Rates Of Childhood Sexual Abuse Research Articles

Childhood Sexual Abuse and Adult Sexual Identity Formation: Intersection of Gender, Race, and Sexual Orientation

There is a significantly higher rate of childhood sexual abuse among individuals who identify as lesbian, gay, bisexual, or queer. We describe how being a survivor of childhood sexual abuse can later affect adult sexual identity formation by examining it through the intersection of gender, race, and sexual orientation. Adult lesbian, gay, bisexual, and queer abuse survivors may experience unique clinical challenges while healing from this type of traumatic experience and developing a healthy lesbian, gay, bisexual, or queer identity. We recommend a multicultural clinical approach for family therapists in order to best treat this vulnerable population.

Sexual violence against women: The scope of the problem

Rape and sexual violence occur in all societies, and cut across all social classes. Prevalence estimates of rape victimisation range between 6 and 59% of women having experienced sexual abuse from their husbands or boyfriends in their lifetime. Two population-based studies from South Africa have found that 28% and 37% of men, respectively, have perpetrated rape. Estimates of rape perpetration from high-income countries seem to be lower than those from low- and middle-income countries; however, current data make it impossible to confirm this. Women and girls are much more likely to be the victims and men the perpetrators and, in most instances, the perpetrator is known to the victim. Children are particularly vulnerable to sexual abuse, with girls being at greater risk, especially while at school and at home. High rates of child sexual abuse are emerging from the research, with an increasing understanding of the effect of child sexual abuse on later perpetration and victimisation, highlighting the importance of primary prevention for sexual violence to address childhood exposures to violence. Much of our knowledge about sexual violence has historically been based on research undertaken in high-income countries. This, however, is changing with the emergence of good-quality studies from other settings, particularly in Africa, alongside an increasing number of multi-country studies looking at interpersonal and sexual violence. Most countries lack population data on perpetration of sexual violence, across all categories, including children, and a major gap exists in research on sexual violence among sub-groups and populations. Much of the existing research has limitations that affect cross-study comparability, owing to differences in definitions, research tools, methods and sampling used. Improved research is essential. Research priorities for understanding the magnitude of sexual violence prevalence include assessment of the prevalence and patterns of sexual violence victimisation and perpetration in a range of settings, across a range of acts of sexual violence, in men and women, in adults and children, using methodologies based on best practice in gender-based violence research and standard measures of different forms of sexual violence; research on the social context of sexual violence perpetration and victimisation by both men and women; and methodological research to measure sexual violence for particular population sub-groups or violence types, such as child perpetrators or young child victims, or sexual harassment at work and school.

Penn State Scandal Draws Attention to Child Sexual Abuse

Penn State Scandal Draws Attention to Child Sexual Abuse

A COMPARISON OF MELANCHOLIC AND NONMELANCHOLIC RECURRENT MAJOR DEPRESSION IN HAN CHINESE WOMEN

BackgroundAlthough the diagnosis of melancholia has had a long history, the validity of the current DSM-IV definition remains contentious. We report here the first detailed comparison of melancholic and nonmelancholic major depression (MD) in a Chinese population examining in particular whether these two forms of MD differ quantitatively or qualitatively.MethodsDSM-IV criteria for melancholia were applied to 1,970 Han Chinese women with recurrent MD recruited from 53 provincial mental health centers and psychiatric departments of general medical hospitals in 41 cities. Statistical analyses, utilizing Student's t-tests and Pearson's χ2, were calculated using SPSS 13.0.ResultsMelancholic patients with MD were distinguished from nonmelancholic by being older, having a later age at onset, more episodes of illness and meeting more A criteria. They also had higher levels of neuroticism and rates of lifetime generalized anxiety disorder, panic disorder, and social and agoraphobia. They had significantly lower rates of childhood sexual abuse but did not differ on other stressful life events or rates of MD in their families.DiscussionConsistent with most prior findings in European and US populations, we find that melancholia is a more clinically severe syndrome than nonmelancholic depression with higher rates of comorbidity. The evidence that it is a more “biological” or qualitatively distinct syndrome, however, is mixed.

