Sequelae of child sexual abuse: a child and parent assessment

We present a case example of a 9-year-old, biracial girl and her mother. We integrate data collected from rating scales (e.g., Child Behavior Checklist; Achenbach & Rescorla, 2001), a free response measure (Thematic Apperception Test; Murray, 1943), and a direct observation measure (Parent-Child Interaction Assessment-II; Holigrocki, Kaminski, & Frieswyk, 1999, 2002) and reveal how a child sexual abuse victim's internal representations and symptoms manifest in both an interpersonal context and in the realm of play. We discuss assessment findings regarding how they provide for an idiographic understanding of the child.     

The credibility of children's allegations of sexual abuse

Sexual abuse, the fastest growing type of abuse complaint, often raises issues concerning the credibility of individual allegations. This paper discusses historical, developmental, and societal factors affecting children's credibility and recommended assessment methods that maximize a child's capacity to relate his or her experience. Clinical factors leading to false allegations are discussed.     

Evaluating rate,accuracy, and fluency of young children's diadochokinetic productions: a preliminary investigation

Diadochokinetic (DDK) rates are commonly assessed in children with speech-language disorders, even though the implications of fast or slow DDK rates are not clear. This study explored the possibility that the accuracy and fluency of DDK productions may provide a meaningful supplement to traditional measures of DDK rate. Participants were 15 boys, age 3-7, with normal speech-language development, who were asked to produce "puh-tuh-kuh" or "pattycake" in a standard DDK task. Analyses revealed that normally developing children produce frequent articulation errors but few disfluencies during DDK tasks. Errors and disfluencies did not affect DDK rate, suggesting that the rate of DDKs may be a relatively insensitive measure of children's speaking abilities. Although an expected correlation was found between age and overall DDK rate, no correlations were found between age and the frequency of articulation errors or speech disfluencies. Findings suggest that measures of DDK accuracy and fluency may provide information about children's speech development that is independent of age and may be more closely related to oral motor development than rate. Overall, results underscore concerns with the interpretation of DDK rate and highlight ways that rate measures might be supplemented with measurement of accuracy and fluency in the evaluation of children's speaking abilities. EDUCATIONAL OBJECTIVES: The reader will learn about a technique that may facilitate the evaluation of young children's oral DDK abilities. The reader will learn about the frequency and type of errors children produce on DDKs and how this information can be used in the assessment of children's oral motor abilities.     

Neurobehavioral sequelae of child sexual abuse.

This study examined intellectual and memory functioning in a sample of sexually abused children compared to demographically and age-matched controls. The severity of abuse and other pertinent factors were also examined in relation to cognitive performance. Elevated levels of psychopathology were present in the abused children, as well as diminished performance on tasks influenced by attention/concentration. However, after controlling for differences in IQ and socioeconomic status (SES), significant differences in memory function were not found. Results are discussed in the context of stress effects on cognition and the potential resiliency of cognitive function in children undergoing treatment for sexual abuse.     

The challenge of defining child sexual abuse

Although child sexual abuse has been a concern for many researchers, therapists, and advocates for the past 3 decades, several fundamental issues regarding child sexual abuse remain unresolved. In particular, the term child sexual abuse has never been unequivocally defined. The lack of a commonly accepted definition of child sexual abuse continues to inhibit research, treatment, and advocacy efforts. Early researchers used broad and inclusive definitions of child sexual abuse--definitions that often continue to be used today. The consequences of these definitions are discussed, and strategies for developing other definitions of child sexual abuse are suggested.     

The relation of child sexual abuse and depression in young women: comparisons across four ethnic groups

To investigate the relation of child sexual abuse to depression and whether this relation differed by ethnicity (African Americans, Mexican Americans, Native Americans, and non-Hispanic whites), we surveyed 2,003 women between 18 and 22 years of age about family histories, sexual abuse, and depression. Reported rates of child sexual abuse were similar across ethnic groups; approximately one-third of each group reported some form of sexual abuse and about one-fifth of each ethnic group reported experiencing rape. After controlling for background characteristics identified as risk factors for both child sexual abuse and depression, severity of child sexual abuse was significantly related to depressive symptoms only for non-Hispanic whites and Mexican Americans. Child sexual abuse variables accounted for more variance in depression than background variables only for Mexican American women. Child physical abuse was the strongest predictor of adult depression and the only significant predictor for each ethnic group.     

Response latency as a predictor of the accuracy of children's reports

Researchers have explored various diagnostic cues to the accuracy of information provided by child eyewitnesses. Previous studies indicated that children's confidence in their reports predicts the relative accuracy of these reports, and that the confidence-accuracy relationship generally improves as children grow older. In this study, we examined the added contribution of response latency to the prediction of children's accuracy over and above that of confidence ratings. In Experiments 1 and 2, 2nd and 5th graders studied picture-event pairs and were tested using forced-choice, 2-alternative, or 5-alternative questions. In Experiment 3, children watched a slideshow depicting a story and were tested by 5-alternative questions about story details. The children indicated their confidence in each response, and response latency was measured. The results of all experiments suggested that children in both age groups relied on response latency as a cue for confidence, and this reliance contributed to the success with which they monitored the accuracy of their reports. When the test format was easy (Experiment 1), 2nd graders were as accurate as 5th graders in monitoring the accuracy of their answers, and the latency of their responses was no less predictive of accuracy. When the task was more difficult, age differences emerged. Nevertheless, in all experiments and for both age groups, response latency was found to have added value for predicting accuracy over and above that of confidence. Theoretical and practical implications of these findings for predicting the accuracy of children's reports are discussed.     

