Victims Of Child Sexual Abuse Research Articles

Is there a role for paediatric Sexual Assault Nurse Examiners in the management of child sexual assault in Australia?

In Australia, paediatricians and Child Protection Specialists provide the medical and forensic examinations of child victims of sexual assault. There are workforce challenges in the recruitment and retention of doctors to undertake child sexual assault (CSA) work particularly in remote and rural areas. Pediatric Sexual Assault Nurse Examiner (PSANE) programs have existed in the USA and the UK for many years. Using Rapid Evidence Assessment (REA) methodology, a systematic search of the literature was performed to ascertain what is known about SANE programs, to evaluate the evidence for their effectiveness across a number of domains (accessibility, health and legal outcomes and cost effectiveness) and to inform policy on models of care and elements of best practice which may be appropriate for local implementation in Australia. This review showed that despite the limited evidence available and significant gaps in the evidence, SANEs provide a high standard of medical care and are not detrimental to the legal process. By providing recommendations regarding the potential value, effectiveness and feasibility of establishing a PSANE program in Australia, this article may be of interest to other high income countries facing similar workforce challenges in meeting the needs of children with alleged sexual assault.

Rapport‐Building in Investigative Interviews of Alleged Child Sexual Abuse Victims

SummaryResearch shows that both utterance type and rapport‐building can affect children's productivity during the substantive phase of investigative interviews. However, few researchers have examined the effects of utterance type and content on children's productivity within the rapport‐building phase. In the present study, transcripts of interviews with 94 4‐ to 13‐year‐old alleged victims were examined. Interviews were conducted using either the National Institute of Child Health and Human Development (NICHD) Protocol or the Memorandum of Good Practice (MoGP). The NICHD Protocol interviews contained more invitations and questions about events and hobbies/likes than the MoGP interviews. Children's productivity was associated with utterance type and topic, showing both the benefits of invitations and questions asking about past events. Our findings complement research focusing on the substantive phase of child forensic interviews, suggesting that both utterance type and prompt content during the rapport‐building phase can affect children's immediate productivity. Copyright © 2016 John Wiley & Sons, Ltd.

The Cycle of Abuse: When Victims Become Offenders

Various psychological theories exist in the literature to explain the behavior of men who commit child sex offences, including the belief that child sexual abuse (CSA) is a predisposing factor for the transition from victim to offender. These theories are, however, unable to explain the fact that while most victims of CSA are female, most perpetrators of CSA are male. The sex specificity of CSA in terms of victims and offenders suggests that the experience of CSA and its psychosocial effects may be different for boys, compared to girls. We hypothesize that CSA experiences may involve risk factors that affect the development of sexually abusive behavior for boys, rather than girls. Our aim was to determine whether the literature provides evidence of a cycle of abuse from victim to offender, and, if so, to document its characteristics. We undertook a comprehensive literature review of studies on both victims and offenders, including studies which revealed the following: age of onset of CSA, duration of abuse, gender of the abuser, the relationship between victim and abuser, grooming behaviors, the types and severity of abuse, and disclosure of abuse. While we found no evidence for the existence of a cycle of abuse for female CSA victims, we discovered evidence to support the existence of a cycle of abuse for male CSA victims who had experienced particular abuse characteristics. As an original contribution to the literature, we identified four factors that may be associated with a boy’s transition from victim to offender as well as the methodological issues to be addressed in future research. Based on criminological theories, we argue that these four factors share a common theme, that is, that they represent experiences of power (for the abuser) and powerlessness (for the victim).

Children's disclosure of sexual abuse during early forensic psychiatric evaluation in Southern Taiwan.

Many surveys of child sexual abuse (CSA) in Western countries focus on the victims' disclosures and their associated factors during forensic interviews, but similar data in Asian countries is scarce. We explored the disclosure rate of CSA allegations during forensic interviews in South Taiwan and the factors predicting such disclosure. We compared our findings with those of previous studies. Data were collected from written forensic psychiatric reports of CSA victims who underwent early forensic psychiatric evaluation at two hospitals in Kaohsiung City from 2010 to 2015. All cases were divided into categories of full or nonfull disclosures. We identified the variables that distinguished between the two groups in bivariate analyses using the independent t test and the Chi-square test. Binary logistic regression analysis was done to determine whether those significant correlates in the bivariate analyses were independent predictors of full disclosure. Among the 55 cases, 32 (58%) were full disclosures. Older age at first interview (odds ratio=1.39), no diagnosis of mental retardation (odds ratio=0.04), and experiencing sexual abuse more than once (odds ratio=5.90) were positive factors independently related to the full disclosure of CSA allegations. The rate of disclosure under the program was comparable to that of prior studies. This may suggest a role for early forensic psychiatric evaluation of children to promote disclosure of CSA allegations. We hope the findings may serve as a basis for future studies of CSA disclosure and associated factors in Taiwanese society.