Brief report: The sexual and physical abuse histories of offenders with intellectual disability

Some studies have found higher rates of childhood sexual abuse in sex offenders while others have failed to find such relationships. This study reviews the sexual and physical abuse histories of 156 male sex offenders with intellectual disability (ID), 126 non-sexual male offenders with ID and 27 female offenders with ID. Sexual offenders reported a higher rate of sexual abuse in childhood than non-sexual male offenders (32.6% vs. 17.8%), while the opposite was true for non-accidental injury (16.0% vs. 32.5%). Female offenders reported the highest rates of sexual abuse in childhood (59.3%). Some specificity of childhood abuse was evident in the male cohorts suggesting limited evidence of a developmental pathway to offending, while the women were a group highly vulnerable to all forms of abuse.

Intimate Partner Violence Among Men Having Sex with Men, Women, or Both: Early-Life Sexual and Physical Abuse as Antecedents

Little is known about the prevalence of intimate partner violence (IPV) among men who have sex with men (MSM) or about childhood adversity as a predictor of IPV among MSM. Studies have documented high rates of childhood sexual abuse among MSM. To evaluate associations of early-life sexual and physical abuse with IPV among African American heterosexual men or MSM, prevalence of early-life (≤ 21 years) sexual and physical abuse was measured among 703 nonmonogamous African American men. Men were classified as (1) MSM who disclosed male sex partners; (2) MSM who initially denied male sex partners but subsequently reported oral-genital and anal-genital behaviors with men; (3) non-MSM. MSM who initially disclosed male sex partners reported significantly (P < 0.0001) higher rates of early physical abuse (36%) and lifetime abuse (49%) compared with non-MSM (15 and 22%), respectively. These MSM reported significantly higher rates of sexual abuse by age 11, age 21, and over a lifetime compared with non-MSM (P < 0.0001). Being an MSM who initially disclosed male sex partners (OR: 2.1; 95% CI: 1.2, 3.6) and early-life sexual abuse (OR: 2.8; 95% CI: 1.8, 4.3) was associated with IPV victimization in current relationships. Similarly, being an MSM with early-life physical and sexual abuse was associated (0.0004 ≤ P ≤ 0.07) with IPV perpetration. Early-life physical and sexual abuse was higher among MSM who disclosed male sex partners compared with heterosexual men; however, all MSM who experienced early-life abuse were more likely to be IPV victims or perpetrators.

Parents' knowledge, attitudes and practices about preventing child sexual abuse: a literature review

AbstractIncreased concern about high rates of child sexual abuse has led to the demand for more prevention programmes, particularly those aimed at parents. Research on how parents manage and reduce the risk of child sexual abuse can help plan programmes. This literature review explores published research on the knowledge, attitudes and practices of parents on the risk and prevention of child sexual abuse and identifies gaps and needs for further research. The majority of studies reviewed originated in North America and Asia, were quantitative, surveyed mainly mothers and were more than ten years old. Recommendations are made for more current and country specific research, further research to gain a deeper understanding of how parents manage the risk of child sexual abuse, more comprehensive research covering a range of knowledge, attitude and practice variables, and greater inclusion of fathers in research. Copyright © 2009 John Wiley &amp; Sons, Ltd.

Childhood Sexual Abuse Is Highly Associated With HIV Risk-Taking Behavior and Infection Among MSM in the EXPLORE Study

