Critical Issues in the Assessment of Child Sexual Abuse

This article explores the feasibility of using standardized psychometric methods in the initial stages of an investigation of child sexual abuse; methods that are less intrusive and therefore less damaging to children and their families. We review the complex conceptual and research issues that arise from attempts to assess the many-sided aspects of child sexual maltreatment. Among those considered in both the clinical and research spheres are problems of definition and diagnosis; limitations of clinical interviews, and a variety of direct and indirect psychological instruments used for investigating sexual maltreatment and risk assessment; the inadequacies of experimental designs; and also the political, practical, and ethical restraints that hinder research in this area. It is argued that there is insufficient evidence based on controlled studies or standardized normative tests to advocate any simple, unidimensional methodology for the screening task. However, recommendations are put forward for the cautious, conjoint use of several procedures in a multidimensional approach to assessing child sexual abuse. Suggestions are also made for future research and development.     

Child Sexual Abuse

Summary

Children who are recent victims of sexual abuse may initially present to their primary care health provider. Often, the outward manifestations of sexual abuse are somatic complaints or nonspecific behavioral changes. Retrospective reports of adults suggest that about 20-30% of women were sexually abused as children, with figures for men ranging from 10-15%. Interview guidelines for children and adolescents emphasize the need for sensitivity to cognitive development and emotional issues while simultaneously being focused on eliciting specific behavioral data. The use of anatomically detailed dolls, in the context of a comprehensive assessment, is discussed. Health care providers are mandated reporters and must disclose suspected child sexual abuse to the state's child protective service department. Guidelines for reporting as well as addressing this issue with parents are discussed.     

Sibling Child Sexual Abuse Research Review and Clinical Implications

SUMMARY

Although sex play is a part of normal childhood development, some sexual activity may be coerced or forced and may have negative long-term consequences and, thus, be considered abusive. However, childhood sexual abuse perpetrated by siblings, cousins, or peers receives relatively little attention from either researchers or practitioners. In the present article, the literature on sibling child sexual abuse is critically reviewed, and particular attention is focused on defining sibling sexual abuse, and determining its scope and effects. Clinical Implications are derived as well. Although the article focuses on sibling sexual abuse, the concepts considered here also apply to other forms of same-age (or near same-age) child sexual relationships.     

Treatment Effects for Common Outcomes of Child Sexual Abuse: A Current Meta-Analysis

The present meta-analysis examined the effects of psychosocial treatments at reducing deleterious outcomes of sexual abuse. The meta-analysis included a total of 35 published and unpublished studies written in English, focusing on youth under the age of 18, and evaluating the effectiveness of treatments for the most common negative outcomes of sexual abuse: PTSD symptoms, externalizing problems, and internalizing problems. Results revealed medium effect sizes for PTSD symptoms, externalizing problems, and internalizing problems following treatment for sexual abuse. This study also examined the potential moderating effects of treatment (e.g., modality, duration, inclusion of caregiver) and participant (e.g., age, gender, ethnicity) characteristics. Results indicated that longer interventions were associated with greater treatment gains while group and individual treatments were equally effective. These findings shed new light on treatment effectiveness and provide useful information regarding the conditions under which treatment may be most effective. Future directions for research in this area are discussed.     

Legal Issues in Child Abuse and Neglect

No abstract available for this article.     

Counseling Child Sexual Abuse Victims: Myths and Realities

The goal of the authors is to (a) create an awareness among counselors about the nature and prevalence of child sexual abuse, (b) examine myths and realities about the topic, and (c) present recommendations for interviewing suspected victims of child sexual abuse.     

An Investigation of Current Practice in Dealing With Child Sexual Abuse in Ireland

In this study, the authors sought to ascertain current practices for dealing with child sexual abuse in Ireland. The implications for the differing responses of social workers and psychologists were considered.     

Victim Recantation in Child Sexual Abuse Cases

Summary

This article explores the reasons for victim recantation in child sexual abuse cases, problems that surface with a recantation, and practical steps multidisciplinary professionals can take to prevent the recantation of truthful allegations. Secondly, the article discusses the roles of investigative team members in the investigation and evaluation of a victim's recantation and in the trial which may follow. Finally, the article addresses possible final outcomes of criminal court intervention and the team's role in continued support for the child.     

Sexual Abuse of Boys: Current Perspectives

Boys may be equally at risk for sexual victimization as girls, yet they are a unique clinical group whose needs have not been addressed significantly.     

