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1.
OBJECTIVE: The principal objective of this paper is to identify the economic costs and benefits of pedophile treatment programs incorporating both the tangible and intangible cost of sexual abuse to victims. METHOD: Cost estimates of cognitive behavioral therapy programs in Australian prisons are compared against the tangible and intangible costs to victims of being sexually abused. Estimates are prepared that take into account a number of problematic issues. These include the range of possible recidivism rates for treatment programs; the uncertainty surrounding the number of child sexual molestation offences committed by recidivists; and the methodological problems associated with estimating the intangible costs of sexual abuse on victims. RESULTS: Despite the variation in parameter estimates that impact on the cost-benefit analysis of pedophile treatment programs, it is found that potential range of economic costs from child sexual abuse are substantial and the economic benefits to be derived from appropriate and effective treatment programs are high. CONCLUSIONS: Based on a reasonable set of parameter estimates, in-prison, cognitive therapy treatment programs for pedophiles are likely to be of net benefit to society. Despite this, a critical area of future research must include further methodological developments in estimating the quantitative impact of child sexual abuse in the community.  相似文献   

2.
OBJECTIVE: This study aimed to establish the views of a group of mental health professionals from various disciplines working in mental health service in a British hospital about the needs of clients who had experienced childhood sexual abuse. METHOD: Staff members were asked to complete an anonymous survey which asked questions relating to knowledge of sexual abuse and its effects, and the needs of clients and staff in working with this client group. A total of 54 people responded to the survey, 42 were female, 11 male. Most (72%) reported having over 10 years experience working in mental health, working in both in-patient and out-patient settings. RESULTS: While respondents were reasonably knowledgeable about childhood sexual abuse, they were not very comfortable, competent or supported in their work with this client group. There were no differences in responses according to the age or gender of respondents, but less experienced staff were more likely to feel supported. Those that had received training and/or supervision felt significantly more capable in working with this client group. CONCLUSIONS: The study offers some support for the development of specialist training, consultancy and supervision programs for mental health staff in the area of child sexual abuse.  相似文献   

3.
OBJECTIVE: This study was designed to determine whether it is possible to prevent those sexually abused boys who are at risk of abusing other children from doing so, and to assess whether factors associated with an experience of sexual abuse in young people who are offending can be dealt with as a key aspect of therapeutic work alongside treatment of offending behavior. METHOD: The author examined cross-sectional and longitudinal research which demonstrates the impact on sexually abused children of living in a climate of violence, suffering physical abuse, exposure to abuse of maternal figures, and suffering disruption and poor quality of care and supervision. These factors are confirmed in prospective research. RESULTS: The application of these findings to therapeutic programs for boys who are sexually abused is described, including the assessment of care needs as well as the specific therapeutic work with the young person, and work to modify the family context. The specific treatment of victimization experiences in young people who have committed sexual offenses is also examined, with recommendations for modification of treatment approaches suggested. CONCLUSION: It is vital in therapeutic work with boy victims of sexual abuse that the issue of their abusive potential be considered, even if a relatively small proportion of such boys will go on to abuse others. Given that boys who do sexually abuse are likely to have grown up in a climate of violence and poor care, methods of dealing with such victimization experiences need to be developed alongside offending focused treatments.  相似文献   

4.
Sexual abuse during childhood is a public health and human rights concern throughout the world, including Sub-Saharan Africa. In 2011, Zimbabwe initiated national prevalence data collection on violence against children to inform government policy and programs. We interviewed 567 females and 589 males, aged 18–24 years following standardized and previously tested survey methods from the region. Of females 32.5%, and of males 8.9%, reported experiencing sexual violence before age 18. Most female (62.7%) and male (47.9%) victims of sexual violence experienced more than one incident of sexual violence prior to age 18 years. Three in four females (77.7%) and one in four males (26.7%) of those who experienced sexual violence reported that the first incident was perpetrated by a boyfriend or girlfriend. Few victims received professional help (2.7% of females and 2.4% of males who had reported experiencing sexual violence). Violence against girls is at epidemic levels in Zimbabwe. Most sexual violence against girls occurs within the context of peer relationships. Child victims who seek potentially life-saving support tend not to receive it. This study is evidence of a national public health and child rights emergency in the country and a case for increased, longer-term investment by the government and its development partners in policy reform for enhancing adolescent girls’ empowerment and protection.  相似文献   

