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1.
ObjectiveThe sexually abused–sexual abuser hypothesis states there is a specific relationship between sexual abuse history and sexual offending, such that individuals who experience sexual abuse are significantly more likely to later engage in sexual offenses. Therefore, samples of adult sex offenders should contain a disproportionate number of individuals who have experienced sexual abuse, but not necessarily other types of abuse, compared with samples of other types of offenders.MethodsWe compared rates of sexual and other forms of abuse reported in 17 studies, involving 1,037 sex offenders and 1,762 non-sex offenders. We also examined the prevalence of different forms of abuse in 15 studies that compared adult sex offenders against adults (n = 962) and against children (n = 1,334), to determine if the sexually abused–sexual abuser association is even more specific to individuals who sexually offend against children.ResultsWe observed a higher prevalence of sexual abuse history among adult sex offenders than among non-sex offenders (Odds Ratio = 3.36, 95% confidence intervals of 2.23–4.82). The two groups did not significantly differ with regard to physical abuse history (OR = 1.50, 95% CI = 0.88–2.56). There was a significantly lower prevalence of sexual abuse history among sex offenders against adults compared to sex offenders against children (OR = 0.51, 95% CI = 0.35–0.74), whereas the opposite was found for physical abuse (OR = 1.43, 95% CI = 1.02–2.02).ConclusionThere is support for the sexually abused–sexual abuser hypothesis, in that sex offenders are more likely to have been sexually abused than non-sex offenders, but not more likely to have been physically abused. We discuss potential mechanisms for the relationship between sexual abuse history and sexual offending, including the possibility that a third factor might account for the relationship.Practice implicationsThe most obvious implications of these findings is that the prevention of sexual abuse of children, either through prevention programs directly targeting children or through treatment programs targeting individuals who are likely to sexually offend against children (e.g., known sex offenders against extra-familial boys), may eventually reduce the number of sex offenders. This implication is dependent, however, on a causal role of childhood sexual abuse, and on the effectiveness of prevention and treatment practices. 相似文献
2.
《Child abuse & neglect》2014,38(9):1552-1559
Early marriage and sexual abuse are the two of the most frequent types of childhood abuse. Although early marriage is also a type of sexual abuse, it is associated with different physical, social, and mental outcomes than sexual abuse alone. The purpose of this study was to compare early-married girls and sexually abused girls who were referred for forensic evaluation in Turkey in terms of their sociodemographic characteristics, mental disorder rates, and mental symptom severity. We included 63 adolescent girls for whom a judicial report had been demanded and who were under 15 years old when they were married but were not yet 18 years old during the evaluation (15.51 ± 0.78) and 72 sexually abused adolescent girls between 14 and 18 years old (15.80 ± 1.10) in this study. Following a psychiatric evaluation, the study participants completed the Child Posttraumatic Stress Disorder Reaction Index (CPTS-RI) and the Brief Symptom Inventory (BSI). We used the Windows SPSS 16.0 software program to assess the results. At least one psychiatric disorder was determined in 44.4% of the early-married and 77.8% of the sexually abused cases (p < 0.001). A diagnosis of PTSD or ASD was observed in 11.1% of the early-married cases and in 54.2% of the sexually abused victims (p < 0.001). MDD was determined in 33.3% of the early-married cases and 56.9% of the sexually abused cases (p = 0.006). The CPTS-RI scores of the sexually abused victims were higher than those of the early-married cases (p < 0.001). All of the subscale scores of the BSI were higher in the sexually abused adolescents than in the early-married cases (p < 0.001). Although early marriage has severe physical, social and mental outcomes, it is not as severe as sexual abuse in terms of psychiatric disorder rates and the psychiatric symptom severity it causes. 相似文献
3.
This study examined differences in offending behavior and psychosocial problems between juvenile offenders who have been sexually abused (n = 231), physically abused (n = 1,568), neglected (n = 1,555), exposed to multiple forms of maltreatment (n = 1,767), and non-victims (n = 8,492). In addition, the moderating effect of gender in the association between type of maltreatment and offending behavior/psychosocial problems was examined. Results showed that violent offenses were more common in victims of physical abuse and victims of multiple forms of abuse than in non-victims, both in boys and girls. In boys, sexual offenses were far more common in victims of sexual abuse than in victims of other or multiple forms of maltreatment or in non-victims. In girls, no group differences were found in sexual offending behavior. For both boys and girls, externalizing problems were relatively common in victims of physical abuse and neglect whereas internalizing problems were relatively common in victims of sexual abuse. In victims of multiple forms of maltreatment, both internalizing and externalizing problems were relatively common. Implications for clinical practice are discussed. 相似文献
4.
