Child sexual abuse

From Wikipedia, the free encyclopedia

Child sexual abuse is a form of child abuse in which an adult or older adolescent uses a child for sexual stimulation.[1][2] In addition to direct sexual contact, child sexual abuse also occurs when an adult exposes their genitals to a child, asks or pressures a child to engage in sexual activities, displays child pornography to a child, or uses a child to produce child pornography.[3][1][4]

Effects of child sexual abuse include depression,[5] post-traumatic stress disorder,[6] anxiety,[7] propensity to re-victimization in adulthood,[8] and physical injury to the child, among other problems.[9] Sexual abuse by a family member is a form of incest, and can result in more serious and long-term psychological trauma, especially in the case of parental incest.[10]

Approximately 20% to 25% of women and 5% to 15% of men were sexually abused when they were children.[11][12][13][14][15] Most sexual abuse offenders are acquainted with their victims; approximately 30% are relatives of the child, most often fathers, uncles or cousins; around 60% are other acquaintances such as friends of the family, babysitters, or neighbors; strangers are the offenders in approximately 10% of child sexual abuse cases. Most child sexual abuse is committed by men; women commit approximately 14% of offenses reported against boys and 6% of offenses reported against girls.[11] Most child sexual abuse offenders are pedophiles[16] although some child sexual abuse is committed by individuals who do not meet the diagnostic criteria for pedophilia.[17]

Under the law, "child sexual abuse" is an umbrella term describing criminal and civil offenses in which an adult engages in sexual activity with a minor or exploits a minor for the purpose of sexual gratification.[18][4] The American Psychiatric Association states that "children cannot consent to sexual activity with adults",[19][20] and condemns any such action: "An adult who engages in sexual activity with a child is performing a criminal and immoral act which never can be considered normal or socially acceptable behavior."[19]

Contents

[edit] Effects

[edit] Psychological harm

Child sexual abuse can result in both short-term and long-term harm, including psychopathology in later life.[9][21] Psychological, emotional, physical, and social effects include depression,[5][22][23] post-traumatic stress disorder,[6][24] anxiety,[7] poor self-esteem, dissociative and anxiety disorders; general psychological distress and disorders such as somatization, neurosis, chronic pain,[23]sexualized behavior,[25] school/learning problems; and behavior problems including substance abuse,[26] destructive behavior, criminality in adulthood and suicide. [27][28][29][30][11][31] A specific characteristic pattern of symptoms has not been identified[32] and there are several hypotheses on the causality of these associations.[5][33][34]

Long term negative effects on development leading to re-victimization in adulthood are also associated with child sexual abuse.[8][26] Studies have established a causal relationship between childhood sexual abuse and certain specific areas of adult psychopathology, including suicidality, antisocial behavior, PTSD, anxiety and alcoholism.[35] Adults with a history of abuse as a child, especially sexual abuse, are more likely than people with no history of abuse to become frequent users of emergency and medical care services[23] A study comparing middle-aged women who were abused as children with non-abused counterparts found significantly higher health care costs for the former.[36]

Sexually abused children suffer from more psychological symptoms than children who have not been abused; studies have found symptoms in 51% to 79% of sexually abused children.[37][38][39][40][29] Children may develop symptoms of posttraumatic stress disorder resulting from child sexual abuse, even without actual or threatened injury or violence.[41]

The risk of harm is greater if the abuser is a relative, if the abuse involves intercourse or attempted intercourse, or if threats or force are used.[42] The level of harm may also be affected by various factors such as penetration, duration and frequency of abuse, and use of force.[43][44][9][21] The social stigma of child sexual abuse may compound the psychological harm to children,[45][46] and adverse outcomes are less likely for abused children who have supportive family environments.[47][48].

