Child on child sexual abuse: psychological perspectives

Psychometric evaluation of a single-item screening tool for the presence of problematic sexual behavior among preteen children

BACKGROUND

Preteen children with problematic sexual behavior (PSB) are increasingly coming to the attention of mental health professionals. However, efforts to provide clinical care to these children are hampered by the limited dissemination and implementation of effective screening procedures.

OBJECTIVE

A single-item screening tool designed for implementation in mental health settings was developed and tested for psychometric quality.

PARTICIPANTS

Participants included caregivers of children receiving clinical services as a result of displaying PSB and/or subsequent to disclosure of child maltreatment (n = 341).

METHODS

Caregivers completed the single-item tool at the onset of services and approximately 15 days later. In addition, caregivers completed the Child Sexual Behavior Inventory, the Strengths and Difficulties Questionnaire, and the Child Stress Disorder Checklist-Short Form at the initial assessment.

RESULTS

Analyses demonstrated acceptable test-retest reliability of the tool (phi = 0.70-0.74, p < .001). Validity was established by showing that caregivers providing a positive response on the single-item tool scored children significantly higher on a full-length measure assessing PSB than caregivers denying such concerns on the single-item tool (t = 7.28-9.8, p < .001). However, scores on measures of internalizing concerns and posttraumatic stress symptoms were not distinguished by caregiver responses to the single item tool.

CONCLUSIONS

The newly developed single-item tool appears to offer an efficient, reliable, and valid method of screening preteen children for the presence of PSB.

Pocket ACE: Child sexual abuse survivors missed by the ACEs Study Questionnaire

BACKGROUND

A 1998 seminal study catapulted adverse childhood experiences (ACEs) into the zeitgeist and shaped assessment of these experiences and long-term health consequences via The ACEs Study Questionnaire (ACE-SQ). However, the ACE-SQ's childhood sexual abuse (CSA) item requires the perpetrator have been 5-years or older than the survivor for endorsement. This may not adequately capture CSA and limit the questionnaire's ability to detect survivors.

OBJECTIVE

This study assessed whether CSA survivors were missed by this 5-year modifier, whether service access was restricted, and whether those missed were at elevated risk for adverse outcomes.

PARTICIPANTS AND SETTING

A sample of 974 women (M_age = 30.46) completed an online survey.

METHODS

Histories of CSA were assessed using the original ACE-SQ and an alternative version without the 5-year modifier. Participants were grouped by endorsement (Modifier, No Modifier, No CSA) and compared across numerous physical and mental health outcomes using MANOVA, ANOVA, and logistic regression.

RESULTS

Numerous CSA survivors are presently missed by the 5-year modifier (n = 118 of N = 249). This group demonstrated the same elevated depression (t = 3.44, p = .002, d = 0.34), heightened somatic symptom burden (t = 3.34, p = .003, d = 0.35), and poorer subjective health (t = -2.86, p = .012, d = 0.27) as those captured by the modifier.

CONCLUSIONS

Recommendations for research, practice, and policy include removing the 5-year modifier from CSA assessment, creating an empirically informed CSA definition, and eliminating or adjusting requisite cut-scores for accessing services.

Barriers to Accessing Treatment Services: Child Victims of Youths with Problematic Sexual Behavior

Child sexual abuse (CSA) remains a significant public health problem. Although the deleterious effects on the child victims could be mitigated through evidence-based interventions, victims often fail to be identified and receive clinical assessment and therapy services, particularly when they have been victimized by another youth. Given that at least a third of CSA cases are committed by another youth, understanding the process of identifying and addressing the needs of CSA victims of youth is the focus of the present study. Factors impacting services for child victims of youths with problematic sexual behavior (PSB) were examined through qualitative interviews (N = 226) with mental health agency administrators, direct service providers, and community stakeholders from eight geographically diverse communities across the United States. Responses focused on macro and micro level barriers to the identification and service provision for child victims of PSB of youths. Implications for clinicians and policymakers are discussed, along with strategies to enhance access and provision of services to meet the needs of the child victims.

