Evidence Assessment (REA) was used, the function of which is to: search the literature as comprehensively as possible within given time constraints; collate descriptive outlines of the available evidence on a topic and critically appraise it; sift out studies of poor quality; and provide an overview of the evidence. Over 57,000 documents were scanned, and 296 ultimately systematically analysed. Findings – It was found that children may be re-victimised by various aspects of “the system” and professionals within it, including social workers, police officers, and lawyers. Research limitations/implications – A REA is not a full systematic review, differing in the scope and depth of the searches and depending almost exclusively on electronic databases, not accompanied by searching journals by hand. Originality/value – The findings of this research provide the evidence-base for a new two-year inquiry into the subject of IFCSA by the OCC.

Healing from Intrafamilial Child Sexual Abuse: The Role of Relational Processes between Survivor and Offender

The research aim was to discover the circumstances, if any, in which contact with the parent who had abused them, could help survivors of intrafamilial child sexual abuse (ICSA) to recover from the inherent relational trauma. Thirty-five (31 female and 4 male) participants were recruited from across Australia and New Zealand to speak about their experience of post-abuse contact. The research methodology was primarily qualitative, and analysed in a contextual framework. In the Pre-Contact stage, themes such as the need for empowerment versus the fear of the response, linked to motivations for and against contact. Emotional reactions, and issues of acknowledgment and apology were core themes in the Contact stage. Post-contact themes related to evaluation of the overall experience. The majority of participants believed that their contact experience had helped more than hindered their recovery. Participants articulated the need for more public education about the complexity of ICSA, more options for dealing with the crime, and access to non-judgmental professional help for all the family at disclosure. The emergent themes provide a valuable guide for future research, policy and practice and perhaps most importantly, insight into the needs of victims and their recovery processes.

Torn: Social Expectations Concerning Forgiveness Among Women Who Have Experienced Intrafamilial Child Sexual Abuse.

The authors examine how women who experienced intrafamilial child sexual abuse (IFCSA) perceive social expectations of society toward forgiveness, how they incorporate IFCSA and reconstruct their life stories in relation to these expectations, and the costs and gains from such reconstructions. This is part of a larger study on the phenomenology of forgiveness for IFCSA among grown women. Twenty Jewish Israeli women who had experienced IFCSA were interviewed in depth. Interviews were tape-recorded and transcribed verbatim. Data analyses lead to four types of social expectations: forgiveness by forgetting, avenging, family preservation through forgiveness, and satisfying the voyeuristic needs of society, which has limited interest in forgiveness. These contradictory expectations are discussed in light of the cultural context and the experience of the women interviewed. Implications for practice are suggested.

The Relationship between Intra/Extra-familial Childhood Sexual Abuse and Survivors' Mental Health

The impact of intra-familial sexual abuse and extra-familial sexual abuse on children is the focus of this article. Intra-familial childhood sexual abuse is a common occurrence within the African population but its impact is not reported. A sample of sexually abused children referred for psychological intervention in a general hospital in South Africa was assessed for symptoms of depression, PTSD, and cognitive deficits. The results showed that while most of the children present with subclinical symptoms of depression and posttraumatic stress disorder they scored below average on most tests of cognitive functioning. Psychological theories are used to conceptualize the results.

Inconsistent retrospective self-reports of childhood sexual abuse and their correlates in the general population.

Epidemiological research on childhood sexual abuse (CSA) and its consequences in adult life mainly relies on retrospective reports. This study explores their consistency and the correlates of inconsistent CSA self-reports in a random population sample. A stratified subsample of 2,462 subjects (selected from a large-scale (N = 34,267) representative sample of Dutch adults aged 40 and beyond) participated in a two-phase online questionnaire survey on extra-familial CSA which was conducted on a four- to six-week interval. Subjects reporting CSA were overrepresented. Participants with consistent and inconsistent responses were compared with regard to demographics, family background, abuse severity, and clinical characteristics. Potential correlates of inconsistency were identified using logistic regression analysis. An additional questionnaire (Phase III) administered to inconsistent respondents explored possible reasons for their inconsistency. Of the 1,992 respondents who had reported extra-familial CSA during Phase I, 707 (35.5%) denied this in Phase II. Of the 2,462 respondents in Phase II, 727 (29.5%; 9.2% when considering sample stratification) gave a discrepant answer to the extra-familial sexual abuse item compared to their answers given in Phase I. Reports of less severe abuse, intra-familial CSA, and early parental separation predicted inconsistency. Reasons provided for inconsistency varied from misunderstanding (e.g., reporting intra-familial CSA rather than extra-familial CSA) to emotional motives (e.g., embarrassment, being overwhelmed) or practical considerations (e.g., lack of privacy while filling out the questionnaire). Inconsistent self-reports of extra-familial sexual abuse occur on a substantial scale and are associated with less severe forms of abuse (lack of salience) or classification difficulties (perpetrator being a family member or not). Consistency tests and probing for clarifications or corrections should be routinely conducted in order to increase the quality of CSA epidemiological research.

