EDGC 682 - PowerPoint Presentation

Slide1

EDGC 682Child Sexual Abuse

Fall Semester 2012

Dean Owen, Ph.D., LPCCDepartment of Foundational and Graduate Studies in EducationSlide2

Some questions for you…..Slide3

Question 1

Child sexual abuse always involves some form of physical contact with children.

Source :www.westmichiganconference.orgFalseSlide4

Question 2

Most child molesters are male.

Source :www.westmichiganconference.orgTrueSlide5

Question 3

Child molesters are typically unknown to their victims.

Source :www.westmichiganconference.orgFalseSlide6

Question 4

Most victims of child sexual abuse suffer no long-term effects.

Source :www.westmichiganconference.orgFalseSlide7

Question 5

About 20% of child molesters began abusing children prior to the age of 18.

Source :www.westmichiganconference.orgTrueSlide8

Question 6

Only a small percentage of victims are male.

Source :www.westmichiganconference.orgFalseSlide9

Question 7

Most churches screen workers for potential molesters.

Source :www.westmichiganconference.orgFalseSlide10

Question 8

Church leaders cannot be held liable for child sexual abuse.

Source :www.westmichiganconference.orgFalseSlide11

Question 9

Some

child sexual abuse victims have won settlements of over $1,000.000 from churches.Source :www.westmichiganconference.orgTrueSlide12

Question 10

Child sexual abuse is a criminal offense in all 50 states.

Source :www.westmichiganconference.orgTrueSlide13

Question 11

A child molester may have more than 500 victims in a lifetime.

Source :www.westmichiganconference.orgTrueSlide14

Question 12

Child victims of sexual abuse will have physical signs of abuse.

FalseSlide15

Question 13

Sexual

victimization as a child will inevitably result in the child growing up to become a sex offender.FalseSlide16

Question 14

Child sexual abuse tends to occur primarily in low and lower-middle income families.

FalseSlide17

Question 15

Teaching children to avoid strangers is the best insurance against child sexual abuse.

FalseSlide18

Question 16

Most child abusers look and act perfectly normal.

TrueSlide19

Definitions of child sexual abuseSlide20

Definition:

Child sexual abuse

is a form of child abuse in which an adult or older adolescent uses a child for sexual stimulation.Source: http://www.nlm.nih.gov/medlineplus/childsexualabuse.htmlSlide21

Definition:

Source: American Psychological Association, 1999)

"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.“ APA (1999)Slide22

Definition:

Source: National Society for the Prevention of Cruelty to Children (NSPCC)

Under the law, "child sexual abuse" is an global term which describes 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.Slide23

Definition:

Source: American Psychiatric Association, (1999)

The American Psychiatric Association states that "children cannot consent to sexual activity with adults", and condemns any such action by an adult: "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.”Slide24

Forms

Child sexual abuse includes:

1. sexual touching of any part of the body, clothed or unclothed, including using an object2. all penetrative sex, including penetration of the mouth with an object or part of the body3. encouraging a child to engage in sexual activity, including sexual acts with someone else, or making a child strip or masturbate4. intentionally engaging in sexual activity in front of a child or not taking proper measures to prevent a child being exposed to sexual activity by othersSource: National Society for the Prevention of Cruelty to Children (NSPCC) Slide25

Forms

5. meeting a child following sexual 'grooming', or preparation, with the intention of abusing them

6. taking, making, permitting to take, distributing, showing or advertising indecent images of children7. paying for the sexual services of a child or encouraging them into prostitution or pornography8. showing a child images of sexual activity including photographs, videos or via webcams.Source: National Society for the Prevention of Cruelty to Children (NSPCC) Slide26

Types of Abuse

Child sexual abuse includes a variety of sexual offenses, including:Slide27

Types

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. 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.Source: Definitions of Child Abuse and Neglect, Summary of State Laws, National Clearinghouse on Child Abuse and Neglect Information, U.S. Department of Health and Human Services.Slide28