Although there is a substantial amount of literature documenting the relationship between child abuse and behavioral problems in China, there is, on the other hand, a limited number of studies on the joint and unique associations of maternal and paternal physical abuse with child behaviors within the Chinese context. The present study, using the family systems theory as the theoretical framework, aims to examine these joint and the unique associations of maternal and paternal physical abuse with externalizing and internalizing behaviors among a community sample of Chinese children. A total of 296 children (54.7% boys, mean age 12.31 ± 0.56 years) from two-parent families participated in the study, and they reported their physical abuse experience by their mother and father in the previous year using the Chinese version of the Parent-Child Conflict Tactics Scale. Participants, using the Youth Self Report, reported personal externalizing and internalizing behaviors, and, similarly, their mothers, using the Child Behavior Checklist, assessed children’s externalizing and internalizing behaviors. Linear mixed effect models with random intercept and slope were used to examine the joint and unique associations of maternal and paternal physical abuse with child externalizing and internalizing behaviors. Results revealed that physically abused children were more likely to be simultaneously abused by both mothers and fathers. Furthermore, when compared with their non-abused counterparts, children with physical abuse that was carried out solely by mothers (externalizing behaviors: β = 6.71, 95% CI = 2.45–10.98, p < 0.01; internalizing behaviors: β = 4.52, 95% CI = 0.37–8.66, p < 0.05) or by both mothers and fathers (externalizing behaviors: β = 4.52, 95% CI = 1.80–7.24, p < 0.001; internalizing behaviors: β = 2.98, 95% CI = 0.34–5.61, p < 0.05) reported more externalizing and internalizing behaviors. Externalizing and internalizing behaviors of children who were physically abused solely by fathers did not significantly differ from those of their non-abused counterparts, which may result from the small sample size. The present findings suggest that maternal physical abuse may have a dominant and unique association with child behaviors, regardless of whether paternal physical abuse occurs within the family. Implications for future research and practice within the Chinese context regarding the subject of child behaviors and parental abuse are discussed. 相似文献
5.
Although child sexual abuse (CSA) is associated with psychopathology, limited research examined mechanisms through which CSA leads to psychopathology in children. It is generally assumed that CSA is associated with secrecy among children, to our knowledge this assumption has not yet been empirically tested. This gap in our understanding of the aftermath of CSA is surprising in light of abundant evidence linking secrecy to psychopathology among children. The current study examined whether, as compared to children who have not experienced CSA, CSA victims have a greater tendency for secrecy as reported by mothers and children, and whether psychopathology in CSA victims may be explained by their tendency to keep secrets. Sixty-three non-offending mothers and their sexually abused children (68.3% female; M age = 10.89) and 48 mothers and their non-abused children (62.5% female; M age = 11.17) completed questionnaires on secrecy and psychopathology (i.e., internalizing and externalizing behavior problems). Mothers of abused children perceived higher levels of secrecy and psychopathology in their children as compared to mothers of non-abused children. There were no differences in child-reported secrecy between abused and non-abused children. Mediation analyses revealed that mother-reported secrecy mediated the association between CSA and psychopathology. These findings suggest that secrecy is a potential mechanism underlying psychopathology associated with CSA, which has important implications for treatment of abused children. 相似文献
6.
