A Training Course for Psychologists: Learning to Assess (Alleged) Sexual Abuse Among Victims and Perpetrators Who Have Intellectual Disabilities

People with intellectual disabilities (ID) are at greater risk of being a victim of sexual abuse and may also be more predisposed to perpetrating sexual abuse. Although the prevalence of sexual abuse among people with ID is difficult to determine, it is clear that there are serious consequences for both victims and perpetrators, and professional support is needed. Psychologists play an important role in the assessment of sexual abuse in both victims and perpetrators and require specific knowledge and skills to execute the assessments. We therefore developed a training course for psychologists aimed at increasing their (applied) knowledge of sexual abuse and the related assessment process in people with ID. In a five-day training course, sessions focusing on theories about diagnostic models were combined with sessions focusing on the assessment of sexual abuse of victims and perpetrators. The effectiveness of the training course was determined in terms of (applied) knowledge via the administration of a study-specific questionnaire including a hypothetical case vignette before, immediately after, and six months after completion of the course. The results show that the knowledge of the psychologists related to sexual abuse and the assessment process for sexual abuse increased significantly, and remained above pre-test level at six-month follow-up. These results are promising, but more research is needed to see if the increased (applied) knowledge in turn leads to application in practice and better care for both victims and perpetrators.     

Barriers in the care of patients who have experienced a traumatic event: the perspective of general practice

BACKGROUND: Previous research has indicated that GPs encounter barriers in the care of patients who have experienced a traumatic event. OBJECTIVES: The aims of the present study were to map barriers GPs encounter in the care of patients who experience a traumatic event and solutions for these barriers, and to estimate the influence of GP characteristics on the number of barriers experienced. METHODS: Telephone interviews were conducted among a sample of 500 Dutch GPs stratified by sex. Topics covered barriers in the care of victims of: accidents, incest in the past, ongoing physical or sexual abuse of adults, and ongoing physical or sexual abuse of children. RESULTS: The response rate was 44%. GPs are regularly confronted with patients who have experienced a traumatic event. GPs experience 10% barriers in care of patients who have difficulties getting over an accident, 13% in the care of incest victims, 16% in the care of adults who are physically or sexually abused, and 20% in the care of physically or sexually abused children. Most of the GPs recently updated their knowledge of care of victims of traumatic events, but still the majority feel in need of additional expert training. CONCLUSION: GPs experience the greatest number of barriers in the care of children who are abused. GP characteristics were not related to the number of barriers. However, seeing more victims was related to fewer barriers. To facilitate GP care of victims of traumatic events, GP training and continuing medical education should focus especially on skills education regarding the detection and initial treatment of traumatic events of ongoing physical or sexual abuse.     

Protecting boys from the risk of sexual abuse

Relatively little is known about the sexual victimisation of male children. Because more girls report sexual abuse than boys, it has been widely assumed that boys are less vulnerable or that their abuse is less damaging than the abuse of girls. As a result, child protection programmes have been directed towards the protection of females. Interviews with 194 adult male survivors of sexual abuse suggest that the victimisation of boys is under-recognised, under-reported and that boys are not adequately protected by parents and current child protection curriculum. Subjects identified their sexual curiosity and ignorance as the primary contributors to their victimisation. Non-incest victims also believed that the lack of physical affection from their fathers contributed to their vulnerability. Strategies to facilitate the recognition and reporting of sexual abuse by boys warrant immediate attention.     

The effects of maltreatment on children's health and well-being

Although our society has put in place various forms of legislation to protect children's rights, many children are still subject to various forms of maltreatment such as sexual, physical or emotional abuse and/or physical or emotional neglect. All of these can have serious detrimental effects on the victims. Previous literature in this area has tended to focus on sexual abuse. In contrast, this paper provides an overview of all the different types of maltreatment in terms of characteristics of victims, the range of consequences, mediating factors and types of interventions that may be offered.     

Child and adolescent sexual abuse history in a sample of 1,490 women sexual partners of injection drug-using men.

