Child Of Sexual Abuse Research Articles

Providing Sexual Education to Victims of Child Sexual Abuse: What Is a Clinician to Do?

ABSTRACT Despite the large body of research on childhood sexual abuse, virtually no one has examined the coverage of sexual education in treatment. Agencies from across the United States that specialize in treating child and adolescent victims of sexual abuse were surveyed. The results indicate that sexual education is covered in treatment with children of all ages, with male and female clients, and in both individual and group therapy. There was a statistically significant difference in the coverage of sexual education based on clients' age, but not based on gender or treatment modality. Parents are often included in treatment; however, the amount of parental involvement varies. Published materials, such as children's books and videos, are frequently used. Participants (i.e., clinicians) are satisfied with their coverage of sexual education in treatment even though clients often experience negative reactions. Results suggest that covering sexual education in treatment helps decrease some of the negative effects of sexual abuse. This study also serves as a test of Dillman's Total Design Method of conducting mail surveys.

Media Coverage of Child Sexual Abuse: An Opportunity for Family Therapists to Help Families and Communities

The recent media coverage of child sexual abuse charges involving priests is likely to trigger various needs among the public for professional services. Family therapists should prepare to respond effectively to the high anxiety that these media stories trigger. Family therapists with expertise in human sexuality should use such reports to promote a fuller understanding of all aspects of sexuality for individuals and families. Professionals can integrate much needed aspects of sexuality education in dealing with the mass media, in crisis intervention for persons at risk, and in therapy that centers on child or adult experiences of sexual abuse.

Traumatic events in a general practice population: the patient's perspective.

The aim of the present study was to describe the patient's perspective on the GP's care after violent events: which role is the GP assigned; and how is the care appreciated. Events studied were serious accidents, burglary, robbery, physical and sexual abuse, disasters and war. A postal questionnaire was sent to a random sample of 2997 patients (> or =20 years) from the practice population of 32 GPs (67 500 patients). The response was 50%. Forty-two per cent of the respondents had experienced one or more events. Twenty-eight per cent of the victims desired some kind of professional help; more than half of them desired that care from their GP, three-quarters actually seeking it. Most frequently sought care was sympathy, "a number of good talks", and care for physical complaints. Overall, contentment with the GP's contribution was high; patients especially appreciate sympathy and support, as well as initiative on the GP's part in commencing and pursuing care. Of those who felt no need for professional help, 88% found that they could cope with the traumatic event well enough, with or without the help of family and friends. For those who did not seek help, although they did desire it, the main reasons were that they considered their problems insufficiently medical or felt that their GP lacked the time. In the case of physical and sexual abuse, feelings of guilt and issues of patient confidentiality played a role for some patients. The number of events experienced by our respondents is lower than in previous studies for burglary, robbery, physical and sexual abuse (adults and children); the occurrence of accidents is similar. The majority of the people who experience traumatic events cope with them well enough without professional help. For those seeking help, the GP plays an important role. Care could be improved as follows: the GP should make it clear to patients that he/she can play a role in caring for them in the aftermath of a traumatic event and stress the confidential nature of the consultation. On the whole, GPs should be more supportive and attentive when being consulted about this topic; also patients would like their doctors to be more active in raising the subject, as well as in initiating follow-up.

Independent comment on Audio‐visual and Print Materials

Book reviewed in this article:Psychology and Psychiatry: Integrating Medical Practice Jeannette Milgrom, Graham D. Burrows (Eds.)Systhema — Opinion, Exchange, Discussions. Edition 3: 2000 — Disability, Illness, Death. Institut für Familientherapie Weinheim/GermanyMemory in Dispute Valerie Sinason (Ed.)Women Who Sexually Abuse Children: From Research to Clinical Practice Jacqui Saradjian in association with Helgar HanksCulture and Mental Health: A Southern African View Leslie SwartzThe Learning about Myself (LAMS) Program for At‐Risk Parents: Learning from the Past — Changing the Future Verna Rickard, BinghamtonThe Learning about Myself (LAMS) Program for At‐Risk Parents: Handbook for Group Participants Verna Rickard, BinghamtonFamily Counselling and Therapy 3rd edn Arthur M. Horne (Ed.)Beyond Belief: Psychotherapy and Religion Samuel Stein (Ed.)Couples and the Tao of Congruence Barbara Jo Brothers (Ed.)Lesbians and Gays in Couples and Families: A Handbook for Therapists Joan Laird, Robert‐Jay Green (Eds)

