Dating violence, sexual assault, and suicide attempts among urban teenagers

OBJECTIVE: To evaluate the relationship between dating violence, sexual assault, and suicide attempts among urban adolescents. DESIGN: Secondary analysis of the 2005 New York City Youth Risk Behavior Survey. SETTING: Eighty-seven New York City public high schools. PARTICIPANTS: Representative population-based sample of 8080 students, 14 years and older. MAIN EXPOSURES: Dating violence in the past year and lifetime history of sexual assault. OUTCOME MEASURE: One or more suicide attempts in the past year. RESULTS: Respondents were 50.0% female and primarily black (36.0%) or Hispanic (40.1%). In the past year, 11.7% of females and 7.2% of males reported 1 or more suicide attempts. Lifetime history of sexual assault was reported by 9.6% of females and 5.4% of males. Dating violence in the past year was reported by 10.6% of females and 9.5% of males. In multivariate models, controlling for persistent sadness, sexual orientation, and significant risk behaviors, recent dating violence (odds ratio, 1.61; 95% confidence interval, 1.05-2.47) was associated with suicide attempts in adolescent girls, while lifetime history of sexual assault (odds ratio, 3.86; 95% confidence interval, 2.11-7.06) was associated with suicide attempts in adolescent boys. CONCLUSIONS: In this population of urban youth, recent dating violence among females and lifetime history of sexual assault among males were significantly associated with suicide attempts. Clinicians and educators should be trained to routinely screen adolescents for violence victimization and should have a low threshold for referring these at-risk teenagers for mental health services.     

Recording of community violence by medical and police services

OBJECTIVES: To determine the extent to which community violence that results in injury treated in emergency departments appears in official police records and to identify age/gender groups at particular risk of under-recording by the police. METHODS: Non-confidential data for patients with assault related injury treated in the emergency departments of two hospitals in one South Wales city (Swansea) during a six month period were compared with data relating to all recorded crimes in the category "Violence against the person" in the police area where the hospitals were located. RESULTS: Over the six month period a total of 1513 assaults were recorded by Swansea emergency departments and the police (1019, 67.3% injured males and 494, 32.7% injured females). The majority of these assaults (993, 65.6%) were recorded exclusively by emergency departments; 357 (23.6%) were recorded only by the police and 163 (10.8%) were recorded by both emergency departments and the police. Equal proportions of males (67.3%) and females (67.5%) injured in assaults were recorded by both emergency departments and the police, but men were more likely to have their assault recorded exclusively in emergency departments (odds ratio (OR) 2.1, 95% confidence interval (CI) 1.7 to 2.7) while women were more likely to have their assault recorded exclusively by the police (OR 2.5, 95% CI 2.0 to 3.2). There were no significant relationships between exclusive emergency department recording and increasing age (OR 1.0, 95% CI 0.9 to 1.2), exclusive police recording and increasing age (OR 1.1, 95% CI 1.0 to 1.2), or between age and dual recording (OR 0.9, 95% CI 0.8 to 1.0). CONCLUSIONS: Most assaults leading to emergency department treatment, particularly in which males were injured, were not recorded by the police. Assaults on the youngest group (0-10, particularly boys) were those least likely to be recorded by police and females over age 45, the most likely. Emergency department derived assault data provide unique perspectives of community violence and police detection.     

Serious injuries and deaths of adolescent girls resulting from interpersonal violence: characteristics and trends from the United States, 1989-1998