5.
Tang CS  Yan EC 《Child abuse & neglect》2004,28(11):1187-1197
OBJECTIVES: This study aimed to explore factors relating to intention to participate in community child sexual abuse (CSA) prevention programs among Chinese adults in Hong Kong. METHOD: A total of 1,606 Chinese adults (497 men and 1,109 women) were individually interviewed about their intention to participate in community CSA prevention programs, endorsement of myths about CSA, their acquaintance with CSA victims, worry about CSA, and perceived prevalence of CSA. RESULTS: Among participants, nearly two-thirds believed CSA involved physical injuries of victims, 40% perceived boys as unlikely victims of CSA, and one-third were skeptical about children reports of CSA. About 24% of participants reported that they would definitely take part in CSA prevention programs. Participants who showed definite intention to participate in these programs endorsed fewer myths in relation to CSA, showed more worry about children being at risk of sexual abuse, perceived CSA as more prevalent and involving more physical injuries of victims, and were more likely to be women. CONCLUSIONS: Attention should be addressed to predisposing factors of adult participation in CSA prevention programs.  相似文献   

6.
OBJECTIVE: The aim of this article is twofold: first, to examine the prevalence of being the victim of actual and attempted rape among a large representative sample of Cape Town high school students; and second, to identify the correlates of sexual assault for both boys and girls, including alcohol, tobacco and other drug use, behavioral problems, and suicidality. METHOD: Data for this study were derived from the 1997 South African Community Epidemiology Network on Drug Use (SACENDU) school survey. A stratified sampling procedure was used to select students in Grades 8 and 11 at non-private high schools in Cape Town. A total of 2,946 students completed a survey consisting of socio-demographic questions and items about substance abuse, sexual activity, and other adolescent health risk behaviors. A subsample of 939 was randomly selected to complete items about sexual violence. RESULTS: The results revealed that 8.4% of respondents were victims of attempted rape, while 5.8% were victims of actual rape. Ordinal logistic regression showed that girls were 3.9 times more likely than boys to have been victims of sexual abuse. Family structure was also significantly related to rape as persons who lived with a single parent (OR = 1.74, CI = 1.00-3.04) and those who resided with one biological parent and one step parent (OR = 2.59, CI = 1.34-5.01) were more likely to have been have been victims of sexual abuse than those living with both biological parents. Alcohol use (OR = 2.0, CI = 1.10-3.62), anti-social behavior (stolen property, caused physical damage to property, bullied others, or been in physical fights) (OR = 1.44, CI = 1.12-1.86), suicidal dialogue (OR = 2.48, CI = 1.19-5.19), and suicidal attempts (OR = 3.2, CI = 1.65-6.30) were also significant predictors of sexual abuse victimization. Racially classified social groups (RCSG), age, drug use, and cigarette smoking were not significant predictors of sexual abuse victimization, while socioeconomic status was found to be marginally significant. CONCLUSION: This study reinforces the importance of multiple factors including alcohol use, anti-social behavior, suicidal thoughts and actions, and family structure with respect to sexual assault of adolescents in South Africa. Establishing and strengthening intervention programs, school based child protective protocols, professional education of teachers and school personnel, community prevention programs, and initiatives could help prevent adolescent sexual violence and reduce the sequelae associated with this problem.  相似文献   

