Films for child sexual abuse prevention and treatment: a review.
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Assertiveness↗
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Narcissism and partial lack of reality testing (denial) in incestuous fathers.
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Adolescent↗
Review of 125 children 6 years of age and under who were sexually abused.
The authors present a chart review of 125 children, 6 years of age and under, who presented between early 1981 and mid 1983 to an acute care hospital because of sexual abuse. They represented one-third of the cases of alleged sexual abuse between infancy and 18 years of age referred to the hospital's multidisciplinary sexual abuse team. The ratio of females to males was 3.3:1. Sixty percent of the children were victims of intrafamilial abuse. Of the preschoolers, 72.5% were victims of intrafamilial abuse. At school age there was a reversal with 73% of 6 year olds being abused by extrafamilial offenders. The duration of the abusive relationship was greater in intrafamilial abuse. Purposeful disclosures were more frequent overall but were significantly less frequent when the perpetrator was intrafamilial or when the child was a preschooler. Two-thirds of the children had physical and/or behavioral symptoms. Parents of children who had been the victims of intrafamilial abuse were more likely to be separated or divorced. The difficulties in assessing young victims of alleged sexual abuse and the implications of the findings in this review are discussed.
Child Abuse↗
A contribution to the concept "the exception" as a developmental phenomenon.
The sense of "entitlement" or of being an exception has been noted in people who have suffered from severe childhood deformities or from other forms of severe deprivation. In such cases it constitutes a restitution for earlier suffering. In this vignette from the treatment of a patient who, because of sexual abuse by her mother, did not feel that she owned her own genitals, the sense of entitlement represented a developmental step toward ownership of her own body.
Adult↗
Sexual abuse in vulnerable and high risk children.
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Anxiety, Castration↗
Perpetrators and their acts: data from 365 adults molested as children.
Intake interviews were analyzed from 365 adults molested as children (AMACs). The AMACs were entering treatment at the Child Sexual Abuse Treatment Program (San Jose, CA). This study presents data on the relationship of the perpetrator to the victim, and whether most molestations include intercourse. The majority of the perpetrators (62%) were either biological fathers or father-surrogates. Ninety-nine percent of the perpetrators were known to the victim; 97% were male. As in past studies, fondling from the waist down was the most common type of molestation, occurring in 92% of the cases. Forty-four percent of cases included intercourse. The present findings are compared with past research and are discussed in the context of common misconceptions associated with child sexual abuse.
Adaptation, Psychological↗
Children's reactions to sex abuse investigation and litigation.
This investigation attempted to begin to quantify the extent to which children are helped or further victimized by sex abuse investigation and litigation procedures. Although there is virtually no research on the subject, frequent assumptions have been made that these procedures often further victimize children. Significant changes in state legislation have and are being considered which would protect victims from further victimization. A child victim questionnaire was sent to the presidents of all area child abuse and neglect councils in the state of Iowa as well as to other personnel working with sexually abused children. The somewhat surprising findings revealed that of the 48 questionnaires returned only approximately 21% of the victims perceived that the questioning and investigation was harmful, while approximately 53% saw it as helpful. Other analyses found that ratings of helpfulness were not correlated with the age of the victim, the presence of a supportive adult during questioning, the number of abuse incidents, whether or not the interviews were videotaped, and whether or not the perpetrator was a family member. Testifying in court and high numbers of interviewers were associated with more negative ratings. The limitations and implications of the results are discussed along with suggestions for future research.
Adaptation, Psychological↗
The sexual victimization of male children: a review of previous research.
The evidence available at this time indicates that male children are more likely to be abused by nonfamily rather than family members. Residing in a neglectful home or a mother-headed household and having previous homosexual contact tend to heighten risk for sexual abuse by nonfamily members. Familial sexual abuse appears related to residence in a home where other siblings are being abused, where the father was a victim of sexual abuse as a child, and where parents suffer myriad personal and social adjustment difficulties. Effects of male child sexual abuse appear to be serious and long lasting. The scant writings available at this time imply that the sexually abused male child experiences a range of adjustment and self-esteem problems as an adult and may be at heightened risk to become a child sexual abuser.