BACKGROUND: Little published data are available concerning the death and disability of adolescent girls resulting from interpersonal violence (adolescents are defined as those aged 12-18 years in this study). OBJECTIVES: To determine whether there were sex differences in (a) the characteristics of those who were injured or died, (b) injury severity and outcomes, and (c) injury mechanism; and to describe time trends in these differences. DESIGN: Analysis of data concerning serious injuries due to assaults, recorded in the National Pediatric Trauma Registry (from January 1, 1989, through December 31, 1998), and homicides, recorded in the Web-Based Injury Statistics and Query Reporting System database (from January 1, 1990, through December 31, 1997). SETTING: Patient data from participating pediatric trauma centers (National Pediatric Trauma Registry) in 45 states and national death certificate data (Web-Based Injury Statistics and Query Reporting System). PATIENTS: Six hundred twelve adolescent girls who were seriously injured because of an assault were compared with 2656 adolescent boys who were seriously injured because of an assault. Three thousand four hundred eighty-seven adolescent girls who died due to a homicide were compared with 17 292 adolescent boys who died due to a homicide. RESULTS: Assaulted adolescent girls were more likely to have preexisting cognitive or psychosocial impairments than were adolescent boys (odds ratio, 1.68; 95% confidence interval, 1.12-2.51). Adolescent girls trended toward more injury-related impairments at discharge from the hospital (odds ratio, 1.16; 95% confidence interval, 0.92-1.47). Adolescent girls were more likely to have been stabbed, and less likely to have been shot. Also, adolescent girls were more likely to have been injured at a home or a residence. Compared with all National Pediatric Trauma Registry admissions, assaults declined at the same rate for adolescent girls and boys. The proportion resulting from penetrating trauma declined more slowly for adolescent girls. CONCLUSIONS: Interpersonal violence causes considerable morbidity and mortality for young women. Research and interventions should be developed to respond to adolescent girls who experience interpersonal violence.     

Adolescent risk-taking behavior and the occurrence of sexual assault

The medical records of adolescent sexual assault victims presenting to Harborview Medical Center's Emergency Trauma Center, Seattle, were examined to determine behavioral risk factors preceding the assault. Twenty-six percent of the group were impaired by alcohol or other drugs during the assault. Forty-six percent of the assaults occurred after social interactions with strangers in unprotected surroundings. Five percent occurred after adolescents "hitchhiked" and accepted rides from strangers. Many of the assaults occurred between 10 PM and 4 AM. The incidence of injuries in victims was high (39%), while the incidence of serious injury was zero. Risk-taking behaviors were commonly encountered in adolescent sexual assault victims.     

The association between victim-offender relationship and the age of children and adolescents who suffer sexual violence: a cross-sectional study

ObjectivesSexual violence is a problem that affects children and adolescents regardless of social class, age, origin, religion, education level, marital status, race, or sexual orientation. This study aimed to analyze the associations between victim-offender relationships and the victim's age in cases of sexual violence involving female victims.MethodsThis cross-sectional, retrospective observational study used data from the Brazilian Ministry of Health's Department of Public Health Surveillance in Brasília regarding the reportable crime of rape as informed by female victims in the Federal District between January 1, 2012, and December 31, 2018. The age of the victim was classified as <15 years or 15-19 years. The offenders were classified into eight different categories according to their relationship with the victim: father, stepfather, brother, husband, boyfriend, friend, stranger, and others. The association between the victim-offender relationship and the victim's age was assessed.ResultsOverall, there were 4,617 reported cases of sexual violence, with 78.3% of these (n = 3614) corresponding to children under 15 and 21.7% to adolescents 15-19 years old (n = 1003). Close relatives, including brothers, and friends were the main perpetrators in cases of girls < 15 years old. Strangers and friends were the principal perpetrators in the group of girls 15-19 years old.ConclusionsChildren under 15 are the group most affected by sexual violence. Strategies must be developed to prevent the sexual abuse of children and adolescents and to facilitate the rehabilitation of victimized children.     

Violence risk and protective factors among youth held back in school.

OBJECTIVE: To identify risk and protective factors for violence perpetration among youth with a history of grade retention. DESIGN: Longitudinal analysis of in-home interviews of 13,781 adolescents in grades 7 through 12 conducted in 1995 and 1996. METHODS AND MEASURES: Serious interpersonal violence perpetration at time 2 by time 1 independent variables including measures of community and school context, family context, and individual characteristics. RESULTS: The 20% of girls and 28% of boys who had repeated 1 or more grades were more likely than those who had not to be in the top quintile of violence perpetration at time 2 (P <.001). For both girls and boys with a history of grade repetition, predictive risk factors with an odds ratio of 3 or greater (P <.001) included time 1 violence perpetration, violence victimization, weapon carrying, school problems, and alcohol and marijuana use. Although a high grade point average was a significant protective factor against violence perpetration for both girls (odds ratio, 0.36; P <.05) and boys (odds ratio, 0.23; P <.001), performance on a validated measure of verbal knowledge was not associated with violence perpetration over the study period. School connectedness, parent-family connectedness, and emotional well-being were also significant universal protectors against violence perpetration. CONCLUSIONS: Youth who are held back in school are at heightened risk for violence perpetration. Violence-related behaviors and substance use considerably increase the likelihood of this outcome. The findings suggest that schools can participate in violence prevention by providing youth with a positive community and academic experience.     