Prevention programs often encourage sexually abused children to disclose without fully considering the potential for adverse consequences. This study examined the impact of disclosure on abuse cessation and later adult symptomatology. A clinical sample of 301 adult survivors completed the Impact of Event Scale (IES/IES-R), and the Beck Depression Inventory (BDI-II). Participants were divided into 3 groups: Nondisclosure (n = 221), Disclosure/Abuse Ended (n = 25), and Disclosure/Abuse Continued (n = 55). Multivariate analyses of covariance, adjusting for abuse characteristics (age of onset, penetration, and number of perpetrators) and other trauma exposure, revealed significant differences in psychiatric symptom severity among the three groups, Wilks’ λ = 0. 95, F (6, 584) = 2.69, p = 0.014, ηp2 = 0.03. Specifically, those in the Disclosure/Abuse Continued group scored significantly higher on the IES/IES-R Intrusion subscale (p = 0.04) and the BDI-II (p = 0.01), as compared to the Nondisclosure group. The Disclosure/Abuse Ended group did not differ significantly from the other groups. Results suggest that disclosure may be detrimental unless adequate steps are taken to ensure abuse cessation and appropriate treatment. 相似文献
7.
Sexual abuse has the potential to generate serious emotional consequences for its victims, but there is high variability in the symptoms reported by different victims. Therefore, it is necessary to ascertain the factors associated with the symptoms presented by sexual abuse victims. The aim of the study was to use a single model to evaluate the relationship between sexual abuse characteristics (frequency, violence, relation with the aggressor and physical commitment), cognitive and behavioral factors (self-efficacy, active coping and perceived family support) and internalizing symptoms (anxiety, depression and posttraumatic stress) in a group of sexually abused adolescents. The participants included 106 female adolescent victims of sexual abuse (M = 14.25 years, SD = 1.74). The results of a path analysis indicated that sexual abuse characteristics were unrelated to symptomatology. Only a negative relationship was observed between the victim’s relationship with the aggressor and PTSD symptomatology. The violence of the sexual abuse was negatively related to self-efficacy, and self-efficacy was positively related to active coping and negatively related to symptomatology. Finally, the perception of family support was positively related to self-efficacy and negatively related to symptomatology. These results suggest the need to consider the studied factors in the process of psychotherapy with victims of sexual abuse. 相似文献
8.
The objective of this study was to investigate whether acute pain in abused children was under recognized by doctors and nurses compared to children evaluated for accidental injuries. We hypothesize that an abused child’s reaction to physical pain could be an additional symptom of this challenging diagnosis. For the observational prospective case control study in an emergency department, children were eligible when: younger than six years old, the reported trauma occurred within the previous seven days, the trauma comprised a bone injury or burn, and the child was able to express his or her pain. The case group comprised children for whom the medical team reported their abuse suspicions and supporting information to a court, and whose cases of abuse were subsequently confirmed. The control group consisted of children with a plausible cause for their injury and no obvious signs of abuse. The children were matched according to their age and type of trauma. The pain was assessed by doctors and nurses before analgesic administration using a certified pain scale.Among the 78 included children, pain was significantly less recognized in the abused children vs. the controls (relative risk = 0.63; 95% CI: 0.402–0.986; p = 0.04). We observed a discrepancy between the nurses’ and doctors’ scores for the pain assessments (Kappa coefficient = 0.59, 95% CI: 0.40–0.77). Our results demonstrate that pain expression in abused children is under recognized by medical staff. They also suggest that abused children may have reduced pain expression after a traumatic event. Paying particular attention to the pain of abused children may also optimize the analgesic treatment. 相似文献
9.
《Child abuse & neglect》2014,38(9):1560-1568
History of child abuse is considered one of the important risk factors of suicide attempt in general population. At the same time it has been shown that suicide attempts appear significantly more frequently in alcoholics than in healthy individuals. The objective of this study was to investigate associations between history of childhood sexual abuse and suicide attempts in a sample of Polish alcohol dependent patients. A sample of 364 alcohol-dependent subjects was recruited in alcohol treatment centers in Warsaw, Poland. Information was obtained about demographics, family history of psychiatric problems, history of suicide attempts, sexual and physical abuse during childhood and adulthood and severity of alcohol problems. When analyzed by gender, 7.4% of male and 39.2% of female patients had a lifetime history of sexual abuse; 31.9% of the study group reported at least one suicide attempt during their lifetime. Patients who reported suicide attempts were significantly younger (p = 0.0008), had greater severity of alcohol dependence (p = 0.0002), lower social support (p = 0.003), and worse economic status (p = 0.002). Moreover, there was a significant association between history of suicide attempts and family history of psychiatric problems (p = 0.00025), suicide attempts in the family (p = 0.0073), childhood history of sexual abuse (p = 0.009) as well as childhood history of physical abuse (p = 0.002). When entered into linear regression analysis with other dependent variables history of childhood sexual abuse remained a significant predictor of suicide attempt (OR = 2.52; p = 0.035). Lifetime experience of sexual abuse is a significant and independent risk factor of suicide attempts in alcohol-dependent individuals. 相似文献
10.