Disclosure of Sibling Sexual Abuse by Hospitalized Adolescent Girls: Three Case Reports

Although sibling sexual abuse (SSA) may be the most common type of intrafamilial sexual abuse, it has not been widely studied. The lack of studies makes it very difficult for clinicians to create a comprehensive framework about this complex phenomenon, particularly in comparison with other forms of intrafamilial sexual abuse, such as father-daughter incest. SSA is still underrecognized and underdisclosed but it has the potential to be every bit as harmful as sexual abuse by a parent. The topic rarely finds its way into the more general psychiatry or social work literature. It is imperative to increase healthcare practitioners' awareness of this complex subject to improve their ability to listen to, detect, and manage the disclosures of SSA in adolescent populations. This paper presents vignettes of three 13-to-15-year-old adolescent girls who disclosed SSA during inpatient hospitalization in an adolescent psychiatric and medicine department. These cases illustrate the complexity of SSA, which has been associated with a wide spectrum of both mental and physical symptoms. Adolescent victims of SSA experience serious distress, with various and numerous psychiatric manifestations, including but not limited to depression and suicide attempts, addictive behaviors, post-traumatic stress symptoms, and eating disorders. Physical symptoms should also alert practitioners: adolescent survivors are more likely to be affected by somatic complications such as sexually transmitted diseases, chronic pain, urogenital symptoms, and nutritional disorders. We offer some recommendations to improve the detection and support of distressed adolescents disclosing SSA. Listening to them and offering a protective multidisciplinary response can limit the lasting damage and contribute to the repair process.

Situational Factors Related to Childhood Sexual Abuse in the Orthodox Jewish Community Among Adult and Juvenile Offenders

In recent years, increasing attention has been paid to situational factors associated with childhood sexual abuse (CSA) to explain incidence of CSA, as well as to provide potential targets for prevention efforts. However, very few studies have examined situational factors associated with juvenile perpetration, despite juveniles composing a substantial proportion of offenders. In addition, no studies to our knowledge have applied a situational framework to CSA research in the Orthodox Jewish community (OJC). In the present study, we obtained data from therapists regarding 80 victims of CSA in the OJC from both the United States and Israel. We hypothesized that (a) more abusers' first perpetration would be between ages 12 and 17 than between any other age range, which corresponds to increased sexual urges, as well as increased unsupervised access to minors; (b) among juvenile offenders, the time of day of the abuse would depend on the relationship of the offender to the victim; and (c) age of the victim and grooming strategies would be associated with the frequency of abuse. Our first two hypotheses were confirmed, and our third hypothesis was partially confirmed, as younger victims tended to have higher frequency of abuse. Additionally, we discuss possible implications of significant correlations found during exploratory analyses. Our results generally support the importance of considering culturally specific situational factors when studying or developing prevention efforts for CSA.

Educators' Observations of Children's Display of Problematic Sexual Behaviors in Educational Settings

It is widely recognized that children are sexual beings and their sexual development begins at an early age. Recently, there has been some concern about children's sexual behavior in educational settings (Knowles 2014). Obtaining a better understanding of what behaviors children are displaying in these settings provides valuable information to inform teacher education in this area as well as support systems for children. One hundred and seven Australian educators from care organizations, preschools, and government, independent, and Catholic primary schools participated in an extensive online questionnaire in relation to their understanding of and experiences with children's problematic sexual behaviors and their management strategies. Results found that 40.8% of educators had observed children displaying problematic sexual behavior in their educational setting. Educators' descriptions of their observations variously involved children physically acting out sexually with other children, sexually harassing other children, verbally attempting to coerce other children to participate in sexual behavior, and individual displays of sexual behavior. A minority described behaviors that are considered developmentally typical but are not socially acceptable in an educational setting. These results indicate that there is a need for educator training, child education, and support services to enable an early intervention and prevention strategy to support the well-being of children.

From My Own Brother in My Own Home: Children's Experiences and Perceptions Following Alleged Sibling Incest

Sibling incest is an understudied field despite its high prevalence rates. The current study was designed to characterize the way children describe their experiences and perceptions following alleged sibling incest. The sample consisted of 20 forensic investigations with children who were referred to forensic investigation following suspected sibling incest. The age range of the children was between 6 and 12 years old, including 17 girls and three boys. Thematic analysis was conducted on all the interviews and the children's perceptions greatly echoed the ecological framework while they elaborated on three levels: family level, in which children discussed the context of the abuse and the disclosure; sibling level, in which children discussed their siblings' behaviors and the grooming process; and the child level, in which the children discussed their own behavior during the abuse. The discussion highlights the relevance of the ecological framework to the study's results and stresses the complexity of this phenomenon and the challenges it raises for practitioners in various contexts-child protective, forensic, and clinical.

