Mock Jurors' Perceptions of Child Sexual Abuse Cases: Investigating the Role of Delayed Disclosure and Relationship to the Perpetrator

Child sexual abuse (CSA) claims brought forward weeks, months, or years after the alleged events are commonplace, yet the trial-level ramifications of delayed disclosure remain unclear. In the present study, we investigated the influence of length of delayed disclosure (1 day, 1 month, 10 months) as a function of the victim-perpetrator relationship (next-door neighbor, stepfather) on mock jurors' perceptions of a CSA case. Jury-eligible participants (N = 328) read a mock trial summary describing an alleged incident of CSA between an adult male defendant and a seven-year-old female victim. Participants then rendered various case judgments. When length of delay was 10 months versus 1 day, mock jurors rendered fewer guilty verdicts and lower ratings of victim trustworthiness, believability, memory strength, and memory accuracy. Effects of length of delay varied as a function of the victim-perpetrator relationship, but only when the perpetrator was the victim's next-door neighbor versus stepfather. When the perpetrator was the victim's next-door neighbor, participants rated the likelihood of abuse as higher and the victim's memory as stronger with shorter versus longer lengths of delay. Delay did not vary as a function of the victim-perpetrator relationship when the perpetrator was the victim's stepfather. Findings have implications for trial-level safeguards (e.g., expert testimony) in CSA cases involving delayed disclosure.

The Prevalence of Sexual Grooming Behaviors in a Large Sample of Clergy

Following the exposure of child sexual abuse (CSA) within the U.S. Catholic Church, it was postulated that many of these cases went unreported because sexual grooming was involved. The present study examined the prevalence of sexual grooming behaviors of clergy through the lens of the content-validated Sexual Grooming Model (SGM). The study used archival data from a victim survey of 10,667 cases of alleged CSA within the U.S. Catholic Church. Results revealed the accused clergy frequently used tactics in the gaining access and isolation, trust development, and desensitization stages of the SGM. From the limited data available for the victim selection and post-abuse maintenance stages, the findings showed these tactics were relatively less common. Overall, clergy who were alleged to have committed CSA used tactics consistent with sexual grooming in general, although there were unique aspects of sexual grooming given their institutional role and position.

Viewing Time Measures of Sexual Interest and Sexual Offending Propensity: An Online Survey of Fathers

Relative viewing times (VTs)-time required to view and evaluate sexually salient images-discriminate individuals with a sexual interest in children, as indirectly indexed by their history of sexual offending against children, from those without such history. In an online sample of 652 fathers, we measured VTs and sexual attraction ratings to child and adult images. We assessed participants' sexual offending history and propensity (self-reported likelihood to have a sexual contact with a child, a non-consensual sexual contact with an adult, and propensity toward father-daughter incest). In contrast with VT studies involving clinical or forensic samples, VTs and attraction ratings failed to discriminate participants with a sexual offending history. VTs successfully distinguished participants with a propensity to sexually offend against children but failed to identify those with a propensity toward incest. Conversely, attraction ratings distinguished participants with a propensity toward incest but failed to identify those with a propensity to sexually offend against children. Correlations between VTs and attraction ratings were small. Results illustrate, for the first time, the distribution of VT measures in community fathers, support the feasibility of online administration of VT tasks to detect propensity to sexually offend against children, and indicate that sexual interest in children and incest propensity are distinct.

Physical Disabilities and Low Cognitive Ability Increase Odds of Minor Sex Exchange among Adolescent Males in the United States

Disability is a well-established risk factor for sexual violence victimization among both male and female children. Some research indicates that adolescent females with disabilities are at higher risk of experiencing minor sex exchange (a form of minor sex trafficking victimization) compared to females without disabilities, but there is a dearth of similar research among adolescent males. This study investigates whether physical disability and low cognitive ability are related to sex exchange among minor adolescent males. This cross-sectional analysis using data from a nationally representative cohort study, The National Longitudinal Study of Adolescent to Adult Health (Add Health), included 4,401 male participants who were age 18 or younger at Wave II. Unadjusted and adjusted logistic regression models estimated the odds of adolescent experiences of sex exchange by physical disability and cognitive ability. Both severe physical disability and low cognitive ability in adolescent males were significantly associated with increased odds of exchanging sex, results similar to those found in studies of adolescent females. Because of these associations for both males and females, disability should be taken into account when designing and implementing prevention and intervention programs related to sex trafficking. These results underscore the importance of addressing system-wide gaps contributing to the relationship between disability and the involvement of minors in commercial sex exchange.

Exploration of factors influencing court outcomes in cases involving minors as victims in Ghana

BACKGROUND

The factors that influence positive court outcomes for cases of child sexual abuse (CSA) have been studied in other contexts but very few such studies exist for Sub-Saharan countries. Knowledge of how such cases fare in these court systems is, however, important for a global assessment of such outcomes.

OBJECTIVE

The study explored the predictive effect of the victim, complainant; offender and offence characteristics, and length of the trial on case disposition and dropout.

METHODS, PARTICIPANTS AND SETTING

Three hundred and eighty-nine (389) closed court files related to child sexual abuse in Ghana were reviewed and analyzed.

RESULTS

The findings show that the number of court sittings (length of trial) and complainant characteristics predict negative outcomes for CSA cases in Ghana. Specifically, convictions were less likely to occur where caregivers were the complainants (OR = 0.45), and when there were longer court sittings (OR = 0.95). Victim, offender, and offence characteristics, however, did not influence case outcomes.

CONCLUSIONS

This study is one of the first studies using actual court data to predict the outcome of cases in CSA in Ghana, and makes recommendations for the support of children and caregivers through the court process.

Validating the Screening Scale of Pedophilic Crime Scene Behavior

The Screening Scale of Pedophilic Crime Scene Behavior (SSPC) is a seven-item structured rating scale assessing pedophilic sexual arousal. In the current study, we cross-validated the scale's convergent validity using multiple measures of sexual interest in children (clinical diagnosis of pedophilia, the high fixation/low social competence type of the MTC:CM4, and phallometric assessment of sexual interests toward children) in two independent samples (USA and Canada). In both samples and in relation to all three criteria, the SSPC showed acceptable (phallometry) to excellent (clinical assessment) diagnostic accuracy. Furthermore, the SSPC showed incremental validity in relation to the Screening Scale for Pedophilic Interest and at times outperformed it in convergent validity analyses. The current study also provides psychometric information that can help users choose an appropriate SSPC cutoff score.