Rates and risk factors for sexual violence among an ethnically diverse sample of adolescents

OBJECTIVES: To investigate the occurrence of rape/attempted rape and verbal sexual coercion among an ethnically diverse adolescent population and to evaluate whether unique risk factors existed for victims of either type of forced sexual experience. DESIGN: Cross-sectional survey assessing sexual violence within the past 12 months, behaviors that occurred on each subject's most recent date, and the occurrence of unwanted sexual experiences on any dates in the past year and details about that date. Subjects identified as experiencing either rape/attempted rape or verbal sexual coercion were compared with nonvictims using bivariate and multivariate analyses. SETTING: Urban adolescent health care facility. PARTICIPANTS: Female adolescents and young adults (n = 689) between the ages of 14 and 23 years who presented for care and met the eligibility criteria. RESULTS: Approximately 30% of young women reported having an unwanted sexual experience in the past year. The risk of rape/attempted rape was increased by past mild to moderate (adjusted odds ratio [AOR] = 4.27) or severe (AOR = 15.24) physical aggression by the dating partner; date-specific behaviors, including decreased level of romantic involvement (AOR = 0.63 per point decline) and going to the perpetrator's house to be alone (AOR = 3.01); past sexual victimization as an adolescent (AOR = 4.70); and lower levels of self-reported ethnic identity (AOR = 1.07 per point decline). More important, alcohol use by the victim or perpetrator was unrelated to an increased risk of rape/attempted rape. The risk of verbal sexual coercion was increased by past mild to moderate (AOR = 4.38) or severe (AOR = 13.79) verbal aggression from the dating partner; date-specific behaviors, including decreased level of romantic involvement (AOR = 0.70 per point decline) and greater number of past dates (AOR = 7.53); going to the perpetrator's house to be alone (AOR = 3.52); past sexual victimization as an adolescent (AOR = 9.83); pressures to use alcohol (AOR = 9.49); the victim not drinking alcohol during the date (AOR = 14.38); and increasing age discrepancy between victim and perpetrator (AOR = 1.23 per year increase). CONCLUSIONS: Approximately 1 in 4 urban young women reported having experienced verbal sexual coercion or rape/attempted rape by a date or acquaintance in the past year. Distinct risk profiles for rape/attempted rape and verbal sexual coercion were identified when compared with those who did not report any victimization.     

Variables differentiating singly and multiply victimized youth: results from the National Survey of Adolescents and implications for secondary prevention

The authors examined variables differentiating singly and multiply victimized youth with a national household probability sample of 4,023 adolescents. Youth endorsing one episode (i.e., one incident or series of repeat incidents) of sexual or physical assault were classified as singly victimized (n = 435). Multiply victimized youth were those who endorsed multiple discrete episodes of sexual or physical assault and both sexual and physical assault (n = 396). For boys, heightened risk of multiple victimization was associated with family alcohol problems, Native American race, and earlier age at assault onset. For girls, increased multiple victimization risk was associated with family alcohol problems, older current age, and several characteristics of the initial assault episode-earlier age at onset, acquaintance perpetrator, chronicity, perceived life threat, and injury. Findings imply that secondary prevention programs may be strengthened by broadening risk-reduction strategies to address a greater range of victimization experiences. Additional implications for secondary prevention are discussed.     

At-risk and maltreated children exposed to intimate partner aggression/violence: what the conflict looks like and its relationship to child outcomes

Despite increasing research on children's exposure to intimate partner aggression/violence (IPAV), and co-occurrence of IPAV and maltreatment, little is known about IPAV in at-risk and maltreating families. We explored the nature of IPAV in 554 homes where children were identified as at risk or reported for maltreatment and examined differences between emotional and behavioral outcomes for children in homes where one or both intimate partners is the alleged perpetrator of IPAV. We found in this sample that IPAV primarily took the form of verbal aggression with differences in perpetrator gender for verbal, minor, and severe violence. There were few child outcomes predicted by perpetrator gender: Significant child behavior problems were found with all types of IPAV and both genders as perpetrators. Results suggest the need for comprehensive assessments of IPAV when assessing risk, safety, and harm issues for children reported as being at risk or victims of maltreatment.     

