Evaluation of a brief intervention for educating school children in awareness of physical and sexual abuse

The development and evaluation of procedures for imparting information to children regarding inappropriate treatment by adults is a challenging task that warrants increased methodological sophistication. The present study was conducted to evaluate proximal changes in fourth and fifth graders' knowledge and attitudes of physical and sexual abuse following brief skits and focal discussion in the classroom. The study used a control group of children that did not receive the intervention, which permitted a more accurate understanding of the program's effectiveness. Relative to controls, children who received the program showed an overall increase in knowledge of correct actions to take in the event of potential or actual abuse. Limitations of the study, as well as suggestions for broadening the scope and impact of child abuse prevention programs for children are discussed in relation to these findings.     

Pregnancy and delivery for women with a history of child sexual abuse

OBJECTIVE: To study whether women with a history of child sexual abuse are at increased risk of delivering low birth weight infants. Secondary aims were to study smoking habits, obstetric complications, health care use, and health complaints during pregnancy among women with a history of child sexual abuse. METHOD: In a case control study, 82 women with birth of a low birth weight infant (< 2500 g) (cases) and 91 women with birth of a normal birth weight infant (controls) were interviewed about experiences of child sexual abuse. RESULTS: Fourteen percent of the women disclosed a history of child sexual abuse involving at least genital touch. Birth of a low birth weight infant was not associated with a history of child sexual abuse (OR 1.03, 95% CI .44-2.40). More women with a history of child sexual abuse were smokers during pregnancy (56% vs. 31%) compared with nonabused women. Abused women reported lower age at menarche and sexual debut. Nonscheduled contacts with the antenatal care clinic and discomfort during pregnancy were more frequent among abused women when controlled for low birth weight. CONCLUSIONS: Women who delivered low birth weight infants were not more likely to have experienced child sexual abuse than women who delivered nonlow birth weight infants. Abused women were unemployed and daily smokers more often than nonabused women. Some of the abused women reported more health complaints, and more use of health care services during pregnancy, but did not have more obstetric complications during pregnancy and delivery.     

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.     

Condom Carnival: feasibility of a novel group intervention for decreasing sexual risk

Young people who engage in unprotected sex are at risk of negative consequences. The current study explored pre-post assessment data from 124, mostly Black, young people (M age = 19.6, SD = 2.8) attending an educational and vocational training programme who participated in the Condom Carnival, a novel, brief, interactive, peer-led, culturally tailored, sexual risk reduction group intervention. Condom Carnival activities provided practice negotiating condom use and using condoms correctly, instruction on safe lubricant use, and opportunities to dispel myths regarding condom size and breakage. We examined the preliminary impact of the Condom Carnival in increasing participants’ condom-related self-efficacy, lubricant safety awareness, and condom-related behavioural intentions and behaviour likelihood. Despite previous exposure to prevention efforts, participants reported significant increases in lubricant safety awareness (p < 0.001) and intentions to carry a condom in the next year (Z = ?2.05, p = 0.04). Although participants reported high condom-related self-efficacy and intentions to use a condom, only three-quarters of young people endorsed intentions to always carry a condom. Findings indicate the need to explore the gap between intentions to use and carry condoms and to develop effective strategies to increase condom carrying among young people. Further assessment of the Condom Carnival as an add-on intervention to enhance sexual risk reduction efforts among youth is warranted.     

Coping with sexual abuse: development and evaluation of a videotape intervention for nonoffending parents