Characteristics of Sexually Abused Children and Their Nonoffending Mothers Followed by Child Welfare Services: The Role of a Maternal History of Child Sexual Abuse

ABSTRACTConsidering the importance of mother’s support in the adaptation of a sexually abused child, it is relevant to determine if the mothers and children involved in an intergenerational cycle of child sexual victimization differ from dyads in which only the child has been abused. The purpose of this study was to compare mother–child dyads with sexually abused children according to whether the mother had herself been victim of child sexual abuse. The sample included 87 dyads with sexually abused children aged 3–18 years old and their mothers (44 reporting maternal and child abuse), followed by social welfare services of the province of Quebec (Canada). The two groups of mothers were compared on their past family abuse experiences and past family relations, their mental health history, their current psychological distress, their parenting behaviors, and their current levels of family functioning. Children were compared on their adaptation. Multivariate analyses indicated that mothers reporting child sexual abuse were more likely to report more other maltreatments in their childhood and greater prevalence of lifetime history of alcohol abuse disorders, dysthymia, and panic disorder compared with mothers who had not experienced CSA. Compared to children whose mothers had not experienced CSA, those whose mothers had experienced CSA showed higher rates of problems behaviors and were more likely to report having been sexually abused by a trusted person. These results highlight the specific clinical needs for the assessment and treatment for sexually abused children whose mothers experienced child sexual abuse.

Delay in disclosure of non-parental child sexual abuse in the context of emotional and physical maltreatment: A pilot study

The present pilot study sought to identify predictors of delays in child sexual abuse (CSA) disclosure, specifically whether emotional and physical abuse by a parental figure contributes to predicting delays over and above other important victim factors. Alleged CSA victims (N=79), whose parental figures were not the purported sexual abuse perpetrators, were interviewed and their case files reviewed, across two waves of a longitudinal study. Regression analyses indicated that experiencing both emotional and physical abuse by a parental figure was uniquely predictive of longer delays in disclosure of CSA perpetrated by someone other than a parental figure. Victim–CSA perpetrator relationship type and sexual abuse duration also significantly predicted CSA disclosure delay, whereas victim age at the time of the police report, victim gender, and victims’ feelings of complicity were not significant unique predictors. Child abuse victims’ expectations of lack of parental support may underlie these findings. Parent–child relationships are likely crucial to timely disclosure of CSA, even when a parent is not the CSA perpetrator.

The independent effects of child sexual abuse and impulsivity on lifetime suicide attempts among female patients

Child sexual abuse (CSA) is a causal agent in many negative adulthood outcomes, including the risk for life-threatening behaviors such as suicide ideation and suicide attempts. Traumatic events such as CSA may pose risk in the healthy development of cognitive and emotional functioning during childhood. In fact, high impulsivity, a risk factor for suicidal behavior, is characteristic of CSA victims. The current study aims to understand the relations among CSA, impulsivity, and frequency of lifetime suicide attempts among a female patient sample admitted for suicidal behavior. Participants included 177 female patients between the ages of 18 and 63 years admitted at two hospitals in Buenos Aires, Argentina. Number of previous suicide attempts and CSA were assessed via structured interviews, while impulsivity was assessed with the Barratt Impulsiveness Scale (BIS-11). A model of structural equations was employed to evaluate the role of impulsivity in the relation between CSA and suicide attempts. CSA (β=.18, p<.05) and impulsivity (β=.24, p<.05) were associated with the number of previous suicide attempts. However, impulsivity was not significantly associated with CSA (β=.09, p>.05). CSA and impulsivity are independently associated with lifetime suicide attempts among female patients with recent suicidal behavior.

A systematic literature review: which factors influence English and Welsh perceptions towards victims of child sexual abuse?