Child abuse, including sexual abuse, especially chronic abuse starting at early ages, has been found to be related to the development of high levels of dissociative symptoms, which includes amnesia for abuse memories.[49] The level of dissociation has been found to be related to reported overwhelming sexual and physical abuse.[50] When severe sexual abuse (penetration, several perpetrators, lasting more than one year) had occurred, dissociative symptoms were even more prominent.[50]

Young children who are abused sexually by adult females may incur double traumatization due to the widespread denial of female-perpetrated child sexual abuse by non-abusing parents, professional caregivers and the general public.[51] Turner and Maryanski in Incest: Origins of the Taboo (2005), suggest that mother-son incest causes the most serious damage to children in comparison to mother-daughter, father-daughter and father-son child incest. Crawford asserts that our socially repressed view of female and maternal sexuality conceals both the reality of female sexual pathologies and the damage done by female sexual abuse to children.[52]

[edit] Research factors

Because child sexual abuse often occurs alongside other possibly confounding variables, such as poor family environment and physical abuse,[53] some scholars argue it is important to control for those variables in studies which measure the effects of sexual abuse.[21][33][54][55] In a 1998 review of related literature, Martin and Fleming, state "The hypothesis advanced in this paper is that, in most cases, the fundamental damage inflicted by child sexual abuse is due to the child's developing capacities for trust, intimacy, agency and sexuality, and that many of the mental health problems of adult life associated with histories of child sexual abuse are second-order effects."[56] Other studies have found an independent association of child sexual abuse with adverse psychological outcomes.[33][21][7]

Kendler et al. (2000) found that most of the relationship between severe forms of child sexual abuse and adult psychopathology in their sample could not be explained by family discord, because the effect size of this association decreased only slightly after they controlled for possible confounding variables. Their examination of a small sample of CSA-discordant twins also supported a causal link between child sexual abuse and adult psychopathology; the CSA-exposed subjects had a consistently higher risk for psychopathologic disorders than their CSA non-exposed twins.[33] After controlling for possible confounding variables, Widom (1999) found that child sexual abuse independently predicts the number of symptoms for PTSD a person displays. 37.5% of their sexually abused subjects, 32.7% of their physically abused subjects, and 20.4% of their control group met the criteria for a diagnosis of PTSD. The authors concluded, "Victims of child abuse (sexual and physical) and neglect are at increased risk for developing PTSD, but childhood victimization is not a sufficient condition. Family, individual, and lifestyle variables also place individuals at risk and contribute to the symptoms of PTSD." The same study reported that "sexual abuse, perhaps more than other forms of childhood trauma, leads to dissociative problems" and that "these PTSD findings represent only part of the picture of the long-term psychiatric sequelae associated with early childhood victimization ... antisocial personality disorder, alcohol abuse, and other forms of psychopathology."[6]

A 1998 meta-analysis by Rind et al generated controversy by suggesting that child sexual abuse does not always cause pervasive harm; that some college students reported such encounters as positive experiences; and that the extent of psychological damage depends on whether or not the child described the encounter as "consensual." [57] The study was criticized in published reviews by scientists for flawed methodology and conclusions,[58][59][60][61] though it's publication by peer-review has been tacitly or implicitly defended.[62][63][64] Following extensive publicity, the US Congress condemned the study for its conclusions and for providing material used by pedophile organizations to justify their activities.[65] Russell (1999) speculated that the perception of a sexually abusive event as 'positive' could stem from a mechanism for coping with traumatic experiences, a form of rationalization.[66]

[edit] Physical harm

[edit] Infections and injury

Depending on the age and size of the child, and the degree of force used, child sexual abuse may cause infections, sexually transmitted diseases,[67] or internal lacerations. In severe cases, damage to internal organs may occur, which, in some cases, may cause death.[68] Herman-Giddens et.al. found six certain and six probable cases of death due to child sexual abuse in North Carolina between 1985-1994. The victims ranged in age from 2 months to 10 years. Causes of death included trauma to the genitalia or rectum and sexual mutilation.[69] Vaginitis has also been reported.[67]