Previous studies have found high rates of childhood sexual abuse (CSA) among US men who have sex with men (MSM). CSA history has been associated with a variety of negative effects later in life including behaviors that place MSM at greater risk for HIV acquisition and transmission. The present analysis is the first to examine the longitudinal association between CSA and HIV infection, unprotected anal sex, and serodiscordant unprotected anal sex, as well as mediators of these relationships among a large sample of HIV-uninfected MSM. The EXPLORE Study was a behavioral intervention trial conducted in 6 US cities over 48 months with HIV infection as the primary efficacy outcome. Behavioral assessments were done every 6 months via confidential computerized assessments. Longitudinal regression models were constructed, adjusting for randomization arm, geographical location of study site, age at enrollment, education, and race/ethnicity. Of the 4295 participants enrolled, 39.7% had a history of CSA. Participants with a history of CSA [adjusted hazards ratio = 1.30, 95% confidence interval (CI): 1.02 to 1.69] were at increased risk for HIV infection over study follow-up. A significant association was seen between history of CSA and unprotected anal sex (adjusted odds ratio = 1.24, 95% CI: 1.12 to 1.36) and serodiscordant unprotected anal sex (adjusted odds ratio = 1.30, 95% CI: 1.18 to 1.43). Among participants reporting CSA, the EXPLORE intervention had no effect in reducing HIV infection rates. Participants reporting CSA were significantly more likely to have symptoms of depression and use nonprescription drugs. A predictive relationship between a history of CSA and subsequent HIV infection was observed among this large sample of HIV-uninfected MSM. Findings indicate that HIV-uninfected MSM with CSA histories are at greater risk for HIV infection, report higher rates of HIV sexual risk behavior, and may derive less benefit from prevention programs. Future HIV prevention interventions should address the specific mental health concerns of MSM with a history of CSA.

The international epidemiology of child sexual abuse: A continuation of Finkelhor (1994)

Objective The purpose of this paper was to compare the prevalence rates of child sexual abuse reported by [Finkelhor, D. (1994). The international epidemiology of child sexual abuse. Child Abuse & Neglect, 18 (5), 409–417] with those found in recent publications in order to confirm the widespread prevalence of child sexual abuse. Methods Relevant articles about prevalence of child sexual abuse were identified through searches of computerized databases and a handsearch of Child Abuse & Neglect and the Journal of Child Sexual Abuse. Results Thirty-eight independent articles were identified, corresponding to 39 prevalence studies; these articles report the prevalence of childhood sexual abuse in 21 different countries, ranging from 0 to 53% for women and 0 to 60% for men. Conclusions Comparison of the present study with that of [Finkelhor, D. (1994). The international epidemiology of child sexual abuse. Child Abuse & Neglect, 18 (5), 409–417] shows a similarity between prevalence distributions; there appears to be a general pattern that remains more or less constant over the years, especially in women. Practice implications Twelve years after the first revision study about the international prevalence of child sexual abuse, there is still a need for new data about this topic. The present study shows child sexual abuse is still a widespread problem in the society. In this research, carried out on 38 independent studies, there is new data for 21 countries over the world, being especially relevant the results obtained from other countries different from those pertaining to North America or Europe. It is important to point out the high prevalence found in most of the countries, so this information could be a new warning to make society and governments aware of this problem and undertake actions to prevent sexual abuse in childhood.

History of Childhood Sexual Abuse and Unsafe Anal Intercourse in a 6-City Study of HIV-Positive Men Who Have Sex With Men

We assessed rates of childhood sexual abuse and its demographic and mental health correlates among HIV-positive men who reported unsafe anal intercourse with other men in the past year. We conducted a cross-sectional analysis of baseline data from 593 HIV-positive men who have sex with men enrolled in the Positive Connections intervention. Childhood sexual abuse was reported by 47% of participants; 32% reported frequency as often or sometimes. Men reporting abuse were more likely to be Latino (odds ratio [OR] = 2.6; 95% confidence interval [CI] = 1.6, 4.2; P < .001) or African American (OR = 1.8; 95% CI = 1.2, 2.7; P = .005) than White. Among those who were abused, more frequent abuse was associated with more sexual contacts (for each, rate ratio [RR] = 1.3; P < .001) and unsafe anal intercourse (often, RR = 1.5; sometimes, RR = 2.0; P < .001) compared with men who were not abused. History of childhood sexual abuse is highly prevalent among HIV-positive men who engage in risky sexual behavior with other men and appears to be more common among men of color. Our findings suggest that abuse is associated with a significantly increased risk of sexually transmitted infections.

