Perpetrators and context of child sexual abuse in Kenya

Child sexual abuse (CSA) interventions draw from a better understanding of the context of CSA. A survey on violence before age 18 was conducted among respondents aged 13–17 and 18–24 years. Among females (13–17), the key perpetrators of unwanted sexual touching (UST) were friends/classmates (27.0%) and among males, intimate partners (IP) (35.9%). The first incident of UST among females occurred while traveling on foot (33.0%) and among males, in the respondent's home (29.1%). Among females (13–17), the key perpetrators of unwanted attempted sex (UAS) were relatives (28.9%) and among males, friends/classmates (31.0%). Among females, UAS occurred mainly while traveling on foot (42.2%) and among males, in school (40.8%). Among females and males (18–24 years), the main perpetrators of UST were IP (32.1% and 43.9%) and the first incident occurred mainly in school (24.9% and 26.0%), respectively. The main perpetrators of UAS among females and males (18–24 years) were IP (33.3% and 40.6%, respectively). Among females, UAS occurred while traveling on foot (32.7%), and among males, in the respondent's home (38.8%); UAS occurred mostly in the evening (females 60.7%; males 41.4%) or afternoon (females 27.8%; males 37.9%). Among females (18–24 years), the main perpetrators of pressured/forced sex were IP and the first incidents occurred in the perpetrator's home. Prevention interventions need to consider perpetrators and context of CSA to increase their effectiveness. In Kenya, effective CSA prevention interventions that target intimate relationships among young people, the home and school settings are needed.     

Child sexual abuse in Indonesia: A systematic review of literature,law and policy

BackgroundLike many middle-income countries, knowledge about child sexual abuse (CSA) is limited in Indonesia. The national government has stated a commitment to protect children from the worst forms of abuse, yet the sensitivity of CSA along with the complexity of culture and law, present substantial challenges.ObjectiveThis article reviews current knowledge about CSA in Indonesia, in the context of existing laws and policies that influence CSA prevention and intervention.MethodA systematic review of this research was conducted in the following manner: a review of scholarly literature and grey literature in English (19 papers) and in Bahasa Indonesian (11 papers), and a review of CSA-related Indonesian laws (4 documents) and policies (5 documents).ResultsThis review finds that knowledge about CSA in Indonesia is still limited. The taboos on discussing sexual matters were identified as factors that impede reporting of CSA. Poverty also leads to increasing children’s risk of sexual abuse. There was less attention to CSA occurring within family contexts and focus was more upon its occurrence outside of the family. The study identified that contradictory definitions of children within the law add to children’s vulnerability to CSA; this is especially the case for girls. Current child protection strategies in prevention and intervention lack specific focus on CSA.ConclusionFurther research is needed to enable the development of evidence-based approaches to better harmonize the development of law and policy with contemporary knowledge about CSA.     

Child sexual abuse research knowledge among child abuse professionals and laypersons

The purposes of this study were to: (1) Assess child abuse professionals’ and nonprofessionals’ knowledge of scientific research findings that are relevant to forensic child sexual abuse (CSA) evaluations and (2) describe associations between child abuse professionals’ levels of research knowledge and their education and experience. An 18-item multiple-choice test was administered to 188 child abuse professionals and 457 nonprofessionals (undergraduate college students) in Brazil and the United States. The nonprofessionals’ average percent correct, M = 44%, was not significantly different than what would be expected for random guessing (45%). The professionals’ average percent correct, M = 55%, was higher than that of nonprofessionals and random guessing (both ps < .001). The average percent correct score for the US-sample psychologists, M = 76%, was higher than the average score of the other professionals, M = 51%, p < .001. Professionals’ educational level, as measured by the highest academic degree obtained, was positively associated with percent correct scores, Spearman's ρ = .46, p < .001. Controlling for educational attainment, professional experience, as measured by the total number of CSA evaluations performed, was weakly associated with percent correct scores, partial r = .15, p = .04. Percent correct scores were low for both nonprofessionals and professionals. Most of the participants in this study were uninformed or misinformed about scientific research findings that are important for conducting optimal forensic CSA evaluations and for making accurate judgments about the validity of sexual abuse allegations.     