Predictors and severity of injury in assaults with barglasses and bottles

BACKGROUND: Although glasses and bottles are frequently used as weapons in assaults, there is little knowledge on which prevention strategies can be based. DESIGN: Scrutiny of a random sample of 1288 criminal injury compensation applications. OBJECTIVE: To identify predictors and relative severity of glass and bottle injury. METHOD: Injury site, severity, treatment, and demographic characteristics of victims and assailants were studied with reference to awards from the UK national Criminal Injuries Compensation Authority (CICA). MAIN OUTCOME MEASURES: Gender of victims and assailants, injury sites, treatment, and award (UK pounds) as indices of injury severity. RESULTS: Annual CICA awards to all victims of assaults in licensed premises during 1996-98 amounted to pound 4.08 million (for all glass/bottle assaults: pound 1.15 million = 28%). The mean cost of 746 glass assaults was pound 2347, compared with pound 2007 for 542 injuries from bottle assaults (mean difference pound 340; p<0.01). This difference largely reflected more eye injuries with glasses (26 cases: 3% of all glass assaults) than with bottles (eight cases: 1% of all bottle assaults). Bottle assault was significantly associated with unidentified assailants and scalp injuries; whereas glass injury was significantly linked to pub opening hours (midday to midnight), Thursdays, eye and face injuries, and treatment requiring sutures. Mean age of bottle assault victims (26.1 years) was lower than of glass victims (27.3 years; p<0.01), and same gender assaults were more frequent than between gender assaults for both bottle (p<0.001) and glass (p<0.001) assaults. Female victims were allocated to lower compensation awards more frequently than male victims; this was the case for both bottle (p<0.05) and glass (p<0.01) assaults. CONCLUSIONS: Assaults with bottles caused less serious injury and resulted in lower compensation costs. Injury distribution was linked to victim gender and weapon choice, but not to assailant gender. Prevention strategies should focus on both bottle and glass assaults and should take account of the setting and time in which drinking occurs.     

Premature sexual activity as an indicator of psychosocial risk

Although unprotected premature sexual activity is associated with well-defined biologic risks of sexually transmitted disease and pregnancy, the concomitant psychosocial risks are less well documented. The strength of association (odds ratio) of coital status with other risk behaviors and feelings was examined in 1504 junior high school students. Among the 12 through 16-year-old students, 63% of the boys and 36% of the girls were nonvirginal (had had intercourse at least once). The proportion of sexually experienced boys and girls increased with age. Nonvirginal boys and girls were significantly (P less than .001) more likely than their virginal cohorts to engage in other activities considered risky. The odds ratios for nonvirginal youth ranged from 3.5 for girls having used drugs other than alcohol or marijuana, to 10.4 for girls having used marijuana. Nonvirginal boys and girls were also at significantly greater risk for engaging in minor delinquent acts and having school problems. Nonvirginal girls (but not boys) were 6.3 times more likely to report having attempted suicide. The strength of associations with feelings was weaker. Nonvirginal girls were at slightly greater risk for reporting feeling lonely, feeling upset, and having difficulty sleeping. A significant proportion of the students reported sexual experience and ever use of alcohol or marijuana (45% of boys, 27% of girls). There were strong age effects so that by age 15 years, 63% of the boys and 50% of the girls reported experience with both activities. The data suggest that early sexual experience among adolescents is associated with other potentially health-endangering behaviors and that the syndrome of problem behaviors is important in this age group.     

Self‐reported violence amongst adolescents in Denmark: is alcohol a serious risk factor?

AIM: To describe the prevalence of adolescents' exposure to different types of violence (at home and outside the home) and associations between severe violence and alcohol consumption, taking account of gender and the influence of other factors. METHODS: A multimedia computer-based survey amongst a nationally representative sample of 9th grade pupils included comprehensive data on exposure to physical violence, use of alcohol and additional socio-demographic and behavioural factors. Analyses included gender disaggregated cross tabulations and logistic regressions. RESULTS: Around 9.3% of girls and 12.3% of boys reported being victims of physical violence within the last 12 months. Also, 2.7% of girls and 3.5% of boys reported severe violence. Gender differences existed in place of occurrence; girls were more frequently assaulted at home, boys outside the home. Alcohol was only associated with violence exposure outside the home for boys, not girls. CONCLUSIONS: About one-tenth of adolescents in Denmark reported exposure to any physical violence and 3% to severe violence during the last year. Alcohol consumption was not a risk factor for girls and only a risk factor for boys regarding violence occurring outside the home.     