Predicting the child-rearing practices of mothers sexually abused in childhood☆, ☆☆

Objective: Although empirical investigations have established a relationship between childhood sexual abuse and numerous long-term consequences, surprisingly little research has addressed the possible effects of childhood victimization on the later child-rearing practices of adult survivors. The present study examined hypothesized predictors of three parenting styles among adult survivors of sexual abuse as compared with adult children of alcoholic parents. Method: Forty-five clinical outpatients completed a questionnaire battery assessing experiences of childhood abuse, current economic and social resources, and parenting attitudes and practices. The child-rearing practices of participants were compared with those reported by a community sample of 717 mothers. Additional analyses examined the extent to which sexual abuse and its adult sequelae predicted the parenting behaviors reported by the present sample. Results: Both sexual abuse survivors and children of alcoholics reported significantly higher rates of permissive parenting practices than mothers in the community sample. Multiple regression analyses further revealed unique relationships between sexual abuse and parenting, over and above the variance explained by physical abuse, current socioeconomic status, and the experience of growing up in an alcoholic home. Mothers’ sexual abuse severity, social support satisfaction, and dysfunctional parenting attitudes moderated several of these relationships. Conclusions: The present findings suggest that sexual abuse and its adult sequelae may have negative consequences for the parenting practices of survivors, particularly for survivors’ ability to providetheir children with appropriate structure, consistent discipline, and clear behavioral expectations. Implications for the psychosocial development of survivors’ children are discussed.

Repeated sexual abuse allegations: a problem for primary care providers

Sexual abuse of children is a problem of epidemic proportions in the United States. Primary care providers, including pediatric nurse practitioners, are increasingly presented with the problem of alleged sexual abuse in their patients, and primary care providers typically find it difficult to perform medical evaluations of children for sexual abuse. Having a child present repeatedly with sexual abuse concerns that cannot be substantiated is a stressful and frustrating experience for primary care providers. A case study is presented that illustrates the complexity and difficulty of one such case. A review of the literature will discuss the impact of divorce and Munchausen syndrome by proxy on repeated allegations of sexual abuse. Implications for practice are discussed, and a plan that addresses repeated sexual allegations in primary care settings is outlined. J Pediatr Health Care. (2001). 15, 71-76.

Abusos sexuales: una situación de desprotección

The objective of this article is to make clear the difficulties found in the psychological treatment of the sexual abuse children when the mothers’ victims do no bet on their son. When these characteristics a re present, beside the difficulties and the abuse trauma, we have to add all the derived complica tions from the judicial process that is taken place at the same time and involve to all the family system’s members. Nor to have into account these considera tions is to obviate a very important part of the the rapeutic process which is related with the final prog nosis of the case. We also pretend with this article to share our experience in relation to our clinical work in a spe cialized service at the Local Administraton, based in a not hospital setting.