Child↗
Suicide of perpetrators after disclosure of child sexual abuse.
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Adolescent↗
Behavioral sequelae of physical and/or sexual abuse in adolescents.
In a survey of 500 admissions to a short-term residential chemical dependency treatment center for adolescents (ages 12 to 18), 150 adolescents (30%) had been identified as victims of physical and/or sexual abuse. While the abused group had a higher incidence of prior social service and mental health intervention, extraordinarily 68% of these abuse cases had not been reported by children, family, or interviewers prior to the adolescents having entered the chemical dependency residential treatment facility. This chemically dependent, previously abused group was differentiated from a comparison group of nonabused, chemically dependent adolescents, and a second comparison group of nonabused, nonchemically dependent adolescents. Results indicated a higher incidence of acting out behavior, runaways, legal involvement and sexual promiscuity within the abused group.
Adaptation, Psychological↗
Child perpetrators--children who molest other children: preliminary findings.
While the seriousness of sexual abuse by adolescents is finally beginning to receive adequate attention from the professional community, the existence of child perpetrators is largely dismissed and denied. Forty-seven boys between the ages of 4 and 13 are described who have molested children younger than themselves. Coercion was involved in all of the cases included in this study. These children had been treated in a program especially designed for child perpetrators at Children's Institute International in Los Angeles. Prior to their own sexually abusive behaviors, 49% of these boys had been sexually abused and 19% physically abused. The children all knew the people who victimized them. These male child perpetrators all knew the children they molested. In 47% of the cases the sexual abuse was of a sibling. The average number of victims of these children was 2.1 with a range of 1 to 7. The mean age at the time of perpetration was 8 years, 9 months. The mean age of the victims of these children was 6 years, 9 months. There was a history of sexual and physical abuse in the majority of the families of these children, as well as a history of substance abuse. This population is compared to adolescent perpetrators.
Child↗
Attributing responsibility in cases of father-daughter sexual abuse.
This study examined the effects of social workers' attributions of responsibility on their strategies in cases of father-daughter sexual abuse. Social workers read three vignettes illustrating such abuse. Following each vignette, they rated the degree of responsibility they attributed to the father, mother, and daughter described in each vignette, and the likelihood that they would recommend the incarceration of the father or the placement of the daughter into foster care. The more responsibility workers attributed to the father and daughter and the less they attributed to the mother, the more likely they were to recommend the father's incarceration. The more responsibility they attributed to the father, the more likely they were to recommend that the daughter be placed into foster care.
Attitude of Health Personnel↗
Sexual abuse of children under 12 years of age: a review of 511 cases.
In a retrospective study of 511 cases of alleged sexual abuse in children 12 years of age and under, data were analyzed with respect to the victim's age, sex, and the type of sexual abuse (intra- or extrafamilial). A total of 85.5% of the victims were female and 14.5% were male with ages ranging from 2 months to 12 years. The mean age of female victims was 6.8 years and that of male victims, 7.4 years. Most victims (68%) presented with histories of single assault by a known perpetrator (78%). Characteristics of abuse were found to be associated with the victim's age, sex, and relationship to the assailant. School-age victims were more likely to be abused by an individual outside the family or by a complete stranger. Older victims were also more likely to be involved in severe forms of sexual abuse (penetration, attempted penetration or oral-genital contact), associated with acts of abduction and with reports to the police. Male victims were more likely to be assaulted by a stranger, outside the home environment, and to suffer a more severe form of sexual abuse than female victims. Finally, extrafamilial sexual abuse was distinguished from intrafamilial sexual abuse insofar as it was more often a single episode, occurring outside the home environment, involving an act of abduction and physical force, and being reported to the police.
Age Factors↗
Child sexual abuse: very young perpetrators.
Three cases of child sexual abuse by child perpetrators are presented showing that sexual abuse of a child by a child may result in the victim becoming a perpetrator, thereby contributing to a potential reservoir of adolescent and adult perpetrators. Sexual play between children requires increased attention from caretakers to determine whether it is abusive, imitated from prior experience, and potentially transmissible to other children. Parents need to be informed, possibly through schools, that incidents of sexual interaction between children should be reported. To punish children for such behavior may protect the perpetrator and silence the victim(s).