Child emotional aggression and abuse: definitions and prevalence

Objective

Research on and intervention for child emotional abuse and emotional aggression toward children have been severely hampered because there have been no agreed-upon, clinically usable definitions.

Methods

We have (a) proposed and field-tested a set of criteria to operationally define child emotional abuse for clinical settings and (b) used these criteria to design a parent-report measure of parental emotional aggression and child emotional abuse that could be used in research. In this paper, we review the development and field trials of these criteria for making substantiation decisions.

Results

Agreement between master reviewers and field decisions was extremely high in a 5-site development trial (96% agreement, κ = .89) and a 41-site dissemination trial (90% agreement, κ = .73). We compare these criteria to other research criteria in the literature. We then present data collected using a self-report measure designed to parallel these criteria from an anonymous online survey of US Air Force personnel and their spouses. The final sample (N = 52,780) was weighted to be representative of the United States civilian population. The prevalence of parents’ emotionally aggressive acts was much higher than the prevalence of emotional abuse (acts plus impact), but rates of parents’ acts of emotional aggression were lower than those typically reported in the literature. Additional analyses tested for differential effects due to gender of perpetrator (i.e., mothers or fathers), age of victim, and clustering within families. These factors did not drive rates of aggression or abuse.

Conclusions

In sum, the criteria developed and proposed appear to support reliable clinical decision making regarding child emotional abuse and can be translated to research survey tools that better capture the continuum of parents’ emotional aggression and child emotional abuse than the measures that are currently available, advancing the state of the science with respect to child emotional abuse.     

Child maltreatment and risk patterns among participants in a child abuse prevention program

The relationship between risk factors and Child Protective Services (CPS) outcomes in families who participate in home visiting programs to prevent abuse and neglect and who are reported to CPS is largely unknown. We examined the relationship between parental risk factors and the substantiation status and number of CPS reports in families in a statewide prevention program. We reviewed CPS reports from 2006 to 2008 for families in Connecticut's child abuse prevention program. Six risk factors (histories of CPS, domestic violence [DV], mental health, sexual abuse, substance abuse, and criminal involvement) and the number of caregivers were abstracted to create risk scores for each family member. Maltreatment type, substantiation, and number of reports were recorded. Odds ratios were calculated. Of 1,125 families, 171 (15.6%) had at least one CPS report, and reports of 131 families were available for review. Families with a substantiated (25.2%) versus unsubstantiated (74.8%) first report had a high number of paternal risk factors (OR = 6.13, 95% CI [1.89, 20.00]) and were more likely to have a history of maternal DV (OR = 8.47, 95% CI [2.96, 24.39]), paternal DV (OR = 11.23, 95% CI [3.33, 38.46]), and maternal criminal history (OR = 4.55; 95% CI [1.32, 15.60]). Families with >1 report (34.4%) versus 1 report (65.6%) were more likely to have >3 caregivers, but this was not statistically significant (OR = 2.53, 95% CI [0.98, 6.54]). In a prevention program for first-time families, DV, paternal risk, maternal criminal history, and an increased number of caregivers were associated with maltreatment outcomes. Targeting parental violence may impact child abuse prevention.     

Child sexual abuse,disclosure and PTSD: A systematic and critical review

BackgroundChild sexual abuse (CSA) is a prevalent exposure with potentially serious, negative health consequences, including post-traumatic stress disorder (PTSD) and its symptomatology.ObjectiveTo conduct a systematic and critical review in order to investigate the relationship between CSA disclosure patterns and PTSD.Participants and settingStudies included clinical, college and community-based samples of adults’ and children’s experiences of CSA.MethodsWe conducted systematic searches in five databases (Medline, Embase, PyscINFO, CINAHL, ERIC, Sociological Abstracts) from database inception to October 17, 2017 using index terms and keywords for CSA, disclosure, and PTSD. We included any English-language, primary studies involving children or adults with experiences of CSA that used quantitative research designs to explore the relationship between disclosure and PTSD. We used systematic critical review methodology in order to investigate the relationship between disclosure and PTSD symptoms and disorders. We also investigated factors that explained the relationship between disclosure and PTSD, such as individual, exposure or environmental factors.ResultsTwenty-two articles reporting 20 studies were included in this review. Studies assessing the relationship between CSA and PTSD tended to account for personal (e.g., gender) and CSA exposure variables (e.g., severity of CSA) only. While authors generally used validated measures to assess for PTSD symptoms and disorders, they tended to use author-generated or unvalidated measures to assess for disclosure process variables.ConclusionThe relationship between factors that affect disclosure, and responses to disclosure, are not well theorized in quantitative literature. Study findings suggest important avenues for future research, such as the need to assess disclosure longitudinally.     

