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.     

School programs to prevent intrafamilial child sexual abuse

The incidence of child sexual abuse would argue for the schools assuming a larger role in the development of preventive and educational programs. Because of the public school system's consistent and longitudinal contact with children and families it is perhaps the most promising institution for the delivery of preventive efforts. This article presents specific suggestions for school-based programs directed toward the prevention of intrafamilial child sexual abuse. Further, it is argued that for maximum effectiveness, the support of local parent-teacher organizations be elicited; that educational programs be presented separately for parents and children; and that a variety of programs in concert with the development level of participants be presented on topics related to child sexual abuse. Topics regarded as important for prevention efforts are factual information on sexual abuse, appropriate and inappropriate touch, the respective role responsibilities and rights of parents and children, and a sex education approach that stresses the values of nonexploitation and discrimination in the choice of whether to engage in sexual behavior and the choice of partners.     

Abuse in the investigation and treatment of intrafamilial child sexual abuse

This paper examines the effects of current practice in the investigation and treatment of documented incest abusers on the offenders and families involved. Fifteen offenders attending the Utah Parents United group completed a questionnaire on the sequence of events in the investigation and prosecution of their cases and the concomitant results of the investigation on their job status, living and financial situations, family and social relationships, and media reporting of the abuse. Results indicate that there is great variability in the investigation and prosecution of incest cases and the public announcement of abuse convictions. The consequences of the abuse investigation are devastating for offender and his family in terms of job loss; need for public assistance; family disbandonment through removal of the offender, victim, or both from the family, marital separation, and foster care for nonabused siblings; changes of residence, and the public announcement of the abuse in the media. Results also show that offenders receive little, if any, social support from family or friends. Changes in the current approach to the investigation and prosecution of incest offenders are proposed and include the following: (1) banning the publication of convictions for child abuse; (2) streamlining the legal process so that it is consistent from case to case; and (3) developing diversion programs as alternatives to prison for offenders. Suggested are self-help, court-ordered therapeutic programs, such as Parents United, that are designed for the treatment of families involved in child sexual abuse and incest. The desired outcomes of such a diversion program are low offender recidivism, avoidance of the offender's family being placed on welfare, less reliance on foster care placement for the offender's children, involvement of the offender's family in moving toward reunion when feasible, and the use of existing half-way houses in lieu of incarceration when necessary.     

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.     

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.     

Children's disclosures of sexual abuse: learning from direct inquiry

Objectives

Published protocols for forensic interviewing for child sexual abuse do not include specific questions about what prompted children to tell about sexual abuse or what made them wait to tell. We, therefore, aimed to: (1) add direct inquiry about the process of a child's disclosure to a forensic interview protocol; (2) determine if children will, in fact, discuss the process that led them to tell about sexual abuse; and (3) describe the factors that children identify as either having led them to tell about sexual abuse or caused them to delay a disclosure.

Methods

Forensic interviewers were asked to incorporate questions about telling into an existing forensic interview protocol. Over a 1-year period, 191 consecutive forensic interviews of child sexual abuse victims aged 3-18 years old in which children spoke about the reasons they told about abuse or waited to tell about abuse were reviewed. Interview content related to the children's reasons for telling or for waiting to tell about abuse was extracted and analyzed using a qualitative methodology in order to capture themes directly from the children's words.

Results

Forensic interviewers asked children about how they came to tell about sexual abuse and if children waited to tell about abuse, and the children gave specific answers to these questions. The reasons children identified for why they chose to tell were classified into three domains: (1) disclosure as a result of internal stimuli (e.g., the child had nightmares), (2) disclosure facilitated by outside influences (e.g., the child was questioned), and (3) disclosure due to direct evidence of abuse (e.g., the child's abuse was witnessed). The barriers to disclosure identified by the children were categorized into five groups: (1) threats made by the perpetrator (e.g., the child was told (s)he would get in trouble if (s)he told), (2) fears (e.g., the child was afraid something bad would happen if (s)he told), (3) lack of opportunity (e.g., the child felt the opportunity to disclose never presented), (4) lack of understanding (e.g., the child failed to recognize abusive behavior as unacceptable), and (5) relationship with the perpetrator (e.g., the child thought the perpetrator was a friend).

Conclusions

Specific reasons that individual children identify for why they told and why they waited to tell about sexual abuse can be obtained by direct inquiry during forensic interviews for suspected child sexual abuse.

