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).     

Child sexual abuse and incest: community-based intervention

OBJECTIVE: The primary aim of this article is to determine the effectiveness of community intervention in the case of child sexual abuse. The article describes and analyses an actual case in a small urban community in Israel. METHOD: After several incidents of child sexual abuse, much of it incestuous, were brought to light in the community, they were discussed openly, contained, and punished. A community campaign, in which community activists as well as all the service providers were involved, was organized by community social workers. Individual, group, and community interventions were used. RESULTS: The continuation of the abuse has been checked, and, so far, there is no evidence to suggest its resurgence. Community apathy to child sexual abuse seems to have been halted and reversed. The involvement of community residents, particularly the activists, has increased, and this appears to be the major factor in changed community norms toward child sexual abuse. CONCLUSION: Implications of the individual, group, and community interventions are discussed. An integrated program of intervention practices is advocated to contain and prevent the incidence of child sexual abuse and incest.     

Child sexual abuse in Tanzania and Kenya

OBJECTIVE: Most research on child abuse in Tanzania and Kenya is unpublished in the international literature. The purpose of this paper is to examine the various commentaries and reports extant, toward an overview of the nature and frequency of child sexual abuse in Tanzania and Kenya. METHODS: Contacts were made with academics, government departments, NGOs, and UN agencies. This was followed by a field trip in the summer of 2001 where all available reports were examined and a wide range of interviews conducted. RESULTS: Little empirical data exist on child sexual abuse in Tanzania. It is widely perceived that it may be increasing as a result of AIDS sufferers' attempts to cleanse themselves. The breakdown of traditional childcare systems, foreign influences, poverty, and the lowly position of girls in society are also implicated. More research has been conducted in Kenya. It is clear that first coitus occurs at a young age for many Kenyan children and adolescents. Also, a degree of force, trickery, or material exchange is not uncommon in adolescent sexual relations. CONCLUSIONS: Child sexual abuse is under-researched in Tanzania and Kenya. Studies by UN agencies such as United Nations Children's Fund (UNICEF) and the International Labour Organisation (ILO) have focused on the commercial sexual exploitation of children, to the neglect of more pervasive abuse in children's own communities by family, relatives, and neighbors. Nationwide surveys of the general population are required for an empirical understanding of this topic. Given the high incidence of AIDS/HIV in both countries, it is important to know if the epidemic is increasing the risk of rape or incest for children.     

Child sexual abuse: relationship between sexual acts and genital findings

A comparison was made between the findings observed during the examination of female victims of sexual abuse with the sexual acts to which the perpetrator confessed to have performed. In Shelby County, TN, during the calendar years 1985-1987, 30 individuals confessed to have sexually assaulted 31 girls. The mean age of the girls was 9.1 years, and that of the offenders was 30 years. In 18 of the 31 cases the offender admitted to vaginal penetration. Specific findings were observed in 11 of these 18 (61%) girls, compared with only 3 of 13 (23%) girls when penetration was denied. Although specific findings were more commonly observed when the perpetrator admitted to vaginal penetration, in 7 of 18 girls (39%) the examiner described normal appearing genitalia (n = 2), or nonspecific abnormalities only (n = 5). The author concludes that all complaints of sexual abuse must be considered potentially valid and should be investigated further, even if the physical examination fails to detect any abnormalities.     

Child sexual abuse and bulimic symptomatology: relevance of specific abuse variables

OBJECTIVE: This study examined specific aspects of child sexual abuse in relation to symptom severity among hospitalized patients diagnosed with bulimia nervosa. METHOD: Participants were 45 hospitalized bulimic women who reported a history of child sexual abuse. Structured interviews were conducted in order to obtain detailed information regarding specific features of the abusive event(s). Participants also completed instruments that measured depression and eating pathology. RESULTS: There were no significant differences in severity of depression or eating disturbance among women reporting differing abusive experiences including intrafamilial versus extrafamilial abuse, abuse with or without the use of physical force, one versus multiple incidents, early abuse versus abuse occurring after age 14, contact versus noncontact abuse, disclosed versus undisclosed, and combined physical/sexual abuse versus sexual abuse alone. CONCLUSION: The specific characteristics of child sexual abuse are not related to the level of symptomatology for hospitalized bulimic patients. This study suggests that differences in the nature of the abuse may not be as important as the fact that the abuse occurred in the first place.     