Adolescent↗
Sexual abuse of English boys and girls: the importance of anal examination.
Child sexual abuse is attracting increasing attention in the United Kingdom. In Leeds this is reflected in the work of two pediatricians who receive multiagency, direct referrals for children of all ages. Over two years 1,368 referrals were received for all kinds of abuse and neglect, including 608 for suspected sexual abuse (Hobbs & Wynne, 1987a), of which 337 (243 girls, 94 boys) were confirmed or probable cases. The abuses included genital touching, masturbation, oral, vaginal and anal penetration. Of these abuses, 30% (which were frequently multiple) involved and penetration by finger or penis; and 42% of 337 children exhibited one or more anal findings, rising to 60% of 115 children in the 0-5 years of age group. The diagnosis of abuse was made from results of multidisciplinary assessment including medical examination. Genital findings were present in 3% of boys and 50% of girls. Anal findings included erythema; swelling (tyre); laxity; shortening or eversion; reflex anal dilatation (dilatation); fissures; venous congestion; reversible and permanent skin changes; twitching; funnelling; hematoma and bruising; as well as signs of infection. The pattern of anal signs varied with the age of the child and chronicity of abuse, as judged from the history. Healing and resolution of anal physical findings on follow-up were observed from days to months after initial examination. The general absence of these findings in the group of children judged not to have been sexually abused supports a cause and effect hypothesis, but further research is required. Medical examination of every child where symptoms, signs, or situation raise the possibility of abuse or neglect must include anal inspection, but instrumental or digital examination is not recommended.
Adolescent↗
Characteristics of a clinical sample of sexually abused children: how boy and girl victims differ.
The article describes a clinical sample of 87 boy victims of child sexual abuse and compares them to 226 girl victims. Boys were on average 6.3 years of age at onset of the sexual abuse; girls were 5.5 years. Boys were more likely to be victimized by someone outside the family than girls, but about two-thirds of the boys were abused by someone within the family. Male victims were more often abused by someone who sexually abused other children than were female victims. The majority of perpetrators were men; however girls were more likely than boys to be abused by men, and boys by both men and women. Only a small percentage of the offenders were women acting alone, but boys were more likely to be abused by women than girls. In addition, data on the role relationship between victim and offender and how these relationships differ for boy and girl victims are presented.
Adolescent↗
What sexual offenders tell us about prevention strategies.
A sample of 20 adult sexual offenders were interviewed about the process whereby they selected, recruited and maintained children in a sexual abuse situation. Offenders were selected if they were making "successful" progress in treatment in order that they might be less likely to distort their descriptions. Offenders were interviewed by their therapist in a community treatment program using a semistructured interview guide. Results suggest that this sample of offenders claim a special ability to identify vulnerable children, to use that vulnerability to sexually use a child that sexual abuse is inherently coercive, even though many offender statements minimize the level of coercion and violence, and that offenders systematically desensitize children to touch. Implications for prevention of sexual abuse are highlighted.
Adult↗
Sex abuse prevention programs: offenders' attitudes about their efficacy.
Little scientific basis exists for the content of school-based programs which are intended to help children protect themselves from sexual abuse. Children are taught about protecting themselves from a stereotypical old male stranger, yet perpetrators are most frequently young, known to the victim, and use a variety of methods to gain access to children. Programs generally include concepts of body ownership, acceptable touching, good vs. bad secrets, saying no, telling, and trusting one's intuition. Seventy-two prison inmates incarcerated for child sexual abuse were surveyed to evaluate their attitudes about the effectiveness of topics intended to prevent abuse. Offenders described the ideal victim and the modus operandi they used to involve children. Inmates indicated which topics in prevention programs they believed were efficacious and which topics would have little value in preventing abuse. Responses of incestuous and nonincestuous abusers were compared. Inmates indicated that parents could help prevent child abuse and that they must be involved if programs are to be effective. Information from abusers is useful and can be incorporated into programs if the potential for prevention of abuse is to be improved.
Adult↗