Detecting Grooming Behaviors in Same-Sex versus Opposite-Sex Child Sexual Abuse

Child sexual abuse (CSA) is a prevalent concern that often leads to severe, life-long consequences. Grooming is an early indicator of CSA, and it is imperative to be able to recognize these behaviors in adult-child relationships to prevent abuse from occurring. Research on CSA and grooming has primarily focused on opposite-sex (male adult and female child) abuse while little research has focused on same-sex (male adult and male child) abuse. The current study examined how the sex of the adult-child pair might impact the identification of grooming behaviors. Participants in this study were presented with a series of vignettes depicting grooming and non-grooming behaviors in either same-sex or opposite-sex adult-child pairs. Participants were more likely to label the behaviors presented as grooming when shown situations involving an opposite-sex adult-child pair as opposed to a same-sex adult-child pair.

Brief Report: Child Sexual Abuse and Somatic Symptoms in Older Adulthood for Men

Somatic symptom disorders are often misdiagnosed or minimized among men, especially in middle and older adulthood. Previous research investigating links between somatic disorders and early trauma, such as childhood sexual abuse (CSA), have mostly been based on small, non-representative, female samples using cross-sectional designs. The current study used data from the Wisconsin Longitudinal Study to assess associations between CSA and somatic symptom severity among men in middle- and late-adulthood (mid-50s to early 70s) with histories of CSA (n = 129) and a matched, non-abused comparison group (n = 2,322). Childhood (e.g., co-occurring adversities and parental education) and demographic background variables (e.g., marital status, self-rated health, and income) were controlled. Growth curve modeling was used to explore trajectories of somatic symptoms over time. Results indicated that the CSA group had higher somatic symptom severity than the non-abused group (γ01 = .10, p < .05); symptoms decreased over time for both groups with no significant differences in the rate of change. Healthcare providers should include CSA in assessments for men. Because contemporary somatic symptoms may represent unresolved early life course trauma, mental health support services should be expanded for this population. Future research should explore gender-appropriate treatment modalities for older men with histories of CSA.

Caregivers' Considerations of Remorse and Responsibility Among Youth Who Sexually Offend

When a youth sexually offends, most of the reactions and repercussions that follow are understandably negative. However, there is limited research about mixed reactions involving remorse and responsibility on the part of the adolescent who offended and their relatives. Based on qualitative interviews with 16 caregivers among 10 families in Canada, this article presents the parents' perspectives on the various processes, benefits, challenges, and outcomes related to expressions of remorse and experiences of responsibility among youth who sexually offended, their victims, and their parents. This study sheds particular light on how adolescent perpetrators of sexual harm and especially their caregivers do feel deeply remorseful and responsible for the impacts of sexual offending behavior, which is contrary to public scrutiny that negatively projects responsibility onto youth offenders and their parents. Thus, our findings emphasize the constructive and considerate ways in which remorse is felt and responsibility is assumed; and by extension, they point to the importance of restorative practices in efforts toward reconciliation and accountability.

Double-Edged Sisterhoods: Transgender Identity, Peer Groups and the Commercial Sexual Exploitation of Transgender Girls

One of the existing gaps in the literature on the commercial sexual exploitation (CSE) of children is on transgender (trans) girls. Most of the available literature is heavily skewed toward experiences of cisgender girls. However, there is an undeniable need to understand the experiences of trans children given their unique experiences and vulnerabilities to CSE related to their identity. This article is a case study on the complex interaction between trans identity, peer influence, and other micro, meso, and macro factors that have predisposed trans girls to CSE. The paper is based on interviews with six trans girls, complemented by interviews with four social workers, research notes, and a review of related literature. Data was analyzed thematically. Based on the findings, peer groups provide critical support to trans girls, particularly, in terms of trans identity formation, gender transition information, security and protection, and other forms of support. Ironically, they play the contradictory role of priming and initiating them to CSE. Various structural and personal factors have compounded these and predisposed them to victimization. An interplay of macro (societal), meso (interpersonal), and micro (individual) factors have come into play in the commercial sexual exploitation of these trans girls.

A conjunctive analysis of false accusations, official misconduct, and race in violent and sexual exonerations cases

The National Registry of Exonerations tracks cases of individuals who have been convicted and exonerated in the United States since 1989. The objective of the current study was to explore the misconduct patterns in violent and sexual offense cases using a novel method with a focus on cases where suspects were falsely accused, either deliberately or by mistaken witness identification. A conjunctive analysis of case configurations (CACC) was conducted using 1690 males convicted of murder/manslaughter, rape/sexual assault, and child sexual abuse. The results showed that compared to Whites, Blacks had a disproportionate amount of official misconduct in both sexual and non-sexual homicide cases. Blacks also had a disproportionate amount of misconduct by multiple actors and multiple types. Blacks had more cases of mistaken witness identification and a disproportionate amount of official misconduct in sexual assault cases. Implications and recommendations are discussed.

"Psychologically and emotionally, it affects me 'til this day": exploration of childhood sexual abuse perspectives among older adults living with HIV in South Carolina

OBJECTIVES

The influence of childhood sexual abuse (CSA) may be seen immediately or across the life course. CSA is also associated with increased HIV-risk behavior, and greater likelihood of an HIV/STI diagnosis. The aim of this study was to explore the perspectives of CSA among older adults living with HIV.

METHODS

Twenty-four adults living with HIV aged 50 to 67 years (mean age = 58.5 years), with a history of CSA, receiving care from an HIV clinic in South Carolina, participated in the study. In-depth semi-structured interviews were conducted, audio recorded and analyzed using a thematic analytic approach. The iterative analytic process included a three-step approach: discussion of initial thoughts and key concepts, identification and reconciliation of codes, and naming of emergent themes.

RESULTS

Four themes emerged: Psychological issues due to CSA, relationship challenges due to CSA, self-blame, and reliving childhood trauma (subtheme: lack of influence of CSA today). Some participants reported feeling the influence of CSA several years after the event while others noted that that there was a lack of influence of CSA at present.

CONCLUSIONS

Trauma-informed intervention programs are needed for older adults living with HIV who still experience the influence of their CSA experience. Future research should delve into the design and feasibility of implementing these programs.

Prevalence of Child Sexual Abuse in Spain: A Representative Sample Study

The prevalence of child sexual abuse (CSA) is difficult to assess, and rates vary widely across studies due to methodological and sample differences. In Spain, prevalence data from representative samples are lacking. The objective of this study was to determine the prevalence of different CSA experiences in a sample that was representative of the Spanish population in terms of gender, age, and region. The sample comprised 1,071 (539 male and 532 female) Spanish adults (M_age = 45.37; SD = 14.84). Participants completed an anonymous online survey about different types of CSA and were asked whether they had disclosed the experience at the time. Prevalence was analyzed as a function of gender and generation. Results indicated prevalence rates ranging from 2.8% to 18.5%, depending on the type of experience. The most common experience suffered during childhood was being shown pornographic material, while that with the lowest prevalence was being forced to perform a sexual act involving penetration. Prevalence was higher in females than males for eight of the ten experiences considered. Young adults from Generation Z were the most likely to report having suffered three of the CSA experiences, two of them related to technology. Only 27.5% of respondents said that they had told someone about the abuse at the time, mainly their mother (more common among females) or a friend/peer (more frequent among males). The results suggest that CSA is prevalent in Spain, with considerable rates for several types of abusive experience, especially among females and the youngest generation. The implications of the results are discussed. The findings may inform social policy and the development of effective prevention programs.