Smoke and Mirrors: The Devastating Effect of False Sexual Abuse Claims

Back to table of contents Previous article Next article Book Forum: Abuse During ChildhoodFull AccessSmoke and Mirrors: The Devastating Effect of False Sexual Abuse ClaimsKARI LOCKWOOD, R.N., and SANJAY GUPTA, M.D., KARI LOCKWOODSearch for more papers by this author, R.N., and SANJAY GUPTASearch for more papers by this author, M.D., Olean, N.Y.Published Online:1 Oct 2000https://doi.org/10.1176/appi.ajp.157.10.1713-aAboutSectionsView EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail This is a must-read book for the public as well as mental health professionals. Terence W. Campbell demonstrates how false sexual abuse claims can mark innocent people as well as families for life. He illustrates his point by recounting numerous cases where he has testified as a consultant.The first section of the book describes the origins and misinterpretations that lead to false sexual abuse claims. Campbell demonstrates how this horrible experience can happen anywhere and to anyone and states that the frequency of false allegations of child sexual abuse likely exceeds that of reports of actual abuse. He discusses how these false allegations are detrimental to those who are victims of actual abuse. The descriptions of the allegations are very explicit, detailed, and substantiated by real-life examples. Campbell demonstrates how children respond to therapists in a way that the therapists want. He explains how a child will tell the interviewer what the interviewer may want to hear because the child may think that is the correct answer. The stories become so entangled that the alleged victims and their families begin to believe their own fabricated stories. The accused then becomes the actual victim. Innocent people spend time in prison and are scarred for life. Campbell gives examples of numerous tools that have been developed to screen children for sexual abuse, such as the Sexual Abuse Legitimacy Scale developed by Dr. Richard Gardner. These scales are often used incorrectly, and the procedural recommendations are often ignored. Some interviewers have already made up their mind that the child has been sexually abused before using the scales.In the second part of the book, Campbell hones in on the role of psychotherapists in bringing out memories that are not real. He demonstrates how clients are convinced after a session with the therapist that they were sexually abused as children in horrible ways and that they need further sessions to remember and to deal with the past. Campbell demonstrates how some clients are treated by poorly trained therapists who can destroy relationships among family members by contaminating what the clients think and remember. There definitely needs to be a change in the way some aspects of mental health practice are overseen. The stigma regarding the field of mental health thrives because of the few who practice poorly.This book is easy to read and understand. Typographical errors and misspellings are rare, and the editing is of high quality. Overall, Smoke and Mirrors is a must read for any professional who deals with the public, especially anyone in the health and judicial system.By Terence W. Campbell, Ph.D. New York, Perseus, 1998, 325 pp., $28.95. FiguresReferencesCited byDetailsCited ByNone Volume 157Issue 10 October 2000Pages 1713-a-1714 Metrics History Published online 1 October 2000 Published in print 1 October 2000

Sexual abuse characteristics associated with survivor psychopathology

Objective: This study was designed to examine predictors of psychopathology in non-clinically referred, sexually abused (SA) children, ages 6–16 years, 30–60 days following abuse disclosure and termination. Method: Eighty SA children were administered a structured diagnostic interview and a variety of rating-scale instruments. Several forms of psychopathology were assessed, including posttraumatic stress, global functioning, anxiety, depression, and externalizing behavior. Abuse interviews also were used to guide the collection of demographic (victim age, gender) and abuse-related information (e.g., frequency of abuse). Results: Abuse-related factors and demographic variables accounted for greater than half of the variance predicting global functioning, and accurately predicted posttraumatic stress disorder (PTSD) status for 86% of the participants. Also, analyses yielded significant predictors of parent-reported attention problems and sexual behavior. Of additional importance, none of the abuse-related and demographic variables predicted scores on measures of general anxiety, depression, and externalizing behavior. Conclusions: Specific demographic and sexual abuse information may, to some extent, be used to identify children who are at increased risk for short-term post-abuse psychopathology. Although the present findings suggest that such information may not be useful in the prediction of general anxiety, depression, and externalizing behavior, demographic and abuse-related variables importantly appear to account for significant variance in the prediction of global functioning, posttraumatic stress, attentiveness, and sexual behavior. Additional research is needed to improve mental health professionals’ ability to identify SA children who are at high risk for psychopathology.

PTSD scale of the Child Behavior Checklist: concurrent and discriminant validity with non-clinic-referred sexually abused children.

Several assessment instruments include measures that are purported to assess characteristics of posttraumatic stress disorder (PTSD). Although these measures are used often by researchers and clinicians, few are supported by extensive validity data. The PTSD scale of the Child Behavior Checklist (CBCL) is one that has not yet encountered significant challenges to its validity. We examine the concurrent and discriminant validity of the CBCL-PTSD scale. Participants included 63 non-clinic-referred sexually abused (SA) children, 60 non-SA psychiatric outpatient children, and 61 non-SA, non-clinic-referred schoolchildren. Results revealed questionable concurrent validity for this scale, and suggest poor discriminant validity between SA children and non-SA psychiatric outpatients.

