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.     

Legal proceedings,reforms, and emerging issues in child sexual abuse cases

Criminal and civil proceedings are outlined for cases of intrafamilial child abuse. Statutory reforms and court decisions in the area of sex abuse are reviewed, citing their potential beneficial and harmful effects on both offenders and victims. Finally, the roles of children and mental health experts in court proceedings are discussed.     

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.     

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.     

Risk factors for child sexual abuse

We review the risk and protective factors for child sexual abuse. Overall, characteristics of perpetrators, victims, and families of victims were moderate to strong risk factors for child sexual abuse. However, it is difficult to distinguish between risk factors for extra-familial and intra-familial child sexual victimization because most of the studies combined these two types of child sexual abuse, although the risk factors for these two types of child sexual abuse most likely differ. Research in this area is difficult because etiological and prevention models of victimization would differ substantially from those of perpetration. Given the low yearly prevalence of child sexual victimization, very large samples would be necessary to obtain sufficient power. Thus, most studies have used lifetime prevalence, which may provide much useful information but which add substantial time confounds. Finally, child sexual victimization is probably a misnomer, as the nature, impact, and etiology of sexual victimization most likely differs over the large age span of childhood and gender. Because improved models and prevention programs require improved etiological models (based on knowledge of risk and protective factors), we hope that this review will focus stakeholders on the need for continued research in this area.     

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 role of corroborative evidence in child sexual abuse evaluations

Published studies of forensic child sexual abuse (CSA) evaluations by mental health and medical professionals and paraprofessionals (MHPs) were analysed in order to evaluate two widely held assumptions. These related assumptions are (1) evidence that corroborates children's reports of sexual abuse is rare in forensic CSA evaluations; and (2) in the vast majority of evaluations, MHPs base their judgements about whether or not sexual abuse allegations are true on their assessments of children's reports of sexual abuse and other psychosocial data. Data from five chart review studies of a combined total of 894 forensic CSA evaluations provided sufficient information to assess the validity of these assumptions. Corroborative evidence was present in 36% of the 894 evaluations and in 54% of evaluations in which MHPs judged the allegations likely to be true, contradicting the first assumption. In the evaluations in which corroborative evidence was present, the presence or absence of a child's report of sexual abuse was only weakly associated with MHPs' judgements about the validity of the allegations (allegations in almost all corroborated cases were judged likely to be true, even in the absence of a child's report), partially contradicting the second assumption. Implications of this analysis for research and policy are discussed. Copyright © 2010 John Wiley & Sons, Ltd.     

Involving parents in child sexual abuse prevention programs

Conclusion The importance of involving parents in child sexual abuse prevention programs has been given much lip-service by prevention educators, but relatively little time, energy or resources in reality. This seems short-sighted at best, if the goal of these programs is truly prevention as they purport. Although the results of this study may have limited generalizability because of its sample size and its highly educated respondents, it is the first study to compare the knowledge of attending versus nonattending parents of a typical one-shot parent workshop. The results indicated that the parents as a whole were fairly well versed in the facts of sexual abuse, although as in previous studies, they did not extend the statistics on sexual abuse to their own children. However, probably the most important results were the enthusiastic responses for parent programs and involvement but in different formats, at different times, and in different environments than the current typical PTO evening, one-time meeting. Clearly child sexual abuse prevention programs should experiment with innovative ways to reach parents. If prevention programs can involve a small minority of motivated parents as they seem to be able to do, then together these parents and the educators may be able to develop methods and resources to involve the large majority of currently uninvolved parents. Such an integrated and involving community approach to the prevention of child sexual abuse seems necessary if the goal of prevention is ever going to be reached.     

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.     

A parenting group for women dealing with child sexual abuse and substance abuse

This article describes a group developed to address the parenting needs of women dealing with child sexual abuse and substance abuse. A solution-focused 12-week group intervention is described, and the results of an evaluation are presented. Participants included 29 women who attended seven parenting groups. The results suggest that the group was perceived as beneficial by the women, who reported an increase in self-esteem, parenting satisfaction, and parenting self-esteem and an improvement in their attitudes toward their children.     

The credibility of sexual abuse allegations: Child sexual abuse, adult rape, and sexual harassment

Allegations and denials of sexual abuse often occur in a context in which there is rarely decisive evidence. The present study investigated the credibility of allegations of three kinds of sexual abuse—child sexual abuse, adult rape, and sexual harassment—that also contained a denial by the alleged perpetrator. Perceptions of fair punishment were investigated for the perpetrator if he did actually commit these acts and for the accuser if she was lying. Results indicated that allegations were generally rated in the credible direction. Allegations of child sexual abuse were rated more credible than allegations of rape or sexual harassment. Females found all allegations more credible than males. Males were more likely to believe allegations in the child sexual abuse condition than either the rape or sexual harassment conditions. Females were more likely to believe sexual harassment allegations. Punishments were generally the most severe for child sexual abuse, and psychotherapy was a popular disposition for both perpetrators and those making false allegations.     

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.