[edit] Neurological damage

Research has shown that traumatic stress, including stress caused by sexual abuse, causes notable changes in brain functioning and development.[70][71] Various studies have suggested that severe child sexual abuse may have a deleterious effect on brain development. Ito et al. (1998) found "reversed hemispheric asymmetry and greater left hemisphere coherence in abused subjects;"[72] Teicher et al. (1993) found that an increased likelihood of "ictal temporal lobe epilepsy-like symptoms" in abused subjects;[73] Anderson et al. (2002) recorded abnormal transverse relaxation time in the cerebellar vermis of adults sexually abused in childhood;[74] Teicher et al. (1993) found that child sexual abuse was associated with a reduced corpus callosum area; various studies have found an association of reduced volume of the left hippocampus with child sexual abuse;[75] and Ito et al. (1993) found increased electrophysiological abnormalities in sexually abused children.[76]

Some studies indicate that sexual or physical abuse in children can lead to the overexcitation of an undeveloped limbic system.[75] Teicher et al. (1993)[73] used the "Limbic System Checklist-33" to measure ictal temporal lobe epilepsy-like symptoms in 253 adults. Reports of child sexual abuse were associated with a 49% increase to LSCL-33 scores, 11% higher than the associated increase of self-reported physical abuse. Reports of both physical and sexual abuse were associated with a 113% increase. Male and female victims were similarly affected.[73][77]

King et al. (2001), studying 5 to 7 year old girls who had been abused within the last two months, found victims of early sexual abuse had significantly lower cortisol levels than control subjects.[78] Victims of severe childhood abuse who suffer from PTSD have been found to have increased cortisol levels.[79]

Navalta et al. (2006) found that the self-reported math Scholastic Aptitude Test scores of their sample of women with a history of repeated child sexual abuse were significantly lower than the self-reported math SAT scores of their non-abused sample. Because the abused subjects verbal SAT scores were high, they hypothesized that the low math SAT scores could "stem from a defect in hemispheric integration." They also found a strong association between short term memory impairments for all categories tested (verbal, visual, and global) and the duration of the abuse.[80]

[edit] Prevalence

Child sexual abuse occurs frequently in Western society.[81] Prevalence estimates range between 10% in the UK[82] and up to 62% for females and 16% for males in the United States.[83][84] The US Department of Health and Human Services reported 83,600 substantiated reports of sexually abused children in 2005.[85][86] The total number of incidents that were not reported is even larger.[87]

Surveys have shown that one fifth to one third of all women reported some sort of childhood sexual experience with a male adult.[88] Based on a literature review of 23 studies, Goldman & Padayachi found that the prevalence of child sexual abuse varied between 7-62% for girls and 4-30% for boys.[89] A 1992 survey studying father-daughter incest in Finland reported that of the 9,000 15-year old high school girls who filled out the questionnaires, of the girls living with their biological fathers, 0.2% reported father-daughter incest experiences; of the girls living with a stepfather, 3.7% reported sexual experiences with him. The reported counts included only father-daughter incest and did not include prevalence of other forms of child sexual abuse. The survey summary stated, "the feelings of the girls about their incestual experiences are overwhelmingly negative."[90] Others argue that prevalence rates are much higher, and that many cases of child abuse are never reported. One study found that professionals failed to report approximately 40% of the child sexual abuse cases they encountered[91] A study by Lawson & Chaffin indicated that many children who were sexually abused were "identified solely by a physical complaint that was later diagnosed as a venereal disease...Only 43% of the children who were diagnosed with venereal disease made a verbal disclosure of sexual abuse during the initial interview."[92] It has been found in the epidemiological literature on CSA that there is no identifiable demographic or family characteristic of a child that can be used to bar the prospect that a child has been sexually abused.[83]

In US schools, according to the US Department of Education.[93], "nearly 9.6% of students are targets of educator sexual misconduct sometime during their school career." In studies of student sex abuse by male and female educators, male students were reported as targets in ranges from 23% to 44%.[93] In U.S. school settings same-sex (female and male) sexual misconduct against students by educators "ranges from 18-28% or reported cases, depending on the study"[94]