Multiple forms of child abuse and neglect: adult retrospective reports

There are few research reports of the experience of multiple forms of child abuse and neglect (multi-type maltreatment). A critical review is presented of 29 studies in which adult retrospective reports of more than one form of child maltreatment (sexual abuse, physical abuse, psychological maltreatment, neglect, or witnessing family violence) are assessed. Empirical investigations of the extent and impact of multi-type maltreatment are identified. Data on the relationship between the different forms of maltreatment and the adjustment problems associated with each type of maltreatment are critiqued. As well as using dichotomous measures of maltreatment, an important methodological problem was the failure of researchers to assess all child maltreatment types, the relationship between multi-type maltreatment and adjustment, and the role of variables influencing the occurrence or impact of maltreatment. Considerable overlap was found in the occurrence of maltreatment types. The compounding or interacting effects of experiencing multi-type maltreatment were ignored in many studies. Where an assessment was made of the specific impact of multi-type maltreatment, it was associated with greater impairment than single forms of abuse or neglect. A multi-dimensional approach to prevention and treatment of child abuse and neglect is required in which children's vulnerability to multi-type maltreatment is addressed.     

Evaluation of school-based child sexual abuse prevention program

The aim of the present work is to evaluate the efficacy of a program entitled "Prevention of child sexual abuse" the first structured program in Spain designed to prevent such risks. With this purpose, we carried out a study of 382 minors with ages ranging between 8 and 12 years. The result s show that the program has a very positive impact, increasing the awareness of the minors about this type of risk and improving their skills for coping with a possible event of sexual abuse. The efficacy of the program is also apparent, at the level of secondary prevention, in that it increased the likelihood that the children would reveal such events. Finally, exploration of the possible adverse effects of the program showed that the negative effects observed by parents and educators are negligible.     

Probative aspects of the medical evaluation for child sexual abuse

The medical evaluation of a child for sex abuse has been viewed by some as an acid-test for the presence of abuse. This article examines the medical evaluation for child sexual abuse, evidence potentially revealed by the examination, and the probative value of such evidence.     

Family process in the treatment of intrafamilial child sexual abuse

The paper describes the changes in family dynamics that occur throughout the process of family-orientated treatment of families where father–daughter incest or stepfatherr–stepdaughter child sexual abuse has occurred. A detailed step-by-step analysis of the developing family process in incest families during therapy is given. The analysis establishes the nature of the original pattern of family relationships, explores the impact made by crisis intervention on the family structure and then outlines therapy and termination of treatment. Characteristic mechanisms in the family process during therapy are described. A detailed clinical example demonstrates the basic therapeutic moves and the mechanisms involved.     

Self-centeredness and the adult male perpetrator of child sexual abuse

Self-centeredness has been identified as a quality of the adult male perpetrator of child sexual abuse, but little or no effort has been expended toward defining the concept clearly. In this paper, the research literature on the perpetrator and psychoanalytic writings on narcissism are reviewed for the purpose of developing a comprehensive definition of self-centeredness. Literature related to the social and developmental context of child sexual abuse also is discussed. In the final section of the paper, implications for primary prevention and treatment are drawn.This is a revised version of a paper presented at the Groves Conference on Marriage and the Family, July, 1986, in London, England. Support for the paper was provided through the Minnesota Agricultural Experiment Station and the Faculty Summer Research Fellowship Program, Graduate School, University of Minnesota.     

Discrepancies in parents' and children's reports of child emotion regulation

The ability to regulate one’s emotions effectively has been linked with many aspects of well-being. The current study examined discrepancies between mothers’ and children’s reports of child emotion regulation. This investigation examined patterns of discrepancies for key aspects of emotion regulation (i.e., inhibition and dysregulated expression) and for three emotions (anger, sadness, worry). A total of 61 mother-child dyads (mean children’s age = 9.3 years) participated. As hypothesized, discrepancies for inhibition subscales were of a larger magnitude than those for dysregulated expression subscales. Furthermore, age was related to discrepancies in both anger subscales, parent reports of child externalizing symptoms were related to anger dysregulated expression discrepancies, and child reports of internalizing symptoms were related to sadness dysregulated expression discrepancies. Overall, the findings suggest that patterns of discrepant reports are not random but rather may provide meaningful and useful information about the nature of emotion regulation.     

Thought control strategies as mediators of trauma symptoms in young women with histories of child sexual abuse

The current retrospective study examined thought control strategies, or cognitive techniques individuals use to deal with unpleasant thoughts following stressful events, as potential mediators of adjustment in young women with histories of child sexual abuse (CSA). In a sample of 76 undergraduate women who self-reported on abuse experiences, thought control strategies, and current trauma symptoms, several key findings emerged: (i) Greater severity of the CSA event was associated with greater reported use of worry and punishment strategies and less use of social control strategies; (ii) Increased use of worry and punishment strategies following the CSA event was associated with greater levels of trauma symptoms, while increased use of social control strategies following the CSA event was associated with lower levels of trauma symptoms; and (iii) Worry, punishment, and social control strategies served as mediators between CSA severity and trauma symptoms. The results suggest that thought control strategies, specifically increased worry and punishment, and decreased social control, play a vital role in understanding adjustment after CSA. Future research should examine the roles of these cognitive control strategies as possible avenues of intervention following CSA.     

Prevention of child sexual abuse. Myth or reality

Programs to prevent child sexual abuse have proliferated as a result of increased public awareness and professional documentation of its incidence. We describe the content and format of these prevention programs in general and examine selected programs for effectiveness. Although there is limited evidence for an increase in knowledge for program participants, most evaluations suffer from basic design problems and present few results indicative of either primary prevention or detection. Overall, we argue that self-protection against sexual abuse is a very complex process for any child and that few, if any, prevention programs are comprehensive enough to have a meaningful impact on this process. Finally, we discuss several untested assumptions that guide these programs. We conclude that it is unclear whether prevention programs are working or even that they are more beneficial than harmful.