Sibling sexual abuse: why don't we talk about it?

AIMS AND OBJECTIVES

To explore two hypotheses for explaining why there is little written about sibling sexual abuse and to raise awareness of the subject in order better to protect children and to facilitate sensitive patient care.

BACKGROUND

While there is no universal agreement over its definition, sibling sexual abuse is acknowledged internationally as a prevalent form of child sexual abuse but tends not to be recognised by health professionals. It is also under-represented within the literature in comparison with other forms of intrafamilial sexual abuse. Understanding why this is may help to illuminate the potential barriers to effective professional responses. Two explanations which emerge strongly are the existence of a sibling incest taboo and a prevailing belief that sibling sexual behaviour is largely harmless.

DESIGN

Discursive position paper.

METHOD

The paper examines the two hypotheses through exploration of the extant literature on sibling incest and sibling sexual abuse.

CONCLUSIONS

Sibling sexual abuse accounts for a significant minority of child sexual abuse and has the potential to be as harmful as sexual abuse by a parent. An abhorrence at the thought of sibling sexual activity and a prevailing view of its harmlessness may hinder nurses' detection of and appropriate responses to sibling sexual abuse, but do not provide convincing explanations for the dearth of literature. Instead, a deeply held perspective of sibling relationships as non-abusive offers a more profound explanation.

RELEVANCE TO CLINICAL PRACTICE

A knowledge of sibling sexual abuse and its consequences are important both for the effective protection of children and the sensitive and appropriate treatment of patients who present with a variety of physical and mental health concerns. A perspective that sibling relationships are non-abusive provides a deeper level of understanding of the powerful obstacles to raising awareness of and responding appropriately to this form of abuse.

Etiological Risk Factors for Sibling Incest: Data From an Anonymous Computer-Assisted Self-Interview

Retrospective data from 1,821 women and 1,064 men with one or more siblings, provided anonymously using a computer-assisted self-interview, were used to identify risk factors for sibling incest (SI); 137 were participants in SI. In order of decreasing predictive power, the risk factors identified by the multiple logistic regression analysis included ever having shared a bed for sleeping with a sibling, parent-child incest (PCI), family nudity, low levels of maternal affection, and ever having shared a tub bath with a sibling. The results were consistent with the idea that SI in many families was the cumulative result of four types of parental behaviors: (a) factors that lower external barriers to sexual behavior (e.g., permitting co-sleeping or co-bathing of sibling dyads), (b) factors that encourage nudity of children within the nuclear family and permit children to see the parent's genitals, (c) factors that lead to the siblings relying on one another for affection (e.g., diminished maternal affection), and (d) factors that eroticize young children (e.g., child sexual abuse [CSA] by a parent). Thirty-eight of the 137 SI participants were participants in coerced sibling incest (CSI). In order of decreasing predictive power, risk factors for CSI identified by multiple logistic regression analysis included ever having shared a bed for sleeping with a brother, PCI, witnessing parental physical fighting, and family nudity. SI was more likely to have been reported as CSI if the sibling had touched the reporting sibling's genitals, and less likely to have been reported as CSI if the siblings had shared a bed.

Psychological Symptoms of Sexually Victimized Children and Adolescents Compared With Other Maltreatment Subtypes

The differential effects of sexual victimization and other forms of maltreatment on psychological functioning are not well understood. A sample of sexually victimized children and adolescents (N = 70; 6.3-17.9 years) and a group of youth with a history of nonsexual maltreatment (N = 108; 6.7-16.9 years) were compared using measures of mental health and psychosocial functioning. Assessments included standardized clinical interviews on individual maltreatment history and current psychopathology as well as questionnaires on behavioral and emotional symptoms, including posttraumatic stress symptoms. The results from this study suggest that the risk of experiencing any current mental disorders was independent of type of maltreatment. The risk of meeting the criteria for a current diagnosis of major depression, however, is greater among youth with a history of maltreatment that includes sexual victimization. The significant impact of sexual victimization on posttraumatic stress symptoms was found to be nonsignificant after controlling for age and gender effects. The results indicate that the outcomes of child maltreatment depend on type of maltreatment, but age and gender must be taken into account.