Prevalence of child sex rings

Within a geographically defined population of 710,000, 31 child sex rings were identified by the police during a 2-year period. A total of 47 male perpetrators aged 16 to 82 years and 334 children aged 4 to 15 years were involved. The perpetrators usually operated alone or in pairs. Three rings were expanding and developing into semicommercial enterprises, however and four or more men participated in them. Children acting as ringleaders recruited victims for the perpetrator in 22 rings, usually in exchange for money. The offenses reported included fondling and masturbation (30 rings), oral, anal, or vaginal intercourse (21 rings), and production of child pornography (two rings). In addition, two adolescent prostitution rings involving 12- to 18-year-old boys were investigated by the police. During the 2-year period these sex rings accounted for 4.6% of all cases of child sexual abuse reported to the police and 6.6% of the subsequent prosecutions.     

Gut prolapse into the perineum in a case of sexual assault

A six-year-old female victim of sexual assault, with grade IV perineal injury with massive intestinal prolapse out of the perineum, is reported to highlight the severity of injury during sexual assaults.     

Intimate partner abuse and high-risk behavior in adolescents

OBJECTIVES: To determine the associations between abuse by an intimate partner and risk behaviors among adolescents and to determine whether these associations vary by gender. DESIGN AND PARTICIPANTS: Ordinal and linear regression analyses of 1996 cross-sectional data from 4347 adolescents surveyed for wave 2 of the National Longitudinal Study of Adolescent Health public use data set. MAIN OUTCOME MEASURES: A 5-point scale was used to measure whether the adolescent had been the victim of any of the following behaviors by an intimate partner: insulted in public, sworn at, threatened with violence, or had something thrown at them. Risk behavior involvement was determined using 5 measures: substance use, antisocial behavior, violent behavior, suicidal behavior, and depressed mood. RESULTS: There was no significant difference in the frequency of abuse by an intimate partner for males (21.0%) vs females (22.1%). In females, after adjusting for sociodemographic factors and number of intimate partners, a history of abuse was significantly associated with substance use (values given as beta, 99% confidence interval) (0.87, 0.51-1.23), antisocial behavior (0.15, 0.10-0.20), violent behavior (0.06, 0.01-0.11), depressed mood (1.82, 1.21-2.43), and suicidal behavior (odds ratio, 1.37, 1.14-1.63). In males, abuse was independently associated with antisocial behavior (0.11, 0.03-0.19), violent behavior (0.09, 0.04-0.14), and depressed mood (1.29, 0.53-2.06). Abuse by an intimate partner had a significantly stronger association with substance use in females (0.87, 0.51-1.23) vs males (0.34, -0.09 to 0.77). CONCLUSIONS: Abuse by an intimate partner is common among adolescents and has strong associations with risk behaviors among male and female victims of abuse.     

Adolescent femicide: a population-based study

BACKGROUND: Homicide is the third leading cause of deaths for girls aged 11 to 14 years and the second leading cause of death for girls aged 15 to 18 years. However, few studies examine the contextual issues of adolescent femicide, especially among 11- to 14-year-old victims. OBJECTIVES: To obtain quantitative and contextual information about adolescent femicide, and to compare the context of femicide in younger vs older adolescents. METHODS: Data from the North Carolina medical examiner were analyzed for all 11- to 18-year-old female homicide victims during 1990 to 1995. Police interviews were conducted for 1993 to 1995 cases to determine context, the relationship of victim and perpetrator, and criminal histories. RESULTS: There were 90 victims; 63 were aged 15 to 18 years, 55 were killed with firearms, and 40 were behind in school. Of 37 femicides for which law enforcement interviews were conducted, the most common contexts were altercation (n = 9), broken or desired relationship (n = 8), reckless behavior with a firearm (n = 6), retaliation (n = 5), and drug related (n = 3). Most perpetrators were men (89%; n = 33), were older than their victims (mean age difference, 8 years), and had criminal records (59%; n = 21). Seventy-eight percent of victims (n = 29) were killed by an acquaintance or intimate partner. CONCLUSIONS: Femicide contexts differed by age. Younger adolescents (aged 11-14 years) were more likely to be killed by a family member in the context of an argument than by an intimate partner or acquaintance in the context of a broken relationship or reckless behavior with a firearm. Many victims were engaged in high-risk behaviors, including dropping out of school, running away from home, using drugs, and dating much older men with criminal records. Intervention specialists targeting high-risk female adolescents should be aware that this population may also be at increased risk of femicide.     

