The process of incest: Biologic father and stepfather families

This article compares incest between biologic fathers and their daughters and stepfathers and their stepdaughters. The term "incest" is applied to each of these types of families. The sample for the study was located in a mental health treatment facility designed to work specifically with incestuous families and includes 102 cases (56 stepfather families; 46 biologic father families). The data were obtained by interviews with the four primary program therapists. Differences in sexual behavior between the two groups indicated that biologic fathers more frequently engaged in full intercourse, more frequently involved multiple daughters and more frequently began the sexual activity when their daughters were adolescents than did stepfathers. Possible explanations of the differences are explored.     

The incidence and prevalence of intrafamilial and extrafamilial sexual abuse of female children

Data obtained from a random sample of 930 adult women in San Francisco provide the soundest basis heretofore available for estimating the prevalence of intrafamilial and extrafamilial sexual abuse of female children. This article describes the methodology of this survey, as well as some of the key findings. For example: 16% of these women reported at least one experience of intrafamilial sexual abuse before the age of 18 years; 12% reported at least one such experience before the age of 14 years; 31% reported at least one experience of extrafamilial sexual abuse before the age of 18 years; and 20% reported at least one such experience before the age of 14 years. When both categories of sexual abuse are combined, 38% reported at least one experience before the age of 18 years; and 28% reported at least one such experience before the age of 14 years. Only 2% of the cases of intrafamilial and 6% of the cases of extrafamilial child sexual abuse were ever reported to the police. A plea is made for the urgent need to recognize the magnitude of the problem of child sexual abuse, and to act to prevent it.     

Child sexual abuse: A study of prevalence in Great Britain

Of 2019 men and women (aged 15 years and over) interviewed as part of a MORI Survey of a nationally representative sample of Great Britain, 10% reported that they had been sexually abused before the age of 16 (12% of females; 8% of males). There was no increased risk associated with specific social class categories or area of residence. For all types of sexual abuse, the mean age of victims when first abused was significantly lower for females. Subjective reports of the effects of sexual abuse indicated that the majority (51%) felt harmed by the experience, while only 4% reported that it had improved the quality of their life. We estimate that there are over 4.5 million adults in Great Britain who were sexually abused as children, and that a potential 1,117,000 children will be sexually abused before they are 15 years of age. At least 143,000 of these will be abused within the family. The social and mental health implications are enormous, and the authors suggest that an effective intervention and prevention policy is urgently required.     

Characteristics of victims and perpetrators of intrafamilial sexual abuse

BackgroundIntrafamilial sexual abuse (SA) is one of the most traumatic experiences a person can experience and comes with lifelong effects. Considering the increase in the number of children in orphanages due to intrafamilial SA in Turkey, addressing this problem in more detail is crucial. For this reason, this study aims to determine the characteristics of intrafamilial SA cases.MethodIn this study, the characteristics of 216 intrafamilial SA cases who were referred to the Ankara Child Advocacy Center between 2010 and 2015 were analyzed retrospectively. The ages of the victims varied between 3 and 17.ResultsThe most common identity of the perpetrator was the biological father (50%), biological sibling (14.4%), stepfather (13.9%), and parent’s boyfriend (12%). Of the perpetrators, 6.5% were female and 93.5% were male. Of the victims, 3.3% had a history of pregnancy. In addition, one out of four victims (27.3%) had experienced physical violence from their parents, the socioeconomic level of the majority of the families (90.2%) was low, the education levels of their parents were low (high-school-level education and below), and one of two families (52.6%) experienced domestic violence. Furthermore, the perpetrators in the biological intrafamilial SA group exhibited similar behavior with the sociolegal group in terms of penetration, and the age distribution of the victims was similar.ConclusionsConsequently, this study has revealed a lot of new information about intrafamilial SA cases. These findings will hopefully be useful in identifying and preventing victims at risk for intrafamilial SA.     