Lifetime Prevalence and Characteristics of Child Sexual Victimization in a Community Sample of Spanish Adolescents

The purpose of this study was to investigate the lifetime prevalence and characteristics of self-reported child sexual victimization and associations between sexual victimization and sociodemographic characteristics and victimological profiles in community adolescents in Spain. The Juvenile Victimization Questionnaire (Finkelhor, Hamby, Ormrod, & Turner, 2005) was applied to a sample of 1,105 community adolescents (M = 14.52 years, SD = 1.76). Experience of sexual victimization (with or without physical contact) was reported by 8.8% of the sample, at a mean age of 13 years old. Sexual victimization was more prevalent in girls (14.2%) and in older adolescents (10.6%). Offenders were mainly male (87.6%) and were mostly friends, neighbors, or schoolmates (52.6%). No injuries resulted from victimization (4.3%), although the percentage of penetration or attempted penetration was very high (30.6%). Only 9.3% of victims reported the incident to the police or the justice system. In regard to victimological profiles, sexual victims also experienced other forms of victimization (M = 7.16; SD = 3.39): boys reported more conventional crimes, peer and sibling victimization, and witnessing community violence than other victims, whereas sexually victimized girls reported more caregiver victimization and property crimes. Sexually victimized youth present a distinctive sociodemographic and victimological profile. Professionals need to be aware of these characteristics in order to conduct adequate prevention programs. We also need to assess a wide range of victimization experiences when treating sexual abuse victims in order to make adolescents less vulnerable to violence.

The Impact of Sexual Abuse Committed by a Child on Mental Health in Adulthood

Numerous research studies document the negative mental health outcomes associated with the experience of childhood sexual abuse. In addition, factors such as one's relationship with the perpetrator and the severity of the abuse predict the likelihood of future mental health problems. Less attention, however, has focused on the age of the perpetrator, and recent years have seen an increased interest in children who display sexual behavior problems. College students completed measures of mental health functioning and retrospective reports of maltreatment histories. Participants were categorized as abused by an adult (n = 48), teenager (n = 39), or another child (n = 37), and non-abused (n = 219). Victims of abuse, regardless of perpetrator age, displayed higher levels of mental health problems than non-abused participants. There were no differences between the abused groups on any of the mental health outcomes; however, individuals who were abused by other children were less likely to label their experiences as abuse.

The Korean version of the trauma symptom checklist for children: psychometric properties and the connection to trauma among Korean children and adolescents

The purpose of the present study was to develop a Korean version of the trauma symptom checklist for children (TSCC) and to examine its reliability and validity for screening posttraumatic stress symptoms. A normative group of 405 children and adolescents aged 8 to 16 yr participated in the study. A test-retest procedure was conducted with 76 participants from the normative group after 4 weeks. In the traumatized group, 73 children and adolescents of the same age from the Child Sexual Abuse Treatment Center were included. Good internal consistency (Cronbach's alpha) for the total scale (0.95, ranging 0.79-0.85 on the clinical scales) and test-retest reliability for the total scale (r=0.91, ranging 0.71-0.87 on the clinical scales) were found. Confirmatory 6-factor analysis explained 51.1% of the variance. Other measures such as concurrent or discriminative validity were also shown to be satisfactory. In conclusion, the Korean version of TSCC has been shown to be a screening instrument with satisfactory psychometric qualities that is capable of identifying trauma symptoms among children and adolescents who have self-reported experiencing trauma or for whom clinicians have identified traumatic experiences.

What happened to Eric? The derailment of sexual development

A variety of theoretical approaches, from the individual to ecological levels, was applied to the following clinical case in order to understand why a five-year-old boy demonstrated sexual behavior. Inappropriate sexual behavior in children is presented as symptomatic of problems in intrapersonal and interpersonal boundaries, relationship capabilities, and superego consolidation. The case material emphasizes that only when the child is helped to stop his sexual acting out can he access the sources of his emotional distress. The theoretical underpinnings that are relevant to this case will be shown as instrumental in the therapy of this child and his family. By integrating theory with practice, we hope to highlight this sensitive and prevalent issue as well as aid in the early identification and treatment of sexually problematic behavior.