Prevalence of Child Contact Sexual Abuse in the Spanish Region of Andalusia

The aim of this study was to analyze the prevalence and characteristics of child sexual abuse (CSA) in Andalusia, Spain's most populated region. A sample of 817 adults (281 male; M age = 34.7; SD = 13.86) completed the Child Sexual Abuse Experiences Questionnaire. Because the sample was unbalanced, we performed post-stratification by gender, resulting in 562 participants (50% male). Overall, 38.8% of the sample reported at least one type of contact abuse experience, with prevalence ranging from 22% for being fondled to 3.9% for being forced to perform a sexual act involving penetration. The first episode of CSA most commonly occurred between age 6 and 11 years, except for penetration. The majority of reported experiences were repeated and perpetrated by a male. More than half of the victims did not label their experience as sexual abuse, and this apparent lack of awareness about what constitutes abuse was particularly evident among male victims. The prevalence of CSA in Andalusia is higher than for Spain as a whole, highlighting the need to raise public awareness through prevention programs.

The Influence of Authority Role and Victim Gender on Perceptions of Female-Perpetrated Child Sexual Abuse

Child sexual abuse is often perceived differently based on characteristics of the victim and the perpetrator. However, unknown is whether variations in perceptions occur when the relationship to and gender of the victim are manipulated-particularly when the offender is a woman. The current study sought to explore whether authority role (neighbor, teacher, family, or clergy) and victim gender affect perceived outcomes for the victim. A factorial vignette design was used to randomly assign participants to one of eight conditions, and a series of analyses of variance (ANOVAs) were conducted to assess differences in perceived victim outcomes for the vignettes. Results showed significant differences for authority role, victim gender, and the interactions between authority and victim gender for nearly all dependent variables. Respondents recognized that the scenarios presented were damaging and harmful; however, certain authority positions (i.e., teachers) were sexualized leading to diminished perceptions of negative outcomes, particularly for male victims.

Prevalence of Online Sexual Offenses Against Children in the US

IMPORTANCE

Sexual abuse is increasingly facilitated by technology, but the prevalence and dynamics of such offenses have not been well delineated, making it difficult to design prevention strategies.

OBJECTIVE

To examine the frequency and characteristics of online and technology-facilitated sexual abuse against children and youth.

DESIGN, SETTING, AND PARTICIPANTS

In this nationally representative online survey study performed from November 19 to December 29, 2021, young adults aged 18 to 28 years were asked retrospectively about their childhood (<18 years) experiences of online and technology-facilitated abuse. The 2639 participants were sampled from an online panel.

MAIN OUTCOMES AND MEASURES

Participants were asked questions about 11 different kinds of online and technology-facilitated sexual abuse with follow-up questions about their dynamics and offenders. Prevalence rates were calculated for several cross-cutting concepts (online child sexual abuse, image-based sexual abuse, self-produced child sexual abuse images, nonconsensual sexting, online grooming by adults, revenge pornography, sextortion, and online commercial sexual exploitation). Survey weights were applied to obtain population prevalence estimates.

RESULTS

A total of 2639 individuals (48.5% male, 49.8% female, and 1.8% other gender; 23.7% Hispanic, 12.6% non-Hispanic Black, 53.9% non-Hispanic White, 4.8% other race, and 5.0% ≥2 races) were surveyed. Childhood (before 18 years of age) prevalence rates were as follows: online child sexual abuse, 15.6% (SE, 1.0%); image-based sexual abuse, 11.0% (SE, 0.9%); self-produced child sexual abuse images, 7.2% (SE, 0.7%); nonconsensual sexting, 7.2% (SE, 0.7%); online grooming by adults, 5.4% (SE, 0.5%); revenge pornography, 3.1% (SE, 0.5%); sextortion, 3.5% (SE, 0.6%); and online commercial sexual exploitation, 1.7% (SE, 0.3%). The prime age of vulnerability across all categories was 13 to 17 years. Perpetrators in most categories were predominantly dating partners, friends, and acquaintances, not online strangers.

CONCLUSIONS AND RELEVANCE

The results of this national survey study suggest that a considerable portion of youth have experienced online child sexual abuse. Professionals planning prevention and intervention strategies for online sexual abuse should understand that dynamics include diverse episodes that are often extensions of dating abuse, sexual bullying, and sexual harassment, not only events perpetrated by adult internet predators.

Pediatric Forensic Analysis: The Benefits of DNA Collection Beyond 24 Hours

BACKGROUND

Although the presence of forensic evidence aids in successful prosecution of sexual abuse, controversy remains regarding the timing and indications for collection of forensic evidence in child sexual abuse/assault.

OBJECTIVE

The purpose of this study was to describe forensic evidence findings in acute child sexual abuse after implementing more inclusive indications for collection of evidence in a pediatric emergency department and to identify factors associated with yield of DNA.

RESULTS

Of the 306 evidence kits collected and analyzed, 110 (35.9%) kits were positive for an interpretable DNA profile foreign to the patient, which may or may not have contributed to the investigation of the sexual abuse concern. Several factors were associated with increased forensic yield of identifiable foreign DNA: increased age of child victim, 48 hours or less between the latest incident of sexual abuse and the collection of forensic evidence, child disclosure of high-severity sexual abuse acts (anal-genital or genital-genital contact) in the pediatric emergency department forensic interview, and sexual abuse by a nonrelative perpetrator.

CONCLUSIONS

Finally, although certain factors were associated with increased yield of identifiable foreign DNA within each factor, there were multiple outliers where failure to collect forensic evidence would have resulted in a loss of recoverable foreign DNA.

The Lived Experience of Human-Pet Relationships among Adult Survivors of Childhood Sexual Abuse: An Interpretative Phenomenological Analysis

Given the high prevalence and severe consequences of childhood sexual abuse, it is essential to identify ways to support adult survivors. One potential and relatively unexplored resource available to survivors is the human-pet relationship. In the literature, the human-pet relationship is linked to many positive benefits to physiological regulation, mental health, physical health, and social support - areas of functioning where survivors of childhood sexual abuse may be particularly at risk. Despite existing evidence, there is little research on human-pet relationships among survivors of childhood sexual abuse. To help address this gap, this qualitative study explored the lived experience of human-pet relationships among adult survivors of childhood sexual abuse. Utilizing data collection and analysis methods from Interpretative Phenomenological Analysis, semi-structured interviews were conducted with 10 adult survivors of childhood sexual abuse. The following themes were developed from the data: (a) close bond with pet; (b) idiosyncrasies within the human-pet relationship; (c) moral responsibility; (d) fundamental differences between pets and humans; (e) safety in the human-pet relationship; (f) resource for coping with painful experience; (g) positive impact on well-being; (h) buttress for human-human social interaction; (i) medium for skill and knowledge development; and (j) shortcomings of the human-pet relationship. Findings are discussed in the context of the existing literature, along with considerations for practice and future research with childhood sexual abuse survivors.