Significant underreporting of sexual abuse of boys by both women and men is believed to occur due to sex stereotyping, social denial, the minimization of male victimization, and the relative lack of research on sexual abuse of boys.[95] Sexual victimization of boys by their mothers or other female relatives is especially rarely researched or reported. Sexual abuse of girls by their mothers, and other related and/or unrelated adult females is beginning to be researched and reported despite the highly taboo nature of female-female child sex abuse. In studies where students are asked about sex offenses, they report higher levels of female sex offenders than found in adult reports.[96] This under-reporting has been attributed to cultural denial of female-perpetrated child sex abuse,[97] because "males have been socialized to believe they should be flattered or appreciative of sexual interest from a female"[98] and because female sexual abuse of males is often seen as 'desirable' and/or beneficial by judges, mass media pundits and other authorities.[99]

The prevalence of child sexual abuse in Africa is compounded by a belief that sexual intercourse with a virgin will cure a man of HIV or AIDS. This belief is especially common in South Africa, which has the highest number of HIV-positive citizens in the world. According to official figures, one in eight South Africans are infected with the virus.[100] Eastern Cape social worker Edith Kriel notes that "child abusers are often relatives of their victims - even their fathers and providers."[101] More than 67,000 cases of sexual assaults against children were reported in 2000 in South Africa. Child welfare groups believe that the number of unreported incidents could be up to 10 times that number.[101] Researcher Suzanne Leclerc-Madlala states that the myth that sex with a virgin is a cure for AIDS is not confined to South Africa: "Fellow AIDS researchers in Zambia, Zimbabwe and Nigeria have told me that the myth also exists in these countries and that it is being blamed for the high rate of sexual abuse against young children."[102]

In one survey, 2.5% of Taiwenese adolescents report having experienced childhood sexual abuse.[103]

[edit] Incest

Main article: Incest

Incest between a child or adolescent and a related adult has been identified as the most widespread form of child sexual abuse with a huge capacity for damage to a child. [10] 70% of all perpetrators of sexual abuse are related to their victim. [104] Child sexual abuse offenses where the perpetrator is related to the child, either by blood or marriage, is a form of incest described as intrafamilial child sexual abuse.[105]

The most-often reported form of incest is father-daughter and stepfather-daughter incest, with most of the remaining reports consisting of mother/stepmother-daughter/son incest.[106] Father-son incest is reported less often, however it is not known if the prevalence is less, because it is under-reported by a greater margin.[107][108] Prevalence of parental child sexual abuse is difficult to assess due to secrecy and privacy; some estimates show 20 million Americans have been victimized by parental incest as children.[106]

[edit] Types of child sexual assault

Child sexual abuse includes a variety of sexual offenses, including:

  • sexual assault – a term defining offenses in which an adult touches a minor for the purpose of sexual gratification; for example, rape (including sodomy), and sexual penetration with an object.[109] Most U.S. states include, in their definitions of sexual assault, any penetrative contact of a minor’s body, however slight, if the contact is performed for the purpose of sexual gratification.[110]
  • sexual molestation – a term defining offenses in which an adult engages in non-penetrative activity with a minor for the purpose of sexual gratification; for example, exposing a minor to pornography or to the sexual acts of others.[111]
  • sexual exploitation – a term defining offenses in which an adult victimizes a minor for advancement, sexual gratification, or profit; for example, prostituting a child,[112] and creating or trafficking in child pornography.[113]
  • sexual grooming - defines the social conduct of a potential child sex offender who seeks to make a minor more accepting of their advances, for example in an online chat room[114]

[edit] Disclosure

Children who received supportive responses following disclosure had less traumatic symptoms and were abused for a shorter period of time than children who did not receive support [115][116] In general, studies have found that children need support and stress-reducing resources after disclosure of sexual abuse [117] [118] Negative social reactions to disclosure have actually been found to be harmful to the survivor’s wellbeing [119] One study reported that children who received a bad reaction from the first person they told, especially if the person was a close family member, had worse scores as adults on general trauma symptoms, posttraumatic stress disorder symptoms, and dissociation [120] Another study found that in most cases when children did disclose abuse, the person they talked to did not respond effectively, blamed or rejected the child, and took little or no action to stop the abuse [118] Although hearing a victim’s disclosure might be uncomfortable, for the sake of the victim’s wellbeing, it is important to be able to respond effectively. Showing that you understand and take seriously what the child is saying is an important first step. The American Academy of Child and Adolescent Psychiatry provides guidelines for what to say to the victim and what to do following the disclosure [121]