Attention-deficit hyperactivity disorder and posttraumatic stress disorder: Differential diagnosis in childhood sexual abuse

Attention-deficit hyperactivity disorder (ADHD) and posttraumatic stress disorder (PTSD) are the most commonly diagnosed disorders in sexually abused children (SAC). There is a high degree of symptom overlap and comorbidity between these disorders, and differential diagnosis can be confusing. Current diagnostic criteria do not include PTSD as a differential diagnosis for ADHD, nor do existing assessment guidelines address these diagnostic similarities. This may have serious implications for SAC. This literature review describes the psychological impact of child sexual abuse and possible consequences for misdiagnosing ADHD in SAC. A comparison of criteria from the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (American Psychiatric Association, 1994) criteria for ADHD and PTSD is presented, and commonalities are discussed. On the basis of this comparison, recommendations are made for improving clinical decision-making and for facilitating differential diagnosis. Routine inquiry about traumatic experiences in children presenting with ADHD symptoms is suggested to increase accuracy in differential diagnosis.

CHILD SEXUAL ABUSE: WHAT THE UROLOGIST NEEDS TO KNOW

Purpose We define what the urologist needs to know regarding child sexual abuse. Materials and Methods Based on our experience in treating numerous child victims of sexual assault and a review of the contemporary literature, the data concerning child sexual abuse incidence, risk factors, clinical presentation, child interview, physical examination and management were analyzed. Results It is estimated that at least 1 in 4 girls and 1 in 10 boys will suffer victimization by age 18 years. There are no predicting socioeconomic factors. In legally proved cases of child sexual abuse the majority of victims have no diagnostic physical findings. Examination findings change depending on the position of the child, degree of relaxation, amount of labial traction and time to perform the evaluation. Findings that are consistent but not independently diagnostic of abuse include chafing, abrasions or bruising of inner thighs or genitalia, scarring, tears or distortion of the hymen, a decreased amount of or absent hymenal tissue, scarring of the fossa navicularis, injury to or scarring of the posterior fourchette/posterior commissure and scarring or tears of the labia minora. In all 50 states physicians are mandated by law to report to child protection services whenever they suspect that a child has been sexually abused. Conclusions The urologist must routinely examine the anogenital area of children during routine urethral evaluation and include child sexual abuse as part of the routine urological history.

The use of psychodrama to enhance victim empathy in sex offenders: An evaluation

This study examined the effectiveness of using psychodrama to enhance victim empathy in a group of 9 male sex offenders attending a probation service treatment programme in England. The group consisted of 6 child abusers and 3 men who had indecently assaulted women. The psychodrama element took place over 20 sessions and was evaluated with the aid of psychometric tests administered pre and post-intervention. This article focuses specifically on the impact of the intervention on victim empathy and on distortions about the sexual sophistication of children. The hypothesis that the psychodrama input would enhance empathy for victims was supported by the results, which showed statistically significant improvements in levels of empathy for both child and adult victims of sexual abuse. In addition, it was found that clients had significantly lower levels of distortions about child sexuality post-intervention. These findings are encouraging and suggest that using psychodrama in sex offender treatment is worthy of further investigation.

L'examen médical de l'enfant et de l'adolescent victime d'agression sexuelle

Medical examination of sexually-abused children or adolescents aims: 1) to identify clinical evidence of genital or extragenital lesions, 2) to diagnose sexually-transmitted infections or pregnancy, 3) to evaluate the needs for medical care, psychological support, and social investigation. The amount of laboratory evidence depends on the history. Laboratory investigations usually include tests for sperm, bacteriological cultures from all sites, testing for HIV, HCV and HBV antibodies, and the detection of pregnancy. Careful writing of a descriptive medical certificate is an important part of the medical intervention.