Child and adolescent abuse and subsequent victimization: a prospective study

OBJECTIVE: We investigated the possible reciprocal relationship between victimization experiences and psychological functioning by assessing abuse experiences in childhood, adolescence, and during a 2-month follow-up period. METHOD: At the beginning of the study (Time 1), abuse histories, trauma and depressive symptoms, and interpersonal functioning were assessed in 551 college women. Subsequent victimization experiences and psychological outcomes were assessed at the follow-up (Time 2). RESULTS: Path analyses indicated that verbal abuse by the mother and father were predictive of various psychological outcomes as measured at Time 1 and emerged as the only significant predictors of adolescent dating violence. Adolescent dating violence subsequently predicted the experience of dating violence during the 2-month follow-up period. Paternal physical abuse predicted adolescent sexual victimization which subsequently predicted all symptom measures at Time 1. Conversely, the experience of adolescent physical dating violence was not predictive of any of the symptom measures at Time 1. For those women who experienced dating violence during the follow-up, however, the severity of their abusive experiences was related to both depression and interpersonal problems assessed at Time 2. In comparison, for those women who experienced sexual victimization during the follow-up period, the severity of their abusive experiences was related to trauma symptoms. Interpersonal problems emerged as both an aftereffect of adolescent sexual victimization experience and a predictor of a subsequent sexual victimization experience during the follow-up. CONCLUSIONS: Given that emotional abuse emerged as a predictor of adolescent dating violence and psychological outcomes, researchers and clinicians need to continue to explore this problem. Further, it is important to assess how interpersonal problems contribute to the risk of subsequent sexual victimization and to try to break the cycle between adolescent abuse experiences and subsequent physical and sexual assaults.     

Child sexual abuse and its relationship with health risk behaviors among rural children and adolescents in Hunan, China

Objective

The current study was designed to explore the prevalence of child sexual abuse (CSA) and its association with health risk behaviors (i.e., smoking, alcohol use, binge drinking, suicidal ideation, and suicide attempt) among rural children and adolescents in China.

Methods

A sample of 683 rural children and adolescents (8 to 18 years of age) completed an anonymous questionnaire which assessed experiences of CSA and 5 health risk behaviors. Data on several potential confounding factors were also collected.

Results

A total of 123 (18%) respondents reported experiencing at least 1 kind of CSA before 16 years of age, with more boys reporting CSA than girls (21.5% vs. 14.2%). In addition, attending non-boarding schools, lower levels of self-esteem, and higher levels of perceived peer pressure for engagement in health risk behaviors were associated with higher rates of CSA. Multivariate logistic regression analyses revealed that CSA experience was significantly associated with cigarette smoking (aOR = 2.14), binge drinking (aOR = 2.68), suicidal ideation (aOR = 1.69), and suicide attempt (aOR = 2.69) after controlling for several demographic and psychological factors.

Conclusion

More attention should be paid to the issues of CSA among rural children and adolescents in China. Effective CSA prevention intervention needs to address the vulnerabilities of the population, increase children's and parents’ awareness of CSA and ability of self-protection.     

Child abuse and neglect: Training needs of student teachers

Increasing awareness of child abuse and neglect (CAN) raises questions about how well teachers are prepared for their role in child protection. This paper assesses and differentiates training needs of first-year students (n = 216) in Northern Ireland. Multiple-choice tests were used to assess knowledge of CAN statistics; recognising and reporting; policies, procedures, and legislative frameworks; and direct work with children. Considerable gaps in knowledge were found. Results between student groups varied and provide evidence of the need to develop pre-service child protection training. The importance of differentiation between student groups in terms of training content is emphasised.     