Subjects for this study were 1490 community-recruited women sexual partners of injection drug-using men who were interviewed in three U.S. cities during 1990-'92. Data were collected on respondents' childhood and adolescent sexual abuse history, identity of abuse perpetrators and duration of abuse. Over 56 percent of respondents reported a history of sexual victimization by age 18, including 39 percent who were abused before age 12 and over 53 percent who were victimized by abuse involving bodily contact by age 18. One in three women were victimized by unwanted penetration by age 18. White women more likely than African-American and Hispanic women to have been the victims of virtually every type of abusive act investigated here. Overall, nearly two out of three White women had experienced some form of sexual abuse by age 18, including almost 42 percent who were the victims of unwanted penetration by this age. Acts of forced sexual touching and penetration occurring in childhood were most likely to have been carried out by an uncle or other relative of the victim; family members were much less likely to be the perpetrators of adolescent contact abuse. Based on these findings, it appears that many in this special population of women are likely to be at substantial risk for some of the long-term effects of early life sexual abuse, including those that may reduce victims' ability to take preventive action against HIV risk. Recommendations are offered for those who function as caregivers to this population, including drug treatment personnel.     

The importance of recognizing a history of sexual abuse in female adolescents

We have become increasingly aware of sexual abuse in our society, and yet the majority of teens who were sexually abused as children enter adolescence carrying the secret of their abuse. Such hidden abuse may have devastating effects on the development of personal identity, self-esteem, attitudes, behaviors, and interpersonal relationships that may persist and set a pattern for a troubled adulthood. This article details how children cope with a sexually abusive situation, the long-term effects of unresolved sexual abuse, and diagnostic criteria to differentiate a hidden history of sexual abuse from other trauma and conditions. Focus is on recognizing and assessing “legitimate” symptoms that may be conscious or unconscious cries for help by victims of previous sexual abuse. Correct diagnosis is essential to appropriate intervention to lessen possible further psychologic damage during adolescence.     

Child Abuse: Definitions, Reporting, Stereotypes; A Survey of Butte County, California Residents

A student research team surveyed by phone 300 randomly sampled residents of Butte County in Northern California in Spring 1984 on attitudes, stereotypes, and beliefs about child abuse. Prior to the survey, several local and state cases of physical and sexual child abuse had received widespread and dramatic media coverage. Although reported sexual abuse cases have doubled, physical abuse is the most widely recognized form of child maltreatment and sexual abuse is the least. The presence of a child in the home of the reporter is the most significant factor in suspecting and reporting child abuse. Gender is highly significant with males recognizing sexual abuse and recognizing males as the likely perpetrators; females, especially those married and having children, are the least likely to recognize sexual abuse and males as the likely perpetrators. Females were aware of emotional abuse and of anyone as a potential abuser. Recommendations for community education programs are made.     

Planning for sexual abuse prevention training of school teachers and health care workers

Literature points out that there are no socioeconomic differences for victims and perpetrators of sexual abuse in families. It also states that sexual abuse is a "silent disease" and epidemiological data has only recently been available, however, research also convincingly shows that sexual abuse leads to severe post-traumatic and long-term pathological social, psychological, emotional, mental, physical and educational problems for the victim in the school, family, relationship formation and community participation. Ignored in many cases, careful planning is essential to develop a training policy and workshops for teachers and health care workers to recognize the possibility and address the issue of sexual abuse and treatment.     

Maltreatment and Behavioral Characteristics of Youth Who Are Deaf and Hard-of-Hearing

This paper summarizes the available literature on child abuse and neglect among children with disabilities in general and considers children who are deaf and hard-of-hearing within this larger rubric given the low prevalence rates of children who are deaf and hard-of-hearing among the disabled population. This procedure allows for comparisons between disabilities as well as abused and non-abused children who are deaf and hard-of-hearing. Maltreatment data on children who are deaf and hard-of-hearing in a large epidemiological study of the prevalence of child maltreatment among children with disabilities are summarized. Children who are deaf and hard-of-hearing comprised 6.1% of the disabled population who were identified as victims of maltreatment. Their most prevalent form of maltreatment was neglect, followed by physical abuse and sexual abuse. Although children who are deaf and hard-of-hearing are significantly more likely to be maltreated by immediate family members, placement in a residential school is a risk factor for sexual and physical abuse. Maltreated children who are deaf and hard-of-hearing exhibit significantly more behavior problems including Post Traumatic Stress Disorder related behaviors than nonmaltreated peers.     