Types

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

Sexual exploitation – a term defining offenses in which an adult victimizes a minor for advancement, sexual gratification, or profit; for example, prostituting a child, and creating or trafficking in child pornography. Source: Definitions of Child Abuse and Neglect, Summary of State Laws, National Clearinghouse on Child Abuse and Neglect Information, U.S. Department of Health and Human Services.Slide29

Types

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

Sexual Grooming - describes 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.Source: Crosson-Tower, Cynthia (2005). UNDERSTANDING CHILD ABUSE AND NEGLECT. Allyn & Bacon. p. 208. ISBN 0-205-40183-X.Slide30

Prevalence:

Because child abuse is both illegal and immoral in most cultures it becomes problematic to precisely assess just how widespread and prevalent it is. In an attempt to cope with the lack of consistent data a meta-analytic study was done at the University of Barcelona in 2009. This research analyzed 65 research investigations from 22 countries in an attempt to estimate the scope of abuse. The resulting article was published in the Clinical Psychology Review under the title: Prevalence of child sexual abuse in community and student samples: A meta-analysis.

Some of the findings from this study follow:Source: Pereda, N., Guilera, G., Forns, M., & Gomez-Bonito, J. (2009)Slide31

The

study’s findings include:Globally

7.9% of men9.7% of women experienced sexual abuse prior to the age of 18.Slide32

The

study’s findings include:U.S. rates

7.5% for males,25.3% for females.Slide33

The

study’s findings include:Africa had the highest rate (34.4%)

Europe reported the lowest with 9.2%Slide34

The

study’s findings include:For women, seven countries reported prevalence

rates above 20%: Australia (37.8%)Costa Rica (32.2%)Tanzania (31.0%)Israel (30.7%)Sweden (28.1%)United States (25.3%) andSwitzerland (24.2%).Slide35

Effects

The effects of child sexual abuse can include:

Depression (Roosa, Reinholtz, & Angelini, 1999)Post-traumatic stress disorder (Widom, 1999) Anxiety

(

Levitan

, Rector, Sheldon, & Goering, 2003)

Propensity for further victimization

(

Messman

-Moore & Long, 2000)

Physical injury

(

Dinwiddie, Heath, Dunne,

et al

.,

2000)Slide36

Effects

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.

(Courtois,1988)Slide37

Effects

Psychological harm

The short and long-term consequences of child abuses identified by research include: Psychopathology in later life h. Somatization neurosisDepression i. Chronic pain disorderPost-traumatic stress j. Sexualized Behavior Anxiety k. School and learning probs.Eating disorders, l. Substance abuseSelf-injurious behavior m. Self-destructive behaviorPoor self-esteem n. Animal crueltySlide38

Effects

Physical harm (Traumatic Injury)

Depending on: Age, size of child and force used…..Sexual abuse may cause internal lacerations and bleeding…In severe cases, damage to internal organs and even death…(Anderson et al., 2004) Herman-Giddens et al. found six certain and six probable cases of death due to child sexual abuse in North Carolina between 1985 and 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. (Herman-Giddens et. al., 1999)Slide39

Effects

Physical harm (Infections)

Child sexual abuse may cause infections and sexually transmitted diseases. Depending on the age of the child, due to a lack of sufficient vaginal fluid, chances of infections are higher. Vaginitis has also been reported. (De Jong, 1985)Slide40

Effects

Physical harm (Neurological damage)

Research has shown that traumatic stress, including stress caused by sexual abuse, causes notable changes in brain functioning and development. Various studies have suggested that severe child sexual abuse may have a deleterious effect on brain development. (Szalavitz & Perry, 2006)Slide41

Effects

Physical harm (Neurological damage)

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. 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.Slide42

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

. (Courtois, 1988)Slide43

Incest

70% of abusers are immediate family members or someone very close to the family

.Source: Barabara E. Bogorad, Psy.D., A.B.P.P.,Founder and Former Director, Sexual Abuse Recovery Program Unit South Oaks Hospital, New York. "Sexual Abuse:Surviving the Pain". The American Academy of Experts in Traumatic Stress, Inc..Slide44

Incest

Some research suggests that about 30% of all perpetrators of sexual abuse are related to their victim, 60% of the perpetrators are family acquaintances, like a neighbor, babysitter or friend and 10% of the perpetrators in child sexual abuse cases are strangers

.Julia Whealin, Ph.D. (2007-05-22). "Child Sexual Abuse". National Center for Post Traumatic Stress Disorder, US Department of Veterans Affairs.Slide45

Parent-Child Incest

A

child sexual abuse offense where the perpetrator is related to the child, either by blood or marriage, is a form of incest described as intrafamilial child sexual abuse. (Fridell, 1990)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

.