Child abuse in Pakistan: A qualitative study of knowledge,attitudes and practice amongst health professionals

Child abuse is a global problem and pervades all cultures and socio-economic strata. The effects can be profound and life altering for victims. There is substantial literature from high income countries about signs of abuse, but a dearth of data from low and middle income countries like Pakistan. Healthcare professionals (HCP) are ideally placed to detect abuse, but, to inform interventions, an understanding of their experiences, training needs and cultural beliefs is needed. This study aimed to: (1) Explore the challenges that HCP face when managing cases of abuse; (2) Explore cultural beliefs and understand how these shape practice and (3) Identify training needs. A qualitative study using a phenomenological design was conducted. In-depth interviews were conducted with doctors, nurses and security staff in the emergency department of a large private hospital in Pakistan (n = 15). Interviews were undertaken in Urdu, translated into English and analysed using an inductive thematic approach. Multiple challenges were identified. The process of referral to legal services was poorly understood and further training and guidelines was suggested by participants. As the legal system in Pakistan does not allow HCP to keep potentially abused patients in their custody, they felt restricted in their ability to advocate and concerned about the safety of both the identified children and themselves. HCP have potential to detect abuse early; however, in Pakistan there are numerous challenges. HCP require support through training, as well as clear institutional frameworks and legal support to undertake this role.     

Growing up with parental alcohol abuse: exposure to childhood abuse, neglect, and household dysfunction

OBJECTIVE: This study is a detailed examination of the association between parental alcohol abuse (mother only, father only, or both parents) and multiple forms of childhood abuse, neglect, and other household dysfunction, known as adverse childhood experiences (ACEs). METHOD: A questionnaire about ACEs including child abuse, neglect, household dysfunction, and exposure to parental alcohol abuse was completed by 8629 adult HMO members to retrospectively assess the relationship of growing up with parental alcohol abuse to 10 ACEs and multiple ACEs (ACE score). RESULTS: Compared to persons who grew up with no parental alcohol abuse, the adjusted odds ratio for each category of ACE was approximately 2 to 13 times higher if either the mother, father, or both parents abused alcohol (p < 0.05). For example, the likelihood of having a battered mother was increased 13-fold for men who grew up with both parents who abused alcohol (OR, 12.7; 95% CI: 8.4-19.1). For almost every ACE, those who grew up with both an alcohol-abusing mother and father had the highest likelihood of ACEs. The mean number of ACEs for persons with no parental alcohol abuse, father only, mother only, or both parents was 1.4, 2.6, 3.2, and 3.8, respectively (p < .001). CONCLUSION: Although the retrospective reporting of these experiences cannot establish a causal association with certainty, exposure to parental alcohol abuse is highly associated with experiencing adverse childhood experiences. Improved coordination of adult and pediatric health care along with related social and substance abuse services may lead to earlier recognition, treatment, and prevention of both adult alcohol abuse and adverse childhood experiences, reducing the negative sequelae of ACEs in adolescents and adults.     

Child abuse potential inventory and parenting behavior: Relationships with high-risk correlates

The primary purpose of this research was to examine the construct validity of the Child Abuse Potential Inventory by comparing maltreating and high-risk parents' CAP Inventory abuse scores to their behavior during interactions with their children. A second purpose was to determine the degree to which CAP Inventory scores and parenting behavior were related to several known correlates of abuse, as measured by parent and teacher reports. Participants (n = 41) included abusive and high-risk parents and their children referred to a treatment group. Correlational analyses revealed that CAP Inventory scores and observed parenting style yielded highly related findings, supporting construct validity of the CAP Inventory. However, the CAP Inventory and observed behavior index showed a different pattern of relationships to the risk correlates. Implications for assessment of risk status are discussed and recommendations are provided for continued research.     