Assessments of girls genital findings and the likelihood of sexual abuse — agreement among physicians self-rated as skilled

Objectives: To measure agreement about genital examination findings among physicians who rate themselves as skilled in evaluating children for suspected sexual abuse, to compare these physicians' descriptions and interpretations with consensus standards developed by an expert panel, and to investigate the effects of physician and case characteristics on agreement. Study Design: Questionnaires including 7 simulated cases, each consisting of a brief history and 1 photograph of a girl's genitalia, were mailed to random samples of 2 groups: the members of 4 physician organizations concerned with child abuse or pediatric gynecology, and pediatricians at large. Among the surveyed physicians who rated their own skill in evaluating cases of suspected sexual abuse as higher than average, we measured agreement, both overall and between those with the most and with less clinical experience, and assessed their conformity with consensus standard descriptions and interpretations. Results: We received responses from 548 (50.9%) of 1076 physicians; 414 responses (75.5%) were analyzable. Two hundred six physicians (50%) rated themselves as skilled in assessing children for sexual abuse. On average, 45% of these physicians' descriptions and 72.6% of their interpretations conformed with the consensus standards. In 4 cases, between 5% and 20.7% of these physicians described genital findings that the expert panel had considered absent from the photographs. Conformity with standard interpretations tended to be higher in cases with photographs concordant with the accompanying, unambiguous histories ( P =.06). The most experienced physicians resembled the expert panel more closely than did the less experienced self-rated skilled physicians in interpreting 3 simulated cases ( P ≤.001). Conclusions: Assessments of girls' genital findings by physicians who rate themselves as skilled in examining children for suspected sexual abuse often differ. In some cases, among physicians who all rate themselves as skilled, assessments made by very experienced physicians may conform more closely to consensus standards than do assessments made by less experienced physicians. Arch Pediatr Adolesc Med. 1997;151:883-891

The Role of Shame and Attributional Style in Children's and Adolescents' Adaptation to Sexual Abuse

This study examined the role of shame and a self-blaming attributional style as factors that can help explain the level of psychological distress in child and adolescent victims of sexual abuse. A total of 142 participants (82 children, 60 adolescents) were seen within 8 weeks of discovery of the abuse. Regression analyses were used to examine how age at discovery, gender, abuse characteristics, shame, and attribution were related to depression, self-esteem, and traumatic events sequelae. As expected, shame and self-blaming attributions were strongly related to depression, self-esteem, and traumatic events sequelae and accounted for significant variance even after age, gender, and abuse characteristics had been controlled. The relations between number of abusive events and depressive symptoms, self-esteem, and eroticism were mediated by shame and attributional style.

Book review: Women Who Sexually Abuse Children. Jaqui Saradjian in association with Helga Hanks. Wiley: Chichester

European Eating Disorders ReviewVolume 6, Issue 1 p. 73-74 Book Review Book review: Women Who Sexually Abuse Children. Jaqui Saradjian in association with Helga Hanks. Wiley: Chichester Clare Adams, Clare AdamsSearch for more papers by this author Clare Adams, Clare AdamsSearch for more papers by this author First published: 04 December 1998 https://doi.org/10.1002/(SICI)1099-0968(199803)6:1<73::AID-ERV219>3.0.CO;2-XAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume6, Issue1March 1998Pages 73-74 RelatedInformation

Individual psychoanalytical psychotherapy with perpetrators of sexual abuse

Victims of child and other forms of sexual abuse receive increasing attention and resources but it is often difficult to extend the same kind of understanding and possibilities of treatment to their perpetrators. Many of the perpetrators have been victims themselves, which is often a major reason for their having developed in such a way; sometimes the offenders are virtually children themselves (Royal College of Psychiatrists, 1994b).

Abuse of people with learning disabilities and other vulnerable adults

Workers in the field of learning disability drew attention to the problem of sexual abuse and learning-disabled children and adults only a decade ago (Sinason, 1986; Cooke, 1989), at the same time that British society first tolerated the knowledge that non-disabled children were being abused. Although guidelines have been produced and voluntary organisations such as the National Association for the Protection from Sexual Abuse of Adults and Children with Learning Disabilies (NAPSAC), the Association for Residential Care (ARC) and Voice UK have made vital contributions, psychiatric involvement and provision is uneven (ARC &amp; NAPSAC, 1993).

Betrayal of Trust: Professionals Who Sexually Abuse Children

Betrayal of Trust: Professionals Who Sexually Abuse Children