Reported cases of child maltreatment are increasing in Taiwan. Yet, comprehensive epidemiological characteristics of adolescents’ exposure over the wide spectrum of violence are still lacking. The purpose of this study was to estimate the prevalence and magnitude of child maltreatment among Taiwanese adolescents. A population-based study was conducted with 5,276 adolescents aged 12–18 from 35 schools in 17 cities and townships to determine the prevalence of five forms of child maltreatment in Taiwan. A total of 5,236 adolescents completed anonymous, self-report, structured questionnaires. Most adolescents (91%, n = 4,788) experienced at least one form of maltreatment with 83% (n = 4,347) exposed during the previous year. Violence exposure was the most common type of child maltreatment experienced, followed by psychological abuse, physical abuse, neglect, and sexual abuse. Adolescents reported an average of 7.4 (SD = 5.87) victimizations over their lifetime and 4.8 (SD = 4.82) victimizations during the past year. Females reported a higher rate of neglect, while males reported a higher rate of sexual abuse. Most of the sexual abuse perpetrators were known by their victims. Adolescents’ victimization and polyvictimization from child maltreatment in Taiwan deserves a review and modification of national control and prevention policies. 相似文献
11.
Australia needs effective programs to protect children and prevent abuse, but there is little information available for policymakers or families. Using a randomized controlled trial, Learn to BE SAFE with Emmy™, a school-based protection program for young children designed by Act for Kids, was evaluated to determine its effectiveness for promoting young children's knowledge and skills. Grade one children (n = 245) from 15 classrooms across 5 primary schools completed assessment measures. A subset of these children received the program (n = 131) or acted as a comparison group (n = 114). Parents (n = 72) completed questionnaires about their child's participation in the program. When compared with children who had not received the program, children who completed Learn to BE SAFE with Emmy™ demonstrated increased knowledge of interpersonal safety and were more likely to choose a safe response option to hypothetical unsafe scenarios 6 months after participation than at both pre- and post-intervention. Parents reported their children who participated used more safety strategies immediately and 6 months after participation compared to pre-intervention. Outcomes can assist in guiding future policies around the prevention of child abuse and protect the well-being of Australian children. 相似文献
12.
The main aim of this study was to investigate the effect of childhood sexual abuse on medically not well explained or functional somatic symptoms (FSSs) in adolescents. We hypothesized that sexual abuse predicts higher levels of FSSs and that anxiety and depression contribute to this relationship. In addition, we hypothesized that more severe abuse is associated with higher levels of FSSs and that sexual abuse is related to gastrointestinal FSSs in particular. This study was part of the Tracking Adolescents’ Individual Lives Survey (TRAILS): a general population cohort which started in 2001 (N = 2,230; 50.8% girls, mean age 11.1 years). The current study uses data of 1,680 participants over four assessment waves (75% of baseline, mean duration of follow-up: 8 years). FSSs were measured by the Somatic Complaints subscale of the Youth Self-Report at all waves. Sexual abuse before the age of sixteen was assessed retrospectively with a questionnaire at T4. To test the hypotheses linear mixed models were used adjusted for age, sex, socioeconomic status, anxiety and depression. Sexual abuse predicted higher levels of FSSs after adjustment for age sex and socioeconomic status (B = .06) and after additional adjustment for anxiety and depression (B = .03). While sexual abuse involving physical contact significantly predicted the level of FSSs (assault; B = .08, rape; B = .05), non-contact sexual abuse was not significantly associated with FSSs (B = .04). Sexual abuse was not a stronger predictor of gastrointestinal FSSs (B = .06) than of all FSSs. Further research is needed to clarify possible mechanisms underlying relationship between sexual abuse and FSSs. 相似文献
13.