Implementation of A Care Process Model for Pediatric Traumatic Stress in Child Advocacy Centers: A Mixed Methods Study

Child Advocacy Centers (CACs) are well-positioned to identify children with mental health needs and facilitate access to evidence-based treatment. However, use of evidence-based screening tools and referral protocols varies across CACs. Understanding barriers and facilitators can inform efforts to implement mental health screening and referral protocols in CACs. We describe statewide efforts implementing a standardized screening and referral protocol, the Care Process Model for Pediatric Traumatic Stress (CPM-PTS), in CACs. Twenty-three CACs were invited to implement the CPM-PTS. We used mixed methods to evaluate the first two years of implementation. We quantitatively assessed adoption, reach, and acceptability; qualitatively assessed facilitators and barriers; and integrated quantitative and qualitative data to understand implementation of mental health screening in CACs. Eighteen CACs adopted the CPM-PTS. Across CACs, screening rates ranged from 10% to 100%. Caregiver ratings indicated high acceptability. Facilitators and barriers were identified within domains of the Consolidated Framework for Implementation Research. Qualitative findings provided insight into adoption, reach, and caregivers' responses. Our findings suggest screening for traumatic stress and suicidality in CACs is valued, acceptable, and feasible. Implementation of mental health screening and referral protocols in CACs may improve identification of children with mental health needs and support treatment engagement.

Childhood Sexual Abuse and Exposure to Peer Bullying Victimization

Females exposed to child sexual abuse (CSA) are at an increased risk of experiencing further victimization in adolescence. Associations between CSA and several forms of cyber and in-person peer bullying victimization were assessed in a prospective, longitudinal study. Females exposed to substantiated CSA and a matched comparison group (N = 422) were followed over a two-year period. Bullying experiences were assessed in both survey and qualitative interviews. Qualitative data were coded and used to describe the types (e.g., cyber, physical, verbal), and foci (e.g., threats, physical appearance) of bullying victimization. Logistic regression was used to assess the odds that CSA was associated with subsequent bullying victimization, adjusted for demographics, social networking use, and prior bullying. CSA-exposed females were at an increased risk of multiple forms of bullying victimization with a persistent risk of bullying victimization over time. Specifically, they had 2.6 times higher odds of experiencing any bullying at follow-up, 2.9 times higher odds of experiencing cyberbullying at follow-up, and 2 times higher odds of experiencing combined cyber/in-person bullying at follow-up. CSA-exposed females were more likely than comparison females to experience bullying regarding their appearance/weight and dating relationships. Findings provide further insight into the unique circumstances of the cyberbullying and in-person bullying experienced by CSA-exposed females. Females exposed to child sexual abuse (CSA) are at an increased risk of experiencing bullying victimization, specifically cyberbullying and combined cyber/in-person bullying, as well as bullying about their appearance and dating relationships. These findings indicate that bullying prevention needs to include trauma-focused components to target these uniquely vulnerable females.

Experiences of Women Survivors of Childhood Sexual Abuse in Relation to Nonsupportive Significant Adults: A Scoping Review

Childhood sexual abuse (CSA) is a complex trauma with devastating long-term, negative effects on survivors. This study extended the understanding of experiences of women survivors of CSA in relation to nonsupportive significant adults documented in literature, as to date, there exists no summary in literature on this particular topic. As such, a scoping review was conducted on publications between 1980 and January 2020. A total of 26 733 were selected for analysis in accordance with the search terms. After duplicates were removed and the exclusion criteria were applied, a total of 58 articles were selected for inclusion in the review. Thematic analysis was conducted on the studies included, and three themes were developed pertaining to the experiences of women survivors of CSA in relation to nonsupportive significant adults. Theme 1 identified nonsupportive behaviors experienced before disclosure or discovery of abuse. Theme 2 identified nonsupportive behaviors experienced during or after disclosure or discovery of abuse. Theme 3 identified the long-term negative consequences of nonsupportive experiences. These three themes support the findings of Freyd's betrayal trauma theory and Bowlby's attachment theory, extend on the global knowledge base of this topic, and identify gaps for further exploration.

A Hierarchical Cluster Analysis of Childhood Interpersonal Trauma and Dispositional Mindfulness: Heterogeneity of Sexual and Relational Outcomes in Adulthood

The current mixed-method study aimed to 1) identify different childhood interpersonal trauma (CIT) and dispositional mindfulness (DM) profiles in an adult sample; 2) illustrate these profiles with qualitative data documenting childhood sexual abuse (CSA) and CIT survivors' perceptions of their own DM; and 3) examine profile differences on sexual and relational outcomes. Participants were 292 adults who completed an online questionnaire. A subsample of participants having reported a history of CSA (n = 51) also completed semi-structured interviews. Hierarchical cluster, comparison, and content analyses were performed. Analyses yielded three profiles: 1) Lower victimization, high mindfulness; 2) Psychological victimization, low mindfulness; and 3) Multi-victimization, low mindfulness. Participants in profile 1 presented the lowest frequency of CIT experiences and the highest levels of DM and sexual and relational well-being. Profile 2 participants presented higher sexual and relational well-being (i.e., higher sexual satisfaction, lower sexual depression, and fewer interpersonal conflicts) than those in profile 3. By documenting distinct CIT and DM profiles and tying them to different levels of relational and sexual well-being, this study could guide practitioners in designing tailored interventions.

"The most shocking thing was that I didn't respond to the abuse": The peritraumatic responses and transitions as conveyed by survivors of continuous child sexual abuse

BACKGROUND

Child sexual abuse (CSA) is a worldwide phenomenon with ongoing and far-reaching consequences for millions of children worldwide. It is a consensus among researchers that continuous CSA represents a unique challenge.

OBJECTIVE

The current study aimed to explore the peritraumatic responses of survivors of continuous CSA as described in their written narratives of abuse. The transitions between the peritraumatic responses will also be examined, highlighting the unique context of continuous CSA.

PARTICIPANTS AND SETTING

Written narratives of CSA were recruited via an advertisement in the media inviting CSA survivors to share their stories of abuse on an anonymous online platform. The data collection was carried out under the Israeli Independent Public Inquiry on CSA.

METHODS

A qualitative thematic analysis was applied to 32 richly written accounts of abuse.