[edit] Pedophilia

Main article: Pedophilia

The term "pedophilia" refers to persistent feelings of attraction in an adult or older adolescent toward prepubescent children, whether the attraction is acted upon or not.[122][123][124] A person with this attraction is called a "pedophile".[125]

According to the Mayo Clinic, approximately 95% of child sexual abuse incidents are committed by the 88% of child molestation offenders who meet the diagnostic criteria for pedophilia;[126] and pedophilic child molestors commit ten times more sexual acts against children than non-pedophilic child molestors.[126] On the other hand, papers by Okami and Goldberg (1992), and Kevin Howells (1981), state that most data they had reviewed suggest that pedophiles make up a minority of incarcerated child sex offenders.[127][128]

In law enforcement, the term "pedophile" is generally used to describe those accused or convicted of child sexual abuse under sociolegal definitions of child (including both prepubescent children and adolescents younger than the local age of consent);[16] however, not all child sexual offenders are pedophiles and not all pedophiles engage in sexual abuse of children.[129][130][17] Law enforcement and legal professionals have begun to use the term predatory pedophile,[131] a phrase coined by children's attorney Andrew Vachss, to refer specifically to pedophiles who engage in sexual activity with minors.[132] The term emphasizes that child sexual abuse consists of conduct chosen by the perpetrator.[133]

[edit] Offenders

[edit] Adult offenders

[edit] Demographics

Offenders are more likely to be relatives or acquaintances of their victim than strangers.[134] A 2006-2007 Idaho study of 430 cases found that 82% of juvenile sex offenders were known to the victims (acquaintances 46% or relatives 36%).[135] [136]

More offenders are male than female, though the percentage varies between studies. The percentage of incidents of sexual abuse by female perpetrators that come to the attention of the legal system is usually reported to be between 1% and 4%.[137] Studies of sexual misconduct in US schools with female offenders have shown mixed results with rates between 4% to 43% of female offenders.[98] Maletzky (1993) found that, of his sample of 4,402 convicted pedophilic offenders, 0.4% were female.[138] Another study of a non-clinical population found that, among those in the their sample that had been molested, as much as a third were molested by women.[139]

In U.S. schools, educators who offend range in age from "21 to 75 years old, with an average age of 28" with teachers, coaches, substitute teachers, bus drivers and teacher's aides (in that order) totaling 69% of the offenders.[140]

[edit] Psychological Aspects

Offenses may be facilitated by cognitive distortions of the offender, such as minimization of the abuse, victim blaming, and excuses.[141]

Early research in the 1970s and 80s began to classify offenders based on their motivations and traits. Groth and Birnbaum (1978) categorized child sexual offenders into two groups, "fixated" and "regressed."[142] Fixated were described as having an primary attraction to children, whereas regressed had largely maintained relationships with other adults, and were even married. This study also showed that adult sexual orientation was not related to the sex of the victim targeted, e.g. men who molested boys had previously had adult heterosexual relationships.[142]

Later work (Holmes and Holmes, 2002) expanded on the types of offenders and their psychological profiles. They are divided thus[143]:

  • Situational - does not prefer children, but offend under certain conditions.
    • Regressed - Typically has relationships with adults, but a stressor causes them to seek children as a substitute.
    • Morally Indiscriminate - All-around sexual deviant, who may commit other sexual offenses unrelated to children.
    • Naive/Inadequate - Often mentally disabled in some way, finds children less threatening.
  • Preferential - has true sexual interest in children.
    • Mysoped - Sadistic and violent, target strangers more often than acquaintances.
    • Fixated - Little or no activity with own age, described as a "overgrown child."