7.
OBJECTIVE: To explore the experiences of victims of female sex offenders with regard to disclosing sexual abuse to a professional, and importantly, the impact of professional responses on victims. METHOD: The data were derived from one-to-one semi-structured interviews with 14 (7 males, 7 females) victims of child sexual abuse by female perpetrators. Victims ranged in age from 23 to 59 years and were recruited through professional referrals or through poster advertisements in counseling services. Participants responded to questions on their family background, experience(s) of sexual abuse, experience(s) disclosing the sexual abuse to a professional, and the impact of professional responses. RESULTS: The majority of victims reported sexual abuse by their mothers. The average age of onset of the sexual abuse was age 5, lasting, on average, 6 years. Five participants reported experiencing severe, moderate and mild sexual abuse, four reported experiencing both severe and mild sexual abuse and five reported experiencing moderate and mild sexual abuse. The findings underscore the significance of professional intervention in relation to victim disclosures of sexual abuse by females. Professional responses to disclosures, whether positive or negative, appeared to have a crucial impact on the well-being of victims. Supportive professional responses including the acknowledgment and validation of victims' experiences of sexual abuse appeared to mitigate the negative effects of the abuse. In contrast, unsupportive responses where professionals minimized, or disbelieved victims' allegations of sexual abuse appeared to exacerbate the negative effects of the sexual abuse, ultimately inciting secondary victimization. CONCLUSION: The study highlights the need for the development and implementation of professional training initiatives to sensitize professionals to the issue of female sex offending and the intervention needs of victims. Failure to do so could have negative consequences for victims sexually abused by females.  相似文献   

8.
OBJECTIVES: This study aimed to explore the prevalence rate and profiles of abusers and victims of child sexual abuse in a Chinese society. METHOD: A convenience sample of 2,147 Hong Kong Chinese college students completed questionnaires which included items on definitions of child sexual abuse, recall of sexual abuse experience before age 17, information about the sexual abuse incidents, and personal demographics. RESULTS: The overall prevalence rate for various forms of child sexual abuse was 6%, with the rates being higher for females than for males. The average age of the victims at the time of the sexual abuse was 11 years old, with a majority of them experiencing sexual abuse during their teenage years. The average age of the abusers as estimated by the victims was 24 years old, and only 28% of the abusers were strangers to the victims. Males were about three times more likely than females to be sexually abused by their friends, whereas females were about twice more likely than males to be sexually abused by strangers. Only 39% of the victims reported their sexual victimization to others, and 56% of the reported incidents were not followed up. CONCLUSIONS: As compared to Western studies, the present study showed lower rates for more intimate or severe forms of child sexual abuse. The Chinese victims were more reluctant to disclose their sexual victimization than their Western counterparts. Limitations and practical implications of the study are also discussed.  相似文献   

9.
OBJECTIVES: South Africa is reported to have one of the highest rates of sexual violence in the world, with adolescent girls between the ages of 12-17 being particularly at risk. Given that adolescence is considered a critical developmental period for establishing normative sexual behavior, this study explored multiple levels of risk influences that render adolescent girls vulnerable to becoming victims of sexual violence and adolescent boys vulnerable to becoming perpetrators of such abuse in one South African community. METHOD: A case study approach using qualitative rapid focused ethnographic methods was used. This involved 10 focus group interviews and 10 individual interviews with a volunteer convenience sample of adolescent boys and girls between the ages of 14 and 16 years. RESULTS: Inductive thematic analysis revealed that there were indeed multiple levels of risk influences for adolescent girls and boys becoming either victims or perpetrators of sexual violence. Using the Theory of Triadic Influence as a framework, influences at the distal socio-cultural/environmental level included traditional notions of masculinity and normalization of inter-personal violence as well as poverty and the commodification of sex leading to rape supportive attitudes. Influences at the proximal situation context/social normative level included high-risk social norms as well as a weak adult and community protective shield. Finally, influences at the intra-personal level included low self-esteem and self-efficacy as well as inter-personal affective anger. CONCLUSION: Given the multiple levels of risk influences that need to be addressed to protect youth from becoming either perpetrators or victims of sexual violence in the South African context, prevention programs should necessarily be comprehensive, developmentally timed, and community-based.  相似文献   