Removing the child--prosecuting the offender in cases of sexual abuse: evidence from the national reporting system for child abuse and neglect

Sexual abuse has come to public attention so rapidly and is such a difficult problem to deal with that many observers are concerned that the quality of child protective intervention in these cases has been haphazard and indiscriminate. This article analyzes data on all 6,096 cases of child sexual abuse which were "officially reported" in 1978 to see what kinds of intervention were made. The data show that foster placement occurred in more cases of sexual abuse than physical abuse, and was concentrated among cases of older children who reported their own victimization. Criminal action was taken almost five times more often in cases of sexual abuse than in cases of physical abuse, and occurred more often among cases which were directly reported to police and involved offenders with prior criminal records. Black families and poorer families did not seem to be the objects of obvious discrimination in the disposition of these cases.     

Sexual abuse of children in Denver, 1979: Reviewed with implications for pediatric intervention and possible prevention

287 children involved in sexual abuse are reviewed. All were reported in Denver, Colorado, U.S.A., in 1979. Specific attention is given to the origin of the report of cases later determined to be unfounded. Sibling sexual involvement is examined, particularly with reference to the age differential. Perpetrators are categorized as fathers, stepfathers, mother's “boyfriend,” relatives or family friends. These in turn are related to the ages of the children involved. Attention is given to the frequency with which the victimized child had reported the incident(s) months to years before it was reported to an agency. In 50% of the cases the victimized children are under 12 years of age, and in 15% of the cases they are under 6 years of age. Suggestions are made regarding detection and preventive measures, particularly in the history-taking phase of the pediatrician-patient relationship and in vaginal physical findings.     

An exploration of family and individual profiles following father-daughter incest

This paper presents the results of a range of psychometric assessments which attempted to identify family and individual variables associated with father-daughter incest. Psychometric self-report measures were used to examine differences between families in which incest had been confirmed and a matched comparison group. Significant differences between the members of the incest and the comparison groups included behavioral and self-esteem problems in the daughters and differences in the familial environments of the two groups. Daughters who had been sexually abused reported lower levels of self-esteem about their intellectual and school status. Mothers in the incest group reported that their daughters had more conduct problems than the comparison mothers. The incest families were generally reported to be higher in conflict and organization and lower in cohesion, expressiveness, and active recreation. No differences between groups were found for levels of marital adjustment, self-esteem in mothers, or overall level of psychopathology in the perpetrators.     

Suicide attempts in sexual abuse victims and their mothers

Suicide attempts occurred in 11 of 201 (5.4%) families in which sexual abuse was substantiated during a 2$\text{1}\text{2}$-year study period. Thirteen attempts occurred in the eleven families—five in mothers and eight in daughter-victims. No perpetrators in this social agency sample attempted suicide. Three mothers made attempts within the 1st week after the sexual abuse report; these three had borderline personalities, prior suicide attempts, personal histories of incest, and, surprisingly, all returned rapidly to adequate maternal functioning. The two mothers who made attempts later had primary depressions with underlying dependent personalities and never returned to successful mothering of their victimized daughters, both of whom themselves attempted suicide later in the family's treatment course. All eight daughters who attempted suicide were 14 to 16 years old and had been involved in incest with father figures. None of their families remained intact after the disclosure of incest, and their mothers actively blamed and disbelieved these victims. Seven of the eight had behavior problems which may have masked depression.     

The sexual abuse of Afro-American and White-American women in childhood

This study examined the prevalence of child sexual abuse in a multi-stage stratified probability sample of Afro-American and white-American women, 18 to 36 years of age, in Los Angeles County. The sample ranged in demographic characteristics by age, marital status, education and the presence of children. Of the total sample of 248 women, 154 (62%) reported at least one incident of sexual abuse prior to age 18, with 57% of Afro-American women and 67% of white-American women having been abused. Sexual abuse before the age of 18 appears to be of equal concern for both ethnic groups, although similarities and differences in the circumstances under which abuse incidents occurred were subtle and deserve attention. The need for identifying contemporary factors that contribute to the prevalence of abuse over the past 40 years is stressed.     

Screening homeless youth for histories of abuse: prevalence, enduring effects, and interest in treatment

Objectives

To identify the incidence of self-reported physical and sexual child abuse among homeless youth, the self-perceived effects of past abuse, and current interest in treatment for past abuse among homeless youth with histories of abuse.