The purposes of this study were to: (1) Assess child abuse professionals’ and nonprofessionals’ knowledge of scientific research findings that are relevant to forensic child sexual abuse (CSA) evaluations and (2) describe associations between child abuse professionals’ levels of research knowledge and their education and experience. An 18-item multiple-choice test was administered to 188 child abuse professionals and 457 nonprofessionals (undergraduate college students) in Brazil and the United States. The nonprofessionals’ average percent correct, M = 44%, was not significantly different than what would be expected for random guessing (45%). The professionals’ average percent correct, M = 55%, was higher than that of nonprofessionals and random guessing (both ps < .001). The average percent correct score for the US-sample psychologists, M = 76%, was higher than the average score of the other professionals, M = 51%, p < .001. Professionals’ educational level, as measured by the highest academic degree obtained, was positively associated with percent correct scores, Spearman's ρ = .46, p < .001. Controlling for educational attainment, professional experience, as measured by the total number of CSA evaluations performed, was weakly associated with percent correct scores, partial r = .15, p = .04. Percent correct scores were low for both nonprofessionals and professionals. Most of the participants in this study were uninformed or misinformed about scientific research findings that are important for conducting optimal forensic CSA evaluations and for making accurate judgments about the validity of sexual abuse allegations. 相似文献
14.
Neglected children, by far the majority of children maltreated, experience an environment most deficient in cognitive stimulation and language exchange. When physical abuse co-occurs with neglect, there is more stimulation through negative parent–child interaction, which may lead to better cognitive outcomes, contrary to Cumulative Risk Theory. The purpose of the current study was to assess whether children only neglected perform worse on cognitive tasks than children neglected and physically abused. Utilizing LONGSCAN archived data, 271 children only neglected and 101 children neglected and physically abused in the first four years of life were compared. The two groups were assessed at age 6 on the WPPSI-R vocabulary and block design subtests, correlates of cognitive intelligence. Regression analyses were performed, controlling for additional predictors of poor cognitive outcome, including socioeconomic variables and caregiver depression. Children only neglected scored significantly worse than children neglected and abused on the WPPSI-R vocabulary subtest (p = 0.03). The groups did not differ on the block design subtest (p = 0.4). This study shows that for neglected children, additional abuse may not additively accumulate risk when considering intelligence outcomes. Children experiencing only neglect may need to be referred for services that address cognitive development, with emphasis on the linguistic environment, in order to best support the developmental challenges of neglected children 相似文献
15.
《Child abuse & neglect》2014,38(9):1533-1539
To assess the quality and diagnostic accuracy of pediatric sexual abuse forensic examinations conducted at rural hospitals with access to telemedicine compared with examinations conducted at similar hospitals without telemedicine support. Medical records of children less than 18 years of age referred for sexual abuse forensic examinations were reviewed at five rural hospitals with access to telemedicine consultations and three comparison hospitals with existing sexual abuse programs without telemedicine. Forensic examination quality and accuracy were independently evaluated by expert review of state mandated forensic reporting forms, photo/video documentation, and medical records using two structured implicit review instruments. Among the 183 patients included in the study, 101 (55.2%) children were evaluated at telemedicine hospitals and 82 (44.8%) were evaluated at comparison hospitals. Evaluation of state mandatory sexual abuse examination reporting forms demonstrated that hospitals with telemedicine had significantly higher quality scores in several domains including the general exam, the genital exam, documentation of examination findings, the overall assessment, and the summed total quality score (p < 0.05 for each). Evaluation of the photos/videos and medical records documenting the completeness and accuracy of the examinations demonstrated that hospitals with telemedicine also had significantly higher scores in several domains including photo/video quality, completeness of the examination, and the summed total completeness and accuracy score (p < 0.05 for each). Rural hospitals using telemedicine for pediatric sexual abuse forensic examination consultations provided significantly higher quality evaluations, more complete examinations, and more accurate diagnoses than similar hospitals conducting examinations without telemedicine support. 相似文献
16.