Intergenerational transmission of child abuse: Predictors of child abuse potential among racially diverse women residing in domestic violence shelters

Parental risk for perpetrating child abuse is frequently associated with intergenerational patterns of abuse: being abused increases the risk for future abuse. Yet, the mechanisms of intergenerational abuse are unclear, and the risk factors for perpetrating child abuse are interrelated. Research suggests that history of childhood abuse, psychiatric distress, and exposure to intimate partner violence (IPV) are all related risk factors for perpetrating child abuse. We investigated these three risk factors using the developmental psychopathology framework in a racially diverse sample of high-risk women: women residing in domestic violence shelters. 211 mothers residing in domestic violence shelters completed measures of their own childhood abuse (defined narrowly in a 10-item self-report survey), exposure to and severity of IPV victimization, and structured interviews to diagnose psychiatric disorders. We utilized a hierarchical regression model to predict child abuse potential, accounting for risk factors in blocks roughly representing theorized temporal relationships: childhood abuse followed by psychiatric diagnoses, and then recency of exposure to IPV. Consistent with hypotheses, the strongest predictor of current child abuse potential was the psychiatric diagnosis of PTSD. Mediation tests further explicated that the relationship between maternal history of childhood sexual abuse and current potential for perpetrating child abuse is mediated by IPV-related PTSD symptoms. Results suggest that IPV-related PTSD symptoms, rather than exposure to abuse (i.e., childhood abuse or IPV), is most strongly associated with child abuse potential in recent IPV survivors. Interventions which can ameliorate maternal psychopathology and provide resources are recommended for these vulnerable families.     

Child abuse and neglect re-report rates for young children with developmental delays

The study objective was to examine the likelihood and magnitude of child abuse and neglect (CAN) re-reports for young children (0–71 months) with delays in cognitive, language, and adaptive development, compared to typically developing children. The National Survey of Child and Adolescent Well-Being (NSCAW II), a nationally representative and longitudinal survey, was used to examine CAN re-reports at two follow-up waves, 18- and 36-months post baseline assessments. Logistic regression models were employed to determine the correlation between number of developmental delays and a CAN re-report at waves 2 and 3. Results indicate that children with three or more domains of delays had odds 4.73 times higher than children without developmental delays of re-report to CPS at wave 2 but not at wave 3. In this study, children with multiple developmental delays have elevated rates of CAN re-reports when compared to typically developing children. Allocation of child welfare resources should include strategies for preventing maltreatment risk among children with developmental delays.     

Child protection workers dealing with child abuse: The contribution of personal,social and organizational resources to secondary traumatization

The present study compared secondary traumatization among child protection social workers versus social workers employed at social service departments. In addition, based on Conservation of Resources (COR) theory, the study examined the contribution of working in the field of child protection as well as the contribution of background variables, personal resources (mastery), and resources in the workers’ social and organizational environment (social support, effectiveness of supervision, and role stress) to secondary traumatization. The findings indicate that levels of mastery and years of work experience contributed negatively to secondary traumatization, whereas exposure to child maltreatment, trauma history, and role stress contributed positively to secondary traumatization. However, no significant contribution was found for social support and effectiveness of supervision. The study identifies factors that can prevent distress among professionals such as child protection workers, who are exposed to the trauma of child abuse victims. Recommendations are provided accordingly.     

Child abuse among the Zulus: A people in cultural transition

Due to industrialization and Westernization the life-style of the Zulu people has undergone a rapid and radical change. This has led to a breakdown of the traditional culture and has not been replaced by an adequate social support structure. Consequently, the social ills of the First World abound and are compounded by persistent beliefs in witchcraft and the power of the ancestral spirits. The Zulu child has thus been exposed to a wide variety of abuses including sheer brutality, ongoing “minor” trauma, neglect, sexual and alcohol abuse. The extended family of yesteryear no longer exists to absorb the stresses and the nuclear family is frequently incomplete. Some contributions towards a solution are seen in (1) Appropriate education at every possible level; (2) Promoting formal and informal community support groups; (3) Screening mothers perinatally; (4) Developing and promoting an adoption service; and (5) Improving primary health care facilities.