Methods

Homeless and street-involved persons aged 18-23 filled out a questionnaire and participated in a structured assessment of histories of abuse, tobacco use and substance abuse.

Results

Sixty-four homeless youth in Salt Lake City, Utah completed the study, 43 males and 21 females. Eighty-four percent screened positive for childhood physical and/or sexual abuse occurring before the age of 18; 42% screened positive for both physical and sexual abuse; 72% reported still being affected by their abuse. Among all abuse victims, 44% were interested in treatment for their abuse history and 62% of homeless youth who reported still being affected by their abuse were interested in treatment. Individuals were more likely to be interested in treatment if they were female, had not completed high school or had been previously asked about family dysfunction. Many victims who declined treatment offered spontaneous insight into their decision. Interest in treatment was similar to interest in treatment for other behaviors such as smoking and substance abuse.

Conclusions

Histories of abuse are common among homeless youth. A majority of those reporting a history of abuse are still affected by their abuse. Interest in treatment for a history of abuse was comparable to interest in treatment for other morbidities in the homeless youth population such as tobacco use and substance abuse. Our finding that homeless youth continue to be impacted by their abuse and are interested in treatment should prompt more screening for histories of abuse.     

Attribution of causal and moral responsibility to victims of father-daughter incest: An exploratory examination of five factors

This study was designed to assess the extent to which victim characteristics, assault characteristics, and respondents' sex would affect attributions of causal and moral responsibility to an incest victim. The victim was either a 7- or 15-year-old child who responded in either a passive or resisting manner. The incestuous abuse involved either sexual intercourse or fondling, and either high or low levels of coercion. The subjects were undergraduate students (male = 240; female = 240) who responded to a vignette describing a sexual interaction between a father and daughter. The results indicate that significantly more causal and moral responsibility was attributed to the victim in cases where the victim responded passively. A breakdown of the significant form of responsibility x victim age x coerciveness interaction revealed a significant main effect for form of responsibility; significantly more causal (as opposed to moral) responsibility was attributed to the victim. The simple main effects for victim age were significant in all cases except for the moral responsibility, high coercion condition; and the simple main effects for coercion were significant in all cases except for the moral responsibility, 7-year-old victim condition. These findings are discussed in terms of their implications for public education and future research.     

The relationship between parental substance abuse and child maltreatment: findings from the Ontario Health Supplement

OBJECTIVE: This study examined the relationship between reported exposure to child abuse and a history of parental substance abuse (alcohol and drugs) in a community sample in Ontario, Canada. METHOD: The sample consisted of 8472 respondents to the Ontario Mental Health Supplement (OHSUP), a comprehensive population survey of mental health. The association of self-reported retrospective childhood physical and sexual abuse and parental histories of drug or alcohol abuse was examined. RESULTS: Rates of physical and sexual abuse were significantly higher, with a more than twofold increased risk among those reporting parental substance abuse histories. The rates were not significantly different between type or severity of abuse. Successively increasing rates of abuse were found for those respondents who reported that their fathers, mothers or both parents had substance abuse problems; this risk was significantly elevated for both parents compared to father only with substance abuse problem. CONCLUSIONS: Parental substance abuse is associated with a more than twofold increase in the risk of exposure to both childhood physical and sexual abuse. While the mechanism for this association remains unclear, agencies involved in child protection or in treatment of parents with substance abuse problems must be cognizant of this relationship and focus on the development of interventions to serve these families.     