ABSTRACTNegative perceptions towards child sexual abuse (CSA) victims are prevalent within society. This has potential implications for CSA victims in terms of its effects on victim well-being and legal proceedings. Although many studies have investigated which factors influence English and Welsh perceptions, a systematic review has not been conducted to synthesise findings. Nine electronic bibliographic databases, six grey literature databases and one gateway resource were searched. Hand-searches of journals and references were also conducted and field experts contacted. Following the application of the inclusion criteria, studies were quality assessed and data extracted. The search yielded 4182 studies of which 1501 duplicates and 2644 irrelevant studies were excluded. After a further 26 studies were excluded, 11 studies were included in the review. This revealed a sample of 3088 participants with 18 factors investigated. To acknowledge the heterogeneity of the data, a narrative data synthesis approach was used. The review identified firm conclusions regarding respondent gender, whereby males perceived CSA victims as more to blame, more culpable, less reliable and less credible. Other tentative conclusions are discussed. Potential implications of these findings are discussed in terms of professional services and the response victims receive during disclosure.

Prosecutors’ reflections on sexually abused preschoolers and their ability to stand trial

Child sexual abuse (CSA) cases are notoriously difficult to investigate, and less than 10% of cases are prosecuted. We aimed to investigate prosecutors’ experiences of preparing for and prosecuting suspected CSA cases with preschool aged victims. Nine specialized child prosecutors (6 women, 3 men) took part either in individual interviews or in focus groups on this subject. The transcripts were analyzed thematically. The prosecutors said that children's testimony was sometimes held to an adult standard and that child complainants who expressed emotion could be perceived as more credible than their less expressive counterparts. CSA victims were identified as vulnerable victims who had difficulty telling their stories. Some of the interviewers were described as lacking in the ability to approach these children. The results imply that the reliability and credibility of sexually abused preschoolers and their testimony might be influenced by a number of verbal and non-verbal factors and that there are several obstacles preventing prosecutors from prosecuting these cases.

Predicting Treatment Attrition for Child Sexual Abuse Victims

Sexually abused children drop out of treatment more frequently than children receiving services for other issues. While researchers suggest that chaotic family dynamics may lead to inflated attrition rates in this population, other factors that potentially contribute to treatment attrition are virtually unknown. Therefore, the purpose of this study was to investigate the relationship between child and parent characteristics with attrition for sexual abuse victims (N = 132) and their nonoffending caregivers. Results indicate that children with parents who confirmed past or current intimate partner violence were 2.5 times more likely to prematurely terminate from treatment.

Maladaptive Schemas as Mediators in the Relationship Between Child Sexual Abuse and Displaced Aggression

ABSTRACTChild sexual abuse is one of the most serious forms of abuse due to the psychological consequences that persist even into adulthood. Expressions of anger among child sexual abuse survivors remain common even years after the event. While child sexual abuse has been extensively studied, the expression of displaced aggression has been studied less. Some factors, such as the maladaptive early schemas, might account for this deficiency. The objective of this study was to analyze the relationships between child sexual abuse, displaced aggression, and these schemas according to gender and determine if these early schemas mediate the relationship between child sexual abuse and displaced aggression. A total of 168 Spanish subjects who were victims of child sexual abuse completed measures of childhood trauma, displaced aggression, and early maladaptive schemas. The results depict the relationship between child sexual abuse, displaced aggression, and early maladaptive schemas. Women scored higher than men in child sexual abuse, emotional abuse, disconnection or rejection and impaired autonomy. Mediational analysis found a significant mediation effect of disconnection or rejection on the relationship between child sexual abuse and displaced aggression; however, impaired autonomy did not mediate significantly.

Caregiver Needs Following Disclosure of Child Sexual Abuse

ABSTRACTCaregiver support is vital in improving outcomes for child sexual abuse victims; however, the disclosure can significantly affect caregivers, thus impacting their ability to meet their children’s needs. To maximize the support from caregivers, their own needs following disclosure need to be met. This study investigated the impact of child sexual abuse disclosure and associated needs as identified by caregivers. Sixty needs assessment forms were collected from families who accessed a parenting support pilot program run in New Zealand. These forms were completed by nonoffending caregivers during an assessment session with their counselor and consisted of both open-ended and Likert scale questions focusing on both the needs of the child and the family. Caregivers identified a range of impacts of the disclosure on their children, themselves, and other families members and the related support that may be needed. In particular, caregivers identified that they needed support with child behavior management and with their own coping. The findings suggest that interventions with caregivers following disclosure of child sexual abuse may be a valuable adjunct to therapy provided directly to the child.