Use of the Phrase Inventory of Intrafamily Child Abuse (PIICA) with Brazilian Victims of Sexual Abuse

Intrafamily child sexual abuse (ICSA) is considered a major risk factor for the emergence of countless disorders for those who suffer it. Some instruments have been used to diagnose and assess the effects of ICSA, such as the Phrase Inventory of Intrafamily Child Abuse (PIICA). The instrument was completed by 747 Brazilian children aged between 6 and 16 years; 209 were victims of ICSA. The results showed that the victimized children presented higher rates of symptoms in all levels assessed by the PIICA (emotional, social, physical, cognitive, and behavioral) when compared to non-victims. The findings suggest that the PIICA is a reliable, valid, and promising measure to assess the global effects of ICSA.

Perceived Parenting Competencies following Childhood Sexual Abuse: A Moderated Mediation Analysis

Childhood sexual abuse (CSA) survivors may face specific challenges in their parental role because of the negative sequelae of their abuse. This study explored factors that might heighten or buffer the risk for problems in parenting for intrafamilial CSA survivors. A community sample of 54 CSA mothers completed questionnaires assessing the severity of their CSA experiences, current depressive symptoms, partner support, and key parenting dimensions. Six moderated mediational models revealed that CSA severity indirectly impacted the survivor’s bond with her child, limit setting ability, communication, and parental involvement through depressive symptoms at high levels of partner support. Partner support was protective against many difficulties in parenting at low levels of depressive symptoms, but did not promote, and at times hindered, effective parenting at high depressive symptoms. This study’s findings highlight the importance of attending to risk and protective factors in understanding parenting among CSA survivors.

1485 – Evaluation of the effect of specialized group therapy on sexual problems in women with a history of child sexual abuse

Childhood sexual abuse (CSA) is most often associated with sexual problems in adult women. Specialized group therapy is often referred to as the treatment of choice targeting squeal in adults with a history of CSA, but the therapy as well as the outcome measures seldom addresses the sexual problems specifically. The aim of the study was to investigate the effect of specialized group therapy on sexual function in women with a history of intrafamilial child sexual abuse (CSA). This prospective multicentre pre-post study of women with a history of hands-on intrafamilial CSA referred to the psychiatric clinics for specialized group therapy included 158 women. Data concerning social and psychological functioning, body image, and current sexual life were collected using self-rating questionnaires and conducting a clinical interview before and after group therapy. Data were available pre and post treatment for 132 women. There was some effect on unspecific sexual problems and sexual dysfunctions. Still, at the end of treatment nearly half of the women were unsatisfied with their sexual life, and among sexual active women half had still sexual dysfunction. Especially dyspareunia and orgasmic dysfunction were common. The present study showed that women with a history of intrafamilial CSA who had completed specialized group therapy still have many sexual problems and may need psychosexual therapy. This need to be taken in consideration When designing treatment programs.

Sexual function in women with a history of intrafamilial childhood sexual abuse

This study investigated sexual function in women with a history of severe intrafamilial childhood sexual abuse (CSA) and the correlation between sexual problems and the severity of CSA, adult support during childhood and current psychiatric symptoms. The sample consisted of 158 women who subsequently began specialized group psychotherapy for CSA sequellae. Clinical interview and questionnaires (Present Sexual Function, Sexual and Body Satisfaction, Symptom Check List 90-R) were used for data collection in a cross sectional study design. Non-parametric analysis, linear and logistic regression analysis were applied. Of the women, 63% were unsatisfied with their current sexual life, 39% felt uncomfortable with physical endearments and 71% were unsatisfied with their body. Only 82% had an active sexual life and, of these, 73% reported at least one sexual problem, 48% orgasmic problems and 45% dyspareunia. The occurrence of sexual problems was significantly correlated to childhood physical violence, current psychological distress, flashbacks in sexual situations and discomfort with physical endearment. The prevalence of sexual pain disorders were also positively correlated to “no adult support” in childhood. The present study finds that psychiatric patients in terms of women with a history of intrafamilial CSA have wide-ranging sexual problems. It is crucial to screen for sexual problems and address them during treatment.