10.
OBJECTIVE: Study objectives were to describe a hospital Child Protection Team's (CPT) efforts to develop and implement a protocol for systematic evaluation and management of accusations that hospital staff have abused pediatric patients, and to learn how to avoid problematic patient encounters and cope with existing accusations. METHOD: This study reports on a retrospective series of cases from one pediatric hospital between 1982 and 1996. It includes a survey of national children's hospitals' experience from 1990 through 1995. RESULTS: After initial complaints to our hospital's CPT, it became apparent that procedures were inadequate to protect the safety of patients and rights of the accused. A protocol for reporting, evaluation, and management of accusations was developed and implemented by the CPT. Thirty-four accusations of abuse of children by staff were reviewed. Seventeen of the physical abuse cases included bruising, fractures, rough handling, and verbal abuse. Eighteen sexual abuse complaints included touching and sexual statements. Complaints were substantiated in 23% of the accusations, and a third of the identified staff members were fired or resigned. Child victims had a high frequency of chronic illness. They and their families frequently had histories of prior abuse, mental illness, and social disarray. These factors made children more likely to become victims of real abuse and to misinterpret standard hospital procedures as abusive. All service areas of the hospital and types of hospital staff were accused of patient abuse. CONCLUSIONS: Few children's hospitals have formal protocols for internal management of or training programs to avoid complaints. Institutions and their staff who care for children should anticipate abuse complaints, train them in risk reduction methods, and develop accusation management plans.  相似文献   

11.
Rates of childhood sexual abuse are unacceptably high, with potentially long-lasting consequences for those who have been victimized. Currently, there are a number of sexual violence prevention programs that have been developed to lower rates of victimization, increase awareness, and connect victims with resources. Within this area of research, there has been less focus on effective methods of program dissemination. For example, school-based sexual violence prevention programs have had positive outcomes; however, little is known about how these programs are disseminated. The train-the-trainer model of dissemination utilizes master trainers to equip others to implement programs, thereby allowing more adults to teach and subsequently more children to receive the program. This study used survey data from teachers and other school personnel (n = 127) to analyze the utility of a train-the-trainer model of dissemination for a sexual violence prevention program in the state of Hawai’i. Through responses of people who were trained to implement the program (59.8% of whom did implement), aspects of the training, the program itself, and factors affecting whether a person implemented the program were explored. Results suggest that time spent in training, job position, and time in that position predicted whether a person trained to implement the sexual violence prevention program followed through with teaching the program to students. Additionally, 54.7% of people who did implement the program had at least one student disclose sexual violence to them, indicating the importance of sexual violence prevention programming and dissemination of these programs.  相似文献   

12.
This research explored cultures of silence around child sexual abuse (CSA). On July 10, 2018, in response to multiple sexual abuse cases occurring in sport, sport news site Deadspin published a reader letter detailing CSA. This article prompted others to comment by sharing their accounts of CSA. Through qualitative analysis of 47 posts, we analyzed CSA victims’ lived experiences, with a focus on how cultural and social forces silenced them. Results indicated that silencing of CSA victims occurred through three overarching mechanisms: (a) patriarchal master narrative; (b) trauma-related shame; and (c) systemic power. The results illuminate the cultural and social factors that CSA victims experience and provide opportunities for parents, family members, and other stakeholders to better understand these constraints. In doing so, victims can be better supported, and needed discourse on CSA can occur more frequently to help identify solutions to this pervasive social problem.  相似文献   

13.
This study was conducted to compare the parental assessments of problem behaviors, using the Achenbach Child Behavior Checklist, among alleged sexual abuse victims (n = 81) and an age, race, and gender matched group of nonabused comparison subjects (n = 90). Alleged sexual abuse victims demonstrated significantly higher mean total behavior problem, internalizing and externalizing scores than the comparison sample. Subscale profiles were all in the direction consistent with withdrawal, impairment in social interaction, and sexual problems. Item comparison indicated that sexual abuse victims were more likely to be assessed as having some problem behaviors that have been reported as being indicative of sexual abuse. A significant difference was not obtained on several behaviors that have been previously reported as indicative of sexual abuse. These findings support concerns that sexual abuse victims do exhibit more problem behaviors, but caution must be exercised when interpreting individual behaviors because of their frequency in a nonabused sample.  相似文献   