[edit] Child and young adolescent offenders

Main article: Child-on-child sexual abuse

When a prepubescent child is sexually abused by one or more other children or adolescent youths, and no adult is directly involved, it is defined as child-on-child sexual abuse. The definition includes any sexual activity between children that occurs without consent, without equality, or as a result of coercion,[144] whether the offender uses physical force, threats, trickery or emotional manipulation to compel cooperation. When sexual abuse is perpetrated by one sibling upon another, it is known as "intersibling abuse", a form of incest. [145]

[edit] International law

Main article: Laws regarding child sexual abuse

Child sexual abuse is outlawed in every developed country, generally with severe criminal penalties, including in some jurisdictions, life imprisonment or capital punishment.[146][147] An adult's sexual intercourse with a child below the legal age of consent is defined as statutory rape,[148] based on the principle that a child is not capable of consent and that any apparent consent by a child is not considered to be legal consent.

One hundred forty nations are signatories to the United Nations Convention on the Rights of the Child. This international treaty defines a set of protections which signatories agree to provide for the children of their respective countries.[149] Articles 34 and 35 require that signatories protect their nations’ children from all forms of sexual exploitation and sexual abuse. This includes outlawing the coercion of a child to perform sexual activity, the prostitution of children, and the exploitation of children in creating pornography. Signatories also agree to prevent abduction, sale, or trafficking of children.[150]

[edit] History

Child sexual abuse has gained public attention in the past few decades and has become one of the most high-profile crimes. Since the 1970s the sexual abuse of children and child molestation has increasingly been recognized as deeply damaging to children and thus unacceptable for society as a whole. While sexual use of children by adults has been present throughout history, it has only become the object of significant public attention in recent times.

[edit] Early writings

The first published work dedicated specifically to child sexual abuse appeared in France in 1857: Medical-Legal Studies of Sexual Assault (Etude Médico-Légale sur les Attentats aux Mœurs), by Auguste Ambroise Tardieu, the noted French pathologist and pioneer of forensic medicine (Masson, 1984, pp. 15-25).

[edit] The rise of public concern

Child sexual abuse became a public issue in the 1970s and 1980s. Prior to this point in time sexual abuse remained rather secretive and socially unspeakable. Studies on child molestation were nonexistent until the 1920s and the first national estimate of the number of child sexual abuse cases was published in 1948. By 1968 forty four states had enacted mandatory laws that required physicians to report cases of suspicious child abuse. Legal action began to become more prevalent in the 1970s with the enactment of the Child Abuse and Treatment Act in 1974 in conjunction with the creation of the National Center for Child Abuse and Neglect. Since the creation of the Child Abuse and Treatment Act, reported child abuse cases have increased dramatically. Finally, the National Abuse Coalition was created in 1979 to create pressure in congress to create more sexual abuse laws.

Second wave feminism brought greater awareness of child sexual abuse and violence against women, and made them public, political issues. Judith Lewis Herman, Harvard professor of psychiatry, wrote the first book ever on father-daughter incest when she discovered during her medical residency that a large number of the women she was seeing had been victims of father-daughter incest. Herman notes that her approach to her clinical experience grew out of her involvement in the civil rights movement. [151] Her second book Trauma and Recovery, considered a classic and ground-breaking work[152][153] coined the term complex post-traumatic stress disorder[154]." In it she defines this concept not only in terms of prolonged trauma, but in terms of what she calls "subjection to totalitarian control." Examples of this concept include:

...hostages, prisoners of war, concentration-camp survivors, and survivors of some religious cults. Examples also include those subjected to totalitarian systems in sexual and domestic life, including survivors of domestic battering, childhood physical or sexual abuse, and organized sexual exploitation.[155]

In 1986, Congress passed the Child Abuse Victims' Rights Act, giving children a civil claim in sexual abuse cases. The number of laws created in the 1980s and 1990s began to create greater prosecution and detection of child sexual abusers. During the 1970s a large transition began in the legislature related to child sexual abuse. Megan's Law which was enacted in 2004 gives the public access to knowledge of sex offenders nationwide.[156]

