Sexual development and sexual abuse: emergencies in adolescents.
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OBJECTIVE: The aim of the study was to determine whether sexual victimization of children by young aggressors differs from adult aggressors. METHOD: A case review was performed on medical records of children less than 12 years of age referred in 1992 to the Child Protection Clinic at a tertiary care pediatric hospital. RESULTS: Medical evaluation for sexual abuse was carried out on 316 children, 79% girls, 21% boys, mean age 6 +/- 2.7 years. Among known perpetrators, 39 were less than 16 years and 15 were between 16 and 19 years old. Young aggressors were more likely to abuse older female victims (p = .0009). They also were reported to engage in more genital/genital and genital/anal acts (p < .001). The aggressor's young age was found to be an important determinant related to a history of penetrative forms of sexual abuse (OR = 4.015, 95% C.I. 2.0581; 7.8319). Genital examination was specific for abuse (Adam's Class IV or V) in only 6.3% of victims, but significantly more often when the perpetrator was between 16-19 years old (p = .003). CONCLUSIONS: Adolescent aggressors appear to engage in more genital/genital and genital/anal sexual abuse than older aggressors. Victims of aggressors age 16 to 19 had a higher risk of having specific findings on the anal/genital examination.
OBJECTIVE: One aspect of treatment for child abuse and neglect addresses the attributions that the child victim, offender, nonoffending parents, and other family members have about the occurrence of the maltreatment. This paper describes a formal approach for abuse clarification to be used with families in which maltreatment has occurred. The four primary components of the abuse clarification process are: (a) clarification of the abusive behaviors; (b) offender assumption of responsibility for the abuse; (c) offender expression of awareness of the impact of the abuse on the child victim and family; and, (d) initiation of a plan to ensure future safety. The process of abuse clarification is described and suggestions made for appropriate use of the procedure.
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Four computer programs are developed for easy calculations of likelihood ratios (LRs) for paternity testing and kinship determinations. The programs are constructed based on the concepts of Bayes Theorem, conditional probability and pedigree analysis. Computer enumeration is used for handling the calculations. The programs have wide applicability, and users can save and check the results easily. The programs employ the distinctive pull-down manual, making them very easy to use. In this paper, we explain the theory and describe various features of the software.
Participation in research on sexual trauma may provoke disturbing memories and distressing emotions. Despite the proliferation of research on sexual violence during the last decade, little is known about the effects of study involvement on participants. Based on a review of the literature, the author's experiences as a sexual as a violence, researcher, and reflections of women who have participated in such research, this article explores the emotional impact of sexual violence research on participants. Although the risk of lasting harm stemming from participation in trauma research is a legitimate concern, the benefits of confiding a traumatic experience to a trustworthy other seem to outweigh the immediate distress that accompanies discussion of painful experiences. A useful framework for understanding the responses of research participants who talk or write about traumatic experiences is discussed.
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BACKGROUND: The veracity of adult allegations of remote childhood sexual abuse have been the focus of intense debate fueled by the controversy over both repressed and false memory syndromes. Likewise, increased awareness of physician misconduct in recent years has mandated numerous policy statements and task force guidelines to protect patients. CASE: A 23-year-old woman alleged that she had suffered incestuous rape at age 12 years, resulting in pregnancy. She named a physician who she claimed had performed an illegal pregnancy termination. Subsequent evaluations revealed that she had uterovaginal agenesis. CONCLUSION: Neither sexual abuse nor physician misconduct should be tolerated, and all such allegations deserve thorough and expeditious investigations. However, we must remain cognizant that any such allegation may be false and have devastating consequences for the unjustly accused.
Attempting to avoid some of the most common methodological problems involved in research on sexual child abuse, we collected data on crimes, perpetrators, and sanctions in all convicted cases of sexual child abuse in a defined population during a 5-year period. This approach provided amply documented and ascertained cases with precise definitions and descriptions of the crimes involved, no clinical referral bias, and minimal dependence on memory effects. The results are valid for the small proportion of cases that lead to conviction in the context of Swedish legislation. Structured data were collected from the court dossiers in all cases of sexual crimes against minors (less than 15 years of age) tried and sentenced at the courts in the Västra Götaland region of Sweden between 1993 and 1997. The total number of 496 sentences for sexual crimes during the study period included 203 cases of sexual child abuse (40.8%) with 283 victims and 196 perpetrators, all men. Girls were victims in 85% of the cases, boys in 12%, and boys as well as girls in 3%. Sexual penetration had occurred in 54.5% of cases and the total proportion of hands-on crimes was 83%. Most perpetrators, 72%, were well known to the child. The most severe offenses took place within the family. A wide range of acts were classified as sexual child abuse, but most common was sexual penetration of a female child by her biological father or a family friend.
A case of recovered memory of childhood trauma is reported with documented sexual trauma in early childhood, chronicled evidence of the absence of memory for traumatic experience over a period of time, and substantial evidence of 'spontaneous' recovery of memory. This account contains the first available prospective report of memory loss in a case in which there is both documented evidence of trauma and evidence of recovery of memory. The case emerged as part of a broadband, large-scale study of children followed closely from birth to adulthood which was not focused on memory for trauma. Prospective data gathered in a neutral research context, corroborated and supplemented by retrospective information, circumvent many limitations of previous retrospective accounts of recovered memories.
In 25 Canadian criminal trials involving charges of sexual abuse, 849 prospective jurors were asked under oath whether they could hear the evidence, follow the judge's instructions on the law, and decide the case with a fair and impartial mind. Knowing only the nature of the charges against the accused, on average 36% of the jurors stated that they could not be impartial. Some jurors explained that they themselves had been victims of abuse, others expressed fears for children, while others stated simply that they could not set aside a presumption of guilt. These findings from real trials are consistent with a body of social science literature about attitudes toward sexual abuse and sexual assault charges. The article distinguishes between prejudices arising from specific pretrial publicity and generic prejudices that cause prejudgments of the case of any defendant perceived as belonging to a general class of defendants who likely are guilty of the crime(s) charged.
The Screening Scale for Pedophilic Interests (SSPI; Seto & Lalumière, 2001), a brief measure of sexual attraction to prepubescent children that is based on victim characteristics, was used in two samples of 113 and 145 adult male sex offenders with child victims. In both samples, the SSPI was significantly and positively correlated with an index of phallometrically-measured sexual arousal to stimuli depicting prepubescent children. It was also significantly and positively correlated in both samples with violent recidivism (meaning either nonsexually violent offenses or sexual offenses involving physical contact with a victim), and positively correlated with sexual recidivism, significantly so in the second, larger sample. Focusing on the larger sample, the SSPI added to the predictive accuracy of a measure of general antisociality (the Psychopathy Checklist-Revised), while the phallometric index of sexual arousal did not add predictive accuracy once the other two measures were entered. The SSPI also yielded the same interaction between anomalous sexual interests and psychopathy we had previously reported using phallometric data (Rice & Harris, 1997). These findings suggest that the SSPI has predictive utility among adult male sex offenders with child victims, and accounts for variance in sexual offending that is not explained by phallometric testing.