Factors Predicting Central Details in Alleged Child Sexual Abuse Victims’ Disclosure

ABSTRACTThe purpose of this study is to explore the predictive value of child sexual abuse characteristics (relationship between the child and the suspect, reported coercion, type and frequency of abuse) as well as the disclosure context (disclosure made on purpose or accidentally, maternal belief, and protective actions) on the number of central forensically relevant (CFR) details elicited during the investigative interview of alleged child victims. The effects of the child’s age and use of the National Institute of Child Health and Human Development (NICHD) Investigative Protocol were controlled for, in order to focus on the aspects of the sexual abuse and disclosure variables. Of the 116 investigative interviews conducted with children aged from 4 to 14 years old, half followed the NICHD Protocol; the other half were conducted by the same 18 interviewers prior to their training in the NICHD protocol. Police files and interview transcripts were analyzed to collect information about the child sexual abuse characteristics, the disclosure context, and the number of CFR details. As expected, the child’s age and use of the NICHD Protocol were the two strongest predictors of the number of CFR details. Coercion (physical and verbal) as well as maternal protection following the disclosure also increased the number of CFR details. Explanations of these results and implications for further research are discussed.

Going to the dogs: A quasi-experimental assessment of animal assisted therapy for children who have experienced abuse

ABSTRACTExperience of childhood sexual abuse (CSA) is a risk factor for the development of maladaptive outcomes across the lifespan. CSA victims have been found to have a significantly higher risk of developing Post Traumatic Stress Disorder (PTSD) than children who experience non-CSA trauma. While cognitive behavioral therapy approaches have been found to effectively treat PTSD, reviews suggest that children who have experienced CSA commonly disengage from this type of therapy. Engaging children who have been sexually abused may therefore require both innovation and creativity. One approach that is gaining recognition as effectively addressing barriers associated with engagement and retention is animal assisted therapy (AAT). The current article presents a quasi-experimental assessment of an AAT program working with children who present with clinical symptoms of PTSD following CSA. The efficacy of the program is discussed along with implications of the rising interest in AAT initiatives.

CHILD SEXUAL ABUSE, BULLYING, CYBERBULLYING, AND MENTAL HEALTH PROBLEMS AMONG HIGH SCHOOLS STUDENTS: A MODERATED MEDIATED MODEL.

Child sexual abuse is associated with adverse outcomes, including heightened vulnerability that may translate into risk of revictimization. The aims of the study were: (1) to explore the direct and indirect links between child sexual abuse and cyberbullying, bullying, and mental health problems and (2) to study maternal support as a potential protective factor. Teenagers involved in the two first waves of the Quebec Youths' Romantic Relationships Survey (N = 8,194 and 6,780 at Wave I and II, respectively) completed measures assessing child sexual abuse and maternal support at Wave I. Cyberbullying, bullying, and mental health problems (self-esteem, psychological distress, and suicidal ideations) were evaluated 6 months later. Rates of cyberbullying in the past 6 months were twice as high in sexually abused teens compared to nonvictims both for girls (33.47 vs. 17.75%) and boys (29.62 vs. 13.29%). A moderated mediated model revealed a partial mediation effect of cyberbullying and bullying in the link between child sexual abuse and mental health. Maternal support acted as a protective factor as the conditional indirect effects of child sexual abuse on mental health via cyberbullying and bullying were reduced in cases of high maternal support. Results have significant relevance for prevention and intervention in highlighting the heightened vulnerability of victims of child sexual abuse to experience both bullying and cyberbullying. Maternal support may buffer the risk of developing mental health distress, suggesting that intervention programs for victimized youth may profit by fostering parent involvement.

Lessons Learned: Conducting Research With Victims Portrayed in Sexual Abuse Images and Their Parents.

Victims portrayed in sexual abuse images may be resistant to participate in research because of embarrassment or shame due to the sensitive nature and potential permanency of images. No studies we are aware of explore reactions to participating in research after this type of crime. Telephone interviews were conducted with convenience samples of parents ( n = 46) and adolescents who were victims of child sexual abuse ( n = 11; some of whom were portrayed in sexual abuse images), and online surveys were completed by adult survivors depicted in abuse images ( N = 133). The first lesson was that few agencies tracked this type of crime. This lack of tracking raises the question as to what types of data should be collected and tracked as part of an investigation. The second lesson was that few victims at the two participating agencies had been portrayed in sexual abuse images (4%-5%). The third lesson was that once possible cases were identified, we found relatively high percentages of consent to contact and interview completions. This implies that researchers and service providers should not be hesitant about conducting research after an investigation of child sexual abuse. The fourth lesson was that the vast majority of participants reported not being upset by the questions. We hope that the data presented here will encourage agencies to reconsider the types of data being tracked and will encourage researchers to conduct in-depth research with populations that are often difficult to reach to continue improving the professional response to child victimization.