Aile içi cinsel istismar sonrası zedelenmiş cinsellik: Kompulsif cinsel davranışları olan bir olgu sunumu

Intrafamilial child sexual abuse is one of the most diffucult issue to be talked over and studied. All instances of abuse are not recognized or reported because of shame and guilt feelings, or hidden from other family members. It can lead to both immediate and long-term adverse behavioral and psychological effects that carry over into adulthood. A causal model identifying rehationship among sexual abuse situation characteristics, based on Finkelhor and Browne?s traumagenic model of childhood sexual abuse has four traumatic dynamics, including traumatic sexuality with abuse, feeling of betrayal, weakness and stigmatization. Traumatic sexuality can be defined as deviation of the development of sexual feelings and attitudes from normal. The documented long-term effects of childhood sexual abuse on adult functioning include affective disorders, self destructive behaviors, posttraumatic stress disorder and disturbed interpersonal relationships. In this article, we present a case with sexual obsessions and compulsive sexual behaviours, which developed after intrafamilial sexual abuse.

Sexual Abuse, Sexual Orientation, and Obesity in Women

Among adult women an association between childhood sexual abuse (CSA) and obesity has been observed. Research with lesbian women has consistently identified high rates of obesity as well as frequent reports of CSA, but associations between sexual abuse and obesity have not been fully explored. Our aim was to investigate the relationship between sexual abuse (SA) history and obesity among heterosexual (n = 392) and lesbian (n = 475) women (age 35-64) who participated in the Epidemiologic STudy of HEalth Risk in Women (ESTHER) Project in Pittsburgh, Pennsylvania. Obesity was defined as body mass index (BMI) > or =30. Covariates included self-reported SA, sexual orientation, demographic factors, and history of a depression or anxiety diagnosis. SA history was assessed by three factors: (1) SA experienced under the age of 18 by a family member or (2) by a nonfamily member and (3) forced, unwanted sexual experience(s) at age > or =18. Data were analyzed using chi-square tests and logistic regression models. Multiple logistic regression analyses revealed that obesity was associated with African American race, lesbian sexual orientation, intrafamilial CSA, and history of mental health diagnosis. Protective factors were having a household income of at least $75,000 and having a bachelor's degree or higher. Results suggest that lesbian women may be at greater risk of obesity than heterosexual women and that intrafamilial CSA--regardless of sexual orientation--may play a role in the development of obesity.

Childhood experiences of sexual abuse and later parenting practices among non-offending mothers of sexually abused and comparison girls

Objective The primary goal of this study was to explore the relationship between childhood sexual abuse and parenting practices among non-offending mothers of sexually abused girls. Guided by a developmental-ecological perspective of parenting, several models with different potential pathways starting from the mothers’ childhood experiences of sexual abuse and culminating in their parenting practices (e.g., direct, spurious, indirect effect) were hypothesized and explored in the context of the mothers’ past and current psychosocial risks and resources. Two dimensions of parenting were considered: providing positive structure (i.e., ratings of how consistent, fair, easygoing), and using punitive discipline. Methods This study utilized a sample from a longitudinal, multigenerational study in which sexually abused girls, demographically similar comparison girls, and the mothers of both groups of girls participated. For the current study, the data regarding the mothers of the two groups of girls was of primary importance. Results The results from a series of model comparison tests supported the spurious effect of mothers’ childhood sexual abuse on the positive structure dimension. A direct, inverse relationship was found as the most accurate model with the punitive discipline dimension. Overall, childhood experience of punitive discipline, current dissociative symptoms, and satisfaction with social support were indicated as possible correlates of parenting practices among the mothers. Conclusions The significance of these findings is discussed in the context of theories concerning childhood trauma and parenting, as well as the intergenerational process of child maltreatment. Practice implications of the findings are also presented and discussed in terms of intervention programs for families where intrafamilial child sexual abuse occurs.