Practice implications

When asked, children identified the first person they told and offered varied and specific reasons for why they told and why they waited to tell about sexual abuse. Understanding why children disclose their abuse and why they wait to disclose will assist both professionals and families. Investigators and those who care for sexually abused children will gain insight into the specific barrier that the sexually abused child overcame to disclose. Prosecutors will be able to use this information to explain to juries why the child may have delayed his or her disclosure. Parents who struggle to understand why their child disclosed to someone else or waited to disclose will have a better understanding of their child's decisions.     

Child physical and sexual abuse: the roles of sadism and sexuality

Based on the analytical concepts of narcissism and perversion and clinical material, an hypothesis is presented for the understanding of the mental functioning of the physically and sexually abusive parent. Relating the aggressive instinct to narcissism and the sexual instinct to perversion, two modes of functioning are presented which have some points in common and some diverging but which show the dynamics involved in physical and sexual abuse. Understanding the type of emotional relationship between the parents and the type of their emotional investment in their child allows us to see how the complicity of parents works against the child. This understanding implicitly gives insight into the structuring of the personality of the child-victim, who in turn undergoes the risk of himself becoming a physically and/or sexually abusive parent with his own children.     

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.     

Consistency in children's reports of sexual and physical abuse

OBJECTIVE: The goal of the present study was to investigate the consistency of children's reports of sexual and physical abuse. METHOD: A group of 222 children, ages 3-16 years, participated. As part of legal investigations, the children were interviewed twice about their alleged experiences of abuse. The consistency of children's reports of sexual and physical abuse was examined in the two interviews, in relation to age, type of abuse, gender, memory, suggestibility, and cognitive capabilities. RESULTS: Older children were more consistent than younger children in their reports of sexual and physical abuse. Children were more consistent when reporting sexual abuse than physical abuse. Girls were more consistent than boys in sexual abuse reports. Consistency in sexual abuse reports was predicted by measures of memory, whereas consistency in physical abuse reports was not. Cognitive abilities did not predict consistency in sexual abuse or physical abuse reports. CONCLUSIONS: Implications for understanding children's allegations of abuse are discussed.     

A comparison of physical and sexual abuse: histories of sexual and non-sexual offenders with intellectual disability

OBJECTIVES: To review patterns of physical and sexual abuse in cohorts of sexual offenders and nonsexual offenders with intellectual disability. METHOD: Forty-six sexual offenders were compared with 48 male nonsexual offenders in relation to their experiences of sexual and physical abuse in childhood. Comprehensive assessments were taken over a period of at least one year, and were conducted independently by a range of professionals. RESULTS: Thirty-eight percent of the sexual offenders and 12.7% of the nonsexual offenders had experienced sexual abuse, while 13% of the sexual offenders and 33% of the nonsexual offenders had experienced physical abuse. CONCLUSIONS: Sexual abuse seems a significant variable in the history of sexual offenders, while physical abuse seems a significant variable in the history of nonsexual offenders. The results support the view that the "cycle of abuse" is neither inevitable nor an adequate explanation of future offending.     

Children's sexual play and behavior in pre-school settings: staff's perceptions, reports, and responses

OBJECTIVES: The aims of this study were to learn about the nature, frequency, and patterns of young children's observed sexual play and behavior in pre-school settings, and staff responses to them. METHOD: Fifty eight staff in 11 pre-school settings were interviewed and data obtained about their recall of observed sexualized play and behaviors of children in their care. Responses were sought both to an open question and to 20 different hypothetical scenarios describing children's behaviors with a genital or sexual content. They were asked about the proportion of children observed and the frequency of the behaviors. They were also asked for their predicted responses to encountering each of these scenarios. RESULTS: Children's curiosity about genitalia, looking and limited touching were more commonly observed, and drawing or modeling of genitalia and simulating sexual intercourse were also reported. Children inserting anything into another child and oral-genital contact had only rarely been observed. Rare behaviors always caused concern and led to some intervention. Concern about the more common behaviors was related to additional factors such as frequency, manner and talk accompanying the behavior and to other information known about the child. CONCLUSIONS: The results confirm findings from studies in other countries about the reported prevalence of more and less commonly observed sexual and genitally orientated behaviors in young children. They lend justification for concerns about children showing rarely observed behaviors or showing preoccupation with genitalia and indicate the need for a search for an explanation of these behaviors when observed.     