Adolescent male peer sexual abuse: an issue often neglected

Traditionally, sexual abuse is under-reported and under-recognized when the victims are boys. A study carried out by the Government of India in 2007 suggests that every second child/adolescent in the country faces some form of sexual abuse and it is nearly equally prevalent in both sexes. The significance of the problem is undermined all the more when the abuse is perpetrated by a peer. Sexual activity between children and adolescents that occurs without consent or as a result of coercion is tantamount to abuse. A majority of the victims do not disclose the occurrence to anyone. This often neglected issue of adolescent male peer sexual abuse in a sexually conservative country like India is highlighted and discussed through this case, which came to light only after the victim developed a venereal disease.

A comparison of peer and non-peer exposure to unwanted early sexual experiences among students in South Africa and Belgium

OBJECTIVE

This study examined peer and non-peer unwanted early sexual experiences (UESE) among 3,689 university students to establish whether peer UESE is as coercive and bothersome as non-peer UESE.

METHOD

A self-report checklist was administered to all consenting students attending an orientation programme at one South African (SA) and one Belgian university.

RESULTS

Of the respondents 21% indicated that they had UESE before their 16th birthday (39.2% SA and 13.5% Belgians). Of respondents indicating UESE, 22.4% (173) reported that they had UESE with a person where the age difference was greater than 5 years and 54.2% (418) reported UESE with an age difference less than 5 years. Overall, a statistically significant difference was found between peer exposed and non-peer exposed groups at the time the UESE occurred related to bothersomeness of the UESE. SA men and women experienced more psychological pressure or physical force among the non-peer exposed group than the peer exposed group.

Tipos e consequências da violência sexual sofrida por estudantes do interior paulista na infância e/ou adolescência

Discutem-se os tipos de Violência Sexual (VS) sofridos na infância e/ou adolescência e suas vicissitudes, nas trajetórias sexuais de 236 adolescentes, de ambos os sexos, cursando o Ensino Médio no interior do Oeste Paulista que declararam ter sofrido um ou mais tipos de violência sexual. Dentre esses tipos, destacamos a Violência Doméstica Sexual (VDS), aqui definida como intrafamiliar. Nesse caso, observamos que, dentre os 236 adolescentes com histórico de VDS, 94 (39.8%) declararam ter pensado em suicídio e 39 (16.5%) disseram ter tentado, sendo que 35 (89.7%) deles se declararam heterossexuais (27 [77.1%] do sexo feminino) e 4 não-heterossexuais (3 bissexuais e 1 "outro", sendo todos do sexo feminino). A maioria das vítimas finda por relatar o ocorrido aos amigos e responsáveis, mas pouco ou nada é feito, em termos de medidas protetivas a elas.

Polytraumatization and trauma symptoms in adolescent boys and girls: interpersonal and noninterpersonal events and moderating effects of adverse family circumstances

The objective of this study was to investigate the cumulative effect of interpersonal and noninterpersonal traumatic life events (IPEs and nIPEs, respectively) on the mental health of adolescents and to determine if the adverse impacts of trauma were moderated by adverse family circumstances (AFC). Adolescents (mean age 16.7 years) from the normative population (n = 462) completed the questionnaire, the Linköping Youth Life Experience Scale (LYLES), together with Trauma Symptom Checklist for Children (TSCC). The lifetime accumulation of interpersonal, noninterpersonal, and AFC was independently related to trauma-related symptoms in both boys and girls. The number of AFCs moderated the mental health impact of both IPEs and nIPEs in boys but not in girls. Cumulative exposure to both interpersonal and noninterpersonal traumatic events is important for the mental health of adolescents, and, at least for boys, family circumstances seem to be relevant for the impact of trauma. Our results suggest that broader approaches to the study, prevention, and treatment of trauma, including consideration of cumulative exposure, different types of trauma, and additional social risk factors, could be fruitful.

Differences in perceptions of child sexual abuse based on perpetrator age and respondent gender

Child sexual abuse changes the lives of countless children. Child sexual abuse victims experience short and long term negative outcomes that affect their daily functioning. In this study, undergraduate students' perceptions of CSA were obtained using vignettes with an adult or child perpetrator and a general questionnaire. Results indicated participants receiving the child-on-child vignette were less likely to rate the vignette as abuse, saw the abuse as less severe, and assigned less blame to the perpetrator than participants reading the adult-on-child vignette. On a general questionnaire, male participants saw child-on-child abuse as less severe and more encouraged by society than did female participants. The information can be utilized by professionals in treatment planning and preventing revictimization at disclosure.