Racial Disparities In Trauma Exposure, Psychiatric Symptoms, and Service Use Among Female Patients In Veterans Affairs Primary Care Clinics

We sought to compare female African-American (n = 84) and Caucasian (n = 99) veterans from primary care clinics at 4 Veterans Affairs Medical Centers (VAMCs) on rates of trauma, posttraumatic stress disorder, other psychiatric diagnoses, functional status, and use of VA services and disability benefits. Analyses were based on a cross-sectional, epidemiologic design incorporating self-report measures, structured interviews, and chart reviews. With the exception of higher rates of child sexual abuse among Caucasian women and higher rates of physical assault among African-American women, there were no other statistically significant racial differences across analyses. However, some clinically meaningful trends emerged, and the implications of these findings are discussed within the context of our other results. Among female veterans seen in VA primary care clinics, African-Americans and Caucasians do not differ dramatically with regard to the manifestation or severity of psychopathology, or in their use of relevant VA health care services and disability benefits. These data are important because women represent the fastest growing segment of the VA population after aging veterans. Further research is needed to replicate and extend these findings to ensure that female veterans' needs are adequately identified and met by VAMC providers.

Childhood Sexual Experiences and Adult Health Sequelae Among Gay and Bisexual Men: Defining Childhood Sexual Abuse

Gay and bisexual men carry the burden of HIV infections in the United States and have high rates of childhood sexual abuse that predict HIV and other health outcomes. This study examined differential effects of forced, consensual, and no childhood sexual experiences (CSE) on health outcomes among a probability sample of adult men who have sex with men (MSM). The forced sex group had the highest levels of psychological distress, substance use, and HIV risk. There were no differences in rates of depression and suicidal ideation between the consensual- and no-sex groups. The consensual- and forced-sex groups had higher rates of substance use and transmission risk than the no-sex group. The forced-sex group, however, had significantly higher rates of frequent drug use and high-risk sex than the consensual group. Findings suggest that forced CSEs result in a higher-risk profile than consensual or no childhood sexual experiences, the kind of risk pattern differs between forced and consensual childhood sexual experiences, and the underlying mechanisms that maintain risk patterns may vary. It is important to clarify risk patterns and mechanisms that maintain them differentially for forced and consensual sex groups so that interventions may be tailored to the specific trajectories related to each experience.

Childhood Sexual Abuse and Intimate Partner Violence among Women in Methadone Treatment: A Direct or Mediated Relationship?

Women in substance use treatment report rates of childhood sexual abuse and intimate partner violence that far exceed those reported by women in the general population. Previous research with nonrandom samples of women in substance use treatment suggests that there is a statistically significant relationship between childhood sexual abuse and intimate partner violence; however, little is known about the mechanisms of risk between these two public health concerns among this population of women. To address this gap in knowledge and to inform intervention strategies, this study examined direct and mediated relationships between childhood sexual abuse and intimate partner violence risk among a random sample of 416 women in methadone treatment. In addition to high rates of childhood sexual abuse (57.9%), intimate partner violence (lifetime prevalence, 89.7%; 6-month prevalence, 78.4%), posttraumatic stress disorder (PTSD, 28.6%), and global psychological distress (19.5%), findings suggest that the relationship between childhood sexual abuse and intimate partner violence is mediated by mental health problems and that women experiencing PTSD or global psychological distress are 2.7 and 2.4 times more likely to experience intimate partner violence than women without such experiences, respectively. Although not a mediator in this relationship, financial independence reduced women's risk of partner violence by two-thirds. The paper includes discussion of social learning and stress and coping theories to explicate the findings and to inform intervention strategies.