Anne Hastings described these changes in attitudes towards child sexual abuse as "the beginning of one history's largest social revolutions."[157]

According to John Jay College of Criminal Justice professor B.J. Cling,

"By the early 21st century, the issue of child sexual abuse has become a legitimate focus of professional attention, while increasingly separated from second wave feminism...As child sexual abuse becomes absorbed into the larger field of interpersonal trauma studies, child sexual abuse studies and intervention strategies have become degendered and largely unaware of their political origins in modern feminism and other vibrant political movements of the 1970s. One may hope that unlike in the past, this rediscovery of child sexual abuse that began in the 70s will not again be followed by collective amnesia. The institutionalization of child maltreatment interventions in federally funded centers, national and international societies, and a host of research studies (in which the United States continues to lead the world) offers grounds for cautious optimism. Nevertheless, as Judith Herman argues cogently, 'The systematic study of psychological trauma...depends on the support of a political movement.'" [158]

[edit] See also

[edit] Notes

  1. ^ a b Child Sexual Abuse. Medline Plus. U.S. National Library of Medicine, (02 April 2008).
  2. ^ Committee on Professional Practice and Standards (COPPS), Board of Professional Affairs (BPA), American Psychological Association (APA); Catherine Acuff, Ph.D.; Steven Bisbing, Ph.D.; Michael Gottlieb, Ph.D.; Lisa Grossman, Ph.D.; Jody Porter, Ph.D.; Richard Reichbart, Ph.D.; Steven Sparta, Ph.D.; and C. Eugene Walker, Ph.D (August 1999). "Guidelines for Psychological Evaluations in Child Protection Matters". American Psychologist 54 (8): 586–593. doi:10.1037/0003-066X.54.8.586. Lay summary – APA PsycNET (2008-05-07). “Abuse, sexual (child): generally defined as contacts between a child and an adult or other person significantly older or in a position of power or control over the child, where the child is being used for sexual stimulation of the adult or other person.” 
  3. ^ Martin, J., Anderson, J., Romans, S., et al (1993). Asking about child sexual abuse: methodological implications of a two-stage survey, Child Abuse and Neglect, 17, 383-392.
  4. ^ a b Child sexual abuse definition from the NSPCC
  5. ^ a b c Roosa M.W., Reinholtz C., Angelini P.J. (1999). "The relation of child sexual abuse and depression in young women: comparisons across four ethnic groups," Journal of Abnormal Child Psychology 27(1):65-76.
  6. ^ a b c Widom C.S. (1999). "Posttraumatic stress disorder in abused and neglected children grown up," American Journal of Psychiatry; 156(8):1223-1229.
  7. ^ a b c Levitan, R. D., N. A. Rector, Sheldon, T., & Goering, P. (2003). "Childhood adversities associated with major depression and/or anxiety disorders in a community sample of Ontario: Issues of co-morbidity and specificity," Depression & Anxiety; 17, 34-42.
  8. ^ a b Terri L. Messman-Moore & Patricia J. Long, "Child Sexual Abuse and Revictimization in the Form of Adult Sexual Abuse, Adult Physical Abuse, and Adult Psychological Maltreatment," 15 Journal of Interpersonal Violence 489 (2000).
  9. ^ a b c Dinwiddie S, Heath AC, Dunne MP, et al (2000). "Early sexual abuse and lifetime psychopathology: a co-twin-control study." Psychological Medicine, 30:41–52
  10. ^ a b Courtois, Christine A. (1988). Healing the Incest Wound: Adult Survivors in Therapy. W. W. Norton & Company, p208. ISBN 0393313565. 
  11. ^ a b c Julia Whealin, Ph.D. (May 22, 2007). Child Sexual Abuse. National Center for Posttraumatic Stress Disorder, US Department of Veterans Affairs.