Sibling sexual abuse: an empirical analysis of offender, victim, and event characteristics in National Incident-Based Reporting System (NIBRS) data, 2000-2007

Sibling sexual abuse is identified as the most common form of familial sexual abuse. Extant literature is plagued by definitional inconsistencies, data limitations, and inadequate research methodology. Trivialized as "normal" sexual exploration, sibling sexual abuse has been linked to psychosocial/psychosexual dysfunction. Research has relied on retrospective, convenience, and/or homogenous samples. This work drew on eight years of National Incident-Based Reporting System data (2000-2007) to provide aggregate level baseline information. This work extended prior research exploring victim-, offender-, and incident-based characteristics. Results highlight the need for expanded definitional criteria relating to both age and gender to better inform risk assessment and prevention. Findings both corroborate and contrast prior work and suggest victim- and offender-based gender differences.

[Children and adolescents with sexual behaviour problems in residential and partially residential welfare services]

The article considers how sexual behaviour problems in children and adolescents can be defined and investigates the degree to which the system of child welfare in Germany is confronted with clients demonstrating different kinds of problematic sexual behaviour. For the first time, the magnitude of this problem can be estimated by a secondary analysis of data from EVAS ("Evaluation System for Child and Adolescent Welfare Services"), a questionnaire-based evaluation system which supports youth care providers in their quality management. Data on more than 5,000 children and adolescents provided by a questionnaire completed at the point of admission to support services, as defined by paragraphs 32 or 34 SGB VIII (German Child Welfare legislation), is analysed. Information is provided on; prevalence of sexual behaviour problems and disorders of sexual behaviour; comorbidity; resources; psychosocial pressures; reasons for admission; and previous experience of child welfare systems. Clients with non-sexual symptoms function as a control group.

The psychometric properties of the Trauma Symptom Checklist For Children (TSCC) in a sample of Swedish children

OBJECTIVE

To evaluate the psychometric properties of the Swedish version of the Trauma Symptom Checklist for Children (TSCC) and to study traumatic symptoms in a normative group of Swedish children and adolescents.

METHOD

A normative group of 728 children and adolescents age 10-17 and a clinical group of 91 children and adolescents known to have experienced sexual abuse participated in the study. A test-retest procedure was conducted with 79 participants from the normative group.

RESULTS

Good reliability such as internal consistency (Cronbach's alpha) for the total scale .94 (ranging in the clinical scales .78-.83) and test-retest for the total scale r=.81 (ranging in the clinical scales .67-.81) were found. The confirmatory 6-factor analysis explained 50.7% of the variance. Other validity measures such as concurrent validity and criterion related validity were also shown to be satisfactory. The normative sample of Swedish children and adolescents showed lower means on the subscales than has been reported in previous studies from a number of other countries.

CONCLUSION

The Swedish version of TSCC has been shown to be a screening instrument with satisfactory psychometric qualities that is capable to identify trauma symptoms among children and adolescents who have themselves self-reported experiencing trauma or for whom clinicians have identified traumatic experiences.

Child peer sexual abuse: preliminary data on outcomes and disclosure experiences

OBJECTIVE

This study compared experiences of children sexually abused by peers to those of children abused by adolescents/adults. Variables examined included perceived negativity of the abuse, self-reported outcomes, overall psychological functioning, and disclosure.

METHOD

An archival data set containing retrospective reports of childhood sexual experiences was culled for instances of sexual abuse by child peers and adolescents/adults. An equivalent nonabused comparison group was identified. The Self-Report Outcome Checklist (SROC; Gilbert, 1994b), the MMPI-Hugo Short Form (Hugo, 1971) and a disclosure survey were also retrieved from these data.

RESULTS

Compared to abuse by peers, abuse perpetrated by adolescents/adults was more intrusive and intrafamilial. Both groups rated their experiences as equally negative, and reported equally pervasive outcomes. Those abused by adolescents/adults reported significantly higher scores on the Psychopathic Deviate, Psychasthenia, and Schizophrenia scales compared to nonabused controls; similar findings did not emerge for those abused by child peers. Less than a fourth in either abuse group reported disclosing their experience to a parent. Among those who did not disclose, participants abused by child peers anticipated less support from both parents and more anger from their mothers.

CONCLUSIONS

The findings suggest that child peer sexual abuse may be associated with adverse outcomes.