RESULTS

Three peritraumatic responses were identified: the adaptive response, hinting, and attempts to fight and flight. Transitions between these responses were described by the survivors and addressed the heavy load of the abuse, realization of the abuse, fear of consequences and the central role of the survivor's environment.

CONCLUSIONS

The current study provides a unique platform for the exploration of peritraumatic responses in continuous CSA. Alongside the identification of three peritraumatic responses described by the survivors, the current study provides an initial glance into transitions between peritraumatic responses. This insight strengthens the developing notion that peritraumatic responses in the unique context of CSA are a top-down process, often shaped by various contexts and multidimensional dynamics in the children's lives.

Moving school-based CSA prevention education online: Advantages and challenges of the "new normal"

One of the many outcomes of the COVID-19 pandemic was a shift in the delivery of elementary (primary) education. Schools transitioned swiftly to e-learning and prioritized education that was already or could be easily adapted to virtual formats. Given the paucity of online content available, it is not likely that child sexual abuse (CSA) prevention education was prioritized. Given that CSA prevention education has demonstrated success in increasing knowledge, protective behaviors, and disclosures, and the potential long-term need for e-learning options, there is a demand for an exploration of how CSA prevention can be implemented using e-learning strategies. In the current discussion, we explore how school-based CSA prevention education could be implemented in a "new normal" context of e-learning. We first present the existing e-learning content for CSA prevention education. We then describe how best practices for prevention education can be applied to e-learning. Finally, we present considerations for the use of e-learning specifically for CSA prevention education. In short, implementing CSA prevention programs through e-learning offers many affordances for program accessibility and reach, flexibility in implementation and opportunities for greater exposure to content, and a wide range of ways to demonstrate effective skills and engage children in cycles of practice and feedback. E-learning, may also, however, limit important conversations between children and trained instructors that lead to disclosures. The extant literature leaves us unsure as to whether implementing CSA prevention programs through e-learning will result in better or worse outcomes for children. However, given the increasing demand for e-learning options, and the promise of some new e-learning programs, further research on the effectiveness of e-learning CSA prevention programs is warranted.

Child Sexual Abuse and Suicide: Essentials for the Forensic Nurse

Sexual abuse can result in significant negative sequelae for victims. One particularly harmful consequence is suicidal ideation, which can lead to suicide attempts and even death. It is essential to screen children and adolescents for suicidal ideation when providing medical forensic care after disclosure of acute or nonacute sexual abuse/assault. Forensic nurses must feel confident in their abilities to assess suicide risk and provide appropriate intervention and referrals. A thorough understanding of the relationship between sexual abuse and suicidal ideation and behaviors can assist the forensic nurse in the development of practice behaviors to better identify, intervene, and prevent suicidal ideation and behaviors among youth experiencing sexual abuse.

"A Little Bit of Light Dispels a Lot of Darkness": Online Disclosure of Child Sexual Abuse by Authority Figures in the Ultraorthodox Jewish Community in Israel

Social media sites such as Facebook have become popular platforms for promoting public awareness of sexual abuse by encouraging user engagement around this issue. There is, therefore, currently emerging research on the functions and implications of social media as a platform for sexual abuse disclosure. However, as yet, no study has examined this phenomenon specifically through a religious-cultural lens. This study explores perceptions of, barriers to, and motives underlying online disclosure of child sexual abuse (CSA) by religious authority figures (RAFs) in ultraorthodox Jewish society in Israel. The data were gleaned from the popular Facebook page of a nonprofit devoted to raising awareness of CSA in the ultraorthodox community. The analysis was based on admins' posts, anonymous and nonanonymous survivors' shares, users' comments, and in-depth interviews of eight page users. The findings suggest a culture-oriented model of online CSA disclosure (OCSAD), identifying four primary factors (safety, benefit, relevance, and legitimacy) that, weighed against cultural barriers, influence the decision to engage in online CSA disclosure. This context-informed understanding highlights the importance of social media as an alternative platform for CSA disclosure in an isolated but changing cultural arena such as the ultraorthodox community in Israel. The theoretical model is of international interest for its conceptualization of the unique characteristics and perceptions of OCSAD within religious-cultural contexts.

Manifestations of sexual sadism in child sexual assault and the associated victim, offender, and offense characteristics: A latent class analysis

BACKGROUND

Although sadistic child sexual abuse (SCSA) is rare, existing typologies of child sexual abuse have identified the existence of sadistic subtypes in child molestation, as well in the sexual homicide of children. Nonetheless, no study has sought to determine whether there is heterogeneity in the manifestation of sexual sadism between sadistic child abusers.

OBJECTIVE

The present study seeks to examine how SCSA manifests differently between offenders, and whether these differences are associated with specific victim, offender, and offense characteristics.

PARTICIPANTS AND SETTING

The current sample includes adult males (N = 101) who were involved in a child sexual assault and scored at least a 4 on the Severe Sexual Sadism Scale (SeSas). All offenses take place in France between 1990 and 2018.

METHODS

Latent class analysis was used to analyze the sample for heterogeneity. Bivariate analyses were conducted to identify external variables associated with each of the latent classes.

RESULTS

Three distinct latent classes were found: the sadistic kidnapper; the sadistic torturer; and the sadistic ritualist. External validity testing also revealed distinctive characteristics associated with each class.

CONCLUSIONS

SCSA involves a heterogenous population with distinctive sadistic behavioral manifestations that vary in severity and relate to differences in crime-commission processes and offender characteristics. These findings offer important insights for crime prevention and correctional practice.

Profile of Children With Child Abuse From Serbia

OBJECTIVE

To study the demographic and clinical profile of children with suspected physical or sexual abuse.

METHODS

Retrospective records of children who were admitted to hospital between January, 2015 to December, 2020 with suspected physical or sexual abuse were evaluated.

RESULTS

The records of 52 children [mean (SD) age 12.24 (5.32) y, 39 boys] were retrieved. Contusions were the most common injury in 53.8% of boys and 69.2% of girls. The majority (70%) of 8-18 year-old-children were abused by peers, and parents/caregivers were the main perpetrators in 72.7% of younger children.

CONCLUSION

Child abuse is often underreported, and requires a high index of suspicion and multidisciplinary approach of management.

Psychiatric and Forensic Characteristics of Sex Offenders With Child and With Adult Victims

This study presents psychiatric and forensic characteristics of people accused of a sexual crime and sent for evaluation. Data were drawn from the only institutional psychiatric forensic assessment center in Croatia, during a 9-year period, from January 1, 2010 to December 31, 2018. There were 72 cases of sex offenses: 37 with child victims and 35 with adult victims. People accused of sex offenses with child victims were more often sexually abused during childhood and treated psychiatrically as inpatients. They used alcohol less often. Sex offenders with child victims were diagnosed with narcissistic and antisocial personality disorder, dementia, and pedophilic disorder. Those with adult victims were diagnosed with antisocial personality disorder, alcohol related disorders and dementia. Due to these differences, the management of these two groups of offenders in both mental health and penal systems should be different.