Coping with child sexual abuse among college students and post-traumatic stress disorder: The role of continuity of abuse and relationship with the perpetrator

Objective The purpose of this study was to examine the effects of child sexual abuse (CSA) on the use of coping strategies and post-traumatic stress disorder (PTSD) scores in young adults, as well as the role of avoidance and approach coping strategies in those PTSD scores in CSA victims. The role of coping strategies was studied by considering their possible interactive effect with the continuity of abuse and the relationship with the perpetrator; the effect of coping strategies on PTSD was also compared between CSA victim and non-CSA victim participants. Method The sample was comprised of 138 victims of CSA and another 138 participants selected as a comparison group. Data about child sexual abuse were obtained from a questionnaire developed for this purpose. Coping strategies were assessed with the How I Deal with Things Scale (Burt & Katz, 1987), while PTSD scores were assessed with the “Escala de Gravedad de Síntomas del Trastorno de Estrés Postraumático” (Severity of Symptoms of PTSD Scale; Echeburúa et al., 1997). Results Participants who had been victims of CSA showed significantly higher PTSD scores and lower approach coping strategies scores. However, differences in avoidance coping strategies between groups were not consistent and did not always follow the expected direction. Only the use of avoidance coping strategies was related to PTSD, participants who used these showing higher scores. The effects of avoidance strategies were stronger in continued than in isolated abuse, in intrafamilial than in extrafamilial abuse and in CSA victims than in non-victims. Conclusions These results confirm the idea of CSA as a high-risk experience that can affect the victim's coping strategies and lead to PTSD to a lesser or greater extent depending on the coping strategy used. Moreover, the role of these strategies varies depending on whether or not the participant is a victim of CSA and on the characteristics of abuse (continuity and relationship with the perpetrator). Practice implications In terms of intervention, a reduction of avoidance-type strategies appears to have a beneficial effect, especially in the case of intrafamilial and/or continued CSA victims. The encouragement of “spontaneous” approach strategies (devised by the victim herself, without counseling) would probably not lead to more positive outcomes in terms of PTSD symptomatology. However, encouraging CSA survivors to engage in therapy aimed at developing effective approach strategies, as other studies have suggested, may help reduce PTSD symptoms.

African-American Undergraduates' Perceptions and Attributions of Child Sexual Abuse

This study examined perceptions of child sexual abuse and attributions of responsibility in a cross-sectional convenience sample of 384 African-American undergraduates using a scenario manipulating the age of the victim, gender of the victim, and gender of the perpetrator. Multiple interactions of respondent, victim, and perpetrator gender on perception of intrafamilial child sexual abuse and attributions of responsibility for victim, perpetrator, and parents were obtained. These results extended previous research conducted on primarily Caucasian samples and highlighted the moderating role of gender of the respondent for this ethnicity.

Child sexual abuse as a risk factor for sexual risk behaviours among socially disadvantaged adolescents in Ibadan, Nigeria

This study documents the prevalence and association between child sexual abuse (CSA) and risky sexual behaviours among in-school adolescents in Ibadan, Nigeria. A cross-sectional study with 1,079 boys and 1,211 girls was conducted in 22 socially disadvantaged public secondary schools in a suburb of Ibadan, Nigeria. A 70-item sexual risk behaviour questionnaire was used to collect information on lifetime and current sexual experiences. Fifty-five per cent of students reported to have ever experienced at least one form of CSA. Thirty-six per cent reported a history of intra-family CSA, whereas 46% had experienced inter-family CSA. Five hundred and sixty-four (24.6%) of these adolescents were sexually active at the time of the study. There was a strong relationship between having ever experienced CSA and sexual risk behaviours: adolescent boys and girls with CSA were three-fold as likely not to use condom at last vaginal intercourse; thrice as likely to engage in casual sex with a partner known for a day; twice as likely to drink alcohol heavily before sex; thrice for tobacco smoking and three- fold for STD. Logistic regression shows that the relationship between CSA and non-use of condom at last vaginal intercourse remained after controlling for age, family type, parents staying together and hawking after school. We found that experiences of CSA may precipitate risky sexual behaviours in this population. A structural and educational approach towards educating both adolescents and parents of the possible effect of CSA to sexual risk behaviours is presented in this article.

Child maltreatment at a violence recovery centre in Kenya

Kenyan media reports indicate escalating levels of child maltreatment, but the characteristics of the offence are undefined. At the Gender and Violence recovery Center of the Nairobi Women's Hospital, we analysed 342 consecutive children for age, gender, perpetrator characteristics, time and scene of assault and the nature of injuries between February 2003 and April 2004. The children comprised 43.5% of all assault survivors. The mean age was 10.0 years and about 20% of the children were < or =5 years. Most (71.5%) of the child sexual abuse (CSA) was perpetrated by people known to the victim. Intra-family CSA (incest) was highest among the one to five year olds. The proportion of assaults committed against boys reduced with the age of the child. Older children were more likely to be assaulted later in the day and by multiple perpetrators. Most recorded injuries were perineal. The majority of children are assaulted by people they had trusted. The epidemiological correlates of maltreatment differ for younger and older children. More effort is needed to further characterize child violence and protect this vulnerable section of the population.