OBJECTIVE: The aims of the study were: (1) to develop, apply, and evaluate a videotape intervention that targeted the development of supportive behaviors in mothers of children who were being examined because of suspected molestation; and (2) to examine the relationship between mothers' reported responses to and beliefs about the molestation and their children's perceptions of support. METHOD: Mothers (N = 87) who had children 4 to 12 years of age were recruited and randomly assigned to view either a treatment or control videotape during the time when their child was being examined. Observers who were blinded to this assignment observed and rated parent-child interactions in the waiting room prior to and again after the mothers viewed the videotape. One week after this brief intervention, 64 of the mothers and 30 of the children (8- to 12-years-old) were interviewed. RESULTS: Mothers who viewed the treatment tape were more likely to engage in supportive behaviors with their child immediately after viewing the tape, and were able to identify more supportive behaviors at the 1-week followup. In addition, mothers' reports of how they responded to the molestation (including perceived blame) was related to child perceptions of parental support. CONCLUSIONS: The findings indicate that children who have been sexually molested are sensitive to the initial reactions of their nonoffending parent to the disclosure. In addition, there is some evidence that we can design and deliver cost-effective interventions during the early disclosure period that promote more positive (or supportive) responses by the nonoffending parent.     

A survey of intrafamilial sexual abuse treatment centers: Implications for intervention

This study was devised to determine the attitudes of treatment professionals regarding desirable therapeutic approaches for intervening in incestuous family systems. A survey of treatment centers currently providing services for the treatment of intrafamilial sexual abuse in the United States was undertaken. A questionnaire was developed to ascertain preferred methods and modalities of treatment of family sexual abuse. Current methods of treatment were identified and inquiries were made regarding what programs presently offer in terms of treatment. An inventory of 30 questions was mailed to 58 treatment professionals and/or treatment programs included in the study. A response rate of 62% was achieved. Treatment centers primarily offered treatment for family sexual abuse on an outpatient basis and staff composition was interdisciplinary in nature (psychology, nursing, marriage and family therapy, social work and psychiatry). An average of 137 cases of family sexual abuse were treated annually per treatment program, with the daughter or the stepdaughter being the family member most often sexually abused. Further findings were the following: (1) treatment programs stressed group treatment for offenders as the most effective therapeutic intervention, yet group treatment of offenders was not offered by treatment programs as frequently as other types of treatment; (2) an interdisciplinary team approach to treatment of incest cases was preferred, suggesting the need for more than one therapist working with each family sexual abuse case: (3) court intervention was seen as necessary to facilitating the treatment process by 79% of the 36 questionnaires returned; (4) family therapy was expressed as a preferred and essential component to the treatment process with incest cases—yet actual implementation of family therapy treatment was clearly not uniform across treatment programs; (5) the most critical finding of this survey is that there was a consensus among clinicians that there is no one sequence of treatment, and that it varies according to the specifics of each family. Regardless of theoretical orientation, the majority of respondents believe that a comprehensive family systems approach is advantageous to the goal of determining whether the family can and wants to rehabilitate itself.     

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.     

Guilt, isolation and hopelessness among female survivors of childhood sexual abuse: effectiveness of group work intervention.

OBJECTIVE: This study explores the effects of group work intervention on female survivors' senses of guiltlessness, affiliation and hopefulness. METHOD: Secondary comparative analyses of a large quasi-experiment-based clinical data base were accomplished (Richter, Snider, & Gorey): group work intervention (N = 78) and a waiting-list condition (N = 80). RESULTS: Group work was found to have beneficial effects on adult female survivors' appropriate sense of guiltlessness for their childhood sexual abuse, as well as on their sense of affiliation and hopefulness. Consistent across the three outcome measures of guilt/guiltlessness, isolation/affiliation and hopelessness/hopefulness, 16 to 18 of every 20 such women who participated in group work did better than the average woman in the waiting-list comparison group. Moreover, these apparent clinical benefits were maintained for 6 months (all p < .01). CONCLUSION: Such effects may be characterized as very large, and are generally larger than those previously observed in this field of practice that have typically been based on more general measures of depression, self-esteem or global symptoms.     

A feminist study of a political education programme for women

Women’s Campaign School (WCS) is a non-partisan, non-formal three-day educational programme held annually in Vancouver, to empower and inspire women to enter politics and as a means towards socio-political change. Our findings show the WCS provides excellent practical and tactical skills and an experiential learning opportunity that is highly valued by women. However, few felt the lens was feminist and it did little to challenge ingrained gendered social conditioning. We trace dominant discourses of neutrality, anti-feminism, and heteronormativity and discuss the impact these have on creating an emancipatory feminist educational practice for women’s and the culture of politics.     