"God, why?": The Experience of Mothers from the Israeli Ultra-Orthodox Sector after their Child's Disclosure of Sexual Abuse

Studies dealing with the experiences of non-offending mothers from the general population and minority groups after their child's disclosure of sexual abuse are scarce, and studies on mothers from the Jewish ultra-Orthodox community are non-existent. This study takes an initial step in filling this gap by exploring how the normalization of sexual abuse shapes these mothers' experiences. A qualitative phenomenological study was conducted on a sample of 21 mothers from the ultra-Orthodox sector whose children had been sexually abused. It consisted of in-depth, semi-structured interviews of the mothers followed by a drawing task on their experience. The analysis of the interviews yielded four central themes: the role of social stigmatization and religion on the mother's ability to share her child's abuse; the effect of the disclosure on the mothers' mental state and maternal competency; the mothers' ongoing experience in the shadow of this unprocessed/unresolved trauma; and the mothers' coping strategies, including acceptance, faith, and meaning making. The findings highlight the influence of the tension between the need to adhere to religious norms and preserve the social fabric and the need to enhance mothers' and children's well-being.

Blaming Children: How Rape Myths Manifest in Defense Attorneys' Questions to Children Testifying About Child Sexual Abuse

Since rape myths were codified in 1980 (Burt, 1980), scholars have shown that individuals who endorse rape myths perceive victims as less credible and more responsible for rape and perpetrators as less responsible. Studies also show that rape myths hinder successful adjudication of rape cases by influencing juries' assessments of perpetrator guilt (Dinos et al., 2015). While most of this research focuses on sexual assaults involving adult victims, some scholars have found that victims as young as 12 are blamed for rape. If rape myths influence the perceptions of sex offenses even when victims are children, then defense attorneys in child sexual abuse (CSA) cases may be motivated to highlight rape myth in CSA trials. In the current study, we conducted a content analysis of the cross-examinations of 122 children, aged 6 to 17, alleging CSA to determine if and how defense attorneys question children about rape myths. We looked for questions about force and resistance, motives to lie, victim precipitation, and character issues (e.g., habitual drug use). We found that defense attorneys commonly referenced rape myths in CSA trials. A total of 10% of all defense attorneys' lines of questioning referenced a rape myth, and attorneys asked 77% of children at least one rape myth line of questioning. Whether or not attorneys asked about different myths and the content of these questions varied by children's age. Our findings indicate that defense attorneys use rape myths strategically to undermine children's credibility in CSA trials, but they adapt (adult) rape myths in ways that are plausible in the CSA context. Policies formed to prevent the prejudicial impact of rape myths at sexual assault trials involving adults (e.g., rape shield laws) may not adequately prevent their impact in CSA trials. Prosecutors, therefore, should address rape myths at CSA trials.

"Explode into small pieces": Suicidal ideation among child sexual abuse survivors

BACKGROUND

Child sexual abuse (CSA) has been acknowledged as predisposing survivors to an increased risk of suicidal ideation and attempts. Despite this risk being widely recognized, the study of suicidality has mainly focused on psychopathology, while less attention has been given to survivors' experiences and perceptions.

OBJECTIVE

This study aims to uncover the experiences and perceptions of suicidality among adult CSA survivors.

PARTICIPANTS AND SETTINGS

The sample consisted of 41 adult CSA survivors' written narratives of abuse that included references to suicide.

METHODS

Written narratives of CSA experiences were collected from 41 adult participants as part of the Israeli Independent Public Inquiry on CSA to change public policy. An inductive thematic analysis guided the exploration of the stories.

RESULTS

The findings portrayed several main themes regarding the survivors' experiences before, during and after suicidal thoughts and behaviors. These themes elucidated their motivations leading to suicidal attempts, including the wish to end one's self and suffering, self-blame, communicate the abuse and the request for recognition. Additionally, the survivors' stories illuminated their experiences following the suicidal attempts, depicting inadequate treatment and difficulties with the psychiatric labeling of a mental health disorder.

CONCLUSIONS

The findings of this study uncover new insights regarding the link between trauma, posttraumatic suffering, and suicidality within a social interaction context. Furthermore, these findings call medical and psychosocial health practitioners to view post-CSA suffering as trauma-related rather than personal psychopathology and to adjust practices to adapt to survivors' experiences and needs.

An Examination of the Synergy of Age and PTSD on Narrative Coherence in Child Sexual Abuse Testimony

In a criminal proceeding, a witness is considered as reliable if he/she can recall in narrative form the events, chronologically ordered, with salient contextual (place and time) details, and essential evaluations for the definition of meanings. This study aimed to confirm the effects of age and PTSD on narrative coherence and to investigate the moderating role of age on the association between PTSD and narrative coherence. Narrative coherence was analyzed in 92 allegations of children (M = 10.3; range: 4-17), who were victims of sexual abuse. Thirty-five children presented the symptoms for a diagnosis of PTSD. Each deposition has been codified through the Narrative Coherence Coding Scheme, a coding scheme based on the three independent dimensions (context, chronology, and theme). Correlation analysis indicated the positive associations between age and context, chronology, and theme; and the negative associations between PTSD symptoms and context, chronology, and theme. Predictive effect of PTSD became less and less significant with increasing age. This study could underline the importance of age and PTSD (and their synergy) in legal testimony of children who have been sexually abused.

Parenting Stress in Non-Offending Caregivers of Sexually Abused Children

The non-offending caregiver (NOC) population is under studied despite their role in the recovery of child victim-survivors of sexual abuse. Research suggests that NOCs experience significant distress following a child's disclosure of sexual abuse. Trauma has been demonstrated to negatively impact the caregiver-child relationship. This study informs about common NOC stress reactions in response to child sexual abuse (CSA) disclosures and has clinical implications for treating families affected by CSA. Participants included 66 NOCs (age 23-66, M = 41.09, SD = 10.26) who participated in clinical intakes at a CSA treatment program and completed a self-report measure of parenting stress. Depending on the child's age, NOCs were administered either the Parenting Stress Index-fourth edition, Short Form (PSI-4-SF) or the Stress Index for Parents of Adolescents (SIPA). NOCs reported higher than average parenting stress. Statistically significant differences between the clinical and normative samples were found on all PSI-4-SF domains and on majority of SIPA domains. High to Clinically Significant scores were reported by 42% of NOCs for Parent-Child Dysfunctional Interaction. Stress related to their child's social withdrawal was reported by 56% of NOCs. This study provides comparison data for evaluations of NOCs. NOCs may require treatment and family-based approaches are implicated.