Childhood sexual abuse and adult binge drinking among Kanak women in New Caledonia

The long-term consequences of violence against women are poorly documented within the context of political domination, economic inequalities and rapid social change of indigenous communities. Using data from the first population study on violence against women and their consequences on health in New Caledonia, South Pacific, this article investigates the association between childhood sexual abuse and binge drinking among 441 adult Kanak women. Face-to-face standardised interviews were conducted in 2002–2003, among women aged 18–54 years drawn from the electoral rolls. Childhood sexual abuse before 15 years of age was reported by 11.6% of respondents. Nearly all the perpetrators (96%) were known to the victims (63% being a close relative). The rate of frequent binge drinking amongst the women within the last 12 months was 34%. After controlling for social and demographic factors, an independent association was found between childhood sexual abuse and current binge drinking. This study is the first to analyse the contribution of childhood sexual abuse to the likelihood of later heavy alcohol use in an indigenous population in the South Pacific. The findings call for improving and giving priority to care for children who are victims of violence to prevent long-term health consequences and to develop prevention programs aimed at alcohol-related behaviour in women, while taking into account simultaneous individual and collective factors.     

Intimate partner violence among men and women--South Carolina, 1998

Few studies provide population-based estimates of intimate partner violence (IPV) for men and women, especially at the state level. IPV may result in adverse health effects for victims and perpetrators (1-3). To estimate the lifetime incidence of IPV by type of violence (e.g., physical, sexual, and perceived emotional abuse) and to explore demographic correlates of reporting IPV among men and women, the South Carolina Department of Health and Environmental Control and the University of South Carolina conducted a population-based random-digit-dialed telephone survey of adults in the state. This report summarizes the results of the survey, which indicated that approximately 25% of women and 13% of men have experienced some type of IPV during their lifetime. Although women were significantly more likely to report physical and sexual IPV, men were as likely as women to report emotional abuse without concurrent physical or sexual IPV.     

Auswirkungen des Menschenhandels auf die Gesundheit von betroffenen Frauen und m?gliche Handlungsoptionen

Human trafficking is the modern form of slavery. Annually, thousands of women, children and men of all ages are affected. Trafficking in persons has a severe impact on the health of those affected. In particular, young women are very vulnerable and easily accessible for perpetrators. They are forced into prostitution in their own country or abroad. The soundest knowledge is available in the field of exploitation of women with the purpose of prostitution which is why this article will focus on this phenomenon. The causes are reflected in a complex system of push and pull factors. The health implications are enormous. Not only do the women suffer from sexually and non-sexually transmitted infections but also from the physical abuse caused by the perpetrators. The injuries and trauma often lead to post-traumatic stress disorder (PTSD). Doctors are often the only ones who have contact with those concerned which is the reason why they are responsible for identifying and treating the victims as well as helping them to escape their miserable situation. In the area of trafficking in women and minors for sexual exploitation much research is needed. Furthermore, an extensive education campaign is necessary to sensitize medical health care professionals to this situation. Thus, doctors can handle and use the given diagnostic questions and symptom complexes to identify victims and although medical health care professionals are capable of using and handling diagnostic measures to identify the victims, they are not able to prevent human trafficking. However, they can contribute by identifying victims and supply them with medical services and provide educational work.     

Damned and depressed

India's child welfare system is not equipped to deal effectively with the growing problem of child abuse. In addition to physical and sexual abuse, child maltreatment can take the form of marrying off children for parental financial gain, misuse of children to beg and steal, and insistence that children 6-11 years of age work in factories rather than attend school. Numerous studies have found that abused children either develop a submissiveness that makes them vulnerable to repeated victimization or become rebellious and involved in antisocial acting out. Not only does the lack of nurturance and protection from danger at crucial developmental stages compromise the quality of adult life of child abuse victims, but also there is evidence that parental abuse is transferred from generation to generation. Although India's Constitution contains numerous laws aimed at protecting children from abuse, exploitation, and abandonment, the services required for child abuse control--therapy for the child, punishment for the offenders, and support for parents who are psychologically and emotionally overwhelmed--are not available. Needed is a greater emphasis on child abuse prevention through measures such as creation of a pro-child socioethical climate, education through the mass media, prevention of the further disintegration of the joint family system, establishment of village-level committees to monitor the implementation of child care programs, and a commitment to provide recreation and health services to street and working children.     