14.
OBJECTIVE: The aim of this study was to examine the link between childhood experiences of sexual abuse and subsequent revictimization in adolescence. METHOD: A sample of 281 female adolescents between 17-20 years of age, who participated in a prevalence survey of unwanted sexual contacts, completed the Sexual Experiences Survey as a measure of unwanted sexual contacts in adolescence and indicated whether or not they had experienced childhood sexual abuse. RESULTS: Childhood experiences of sexual abuse were reported by 8.9% of the respondents, a further 8.5% indicated they were not sure if they had been sexually abused as children. Both abused women and women uncertain about their victimization status were significantly more likely to report unwanted sexual contacts as adolescents than women who did not state abuse. The link between childhood abuse and subsequent victimization was mediated by a higher level of sexual activity among the abuse victims. CONCLUSIONS: The results support existing evidence on the impact of childhood sexual abuse on sexual relationships in subsequent developmental stages and underline the need to consider childhood sexual abuse as a risk factor of adolescent sexual victimization.  相似文献   

15.
BACKGROUND: In 2002, Georgia had the United States' eighth highest number of persons living with AIDS. Human immunodeficiency virus (HIV) transmission as a result of sexual abuse is uncommon but definitely occurs. In certain circumstances of sexual abuse, antiretroviral post-exposure prophylaxis (ARV-PEP) has been suggested as a means to decrease the risk of HIV infection. Our objective was to assess the utilization of ARV-PEP in patients being evaluated for sexual abuse at a pediatric emergency department in a city with high HIV prevalence. METHODS: A retrospective survey of the characteristics of sexual abuse victims was conducted using information abstracted from sexual abuse report forms of minors examined in 2002 at an inner-city Atlanta children's hospital. RESULTS: Of 227 victims, aged 9 months to 18 years, most were Black, inner-city residents; 190 (84%) patients were female. Only 87 of 227 (38.3%) were seen within 72 h of the abuse, the time frame for offering ARV-PEP. Twenty-three of the 87 had anogenital trauma or bleeding. Five (5.7%), were provided ARV-PEP, whereas 60 (69%) received antibiotic prophylaxis for non-HIV diseases. Those assaulted by strangers were greater than 10 times more likely to be provided ARV-PEP than others (p=.02). Assailants of the 82 victims who did not receive ARV-PEP included 22 strangers and 60 "acquaintances" of unknown serostatus. CONCLUSIONS: For a high HIV prevalence area, the proportion of sexual abuse victims prescribed ARV-PEP was small in relation to those at risk of HIV sexual exposure. Clinicians should be provided guidance on interpretation of community HIV and sexual abuse victim data to assess the appropriateness of ARV-PEP.  相似文献   

16.
Recent revelations about the scope and severity of past child sexual abuse in German institutions set off a broad public debate on this issue, and led to the establishment of a politically appointed Round Table committee and an Independent Commissioner whose mandates were to reappraise the issue and develop recommendations for future policies. A media campaign was launched to publicize the establishment of a Critical Incident Reporting System (CIRS) whereby now-adult victims of past abuse could anonymously provide testimonials and let policy makers know what issues were important to them. Respondents could either call a hotline number or communicate by mail or email. The information collected was documented and analyzed by a research team, and the results of interim reports were included in the recommendations of the Independent Commissioner and the Round Table committee. Most of the respondents described severe and repeated occurrences of childhood sexual abuse. For many, priorities were improvements in therapy and counseling services, the abolishment of the statute of limitations on prosecuting offenders, and financial compensation. Based on the recommendations of the Round Table and the Independent Commissioner, two new laws were adopted as well as an action plan and some guidelines. In addition to rules for recompensation of victims in an institutional context a fund for victims of sexual abuse in intrafamilial context was established by the Federal Government. Another effect of this process was raising societal sensitivity to the problem of child sexual abuse. The use of a CIRS enabled those directly affected by childhood sexual abuse to have some input into a political process designed to address this issue. Such an approach could have applicability in other countries or in other domains of public health and other forms of societal conflict as well.  相似文献   