Perinatal interventions for mothers and fathers who are survivors of childhood sexual abuse

Childhood sexual abuse (CSA) is a worldwide problem with severe long-term consequences. A history of CSA can impact the childbearing experience of mothers and fathers; affecting their mental health, parenting skills and compromising infant development. Nonetheless, the perinatal period offers huge opportunity for intervention and hope. This literature review collates evidence for perinatal psychosocial interventions targeting both mothers and fathers who are survivors of CSA. Publications dating from 1970 to June 2016 were searched using Medline, Maternity and Infant Health, PsychINFO, PsychArticles, PubMed and the International Bibliography of the Social Sciences (IBSS). There were no perinatal interventions that considered the needs of survivor fathers. Sixteen publications on 9 psychosocial perinatal interventions for CSA survivors were identified. However, no sub-analyses specific to CSA survivors were reported. Trauma-specific perinatal interventions drew from a range of theoretical models and varied widely in format. Generally interventions were associated with improvements in maternal mental health, parenting competence, infant attachment security and positive public health outcomes. They were safe and feasible to implement, acceptable to parents and therapist, and therapists were able to implement protocols with adequate fidelity. Yet current data is hampered by small sample size, inconsistent reporting of CSA rates and outcome measures, scarcity of observational data and longer-term follow-up. Intervention modifications are proposed for CSA survivors in view of their unique childbearing experiences.     

Childhood maltreatment experiences and problematic sexual outcomes in adult males who have sexually offended: Further evidence of the potency of male caregiver psychological abuse

BackgroundAlthough research on the developmental antecedents of sexual offending has tended to focus on sexual abuse, recent research in juveniles and adults who have sexually offended suggests that psychological abuse perpetrated by a male caregiver may be a particularly important factor in the development of problematic sexual interests and behaviors.ObjectiveThis study aimed to extend previous findings by investigating the association between psychological abuse by a male caregiver and problematic sexual outcomes in a sample of adult males who had sexually offended.ParticipantsParticipants were 529 adult males incarcerated for sexual offenses, 21% of whom were civilly committed.MethodsChildhood maltreatment and problematic sexual outcomes were assessed using the Multidimensional Assessment of Sex and Aggression, a contingency-based inventory that assesses domains related to sexual aggression. Hierarchical regressions were calculated examining the association between childhood abuse types and sexual outcomes.ResultsChildhood sexual abuse was associated with child sexual (β = .247, p < .001) and other paraphilic interests (β = .189, p < .001). Male caregiver psychological abuse also emerged as marginally associated with child sexual interest (β = .100, p = .059), even after controlling for other abuse types.ConclusionsThese results partially replicate recent findings in a juvenile sample and challenge conventional developmental theories of sexual offending, by suggesting that male caregiver psychological abuse may play a role in the etiology of child sexual interest among males who have sexually offended. This study also suggests a possible gender symmetry effect moderating the developmental consequences of abuse.     

Cumulative childhood maltreatment and its dose-response relation with adult symptomatology: Findings in a sample of adult survivors of sexual abuse

In the present study, we examined the role of cumulative childhood maltreatment experiences for several health related outcomes in adulthood, including symptoms of psychological distress as well as perceived social support and hardiness. The sample comprised adult survivors of sexual abuse (N = 278, 95.3% women, mean age at first abusive incident = 6.4 years). One-way ANOVAs revealed a statistically significant dose-response relation between cumulative childhood maltreatment scores and self-reported symptoms of posttraumatic stress (PTSS), anxiety, depression, eating disorders, dissociation, insomnia, nightmare related distress, physical pain, emotional pain, relational problems, self-harm behaviors as well as on a measure of symptom complexity. Cumulative childhood maltreatment was also associated with lower levels of work functioning. An inverse dose-response relation was found for perceived social support and hardiness. Using a Bonferroni corrected alpha level, cumulative childhood maltreatment remained significantly associated with all outcome measures with the exception of eating disorder symptoms after controlling for abuse-related independent variables in hierarchical regression analyses. Results add to previous literature by showing that dose-response relation between cumulative childhood adversities and adult symptom outcomes could also be identified in a sample characterized by high exposure to adversities, and lends support to the notion put forth by previous authors that cumulative childhood adversities seem to be related to the severity of adult health outcomes in a rule-governed way.     