Child Sexual Abuse History and Feminine Gender-Role Identity

The association between child sexual abuse (CSA) and feminine gender-role identity was examined among 75 women with and 107 without a history of CSA. Undergraduates and hospital employees from a university in the Southern United States completed questionnaires on the internet. Three aspects of feminine identity were assessed, including how much participants identified with feminine versus masculine traits, endorsed stereotypes about women, and viewed themselves as meeting feminine self-standards. Participants with a history of CSA reported greater feminine self-discrepancy and endorsed more derogatory stereotypes about women than the comparison group. CSA was also linked to identifying with more feminine than masculine traits, but only among hospital employees. Results suggest that feminine identity is a meaningful construct to consider in the adjustment of CSA survivors.     

Simulating Memory Impairment for Child Sexual Abuse

The current study investigated effects of simulated memory impairment on recall of child sexual abuse (CSA) information. A total of 144 adults were tested for memory of a written CSA scenario in which they role-played as the victim. There were four experimental groups and two testing sessions. During Session 1, participants read a CSA story and recalled it truthfully (Genuine group), omitted CSA information (Omission group), exaggerated CSA information (Commission group), or did not recall the story at all (No Rehearsal group). One week later, at Session 2, all participants were told to recount the scenario truthfully, and their memory was then tested using free recall and cued recall questions. The Session 1 manipulation affected memory accuracy during Session 2. Specifically, compared with the Genuine group's performance, the Omission, Commission, or No Rehearsal groups' performance was characterized by increased omission and commission errors and decreased reporting of correct details. Victim blame ratings (i.e., victim responsibility and provocativeness) and participant gender predicted increased error and decreased accuracy, whereas perpetrator blame ratings predicted decreased error and increased accuracy. Findings are discussed in relation to factors that may affect memory for CSA information. Copyright © 2015 John Wiley & Sons, Ltd.     

Spirituality and Sexual Abuse: Issues and Dilemmas for Survivors

Abstract

Sexual abuse profoundly affects survivors to the extent that they are unable to maintain previously held viewpoints or ways of being, including those relating to their spirituality. Certainly the experience has considerable potential to complicate the spiritual lives of survivors. For Christian survivors, this may include how they perceive and relate to both themselves and God as well as affect participation in sacraments such as eucharist and reconciliation. Spiritual traditions often promote the embracing of silence, but this may be problematic for survivors who have been silenced and unable to give expression to their experiences. Similarly, socialization resulting in beliefs that Christians should always forgive and/or never be angry needs to be overcome. While negotiating these pitfalls may result in explorations of spirituality being even less straightforward for survivors of sexual abuse than it is for others, a transformative spirituality within a Christian framework can be realized.     

Child Sexual Abuse: A Multidisciplinary Approach to Case Management

Treatment for child victims of sexual abuse is a complex and sometimes lengthy process involving members of numerous social service agencies. Coordination of services can be accomplished through the use of a multidisciplinary team approach to case management. The author provides information about the roles of various team members as well as suggestions for organizing a child sexual abuse multidisciplinary team.     

Survivors' Stories: Navigating Parenthood After Surviving Child Sexual Abuse

Survivors of child sexual abuse may have strained relational functioning in adulthood, which may affect their parenting practices. Understanding that stories indicate personal meanings attributed to a phenomenon, the authors utilized narratology to learn the parenting stories of 9 survivors. Findings include the following themes: negotiating a balance of protecting and letting go, using relational images as guideposts for parenting decisions, and exploring functioning in relational contexts.     

Researching Child Sexual Abuse in South Africa: Complexities in the Field

This study reports on my fieldwork experiences applying qualitative research strategies to study child sexual abuse in South Africa. It considers the challenges associated with, at three stages of data collection: ethical clearance, recruitment and data collection, followed by possible solutions. The study also considers the challenges from ethical and epistemological perspectives. I used a reflective self-study to analyse my experiences. My experiences revealed the following challenges: ethical process due to reasons not linked to the content of the research process would cause delays to the field-work. In addition, the use of [formal institutions] welfare institutions as sole research sites would result in a homogenous sample that does not permit comparison of experiences among the abuse cases. The costs to the researcher in terms of emotional and physical investment can be significant.     

Contesting the Dominant Discourse of Child Sexual Abuse: Sexual Subjects,Agency, and Ethics

Responding to previous scholars’ call to explore the complexities of child sexual abuse (CSA), this article presents narratives of CSA and scrutinizes a binary construction underpinning this discourse of CSA, namely, the positioning of children as powerless and adults as powerful. The narratives belong to three Indonesian young people who have had sexual interactions with adults when they were children. The findings demonstrate how this binary positioning has been both drawn upon and resisted in the ways participants understand their sexual experiences. This article contributes to the existing literature by providing analyses of some vignettes of everyday experiences of how children might be constituted as sexual subjects, including their capability to exercise agency, perform resistance, and negotiate ethics. The implications of the findings are discussed in relation to how the recognition of children as sexual subjects and their sexual agency might be beneficial for parents, educators, and counselors.     

Issues in Sex Therapy with Survivors of Intrafamily Sexual Abuse

No abstract available for this article.