The long-term impact of childhood sexual abuse in Australian women

OBJECTIVE: The aim of this study was to examine the association between childhood sexual abuse (CSA) and a range of adverse adult outcomes in a community sample of women using multivariate analysis which accounted for a number of potential confounding effects. METHOD: Retrospective study of cross-sectional data on the long-term impact of CSA, collected as part of a larger two-stage case-control study of the possible relationship between CSA and alcohol abuse. Data were appropriately weighted to adjust for the different selection probabilities of cases and controls. RESULTS: Significant associations were found between reporting CSA and experiencing domestic violence, rape, sexual problems, mental health problems, low self-esteem, and problems with intimate relationships even after taking into account a range of family background factors. Women who had experienced abuse involving intercourse were the most vulnerable to these negative outcomes. CONCLUSIONS: The findings indicate that the influence of CSA on adverse long-term effects is mediated and influenced both by the severity of the abuse experiences and by a range of family and social background factors.     

Ego development in women with histories of sexual abuse.

As many as a third of the women in this culture experience sexual abuse prior to reaching age 18. Recent literature and research have presented divergent views related to the impact of early abuse on ego development, with arguments supporting both ego fragmentation and ego acceleration. This preliminary study compared the level of ego development, as measured by Loevinger's Washington University Sentence Completion Test (SCT), of 30 women with histories of childhood sexual victimization, and 30 women with no history of abuse. Results indicated no significant difference between the ego levels of the sexually abused and nonabused groups, with a slight trend toward higher ego development in the abused group. Factors contributing to these findings are discussed and recommendations for future research are suggested.     

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.     

The relationship of childhood sexual abuse with later psychological and sexual adjustment in a sample of college women

The purpose of the present study was to explore the relationship of childhood sexual abuse with later psychological and sexual adjustment. Subjects were 383 female college students recruited from undergraduate psychology classes. Each was asked to complete a packet which contained a victimization questionnaire as well as measures of adjustment. A number of small, but significant, relationships were found between a history of childhood sexual abuse and measures of later psychological and sexual adjustment. In light of the relationship between family background and sexual abuse, however, it was questioned whether these associations were due to the sexual abuse per se, or were due to the confounding of sexual abuse with family background. Indeed, once parental supportiveness was controlled, very few significant relationships emerged. There was a trend, however, for the significant correlations to involve the sexual measures rather than the more general adjustment measures. The implications of the current findings, particularly for future research, were discussed.     

Prevalence of child sexual abuse reported by a cross-sectional sample of New Zealand women

OBJECTIVE: The objective is to describe the prevalence of child sexual abuse (CSA) among women in New Zealand, document ethnic specific rates, and outline the frequency of abuse experienced and the most commonly identified perpetrators. Associations between CSA and later adverse consequences were also explored. METHODS: Retrospective report from a random sample of 2,855 women aged 18-64 years old in two regions in New Zealand. Face-to-face interviews with one randomly selected woman from each household were conducted. RESULTS: The overall prevalence rates for CSA were 23.5% for women from the urban region and 28.2% from the rural region. In both urban and rural regions, Māori women more frequently reported experiences of CSA than women from European and other ethnic groups (urban: 30.5% vs. 17.0% and rural: 35.1% vs. 20.7%). The median age of onset of the abuse was 9 years, and the median estimated age of the abuser was 30 years. Half of those who experienced CSA reported that it occurred once or twice, 27% "a few times," and 23% "multiple times." Sole perpetrators were involved in 83% of cases. The majority of cases were perpetrated by a family member, most frequently male. Compared with non-victims, victims of CSA were twice as likely to experience later intimate partner violence and violence by others. CONCLUSIONS: This study reports on a large, population-based sample in an ethnically diverse population in New Zealand, providing the first ethnic-specific rates of CSA available. Findings suggest important priorities for prevention and intervention activities.