Drinking and Drinking-Related Problems Among Heterosexual and Sexual Minority Women

Studies of alcohol use among lesbians have typically used convenience samples with uncertain generalizability or general population samples with small numbers of lesbians. Here we compare rates of high-risk and problem drinking in a large sample of Chicago-area lesbians and a national sample of age- and education-matched urban heterosexual women. Data came from comparable face-to-face interviews with 405 self-identified Chicago-area lesbians and with 548 urban women from a U.S. national sample. Rates of hazardous drinking (heavy episodic drinking, intoxication, drinking-related problems, alcohol-dependence symptoms) were compared for exclusively heterosexual, mostly heterosexual, bisexual, mostly lesbian, and exclusively lesbian subgroups. Exclusively heterosexual women had lower rates than did all other women on all measures of hazardous drinking. Exclusively heterosexual women also reported less childhood sexual abuse, early alcohol use, and depression. Bisexual women reported more hazardous drinking indicators and depression than did exclusively or mostly lesbian women. These results indicate that sexual minority women are likely to have elevated risks of hazardous drinking. The differences between lesbian and bisexual women suggest that more attention is needed to subgroup differences among sexual minority women. Health care providers need to know the sexual identity of their patients and how their sexual identity may affect their risks for hazardous drinking. Higher rates of childhood sexual abuse, early drinking, and depression among sexual minority women suggest that these experiences may be important in assessing and treating problems related to their drinking, and in developing prevention and early intervention strategies.

Childhood Sexual Abuse and Psychosomatic Symptoms in Irritable Bowel Syndrome

ABSTRACT Irritable bowel syndrome is characterized by chronic gastrointestinal symptoms without a demonstrable physical cause. In a subgroup of patients, irritable bowel syndrome may be part of a cluster of psychosomatic symptoms related to childhood sexual abuse. To investigate this possibility, the Dissociative Disorders Interview Schedule (DDIS), the Dissociative Experiences Scale (DES) and the Symptom Checklist-90 (SCL-90) were administered to 105 subjects with either irritable bowel syndrome, inflammatory bowel disease (Crohn's disease or ulcerative colitis), or other gastrointestinal disorders. The subjects in the three groups did not differ on the DES, the SCL-90 or most sections of the DDIS. However, subjects with irritable bowel syndrome reported much higher rates of childhood sexual abuse and psychosomatic symptoms.

Alcoholic subtypes: are two sufficient?

Guided by the literature on alcohol subtypes, cluster analytical solutions ranging from two to five were evaluated for a large (n = 802), ethnically diverse sample of alcoholic in-patients. Personal interview data were collected from in-patients regarding their substance abuse and psychiatric disorder status, risk factors for psychopathology and health outcomes. The data were collected at five alcohol in-patient treatment settings in New York; three settings were in New York City, one in Rochester and one in Buffalo. The sample included 802 participants (481 males and 321 females) with racial/ethnic group diversity (418 blacks, 180 whites, 187 Hispanics, 17 of other ethnic origin). Subjects were assessed with standardized measures of substance abuse and psychiatric disorders, family history of alcoholism, psychopathy, temperament, alcohol expectancies and clinical health variables. Based on internal and external criteria and compatibility with the existing literature, four subtypes were identified: mild course, polydrug, negative affect and chronic/antisocial. On external criteria, the polydrug subtype had the highest rate of family criminality, high-risk sexual behavior and intravenous drug use; the negative affect subtype had the highest rate of childhood sexual abuse, attempted suicide and childhood homelessness; the chronic/antisocial personality (ASP) subtype had the most severe pattern of drinking and antisocial behavior. Findings are discussed with regard to the etiological and clinical utility of the four-subtype formulation, and consistency with recent studies in molecular genetics and pharmacology.