(Turner, 1996)Slide46

Parent-Child Incest

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. (Cartois, 1988)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. (Turner, 1996)Slide47

Incest

Similarly, some argue that sibling incest may be as common, or more common, than other types of incest: Goldman and Goldman (1997) reported that 57% of incest involved siblings;

Cawson et al. (2000) indicated that sibling incest was reported twice as often as incest perpetrated by fathers/stepfathers.Slide48

Treatment

The initial approach to treating a person who has been a victim of sexual abuse is

dependent upon several important factors:Age at the time of presentationCircumstances of presentation for treatmentCo-morbid conditionsThe goal of treatment is not only to treat current mental health issues, but to prevent future ones.See: http://www.childwelfare.gov/pubs/usermanuals/sexabuse/sexabusef.cfmSlide49

Treatment

Children and adolescentsPresentation sources

criminal investigations, custody battles, problematic behaviors, andreferrals from child welfare agencies.The three major modalities for therapy with children and teenagers are family therapy, group therapy, and individual therapy. Which course is used depends on a variety of factors that must be assessed on a case by case basis. Source: Cynthia Winn; Anthony J. Urquiza (2004). Treatment For Abused And Neglected Children: Infancy To Age 18 – User Manual Series. Diane Pub Co. ISBN 0-7881-1661-4.Slide50

Roland

C. Summit, proposed a series of stages through which abuse victims may pass and coined the term Child Sexual

Abuse Accommodation Syndrome. He suggested that children who are victims of sexual abuse depict a range of symptoms that include:Secrecy,Helplessness,Entrapment,Accommodation,Delayed and conflicted disclosure andRecantation.Source: Summit, Roland C. (January 1983). "The child sexual abuse accommodation syndrome". Child Abuse & Neglect 7 (22).Slide51

Offenders

DemographicsOffenders are more likely to be relatives or acquaintances of their victim than strangers

. Fergusson, DM.; Lynskey, MT.; Horwood, LJ. (Oct 1996). "Childhood sexual abuse and psychiatric disorder in young adulthood: I. Prevalence of sexual abuse and factors associated with sexual abuse". J Am Acad Child Adolesc Psychiatry 35 (10): 1355–64. 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%). Joint Submission by The Office of the Governor C.L. Butch Otter, Governor and The Office of the Attorney General Lawrence Wasden, Attorney General January, 2008. "The Prosecution of Child Sexual Abuse in Idaho July 1, 2006 – June 30, 2007"(pdf). Retrieved 2008-01-28.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%. Studies of sexual misconduct in US schools with female offenders have shown mixed results with rates between 4% to 43% of female

offenders.

Educator Sexual Misconduct: A Synthesis of the Literature", U.S. Department of Education, 2004, p25,

Shakeshaft

, C.Slide52

Offenders

DemographicsMaletzky

found that, of his sample of 4,402 convicted pedophilic offenders, 0.4% were female. Maletzky, B.M. (1993). "Factors associated with success and failure in the behavioral and cognitive treatment of sexual offenders". Annals of Sex Research 6 (4): 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. Tomeo, M; Templer, D; Anderson, S; Kotler, D (2001). "Comparative Data of Childhood and Adolescence Molestation in Heterosexual and Homosexual Persons". Archives of Sexual Behavior 30: 5.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. Shakeshaft, C, "Educator Sexual Misconduct: A Synthesis of the Literature", U.S. Department of Education, 2004, p.24-25.Slide53

Offenders

TypologyGroth

and Birnbaum (1978) categorized child sexual offenders into two groups, "fixated" and "regressed."Fixated were described as having a primary attraction to children, 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 often had adult relationships with women.Groth, A. Nicholas & Birnbaum, H. Jean (1978). "Adult sexual orientation and attraction to underage persons," Archives of Sexual Behavior Vo. 7, No. 3, 175–181Slide54