Child sexual abuse in sub-Saharan Africa: a literature review

OBJECTIVE: This article reviews the English-language literature on child sexual abuse in sub-Saharan Africa (SSA). The focus is on the sexual abuse of children in the home/community, as opposed to the commercial sexual exploitation of children. METHODS: English language, peer-reviewed papers cited in the Social Sciences Citation Index (SSCI) are examined. Reports from international and local NGOs and UN agencies are also examined. RESULTS: Few published studies on the sexual abuse of children have been conducted in the region, with the exception of South Africa. Samples are predominantly clinical or University based. A number of studies report that approximately 5% of the sample reported penetrative sexual abuse during their childhood. No national survey of the general population has been conducted. The most frequent explanations for the sexual abuse of children in SSA include rapid social change, AIDS/HIV avoidance strategies and the patriarchal nature of society. Child sexual abuse is most frequently perpetrated by family members, relatives, neighbors or others known to the child. CONCLUSIONS: There is nothing to support the widely held view that child sexual abuse is very rare in SSA-prevalence levels are comparable with studies reported from other regions. The high prevalence levels of AIDS/HIV in the region expose sexually abused children to high risks of infection. It is estimated that, approximately.6-1.8% of all children in high HIV-incidence countries in Southern Africa will experience penetrative sexual abuse by an AIDS/HIV infected perpetrator before 18 years of age.     

Child sexual abuse prevention: evaluation and one-year follow-up

Because of the high incidence and negative psychological consequences of child sexual abuse, prevention programs have been developed and implemented nationwide. Few programs, however, have been comprehensively evaluated. In this multimodal study, a 3-session adaptation of the Feeling Yes, Feeling No curriculum was provided to 286 third and fourth graders from four schools whose responses were compared to 113 delayed-treatment control children from two schools. Program impact was assessed using a knowledge scale, the State-Trait Anxiety Inventory for Children, a videotape vignettes measure, a parent questionnaire, and disclosure data. Treatment children exhibited significantly greater knowledge and better ability to discriminate safe from unsafe situations on the video measure than control children at posttesting. These gains were maintained at 6-week follow-up testing. There were no differences in treatment and control children's self-reported anxiety or parents' reports of negative emotional/behavioral consequences, which were minimal. Over 5% of participating children reported ongoing or past sexual abuse. In the One-Year Follow-Up Study, children's knowledge gains and prevention skills scores on the video measure were maintained at one-year follow-up. A 1-session "booster shot" program further enhanced children's safety discrimination skills on the video measure.     

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.     

Child abuse in the eyes of the beholder: lay perceptions of child sexual and physical abuse

OBJECTIVE: The purpose was to explore the effects of victim and perpetrator gender, type of abuse, and victim-perpetrator relationship on university students' and non-students' perceptions of different kinds of child abuse. METHOD: One hundred and ninety-nine participants (including university students and non-student adults) evaluated each of 24 vignettes (within-subjects design) describing an abusive interaction between a child and an adult. The following four variables were manipulated: the victim's gender, the perpetrator's gender, the type of abuse (physical, relatively mild sexual, or relatively severe sexual), and the perpetrator's relationship to the victim (parent or babysitter). Participants rated each vignette on a number of dimensions: degree of trauma and severity, likelihood of general occurrence and reoccurrence, victim believability, and repressibility of the event. RESULTS: Significant interactions emerged on each dimension. For example, sexual abuse (whether mild or severe) was rated as being more traumatic and severe if perpetrated by a parent, but relationship type did not affect perceptions of physical abuse. In addition, significant perpetrator gender by victim gender interactions indicated that homosexual abuse was perceived as more traumatic and repressible than heterosexual abuse, but as less likely to occur; and male participants tended to be more affected by the gender of the perpetrator and abuse type than female participants. CONCLUSION: The results suggest that people have stereotypes about the circumstances and consequences of child abuse. These stereotypes are often, though not always, consistent with existing empirical findings.     

Child sexual abuse: factors affecting victims' removal from home

This study was conducted to examine factors associated with children's protective service workers' decision to remove sexually abused children from the family home. The decision to remove was analyzed relative to the following six factors: (1) nature of the abuse, (2) severity of abuse, (3) frequency of abuse (4) mothers' employment status, (5) mothers' compliance with a recommended treatment plan, and (6) mothers' belief of the victim. Discriminant function analysis revealed that the discriminant function containing mothers' compliance, mothers' belief, severity of abuse, mothers' employment status, and frequency of abuse, in order of importance of contribution, was significantly related to victims' removal from the home.     