The Legacy of Child Sexual Abuse

The personal narrative, Cherchez la Femme, Cherchez la Femme: A Paradoxical Response to Trauma by Penelope Hollander, is a poetic and poignant account of one woman’s struggles with the psychological effects and enduring legacy of sexual abuse by her father. She writes of the spectrum of confusing and contradictory affects associated with the experience. She tells us there was a “feeling of genuine pleasure from the perpetrator . . . dad aroused great pleasure in me,” but there were also symptoms of “migraines, vomiting, nervous coughing, choking, and truant absenteeism from school”. She raises one of the enduring questions regarding the sexual molestation of children. “What does it mean to be a victim and survivor of childhood trauma?” In this short commentary, I will present my current understanding of the process, but I will introduce it with two caveats: 1) To paraphrase Tolstoy, each victim is unique in his or her own way; and 2) “It’s not so important that we understand everything clearly but that we clearly understand where the obscurities are” (Freud, 1926). We will see there are a lot of obscurities. The history of society is replete with the multiplicity of ways in which children have been traumatized (Demause, 1991). Finkelhor (1994) has commented on the universality of the sexual maltreatment of children. In a review of 19 countries, he found the rates of child sexual abuse to be generally similar around the world (Finkelhor, 1994). Sexual maltreatment of children usually takes one of three forms: 1) the sexual exploitation of children to gratify one’s own physical sexual needs; 2) the excessive erotization of children through inappropriate sexual stimulation; and, 3) the mortification, vilification, and suppression of the child’s emerging sexuality (Finkelhor, 1991). Although the rates of child sexual abuse in the United States have declined in recent years, nevertheless it is estimated that 12% to 35% of women and 4% to 9% of men have unwanted sexual experiences prior to 18 years of age (Putman, 2003). Sexual abusive behaviors refer to any sexual behavior which occurs: 1) without consent, 2) without equality, or 3) as a result of coercion. Children legally and by definition of their limited cognitive development and experiences in the world are not able to give consent. An understanding of the psychological effects of traumatic childhood sexual abuse requires an understanding of the developing child as well as the centrality of affects associated with childhood sexual abuse. While children are generally exposed to the same traumatic happenings as adults, the trauma occurs in a developing child who is in the midst of elaborating an inner representational world, sensual-sexual motivational Psychiatry 67(3) Fall 2004 217

Rates of child sexual abuse are growing in Gambia

Child sexual abuse, through sex tourism and sexual exploitation by men, is increasing in Gambia, says a new report by the Gambian government and Unicef. Many tourists from developed countries visit the country mainly to have sex with young adults or children. Tourists in Gambia come mainly from Britain, Sweden, Norway, Denmark, Finland, the Netherlands, and Germany. “Gambia is a vulnerable target for unscrupulous visitors such as suspected or convicted paedophiles who enter the country in search of a …

Health promotion work in the juvenile justice system

Adolescents in the juvenile justice system (JJS) have a variety of behaviors that put their present and future health at risk. High rates of childhood sexual abuse, substance abuse, sexual risk behaviors and Chlamydia infection form a constellation that is not addressed by JJS, school, or STD clinic providers. Because many do not attend school or use clinical services, locating prevention programs in the JJS presents an important and underused way to reach this population. The goal of Girl Talk-2 was to compare the effects of a theory-driven HIV/STD empowerment intervention to that of a video/lecture program among girls in the JJS. The feasibility of conducting research interventions in the JJS was also assessed.

Lesbians’ Drinking Patterns: Beyond the Data#

Early studies report very high rates of “alcohol abuse” and alcoholism among lesbians. However, serious methodological problems, including nonrepresentative samples that were often recruited in lesbian or gay lesbian bars, limit the validity of findings from these studies. In this article, I briefly review the literature on lesbians’ use of alcohol and present findings from a recent study conducted in Chicago (USA). This study recruited a race- and age-diverse sample of lesbians and a demographically matched group of heterosexual women. Rates of “heavy” alcohol use and alcohol-use-related problems among lesbians were much lower in this study than in early studies. However, lesbians were more likely than their heterosexual counterparts to be in recovery and to have been in treatment for alcohol-use-related problems. Further, high rates of childhood sexual abuse, depression, and suicidal ideation reported by lesbians suggest that at least some groups may be at heightened risk for “heavy” drinking and drinking-related problems. Nevertheless, results of this and other studies suggest that reports of heavy drinking and drinking-related problems among lesbians may have been inflated in earlier studies, or that heavy drinking and drinking-related problems may have declined among lesbians.