Offenders

TypologyLater work (Holmes and Holmes, 2002) expanded on the types of offenders and their psychological profiles. They are divided thus

: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 an "overgrown child."Holmes, Ronald M.; Holmes, Stephen T. (2002-03-12). Profiling Violent Crimes: An Investigative Tool. Thousand Oaks, CA: Sage Publications, Inc. ISBN978-0-7619-2593-4.Slide55

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.According to the Mayo Clinic, approximately 95% of incidents of sexual abuse of children age 12 and younger are committed by offenders who meet the diagnostic criteria for pedophilia; and that such persons make up 65% of child molestation offenders. Pedophilic child molesters commit ten times more sexual acts against children than non-pedophilic child molesters. (Hall & Hall, 2007)Slide56

Offenders

RecidivismRecidivism rates for sex offenders are lower than for the general criminal population

.Estimated rates among child sex offenders vary. One study found that 42% of offenders re-offended (either a sex crime, violent crime, or both) after they were released. Risk for re-offense was highest in the first 6 years after release, but continued to be significant even 10–31 years later, with 23% offending during this time. A study done in California in 1965 found an 18.2% recidivism rate for offenders targeting the opposite sex and a 34.5% recidivism rate for same-sex offenders after 5 years. (Hanson, Steffy, & Gauthier, 1993)Slide57

Offenders

Child and young adolescent offendersWhen 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, 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.Unlike research on adult offenders, a strong causal relationship has been established between child and adolescent offenders and these offenders' own prior victimization, by either adults or other children.Slide58

Signs of Abuse

No child is psychologically prepared to deal with ongoing or intensive sexual stimulation. Even very young children, two or three years old, may sense that the sexual activity is "wrong," but they are unable to stop it. Children are frequently threatened that if they tell anyone, they will be killed or sent away, or their puppy will be killed; or their whole family will breakup

.Slide59

Signs of Abuse

Children subjected to sexual over-stimulation, with or without threats, will develop problems. Those older than five years of age become caught between loyalty to or dependence on the perpetrator, and shame at doing something "wrong." Over time, the child develops low self-esteem, feelings of being worthless or "dirty," and an abnormal view of sexuality. Slide60

Signs of Abuse

Withdrawal and mistrust of adults Suicidal ideation

Difficulty relating to others except in sexual or seductive ways Unusual interest in or avoidance of all things sexual or physical Sleep problems, nightmares, fears of going to bed Frequent accidents or self-injurious behaviors Refusal to go to school, or to the doctor, or home Secretiveness or unusual aggressiveness Sexual components to drawings and games Neurotic reactions (obsessions, compulsiveness, phobias) Habit disorders (biting, rocking) Wears long sleeves in hot weather (to hide bruises?) Unusual sexual knowledge or behavior Prostitution Forcing sexual acts on other children Extreme fear of being touched Unwillingness to submit to physical examination Slide61

Signs of Abuse

Specific physical indicators of recent sexual abuse include:

Difficulty in walking or sitting Torn, stained or bloody clothing Pain or itching in genital area Bruises or bleeding in genital area or mouth Pregnancy or sexually transmitted diseases, especially in preteens Repeated urinary infections or genital blockages Slide62

Signs of Abuse

The effects of early sexual abuse last well into adulthood, affecting relationships, work, family, and life in general. Individual symptomatology tends to fall into four areas:

1. Damaged goods: Low self-esteem, depression, self-destructiveness (suicide and self-mutilation), guilt, shame, self-blame, constant search for approval and nurturance.2. Betrayal: Impaired ability to trust, blurred boundaries and role confusion, rage and grief, difficulty forming relationships.3. Helplessness: Anxiety, fear, tendency towards re-victimization, panic attacks.4. Isolation: Sense of being different, stigmatized, lack of supports, poor peer relations.Slide63

Signs of Abuse

Adult incest survivors may demonstrate some of the following symptoms:

Fear of the dark, fear of sleeping alone, nightmares, night terrors Difficulty with swallowing, gagging Poor body image, poor self-image in general Wearing excessive clothing Addictions, compulsive behaviors, obsessions Self-abuse, skin-carving (also addictive), Suicidality Phobias, panic attacks, anxiety disorders, startle response Slide64

Signs of Abuse

Adult incest survivors may demonstrate some of the following symptoms:

Difficulties with anger/rage Splitting/ de-personalization, shutdown under stress Issues with trust, intimacy, relationships Issues with boundaries, control, abandonment Pattern of re-victimization, not able to say "no" Blocking of memories, especially between age one and 12 Feeling crazy, different, marked Denial, flashbacks Sexual issues and extremes Multiple personalities Signs of posttraumatic stress disorder Slide65
Slide66

References

American Psychological Association (1999). Guidelines for psychological evaluations in child protection matters.

American Psychologist, 54(8), 586-593.Anderson, J., Mangels, N.. & Langsam, A. (2004). "Child Sexual Abuse: A Public Health Issue". The Justice Professional, 17: 107. Cawson, Pat; Wattam, Corinne; Brooker, Sue (2000). Child Maltreatment in the United Kingdom: A Study of the Prevalence of Child Abuse and Neglect. London: National Society for the Prevention of Cruelty to Children. Courtois, Christine A. (1988). Healing the incest wound: adult survivors in therapy. New York: Norton. p. 208. De Jong AR (1985). "Vaginitis due to Gardnerella vaginalis and to Candida albicans in sexual abuse". Child Abuse &

Neglect,

9 (1): 27–9.

Dinwiddie S, Heath AC, Dunne MP,

et al.

(January 2000). "Early sexual abuse and lifetime psychopathology: a co-twin-control study".

Psychological Medicine

30

(1): 41–52.

Finkelhor

, D. (1979). Sexually victimized children. New York: Free PressSlide67

References

Fridell, L. A. (1990). "Decision-Making Of The District Attorney: Diverting Or Prosecuting

Intrafamilial Child Sexual Abuse Offenders". Criminal Justice Policy Review, 4 (3): 249. Goldman JD, Padayachi UK (May 1997). "The prevalence and nature of child sexual abuse in Queensland, Australia". Child Abuse & Neglect, 21 (5): 489–98. Hall RC, Hall RC (April 2007). "A profile of pedophilia: definition, characteristics of offenders, recidivism, treatment outcomes, and forensic issues". Mayo Clinic Proceedings. Mayo Clinic 82 (4): 457–71. Hanson RK, Steffy RA, Gauthier R (August 1993). "Long-term recidivism of child molesters". Journal of Consulting and Clinical Psychology 61 (4): 646–52. Herman-Giddens M., Brown G, Verbiest S, et al. (August 1999). "Underascertainment

of child abuse mortality in the United States".

J Journal of the American Medical Association ,

282(5

):

463–467

.

Levitan

RD, Rector NA, 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 and Anxiety

17

(1): 34–42.

Messman

-Moore, T. L.; Long, P. J. (2000). "Child Sexual Abuse and

Revictimization

in the Form of Adult Sexual Abuse, Adult Physical Abuse, and Adult Psychological Maltreatment".

Journal of Interpersonal Violence

15

(5): 489. Slide68

References

National Society for the Prevention of Cruelty to Children. Retrieved 28 September, 2012. http://

www.nspcc.org.uk/help-and-advice/worried-about-a-child/online-advice/sexual-abuse/sexual-abuse-a_wda87108.htmlMaia; Perry, Bruce (2006). The boy who was raised as a dog: and other stories from a child psychiatrist's notebook: what traumatized children can teach us about loss, love and healing. New York: Basic Books. Pereda, N., Guilera, G., Forns, M., & Gomez-Bonito, J. (2009). The prevalence of child sexual abuse in community and student samples: A meta-analysis. Clinical Psychology Review, 29 (4), 328-338.Roosa MW, Reinholtz C, Angelini PJ (February 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. Turner, Jeffrey S. (1996). Encyclopedia of relationships across the lifespan. Westport, Conn: Greenwood Press. Slide69