Sexual and physical abuse: a threat to reproductive and sexual health

According to the cross-cultural data, violence has two fundamental certainties: 1) that the overwhelming majority of perpetrators are men; and 2) that the targets are usually women. Sexual and physical abuse subsume a wide variety of violent behaviors, some of which are legally recognized as criminal acts. Evidence indicates that the most invisible of all is child sexual abuse, in which nonreporting of crime is prevalent. Although there appears to be no simplistic response to the question as to why men are violent towards women, it is noted that it involves several contributing factors. These include inequalities between women and men at the societal level, and cultural norms and expectations about behaviors of women and men at another level. In terms of the identity of the perpetrators, research has found that a large majority of perpetrators are socialized for violence. The effects of violence on the sexual and reproductive health of the victim are multiple and long lasting. For example, physical consequences of rape include sexually transmitted diseases and HIV infection, as well as unwanted pregnancy, miscarriage, unsafe abortion, homicide, and suicide. With respect to the psychological consequences, the most common symptoms are anxiety, depression, sexual dysfunction, and difficulties with interpersonal relationships. In view of this, there is a need for a long-term management of victims of sexual abuse.     

Intimate Partner Violence Among Men Having Sex with Men,Women, or Both: Early-Life Sexual and Physical Abuse as Antecedents

Little is known about the prevalence of intimate partner violence (IPV) among men who have sex with men (MSM) or about childhood adversity as a predictor of IPV among MSM. Studies have documented high rates of childhood sexual abuse among MSM. To evaluate associations of early-life sexual and physical abuse with IPV among African American heterosexual men or MSM, prevalence of early-life (≤21 years) sexual and physical abuse was measured among 703 nonmonogamous African American men. Men were classified as (1) MSM who disclosed male sex partners; (2) MSM who initially denied male sex partners but subsequently reported oral-genital and anal-genital behaviors with men; (3) non-MSM. MSM who initially disclosed male sex partners reported significantly (P < 0.0001) higher rates of early physical abuse (36%) and lifetime abuse (49%) compared with non-MSM (15 and 22%), respectively. These MSM reported significantly higher rates of sexual abuse by age 11, age 21, and over a lifetime compared with non-MSM (P < 0.0001). Being an MSM who initially disclosed male sex partners (OR: 2.1; 95% CI: 1.2, 3.6) and early-life sexual abuse (OR: 2.8; 95% CI: 1.8, 4.3) was associated with IPV victimization in current relationships. Similarly, being an MSM with early-life physical and sexual abuse was associated (0.0004 ≤ P ≤ 0.07) with IPV perpetration. Early-life physical and sexual abuse was higher among MSM who disclosed male sex partners compared with heterosexual men; however, all MSM who experienced early-life abuse were more likely to be IPV victims or perpetrators.     

Women with Disabilities’ Perceptions of Sexuality,Sexual Abuse and Masturbation

In today’s society, sexuality is recognized as a determining factor in everyone’s wellbeing. As such, it is undeniable that people with physical disabilities have the same affective and sexual needs as everyone else. Nevertheless, people with disabilities face more obstacles that can impair their sex lives. For example, the significant lack of intimacy due to the need for help manipulating personal hygiene products and the behavior of people around them (e.g., overprotection and desexualization) may make them more vulnerable to sexual abuse. Very little scientific and professional documentation or survey data documents their sex lives, and particularly the benefits of masturbation. The purpose of this article is to document the sexual experiences of women with disabilities, the sexual abuse they may suffer and the benefits of masturbation. To do so, a qualitative methodology was used, with eight participants with physical disabilities aged 18 years and over in semi-structured individual interviews. The results of these interviews show, among other things, that masturbation enabled participants to reconcile themselves to earlier negative experiences (e.g., sexual abuse) and to promote their sexual autonomy. Finally, a series of solutions must be applied to facilitate masturbation and protect these women from sexual violence (e.g., prevention programs in educational and hospital settings, better manuals, and training).     