This meta-analytic review examines the association between childhood sexual abuse and risky sexual behaviours with sub-group analyses by gender. Systematic searches of electronic databases including MEDLINE, PubMed, EMBASE, and PsycINFO were performed using key terms. We used a priori criteria to include high quality studies and control for heterogeneities across eligible studies. The review was registered with PROSPERO and used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The final meta-analysis applied fixed-effects model to generate pooled odds ratio (OR). Subgroup analyses were conducted to identify potential methodological moderators. The meta-analysis included 8 eligible studies (N = 38,989, females = 53.1%). The overall syndemic of risky sexual behaviors at adulthood was 1.59 times more common in childhood sexual abuse victims. There was a similar association between childhood sexual abuse in general and subsequent risky sexual behaviors in both females and males. However, in cases of substantiated childhood sexual abuse, there was a greater odds of risky sexual behaviors in females (OR = 2.72) than males (OR = 1.69). The magnitude of association of childhood sexual abuse and risky sexual behaviors was similar for males and females regardless of study time, study quality score and method of childhood sexual abuse measurement. There were nonsignificant overall and subgroup differences between males and females. Childhood sexual abuse is a significant risk factor for a syndemic of risky sexual behaviors and the magnitude is similar both in females and males. More research is needed to explore possible mechanisms of association. 相似文献
17.
Much of what is known about child abuse in Canada has come from reported cases of child abuse and at-risk samples, which likely represent the most severe cases of child abuse in the country. The objective of the current study is to examine the prevalence of a broad range of child abuse experiences (physical abuse, sexual abuse, and exposure to IPV) and investigate how such experiences and sociodemographic variables are related to contact with child protection organizations in Canada using a representative general population sample. Data were drawn from the 2012 Canadian Community Health Survey: Mental Health collected from the 10 provinces using a multistage stratified cluster design (n = 23,395; household response rate = 79.8%; aged 18 years and older). Physical abuse only (16.8%) was the most prevalent child abuse experience reported with the exposure to specific combinations of two or more types of child abuse ranging from 0.4% to 3.7%. Only 7.6% of the adult population with a history of child abuse reported having had contact with child protection organizations. Experiencing all three types of child abuse was associated with the greatest odds of contact with child protection organizations (AOR = 15.8; 95% CI = 10.1 to 24.6). Physical abuse only was associated with one of the lowest odds of contact with child protection organizations. Preventing child abuse is widely acknowledged as an important, but challenging public health goal. Strategies to increase reporting of child abuse may help to protect children and to connect families with necessary services. One obvious priority would be physical abuse. 相似文献
18.
《Child abuse & neglect》2014,38(9):1540-1551
The aim of this study was to describe contextual events, abuse experiences, and disclosure processes of adolescents who presented to a hospital-based Child Advocacy Center for medical evaluation and evidentiary collection as indicated after experiencing multiple perpetrator rape during a single event (n = 32) and to compare these findings to a group of single perpetrator sexual assaults (n = 534). This study used a retrospective mixed-methods design with in-depth, forensic interviews and complete physical examinations of gang-raped adolescents. Patients ranged from 12 to 17 years (M = 14 years). Girls who experienced multiple perpetrator rape during a single event were more likely to have run away, to have drunk alcohol in the past month, and to have participated in binge drinking in the past 2 weeks. Acute presentation of these victims were rare but 30% had hymenal transections and 38% had sexually transmitted infections (STIs). Forensic interviews revealed alcohol was a common weapon used by offenders, and its use resulted in victims experiencing difficulty in remembering and reporting details for police investigation or physical and mental health care. Most victims were raped at parties they attended with people they thought they could trust, and they felt let down by witnesses who could have helped but did not intervene. Although relatively rare, multiple perpetrator rape during a single event is a type of severe sexual assault experience and has significant risks for deleterious health outcomes. These victims require health care by trained providers to diagnose physical findings, treat STIs, screen for trauma, and support victims. 相似文献
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20.
The present study aimed to assess the effects of age and PTSD on the narrative fragmentation in memories for child sexual abuse. Lexical complexity, cohesion and coherence were analyzed within a group of 86 allegations of children (M = 10 years; SD = 3.7; range: 4–17) who were victims of sexual abuse. Results illustrated that age played an important role in establishing narrative coherence and predicted the level of orientation, the sequence of events and the level of evaluation of the event. Instead, PTSD was related to narrative coherence and cohesion. Therefore, in children, the narrative fragmentation could be an effective diagnostic tool for understanding the effects of PTSD. Moreover in a legal setting the traumatic effects of PTSD on the narrative coherence and cohesion could be significant indices in the evaluation of child testimony. 相似文献