17.
It has been recommended that all children suspected of being sexually abused should have medical evaluations. To better understand practices and perceptions of child sexual abuse medical evaluations, a survey was conducted of 579 professionals attending educational programs on child sexual abuse; 85.8% (N = 497) responded. Half (50%) of the respondents reported no previous training in child sexual abuse. Of the 336 nonphysician professionals, 194 (57.7%) were in positions where they make referrals of the victims, and 69% of these did not refer all of the children they saw for medical evaluations. The first referral choice for medical evaluation was most often to the victim's primary physician (57%). For those professionals who did not refer all alleged victims for medical evaluation, neither the victims' age, gender, nor accessibility to care were generally considered relevant in determining the decision to refer. However, the type of abuse and presence of physical and psychological symptoms were considered relevant in making the decision. The majority indicated that the findings of the medical exam were very useful in substantiating or refuting the allegation of abuse. Further training for both medical and nonmedical professionals is needed to increase awareness of the need for and implications of the medical evaluation if children are to receive comprehensive assessments. Physicians may play an active role in this process through education of professionals and provision of care.  相似文献   

18.
The author discusses the importance of training counselors to provide adequate treatment for survivors of sexual abuse, presents the results of a survey of programs approved by the Council for Accreditation of Counseling and Related Educational Programs regarding current training practices, and offers recommendations and a model for developing a training component in sexual abuse counseling.  相似文献   

19.
Increased awareness of the problem of child sexual abuse has resulted in increasing numbers of children presenting to professionals for the evaluation of possible sexual victimization. A multidisciplinary project to develop professionals' knowledge and skills in the identification and evaluation of possible victims is described. The program focused on the child as a victim and emphasized developmental perspectives with regard to identification, interviewing children, the medical examination, and children in the legal system. Fifty-one medical and social work professionals from ten Indiana counties attended the program and responded to questionnaires about their experience and knowledge. Of 40 (78%) respondents, 63% had had no previous training in the medical evaluation for child sexual abuse. Child protective workers referred alleged victims primarily to the child's regular physician (37%) or emergency room (31%) for medical examination. Knowledge about child sexual abuse improved significantly at two weeks postsymposium (p = .001) and remained improved at six months postsymposium (p less than .02). These original participants have subsequently organized similar multidisciplinary programs in their local communities for medical, social, law enforcement, and legal professionals; thus, they have been "seeds" for further educational and cooperative efforts throughout the state.  相似文献   

20.
OBJECTIVE: The aim was to review the literature on female perpetrated child sexual abuse by highlighting how cultural myths about women inhibit recognition of this much hidden phenomenon. METHOD: Three sections are presented. Part 1 evaluates evidence concerning beliefs about child sexual abuse by women which minimize the problem. Part 2 provides a theoretical account of psychological processes that are hypothesized to maintain these beliefs. Part 3 illustrates that professionals working in the area of child sexual abuse are not immune to these processes. As a result, recommendations for future professional practices are made. RESULT: The paper demonstrates that in the context of what is known about child sexual abuse, cultural beliefs which serve to idealize women and minimize their potential harm to children are largely invalid. CONCLUSION: Individuals are urged to suspend their disbelief about female perpetrated child sexual abuse. Denial of the phenomenon may result in it continuing to be under-reported and trivialized. As this persists the price will ultimately be paid by victims of on-going abuse and survivors of past victimization whose suffering will be compounded by disparagement of the issue.  相似文献   

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