Criteria-Based Content Analysis (CBCA) reality criteria in adults: A meta-analytic review

Background/Objective: Criteria-Based Content Analysis (CBCA) is the tool most extensively used worldwide for evaluating the veracity of a testimony. CBCA, initially designed for evaluating the testimonies of victims of child sexual abuse, has been empirically validated. Moreover, CBCA has been generalized to adult populations and other contexts though this generalization has not been endorsed by the scientific literature. Method: Thus, a meta-analysis was performed to assess the Undeutsch Hypothesis and the CBCA checklist of criteria in discerning in adults between memories of self-experienced real-life events and fabricated or fictitious memories. Results: Though the results corroborated the Undeutsch Hypothesis, and CBCA as a valid technique, the results were not generalizable, and the self-deprecation and pardoning the perpetrator criteria failed to discriminate between both memories. The technique can be complemented with additional reality criteria. The study of moderators revealed discriminating efficacy was significantly higher in filed studies on sexual offences and intimate partner violence. Conclusions: The findings are discussed in terms of their implications as well as the limitations and conditions for applying these results to forensic settings.

A Study of the Relationship between Investigators’ Personal Characteristics and Adherence to Interview Best Practices in Training

In the past 20 years, guidelines have been developed to help interviewers investigate cases of alleged child sexual abuse (CSA), but few studies have assessed investigators’ abilities to adhere to these guidelines. This study aimed to evaluate whether some investigative interviewers’ personal attributes are related to their performance in a mock investigative interview with a child victim of sexual abuse. Assessment was conducted in a police training context. A total of 24 French Canadian police investigators followed a one-week training program aimed at using the National Institute of Child Health and Human Development (NICHD) interview protocol. These investigators performed a mock interview at the end of the training to test their practical competence. They also filled out three questionnaires assessing their cognitive abilities, emotional intelligence, and personality traits. Interview performance was positively related to cognitive abilities, female gender, and the personality trait of Openness to Experience, and negatively related to stress management and level of experience. Four regression models are presented to explain interview performance variance. The results of this study show that some personal characteristics, such as cognitive abilities, personality, gender and experience, affect investigative interviewers’ performance with a child victim of sexual abuse in a police training context.

Court support workers speak out: Upholding children’s rights in the criminal justice system

The prevalence of sexual offences against children in South Africa continues to be among the highest in the world. The quality and accuracy of a child’s testimony is often pivotal to whether cases are prosecuted, and whether justice is done. Child witness programmes assist child victims of sexual abuse to prepare to give consistent, coherent and accurate testimony, and also attempt to ensure that the rights of the child are upheld as enshrined in the various laws, legislative frameworks, directives and instructions that have been introduced since 1994. We draw on information from two studies that sought the perspectives of court support workers to explore whether a child rights-based approach is followed in the criminal justice system (CJS) for child victims of sexual abuse. Findings suggest varying degrees of protection, assistance and support for child victims of sexual abuse during participation in the CJS. The findings revealed that the rights of children to equality, dignity and not to be treated or punished in a cruel, inhuman or degrading way were undermined in many instances. Finally, recommendations are given on ways to mitigate the harsh effects that adversarial court systems have on children’s rights.

Emotion Regulation in Sexually Abused Preschoolers: The Contribution of Parental Factors.

Child sexual abuse (CSA) is associated with emotion regulation deficits in childhood. Parents play a crucial role in the development of emotion regulation in their children, especially at younger ages. Close to 50% of mothers of sexually abused children report having been sexually victimized themselves as children. They are consequently at risk of experiencing significant distress following the disclosure of sexual abuse of their child. Parents' distress could interfere with their ability to provide support and to foster development of emotion regulation in their children. The aim of the present study was to explore the relationship of parental factors (history of sexual victimization in childhood and the current level of distress) to sexually abused preschoolers' emotion regulation competencies. Emotion regulation was assessed in 153 preschoolers by their parents with the Emotion Regulation Checklist; 75 of these children were abused (14 boys); 78 were not abused (21 boys) and were part of a comparison group. Parents reported their level of distress using the Psychiatric Symptom Index. Results indicated that parental factors contributed to some dimensions of preschoolers' emotion regulation (namely displays of underregulation of emotion) above and beyond children's victimization status and gender (Cohen's ƒ(2) = .15). Identifying parental distress and history of sexual victimization as positively associated with emotional dysregulation in preschool children victims of CSA has important research and clinical implications.