  12. ^ David Finkelhor (summer/fall 1994). "Current Information on the Scope and Nature of Child Sexual Abuse". The Future of Children (1994) 4(2): 31-53. 
  13. ^ Crimes against Children Research Center
  14. ^ Family Research Laboratory
  15. ^ Kevin M. Gorey and Donald R. Leslie (1997). "The prevalence of child sexual abuse: Integrative review adjustment for potential response and measurement biases". Child Abuse & Neglect Volume 21, Issue 4, April 1997: pp391–398. Elsevier Science Ltd.. doi:10.1016/S0145-2134(96)00180-9. 
  16. ^ a b Ames, A. & Houston, D. A. (1990). ]http://www.springerlink.com/content/g8g66p6370731x85/ Legal, social, and biological definitions of pedophilia.] Archives of Sexual Behavior. 19 (4), 333-342.
  17. ^ a b Laws, Dr. Richard; William T. O'Donohue (1997). Sexual Deviance: Theory, Assessment, and Treatment. Guilford Press, p175-193. ISBN 1572302410. 
  18. ^ The Sexual Exploitation of Children, Chart 1: Definitions of Terms Associated With the Sexual Exploitation (SEC) and Commercial Sexual Exploitation of Children (CSEC) (p. 4), University of Pennsylvania Center for Youth Policy Studies, U.S. National Institute of Justice, August 2001.
  19. ^ a b Leadership Council - APA Statement on Child Sexual Abuse
  20. ^ APA Letter to the Honorable Rep. DeLay (R-Tx.)
  21. ^ a b c d Nelson EC, Heath AC, Madden PA, et al (2002). "Association between self-reported childhood sexual abuse and adverse psychosocial outcomes: results from a twin study.," Archives of General Psychiatry, 59:139–145
  22. ^ Widom, S.; Dumont K., Czaja, S. (2007). "A Prospective Investigation of Major Depressive Disorder and Comorbidity in Abused and Neglected Children Grown Up". Archives of General Psychiatry 64 (1): 49. doi:10.1001/archpsyc.64.1.49. PMID 17199054. ; lay summary
  23. ^ a b c Arnow, B. (2004). "Relationships between childhood maltreatment, adult health and psychiatric outcomes, and medical utilization.". Journal of Clinical Psychiatry 65 (Suppl 12:10-5.). PMID 15315472. 
  24. ^ Joan Arehart-Treichel (August 5, 2005). "Dissociation Often Precedes PTSD In Sexually Abused Childre". Psychiatric News Volume 40 Number 15: p. 34. American Psychiatric Association. 
  25. ^ Faller, Kathleen C. (1993). Child Sexual Abuse: Intervention and Treatment Issues. Diane Publishing, p6. ISBN 078811669X. 
  26. ^ a b "Long-term correlates of child sexual abuse: Theory and review of the empirical literature" . Applied and Preventive Psychology Volume 4, Issue 3, Summer 1995, Pages 143-166. Elsevier Ltd.. 
  27. ^ Freyd, J.J., Putnam, F.W., Lyon, T.D., Becker-Blease, K. A., Cheit, R.E., Siegel, N.B., & Pezdek, K. (2005). "The science of child sexual abuse". Science 308: p501. doi:10.1126/science.1108066. PMID 15845837. 
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  155. ^ Megan's Law
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[edit] Further reading

  • Waterman, Jill; Kelly, Robert J.; Oliveri, Mary Kay; and McCord, Jane (1993). Behind the Playground Walls - Sexual Abuse in Preschools. New York, London: The Guilford Press. ISBN 0-89862-523-8. 
  • Davis, Laura; Bass, Ellen (1994). The courage to heal: a guide for women survivors of child sexual abuse: featuring "Honoring the truth, a response to the backlash". New York: HarperPerennial. ISBN 0060950668. 
  • Lew, Mike. Victims No Longer (Second Edition) : The Classic Guide for Men Recovering from Sexual Child Abuse. Perennial Currents. ISBN 006053026X. 

[edit] External links

[edit] Published articles

v • d • e
Sexual ethics
List of topics in sexual ethics
Age of consent
Child sexuality
Adolescent sexuality
Human sexuality
Sexual abuse
Sexual harassment  · Rape  · Statutory rape  · Child sexual abuse  · Child-on-child sexual abuse
Sex and the law