Child extrafamilial sexual abuse: predicting parent and child functioning

Objective: This study evaluated the emotional and behavioral adjustment of parents and children within 3 months and 1 year after the discovery of child extrafamilial sexual abuse.Method: Ninety-two case parents (63 mothers, 29 fathers) and 56 children were compared to a nonclinical comparison group of 136 parents (74 mothers, 62 fathers) and 75 children. Parent adjustment was assessed using self-report measures while child functioning was assessed using a combination of child-, parent- and teacher-report measures.Results: Mothers, fathers and sexually abused children experienced clinically significant effects both initially and at 12 months post-disclosure. Children’s perceptions of self-blame and guilt for the abuse and the extent of traumatization predicted their self-reported symtomatology at 3 months and 1 year post-disclosure. Child age and gender also significantly contributed to the prediction of many of the child outcome measures. No abuse-related variable was related to any child self-report measure. Mothers’ satisfaction in the parenting role, perceived support and intrusive symptoms predicted their initial emotional functioning. Avoidant symptoms, child’s internalizing behavior and mothers’ initial emotional functioning were significant predictors of longer-term emotional functioning.Conclusions: Results emphasize the need to address children’s abuse-related attributions and underscore the need to expand our focus beyond the child victims to the traumatized families.     

Child sexual abuse prevention: Evaluation of a teacher training model

Teachers are potentially helpful resource persons for large numbers of sexually abused children who may have difficulty disclosing abuse, particularly to family members. In the present study, the effectiveness of a 6-hour teacher training workshop on child sexual abuse prevention was evaluated. Responses of 26 female elementary teachers who participated in the workshop were compared to responses of 19 control teachers on several pre-, post-, and follow-up measures. Relative to controls, trained teachers demonstrated significant increases from pre- to post-testing in knowledge about child sexual abuse and pro-prevention opinions. On a post-only vignettes measure, trained teachers were better able than control teachers to identify behavioral indicators of abuse and suggest appropriate interventions for hypothetical sexually abused children. Over a 6-week follow-up period, trained teachers read more about child abuse than control teachers but did not differ on other behavioral dimensions such as reporting suspected abuse cases. Further research will examine the effects of additional teacher training over an extended follow-up period.     

Child sexual abuse in Japan: A systematic review and future directions

IntroductionEstimating the national prevalence of child sexual abuse (CSA) and its association with health and developmental outcomes is the first step in developing prevention strategies. While such data are available from many countries, less is known about the epidemiology of CSA in Japan.MethodsFor this systematic review, we searched English databases: Embase, Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations, Ovid MEDLINE(R) Daily and Ovid MEDLINE(R), Ovid OLDMEDLINE(R), PsycINFO, and Japanese databases: Cinii, J-Stage, Children’s Rainbow Center Japan, Japan Child and Family Research Institute, Japanese Journal of Child Abuse and Neglect to identify articles published before July 2015 examining the lifetime prevalence of CSA in Japan using non-clinical samples. Data were extracted from published reports.ResultsWe initially identified 606 citations and after abstract review, retrieved 120 publications. Six studies that met the selection criteria and additional two relevant studies were reviewed. The range of contact CSA for females was 10.4%–60.7%, and the prevalence of this type of CSA for males was 4.1%. The range of penetrative CSA for females was 1.3%–8.3% and that for males was 0.5%–1.3%. A number of methodological issues were identified, including a lack of validated measures of CSA, and low response rates.ConclusionIn contrast to a lower prevalence of penetrative CSA, the prevalence of contact CSA among Japanese females may be comparable or higher in relation to international estimates. Future research on children's perceptions of and exposure to sexual abuse, crime and exploitation in Japan is discussed.     

Child sexual abuse in Shelby County, Tennessee: a new epidemic?

Following the introduction of a comprehensive child sexual abuse program in 1985, there was a significant increase in the number of validated incidents of abuse involving minors. However, following the initial increase, the number of validated incidents of abuse remained relatively stable at about 30-35 per month. While the overall validation rate was 57%, it fluctuated widely from as low as 21% to as high 92%. The validation rate rose from 1984 through 1987, declining in the latter part of 1989. The validation rate appeared to reflect the number of validated cases and not be dependent upon the number of reported cases. The number of cases validated was not significantly correlated with time, but was moderately correlated with the number of cases reported (estimated Spearman correlation coefficient was .45 with p less than .05). However, after adjusting for time, the partial correlation between the number of validated and the number of reported cases was no longer significant. The percent of validated cases (the validation rate) was correlated with number of cases validated (estimated Spearmen correlation coefficient was .84 with p less than .0001), but not with the number of cases reported. Validation rates were higher for girls than for boys, 71.1% and 31.8% respectively. The majority of the perpetrators (78%) were known to the children and had access to the victims. In over half the incidents, family members were implicated as the perpetrators.     