Predicting Risk of Reoffending in Persons with Child Sexual Exploitation Material Offense Histories: The Use of Child Pornography Offender Risk Tool in a Scottish Population

In the past decade, there has been an increase in child sexual exploitation material (CSEM) offenses and convictions. Although research shows that individuals with CSEM offence histories generally are at low risk of reoffending, certain factors do increase in CSEM convictions, in order to assist with case prioritization, management and supervision, risk assessment is helpful across agencies. The Child Pornography Offender Risk Tool (CPORT) was created specifically for this population and shows significant predictive validity for various outcomes. This study aimed to validate the use of the CPORT in a Scottish sample of 141 adult males who were convicted of CSEM offenses. Receiver Operating Characteristic (ROC) and logistic regression analyses indicated that the CPORT significantly predicted any recidivism (Area Under the Curve = .81), any sexual recidivism (AUC = .78) and CSEM recidivism (AUC = .74), suggesting that it is a valid risk assessment tool for Scottish populations. Recommendations for further research and clinical implications are discussed.

Pediatricians' Attitudes Toward Child Sexual Abuse in the Republic of Srpska

Child sexual abuse (CSA) affects all cultures and sociodemographic sections. As health professionals, pediatricians are often the first line of defense when it comes to CSA identification and reporting. Our previous study examined encounters, competence, beliefs, and reporting regarding CSA among pediatricians in countries of the former Yugoslavia, Serbia, and Montenegro. Following up on this work, we expanded our research to another neighboring country, the Republic of Srpska (RS). Sixty pediatricians were surveyed in 2020, comprising 30% of all practicing pediatricians in the Republic of Srpska. Compared to their colleagues from Serbia and Montenegro, RS pediatricians revealed an increased perception that children are often abused by someone they do know well, were more confident in their abilities to detect CSA, reported a higher number of CSA cases, and were more interested in further trainings on the subject of CSA. Despite this, the level of underreporting remained high (40%). To our knowledge, this is the first study to both assess and compare CSA-related attitudes in this part of the world. Key differences between RS, other two neighboring countries as well as from other countries worldwide are likely to stem from the level of pediatricians' training and education, as well as from the socio-cultural and legislation context. Although encouraging, our data indicate a need for further research in the countries of the former Yugoslavia.

Children's Peritraumatic Responses During Sexual Abuse Incidents: Exploring the Narratives of Children From Different Ethnoreligious Groups in Israel

The peritraumatic response of children during incidents of child sexual abuse (CSA) is a neglected construct in the literature. Despite the widespread use of the fight-flight-freeze model, recent studies have shown that in the unique context of child abuse, additional peritraumatic responses could be relevant. The current mixed-methods study examined children's peritraumatic responses to CSA. The sample consisted of 249 forensic interviews with children aged from 4 to 13 years. An initial qualitative analysis resulted in identifying various ways in which the children responded to the abuse, the children's decision-making around these responses, as well their perceptions of their response. This analysis was followed by quantitative analyses, which explored the frequency of these peritraumatic responses and their correlation with the characteristics of the children and abuse. Six peritraumatic response categories were identified, the most common being fight, flight, and fear. Only ethnoreligious identity was significantly correlated with the fight-or-flight response, with a significantly lower frequency among Muslim and ultra-Orthodox Jewish children. Frequency of abuse and perpetrator familiarity were correlated with the frequency of the fight-or-flight response, indicating that the latter was less relevant in reoccurring incidents of abuse and with perpetrators who were family members. The findings promote the conceptualization of children's peritraumatic responses during incidents of abuse and the realization of the crucial role of children's ecological systems in their peritraumatic responses to incidents of abuse.

Did Your Mom Help You Remember?: An Examination of Attorneys' Subtle Questioning About Suggestive Influence to Children Testifying About Child Sexual Abuse

Researchers studying children's reports of sexual abuse have focused on how questioners overtly assess coaching and truthfulness (e.g., "Did someone tell you what to say?"). Yet attorneys, and defense attorneys, in particular, may be motivated to ask about suggestive influence and truthfulness in subtle ways, such as with implied meaning (e.g., "Did your mom help you remember?"). Such questions may be particularly challenging for children, who may interpret statements literally, misunderstanding the suggested meaning. The purpose of this study was to examine and categorize how attorneys' ask about suggestive influence and truthfulness. We wanted to learn how attorneys subtly accuse suggestive influence, and how frequently this occurred. We hypothesized that questions indirectly accusing suggestive influence would be common, and that defense attorneys would ask more subtle questions, and fewer overt questions, than prosecutors. We examined 7,103 lines of questioning asked by prosecutors and defense attorneys to 64 children testifying about alleged child sexual abuse. We found that 9% of all attorneys' lines of questioning asked about suggestive influence or truthfulness. The majority (66%) of these were indirect accusations. Indirect accusations of suggestive influence spanned a range of subtleties and topics, including addressing conversational influences (e.g., coaching), incidental influences (e.g., witnessing abuse), and others. We also found defense attorneys were less likely than prosecutors to ask about suggestive influence and truthfulness overtly. We conclude that attorneys commonly ask about suggestive influence and truthfulness in subtle ways that developing children may struggle to understand, and which may result in affirmations of influence, even when allegations are true.

Retrospective Perceptions of Grooming in Same-Sex versus Opposite-Sex Child Sexual Abuse

Research on child sexual abuse (CSA) has predominantly focused on opposite-sex (e.g., male adult-female child) adult-child pairs, neglecting same-sex (e.g., male adult-male child) adult-child pairs. Grooming behaviors are an early indicator of CSA and while it is important to recognize grooming to prevent abuse, research has shown that detecting these behaviors is a difficult task. Despite this difficulty, people retrospectively overestimate their ability to recognize abuse once it is clear that abuse has occurred. The current study investigated how outcome information (abuse did or did not occur) and the sex of the adult-child pair influenced perceptions of adult-child interactions. Participants evaluated vignettes depicting grooming and non-grooming behaviors in same-sex and opposite-sex adult-child conditions. Participants who were told CSA occurred provided higher likelihood ratings that abuse occurred than participants who were not given information about the abuse. There was some evidence that gender pairings influenced retrospective perceptions of these interactions.

Child Sexual Abuse of Elite Athletes: Prevalence, Perceptions, and Mental Health

Despite a series of high-profile media reports of sexual abuse in sport over the past few years, little research has been done to explore the scope of the problem in the United States. The current article reports on prevalence of child sexual assault in elite athletes in the United States. Using a retrospective web survey, adults answered questions on their experiences in sport. Of the 473 elite athletes surveyed, 3.8% (n = 18) reported being sexual assaulted as a minor in the sporting context. Of those reporting assault, most (61%) reported being abused by an adult authority figure (usually a coach) and 44% reported being assaulted by a peer. Abused athletes were significantly more likely to report having been diagnosed with a mental disorder (Fisher's exact test; p < .001). The findings can be utilized to improve prevention and child protection measures and other safeguarding initiatives in sport.