Co-operating to Safeguard

Revised guidance on child protection will shortly be issued in Northern Ireland by the Department of Health, Social Services and Public Safety (DHSSPS). Although reference is made in that document to the needs of both victims and those who abuse other children, it also points to the requirement for separate inter-agency guidance. This paper, which was delivered to a conference at Newcastle, Co Down on 27 February 2002, sets the policy context whereby leadership from the department, clear guidance and a range of practice intervention ranging from prosecution to restorative and family group conferencing should result in: victims feeling that their needs have been considered; those children who abuse and their families experiencing fairness and facing appropriate accountability; and professionals understanding and fulfilling their role in the adjudication, assessment and programme delivery which deals with the abusive behaviour and also in meeting the child's other needs.     

The Child Sexual Abuse Epidemic in Addis Ababa: Some Reflections on Reported Incidents,Psychosocial Consequences and Implications

Background

Though child sexual abuse is a universal phenomenon, only reported cases of the incidence are common source of information to get insight on how to understand the problem. Besides, investigating complaints presented by victims themselves would be a stepping stone for designing prevention and rehabilitation programs. The objective of this study was to identify the nature of sexual incidence and experience victims face.

Methods

The research was conducted by collecting reported child sexual abuse cases from Child Protection Units of Addis Ababa Police Commission and three selected non-governmental organizations working for the welfare of sexually abused children in Addis Ababa. 64 selected samples of victim children were included from the three organizations. They completed a semi-structured questionnaire and data were analyzed.

Results

Of the total reported crime cases committed against children (between July 2005 and December 2006), 23% of them were child sexual victimization. On average, 21 children were reported to be sexually abused each month where majority of the sexual abuse incidence were committed against female children in their own home by someone they closely know. The psychological trauma and physical complaints presented by victims include symptoms of anxiety and depression.

Conclusion

It was found out that child sexual abuse cases presented to the legal office was not properly managed. Female children appear to be more prone to sexual abuse than their male counterparts. By virtue of their nature, many children are at risk of sexual victimization by people they truest. Based on the findings, several implications are made, which includes the importance of nation-wide study to formulate a comprehensive policy guideline for protection and criminalization of child sexual abuse in Ethiopia.     

Recommendations of the Polish Gynecological Society concerning child sexual abuse

The World Health Organisation defines child sexual abuse as the involvement of a child in sexual activity that he or she does not fully comprehend, is unable to give informed consent to, or for which the child is not developmentally prepared and cannot give consent, or that violates the laws or social taboos of society. Child sexual abuse is evidenced by this activity between a child and an adult or another child who by age or development is in a relationship of responsibility, trust or power, the activity being intended to gratify or satisfy the needs of the other person. It is estimated that in the world on average one in 3-4 women and one in 6-10 men were victims of sexual abuse in childhood. In Poland, according to the estimates of the Child's Rights Protection Committee, approximately 20% of girls and 5-6% of boys under the age of 15 years has suffered sexual abuse. In 2007 there was an increase in violence victims in all age categories, but the most alarming data concerned minors under 13 years. Girls fall victim to sexual abuse three times more frequently than boys. Sexual abuse of boys frequently involves violence. Data show that there are fewer women than men who execute such actions against a minor. Most victims (49-84%) know the perpetrator, and approximately 14-20% of acts of violence take place within the family. This article presents recommendations of the Polish Gynecological Society concerning procedures in cases of suspected sexual abuse of children.     

WOMEN BEHIND BARS: COULD NEUROBIOLOGICAL CORRELATES OF PAST PHYSICAL AND SEXUAL ABUSE CONTRIBUTE TO CRIMINAL BEHAVIOR?

Trauma, especially physical and sexual abuse inflicted by others, is often part of the personal histories of female prison inmates. These traumatic events have also been associated with neuropsychiatric conditions commonly found in female inmate populations. The purpose of this article is to provide a review of the literature and research findings about physical and sexual abuse perpetrated against female prison inmates predating their crimes, the neurobiological correlates, and related factors that could have contributed to criminal behaviors. This information is critical for abuse and crime prevention and rehabilitation of female victims who have become criminal offenders.