Child peer sexual abuse: preliminary data on outcomes and disclosure experiences

OBJECTIVE: This study compared experiences of children sexually abused by peers to those of children abused by adolescents/adults. Variables examined included perceived negativity of the abuse, self-reported outcomes, overall psychological functioning, and disclosure. METHOD: An archival data set containing retrospective reports of childhood sexual experiences was culled for instances of sexual abuse by child peers and adolescents/adults. An equivalent nonabused comparison group was identified. The Self-Report Outcome Checklist (SROC; Gilbert, 1994b), the MMPI-Hugo Short Form (Hugo, 1971) and a disclosure survey were also retrieved from these data. RESULTS: Compared to abuse by peers, abuse perpetrated by adolescents/adults was more intrusive and intrafamilial. Both groups rated their experiences as equally negative, and reported equally pervasive outcomes. Those abused by adolescents/adults reported significantly higher scores on the Psychopathic Deviate, Psychasthenia, and Schizophrenia scales compared to nonabused controls; similar findings did not emerge for those abused by child peers. Less than a fourth in either abuse group reported disclosing their experience to a parent. Among those who did not disclose, participants abused by child peers anticipated less support from both parents and more anger from their mothers. CONCLUSIONS: The findings suggest that child peer sexual abuse may be associated with adverse outcomes.     

Child sexual abuse and persistence of risky sexual behaviors and negative sexual outcomes over adulthood: Findings from a birth cohort

ObjectivesTo determine the impact of child sexual abuse (CSA) on adult sexual behaviors and outcomes over three age periods.MethodsA longitudinal study of a birth cohort born in Dunedin, New Zealand in 1972/1973 was used. Information on CSA was sought at age 26, and on sexual behaviors and outcomes at ages 21, 26, and 32. Comparisons were over the whole period from age 18 to 32, then for the three age periods from age 18 to 21, 21 to 26, and 26 to 32, adjusting for measures of family environment.ResultsOverall, 465 women and 471 men (91.9% of the surviving cohort) answered questions about CSA. Contact CSA was reported by 30.3% of women and 9.1% of men. For abused women, significantly increased rates were observed for number of sexual partners, unhappy pregnancies, abortion, and sexually transmitted infections from age 18 to 21; with rates approaching those of nonabused over time. Conversely, for abused men rates were not significantly elevated in the youngest age period, but were for number of partners from age 26 to 32 and acquisition of herpes simplex virus type 2 from age 21 to 32.ConclusionsGender and age are critical when considering the effect of CSA. While the profound early impact of CSA demonstrated for women appears to lessen with age, abused men appear to carry increased risks into adulthood.Practice implicationsCSA is common and should be considered when young women present with unwanted conceptions or seek multiple terminations, and when men continue to have high risk sexual behavior into adulthood. Furthermore, if CSA is disclosed, sexual risks in adulthood need to be considered.     

Child sexual and physical abuse among college students in Singapore and the United States

OBJECTIVES: The purpose of this study was to explore differences in rates and characteristics of child sexual and physical abuse experiences among women in Singapore and the US. METHOD: Participants (N=153) completed an anonymous questionnaire which assessed experiences of childhood sexual and physical abuse, abuse characteristics (e.g., victimization age, severity), and behavioral and subjective reactions to such experiences (e.g., labeling of experiences as abuse, psychological symptomatology). Exposure to other forms of traumatic life events was also assessed. RESULTS: In comparison to Singaporean women, US women were more likely to report a history of child sexual abuse, and to report experiencing more severe forms of sexual abuse. Women in Singapore were more likely than women in the US to report a history of child physical abuse, to report experiencing injury as a result of the abuse, and to disclose the abuse. Singaporean women with a history of child sexual abuse reported elevated psychological symptom levels relative to their nonabused peers and to US women with a history of child sexual abuse, even after controlling for exposure to other types of traumatic events. No significant differences in symptomatology with regard to child physical abuse were observed. CONCLUSIONS: Although preliminary in nature, the present findings are among the first to demonstrate differences in psychological adjustment between sexually abused and nonabused Asian women living in Asia. This study also provides some of the first support for cross-national differences in the psychological adjustment of child sexual abuse survivors.