Depressive symptomatology as a predictor of exposure to intimate partner violence among US female adolescents and young adults

OBJECTIVE: To examine whether depressive symptomatology is predictive of subsequent intimate partner violence victimization among a national prospective sample of female adolescents and young adults. DESIGN: Home interview data from 2 waves of the school-based National Longitudinal Study of Adolescent Health were used to examine whether baseline depressive symptomatology was associated with increased risk of past-year exposure to physical abuse by a current partner at 5-year follow-up, controlling for age, race/ethnicity, parental education, retrospective childhood physical and sexual abuse, and baseline dating violence and forced sex. SETTING: A stratified random sample of 80 US high schools and 52 middle schools. PARTICIPANTS: All young women (n = 1659) were in a current opposite-sex relationship at follow-up. MAIN EXPOSURE: Baseline past-week depressive symptomatology, measured as both a dichotomous and continuous variable. MAIN OUTCOME MEASURES: Past-year exposure to mild and moderate to severe physical abuse by a current intimate partner. RESULTS: In adjusted models with dichotomous depressive symptoms, high baseline symptom levels were associated with 1.86 times the odds of subsequent exposure to moderate to severe partner violence (95% confidence interval, 1.05-3.29). In adjusted models with continuous depressive symptoms, an increase of 1 SD in baseline symptom levels was associated with a 24% increase in odds of exposure to mild partner violence and a 24% increase in the odds of exposure to moderate to severe partner violence. CONCLUSIONS: The findings of this study suggest that depressive symptomatology among girls during adolescence is associated with increased risk of subsequent exposure to physical partner violence. Prevention, identification, and treatment of depressive symptomatology among adolescent girls may help to reduce the likelihood of subsequent victimization.     

Practitioner Review: The victims and juvenile perpetrators of child sexual abuse – assessment and intervention

Background: The assessment of victims of child sexual abuse (CSA) is now a recognized aspect of clinical work for both CAMH and adult services. As juvenile perpetrators of CSA are responsible for a significant minority of the sexual assaults on other children, CAMH services are increasingly approached to assess these oversexualized younger children or sexually abusive adolescents. A developmental approach to assessment and treatment intervention is essential in all these cases. Method: This review examines research on the characteristics of child victims and perpetrators of CSA. It describes evidence‐based approaches to assessment and treatment of both groups of children. A selective review of MEDLINE, Psycinfo, Cochrane Library, and other databases was undertaken. Recommendations are made for clinical practice and future research. Findings: The characteristics of CSA victims are well known and those of juvenile perpetrators of sexual abuse are becoming recognized. Assessment approaches for both groups of children should be delivered within a safeguarding context where risk to victims is minimized. Risk assessment instruments should be used only as adjuncts to a full clinical assessment. Given high levels of psychiatric comorbidity, assessment, treatment, and other interventions should be undertaken by mental health trained staff. Conclusions: Victims and perpetrators of CSA present challenges and opportunities for professional intervention. Their complex presentations mean that their needs should be met by highly trained staff. However, their youth and developmental immaturity also give an opportunity to nip problem symptoms and behaviors in the bud. The key is in the earliest possible intervention with both groups. Future research should focus on long‐term adult outcomes for both child victims and children who perpetrate CSA. Adult outcomes of treated children could identify problems and/or strengths in parenting the next generation and also the persistence and/or desistence of sexualized or abusive behavior.     

Des violences sexuelles,ou de l’impératif catégorique moral et épistémologique de ne plus recourir au vocable d’abus sexuel

In a manner of chronicle of vendean psychiatric life, this article constitutes a testimony in the form of a conclusion of a clinical experience of twelve intense, exciting and often painful years, which nothing had predisposed us to go through. Practicing in infant and juvenile psychiatry at the time, the ethical duty to improve our therapeutic care for victims of sexual assault prompted us to also create care systems for major and minor perpetrators of sexual violence. We have reported in various articles the modalities and effects, illustrated by many clinical cases. In this one, we would like to sensitize the professionals of health, justice, medicosocial, and others to the need to apprehend this problematic with rigor and seriousness by not giving in to the ease of language, which turns out to be counterproductive for the care of victims and perpetrators: that it is no longer possible, to say it clearly, to designate any act of aggression falling within the field of sexual by the French concept of “abus”.