Diagnostic agreement when comparing still and video imaging for the medical evaluation of child sexual abuse

Still photo imaging is often used in medical evaluations of child sexual abuse (CSA) but video imaging may be superior. We aimed to compare still images to videos with respect to diagnostic agreement regarding hymenal deep notches and transections in post-pubertal females. Additionally, we evaluated the role of experience and expertise on agreement. We hypothesized that videos would result in improved diagnostic agreement of multiple evaluators as compared to still photos. This was a prospective quasi-experimental study using imaging modality as the quasi-independent variable. The dependent variable was diagnostic agreement of participants regarding presence/absence of findings indicating penetrative trauma on non-acute post-pubertal genital exams. Participants were medical personnel who regularly perform CSA exams. Diagnostic agreement was evaluated utilizing a retrospective selection of videos and still photos obtained directly from the videos. Videos and still photos were embedded into an on-line survey as sixteen cases. One-hundred sixteen participants completed the study. Participant diagnosis was more likely to agree with study center diagnosis when using video (p < 0.01). Use of video resulted in statistically significant changes in diagnosis in four of eight cases. In two cases, the diagnosis of the majority of participants changed from no hymenal transection to transection present. No difference in agreement was found based on experience or expertise. Use of video vs. still images resulted in increased agreement with original examiner and changes in diagnostic impressions in review of CSA exams. Further study is warranted, as video imaging may have significant impacts on diagnosis.     

Childhood sexual abuse is significantly associated with subsequent sexual offending: New evidence among federal correctional clients

BackgroundAdverse childhood experiences are associated with multiple negative behavioral outcomes and childhood sexual abuse (CSA) is particularly damaging. There is controversial evidence that CSA has a specialized effect on subsequent sexual offending.ObjectiveThe current study tested the hypothesis that CSA is associated with sexual offending.MethodUsing a near-population of correctional clients on supervised release in the Midwestern United States, we examined the hypothesis with hierarchical negative binomial regression models.ResultsCSA was significantly associated with official charges for rape/sexual abuse despite controls for sex, race, age, arrest onset, total arrest charges, total adverse childhood experiences, Antisocial Personality Disorder, sexual sadism, and pedophilia. Age of onset of CSA was also inversely associated with sexual offending with effect sizes ranging between 2–5 standardized z-scores.ConclusionThe current study provides significant evidence that CSA is associated with later sexual offending even when accounting for powerful clinical and criminological covariates.     

Hospitalized youth and child abuse: A systematic examination of psychiatric morbidity and clinical severity

Many children and adolescents who require psychiatric hospitalization have been physically or sexually abused, yet the association between reported histories of abuse and the complexity and severity of mental illness among psychiatrically hospitalized youth is poorly described with regard to current inpatient psychiatric practice. We sought to determine the association between histories of abuse and psychiatric complexity and severity in psychiatrically hospitalized youth including comorbidity patterns, psychotropic medication use, reason for admission and length of hospitalization. A systematic chart review was performed on 1433 consecutive psychiatric hospitalizations of children and adolescents that occurred over a 10-month period. Children with a history of abuse were more likely to be diagnosed with multiple DSM-IV-TR disorders than non-traumatized children. A history of sexual abuse was associated with more medication use than in their non-traumatized peers and a higher likelihood of treatment with antipsychotic medications, both at admission and discharge. Physical and sexual abuse were independently associated with increased length of stays, with exposure to both physical and sexual abuse associated with a 2-day increase in duration of hospitalization compared to non-traumatized patients. The findings from this study draw attention to the adverse impact of abuse on psychiatric morbidity and complexity and suggest the need for trauma-informed treatment in psychiatric hospital settings.     

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.     

Sexual abuse in the national incidence study of child abuse and neglect: An appraisal

The National Incidence Study of Child Abuse and Neglect was a major, government sponsored effort to collect data on reported and unreported child abuse. It used a systematic representative sample methodology and very precisely developed definitions of child abuse. This paper reviews some of the main limitations of the study in regard to findings on sexual abuse. First, there is probably less “new” data in the study on sexual abuse than on other forms of abuse, since so many of the study cases of sexual abuse were “officially reported” cases. In addition, the study limited its definition of sexual abuse only to cases where a caretaker was the perpetrator, a definition that is much more restrictive than what is used in many treatment programs. Finally, the data on perpetrators has a number of problems that stem from the study's definitions of sexual abuse. The paper makes suggestions for future incidence type studies of sexual abuse.