Anatomical doll play of preschoolers referred for sexual abuse and those not referred

Anatomical dolls are used to facilitate children's explanations of sexual abuse. The goal of this study was to identify whether children referred for evaluation of possible sexual abuse would react differently to dolls than would nonreferred controls matched on sex, race, and age. A sample of 35 two- through six-year-olds referred to a hospital child abuse clinic were compared to 35 controls. After a rapport-building exercise, each child played under four conditions in a specially prepared room. Two coders, unaware of the child's group membership, viewed each videotaped session and completed separate behavioral checklists. Six conclusions resulted: (1) anatomical dolls did not create undue anxiety; (2) careful interpretation of sexualized play with dolls is needed; (3) dolls did not overstimulate and cause demonstration of sexual activity; (4) sexual abuse could not be diagnosed solely on the basis of doll play; (5) children in both groups inserted their fingers into doll openings; and (6) practitioners must rely on supporting verbal and physical evidence when making the determination of possible sexual abuse. More training and comfort with anatomical dolls and knowledge of normal child development principles are needed by examiners.     

Characteristics of child physical and sexual abuse as predictors of psychopathology

Childhood physical and sexual abuse victims are at increased risk for developing depression, anxiety, and post-traumatic stress disorder (PTSD) in adulthood. Prior findings suggest abuse onset, duration, and severity moderate relationships between victimization and psychopathology. However, because these abuse characteristics are highly intercorrelated, their unique, individual effects on mental health outcomes remain unclear. To address this gap, the present study examined relationships between physical and sexual abuse characteristics and mental health outcomes and whether these relationships differed by sex. A diverse community sample of late adolescents and emerging adults (N = 1270; mean age = 19.68; 51% female) self-reported the onset, duration, and severity of physical and sexual abuse, as well as their depressive, anxiety, and PTSD symptoms. Results of a multivariate regression model (simultaneously evaluating all physical and sexual abuse characteristics) indicated that physical abuse onset in middle childhood and sexual abuse onset in middle childhood or adolescence were associated with all forms of psychopathology; and physical abuse onset at any time was uniquely linked with PTSD. Duration and severity of physical or sexual abuse did not predict psychopathology after accounting for time of onset. Multigroup analyses indicated that adolescence-onset and duration of sexual abuse respectively predicted anxiety and PTSD in females but not males, whereas sexual abuse severity predicted fewer PTSD symptoms in males but not females. Overall, results suggested that abuse occurring after age 5 may have the most deleterious impact on mental health.     

Behavioral sequelae of physical and/or sexual abuse in adolescents

In a survey of 500 admissions to a short-term residential chemical dependency treatment center for adolescents (ages 12 to 18), 150 adolescents (30%) had been identified as victims of physical and/or sexual abuse. While the abused group had a higher incidence of prior social service and mental health intervention, extraordinarily 68% of these abuse cases had not been reported by children, family, or interviewers prior to the adolescents having entered the chemical dependency residential treatment facility. This chemically dependent, previously abused group was differentiated from a comparison group of nonabused, chemically dependent adolescents, and a second comparison group of nonabused, nonchemically dependent adolescents. Results indicated a higher incidence of acting out behavior, runaways, legal involvement and sexual promiscuity within the abused group.     

Body mass index and anxiety/depression as mediators of the effects of child sexual and physical abuse on physical health disorders in women

The relation between childhood sexual abuse (CSA) and physical health disorders in adulthood, and what factors may serve as mediators, remains poorly understood. Using data from the 2007 Adult Psychiatric Morbidity Survey (N = 3,486), we tested whether CSA was associated with physical health disorders in adult women and if mediated effects via body mass index (BMI), anxiety/depression, alcohol dependence, and smoking were present. Compared to women with no CSA, women who had experienced CSA involving intercourse had more than twice the odds of being obese, more than 3 times the odds of experiencing mental health disorders, more than 4 times the odds of being alcohol dependent, more than 5 times the odds of being drug dependent, and more than 6 times the odds of attempting suicide. Those experiencing both CSA and child physical abuse (CPA) were on average over 11 kg heavier than those with neither CSA nor CPA. After controlling for demographics, CPA, and childhood bullying, CSA was associated with the majority of physical health disorders studied (typically 50–100% increases in odds). Evidence was found consistent with mediation by BMI (typically accounting for 5–20% increases in odds) and anxiety/depression (typically accounting for 8–40% increases in odds), in a dose-response manner, for the majority of physical health disorders. Bidirectional relations among these mediators and physical health disorders, and residual confounding, may have led to overestimation of mediation through BMI and anxiety/depression and underestimation of mediation through alcohol/smoking. Relations between both CPA and childhood bullying and physical health disorders in adulthood were also found. Longitudinal studies employing more sensitive measures of potential mediators are now required.