Erratum

Lau M, Kristensen E. Outcome of Systemic and Analytic Group Psychotherapy for Adult Women with History of Intrafamilial Childhood Sexual Abuse:A Randomized Controlled Study. Acta Psychiatric Scand 2007:116: 96–104. Unfortunately some of the descriptive data have been reported incorrectly. On page 99 the 7th line from the bottom, the correct number of patients included in the completer analysis (CS) is: 40 and 46 as reported on page 100 in fig.1. In table 1 (page 100) the correct number (%) of cohabitant patients is: Group A = 12 (30.0%) and Group S = 23 (50.0%). A wrong version of table 2 was printed. The correct table is available on request from the author Marianne Lau (marlau01@psv1.regionh.dk). The only substantial discrepancy to the table in the original paper relates to use of force in CSA The correct numbers (%) for Group A/Group S are: ‘No violence’: 21 (52.5%)/26 (56.5%), ‘Threats’: 5 (12.5%)/3 (6.5%) and ‘Violence’: 14 (35.0%)/17 (37.0%. The difference between the two groups is still insignificant.

Outcome of systemic and analytic group psychotherapy for adult women with history of intrafamilial childhood sexual abuse: a randomized controlled study

Research suggests that group psychotherapy for adults with a history of child sexual abuse (CSA) is generally beneficial. Only few studies have included random assignment. This study compared the effects of analytic (A) and systemic group psychotherapy (S) on CSA. One hundred and fifty-one women with intrafamilial CSA were randomly allocated to A or S. Quality of life, psychosocial function, psychological distress, and flashbacks were assessed before and after treatment. Both completer analyses and intent-to-treat analyses were carried out. Eighty-two patients completed group therapy. Both therapies led to the improved quality of life, fewer psychopathological symptoms, and better overall functioning, but overall the outcome of S was significantly better than the outcome of A. Women with CSA sequelae benefit from both A and S. In the short-term, S is both statistically and clinically superior to A. Longer-term follow-up data are required for conclusions on maintenance of therapeutic gains.

Women with a history of childhood sexual abuse. Long-term social and psychiatric aspects

The socio-demographics and psychiatric diagnoses in a clinical sample of women with a history of mainly intrafamilial childhood sexual abuse (CSA) are described. The women were referred to five psychiatric centres for incest group psychotherapy. Data were gathered using interviews and self-administered questionnaires. Over a period of 2.5 years, 385 women with mean age of 33 years were referred with a history of CSA. Three hundred and forty of those had experienced intrafamilial CSA. The average age at first abuse was 6.8 years, and it lasted for a mean of 6 years. The women had been abused by a mean of 1.5 perpetrators. A quarter of the women had been subjected to violence in connection with the sexual abuse. The likelihood of violence having occurred rose significantly if there was more than one perpetrator and/or if penetration had been part of the sexual abuse. Violence was less common if the perpetrator was a brother. The women suffered from a broad spectrum of psychiatric symptoms and illnesses. More than half of the women had previously received psychiatric treatment. Compared to a random sample of the general female population, these women were less advantaged with regards to education, financial circumstances and cohabitation. The results emphasize the importance of offering comprehensive social and psychiatric intervention to help reducing the problems following CSA in women.

Child victims of sexual abuse: Children's experience of the investigative process in the criminal justice system

This paper is a selected review of research on issues surrounding the investigation of intra-familial child sexual abuse for children aged eight and above, in the criminal justice system. Particular attention is paid to features of the investigative interview in relation to the child's level of understanding, ability to report and likely emotional response when the proceedings take place. Best practice by police and social care agencies involves establishing valid and reliable information from children while attending to their developmental level and emotional state. The review aims to distil principles optimising this process from both the investigative judicial perspective and the child's focus, as well as from the inter-agency perspective and information sharing. Recommendations are made for improving the interview process based on research and methods from a range of disciplines and to optimise information recording in a format easily shared between agencies. Updated and ongoing training procedures are key to successful practice with training shared across police and social work agencies. The focus of this review is informed by preliminary findings from pilot research in progress on behalf of the Metropolitan Police Child Abuse Investigation Command.