Factors that Influence Mock Jurors' Perceptions of Child Credibility

Child sexual abuse (CSA) remains a significant societal problem; however, few CSA cases are actually brought to trial. The cases that do proceed to trial typically involve little evidence, therefore, it is imperative that legal professionals become more aware of possible factors that may contribute to jurors' perceptions of child complainants and in turn influence their case decisions. The goal of this study was to investigate the influence of jury instructions, child complainant age, child's level of sexual knowledge, and preexisting beliefs about CSA on mock jurors' child credibility ratings. Participants (N = 388) evaluated a mock CSA trial transcript and answered questions related to the child's credibility. Results indicated that child credibility was dependent on mock jurors' knowledge about CSA, which in turn, differed by mock juror gender. Pre-evidence jury instructions also influenced mock jurors' CSA misconception endorsements. Child sexual knowledge level did not influence credibility, nor did it interact with child age. Our study suggests that specialized pre-evidence jury instructions may educate legal fact finders about alleged CSA victims and in turn may enhance their views of children in this specific legal context.

The Spanish Posttraumatic Growth Inventory - Short Form in Adult Survivors of Child Sexual Abuse

BACKGROUND

Child sexual abuse (CSA) survivors can experience psychological changes and growth as a consequence of their victimization experience, known as posttraumatic growth (PTG). The purpose of this study was to evaluate the dimensionality, reliability and validity of the Spanish version of the Posttraumatic Growth Inventory - Short Form (PTGI-SF) (Tedeschi & Calhoun, 1996) in a sample of 104 adult survivors of CSA.

METHOD

Different models of PTGI-SF validated in different languages and samples were tested using Confirmatory Factor Analysis.

RESULTS

The results showed that the original five-factor model exhibited the best goodness of fit. Internal consistency was adequate for the general scale, and acceptable for the five different factors. Furthermore, positive correlations were found between the PTGI-SF total score and psychosocial and mental health problems, as well as gender differences, with women tending to report more PTG than men.

CONCLUSIONS

These results suggest that the Spanish PTGI-SF is a brief, reliable, valid self-report measure for assessing PTG experienced by CSA survivors.

Child Sexual Abuse, Self-esteem, and Delinquent Behaviors During Adolescence: The Moderating Role of Gender

To reflect the complex phenomena of child sexual abuse (CSA), studies should examine possible gender specificities and explore potentially explanatory mechanisms. The current study aimed to test the moderating effect of gender in the mediated relationship between CSA, self-esteem, and delinquency during adolescence. A moderated mediation model was tested among a representative sample of 8,194 high school students (57.8% girls and 42.2% boys) age 14 to 18 in the province of Quebec in Canada. Results showed that self-esteem has an indirect effect on the relationship between CSA and delinquency. Gender (being a boy) was associated with a higher level of self-esteem and an increased risk of delinquent behaviors. Among victims of CSA, boys reported lower levels of self-esteem than girls, which was associated with an increased risk of displaying delinquent behaviors. Self-esteem may be an important target of intervention for sexually abused youth, especially for boys. Focusing on promoting positive self-esteem may also reduce the risk for male adolescents struggling with the deleterious consequences of delinquency.

Clergy-Perpetrated Sexual Abuse in Ghana: A Media Content Analysis of Survivors, Offenders, and Offence Characteristics

While there are no official data and published studies on clergy-perpetrated sexual abuse (CPSA) from Ghana, local media reports continue to show worrying trends of the phenomenon. We drew on 73 media reports from January 2000 to March 2019, to describe the offence characteristics and profiles of the perpetrators and survivors of CPSA in Ghana. The findings showed females aged 10-19 as predominant survivors. The perpetrators were all males found guilty of lone rape, incest, defilement, indecent assault, sodomy, attempted rape, or gang rape. A preventive measure could involve streamlining the recruitment, training, and leadership structures of the church.

A Content Analysis of Posts to an Online Support Forum for "Girl Lovers"

The internet is an effective tool for studying the cognitive distortions among those with a sexual attraction to children. Identified through previous works, users of an online "boy love" forum were found to present a variety of justifications for adult-child sexual relations. The current study extends this line of inquiry, analyzing posts from an online "girl love" forum. We found that the most common justification to appear reflected a belief that societal attitudes and authority figures were to blame for the harms caused by adult-child sex. We also found that the forum provided users with support and reinforcement for such distorted beliefs. Overall, online forums provide a window into the cognitive life of individuals with a sexual attraction to children, and one that reflects beliefs that may be largely unexpressed in the confines of forensic treatment settings.

Multidisciplinary Approach to Emergent Sexual Abuse in a Pediatric Emergency Department: A Simulated Child Advocacy Center Model of Care

INTRODUCTION

The purpose of this study was to compare child sexual abuse interview disclosures and judicial outcomes for cases of child and adolescent sexual abuse/assault seen in a pediatric emergency department (PED) before and after the implementation of a simulated child advocacy center (CAC) multidisciplinary model of care.

METHOD

A retrospective chart and legal records review was conducted from both the PED model of care group and the simulated CAC multidisciplinary model of care for judicial outcomes, child sexual abuse interview disclosures, and sexual abuse case characteristics.

RESULTS

The simulated CAC multidisciplinary model of care did not result in increased indictments, pleas, trials, or disclosure of sexual abuse in the sexual abuse interview when compared with the PED model of care. The simulated CAC multidisciplinary model of care did result in a significantly higher rate of sexual abuse interview completion.

DISCUSSION

Demographic risk factors for sexual abuse victimization as well as perpetration have been identified in the literature and were supported by this study. Law enforcement and child protective services were more frequently present in the PED under the simulated CAC multidisciplinary model allowing for improved protection of children.

Reversal of Amnesia for Trauma in a Sample of Psychiatric Inpatients with Dissociative Identity Disorder and Dissociative Disorder Not Otherwise Specified

The authors interviewed 118 highly dissociative inpatients in a Trauma Program with the Dissociative Disorders Interview Schedule, the Dissociative Experiences Scale and the Adverse Childhood Experiences questionnaire; of the 118 participants 42 met DSM-5 criteria for dissociative identity disorder and 52 for other specified dissociative disorder. The average score on the Dissociative Experiences Scale in the sample of 118 participants was 44.7. The authors also conducted semi-structured interviews inquiring about the circumstances and triggers for reversal of amnesia for childhood trauma in the participants. Only a small minority of the reversal of amnesia took place in therapy sessions, and 24 different triggers for remembering were described. Childhood sexual abuse was by far the most common type of trauma for which amnesia was reversed. The findings are inconsistent with the view that amnesia for childhood sexual abuse is reversed primarily during psychotherapy.