[Child sexual abuse. Epidemiology, clinical diagnostics, therapy, and prevention]

The article provides an overview of the research on sexual abuse and the current political developments in Germany. First, the terminology of sexual child abuse is discussed, followed by the presentation of epidemiological data. The section on diagnostics and therapy shows that--because of mostly nonspecific indicators--the diagnosis of child sexual abuse is very difficult to define. Child sexual abuse is discussed as a traumatic experience for children and adolescents with different psychiatric and physical diseases. Current studies have shown that especially cognitive behavioral therapeutic-oriented approaches are effective in curing posttraumatic stress disorders. Based on the new German Child Protection Act, the focus lies on the clarification of confidentiality for medical professionals and their right to consulting services for child protection. In conclusion, guidelines and minimum standards for a child prevention and protection model are presented as well as institutional recommendations addressed to all institutions (also clinical) that take care of or treat children and adolescents.

Complex traumatic stress in the pediatric medical setting

There has been a recent increase in research focusing on child complex traumatic stress following prolonged or repeated trauma. These traumatic stress reactions often affect many aspects of the child's functioning, including psychological, behavioral, and physical health. In addition, complex traumatic stress experienced by youth with serious medical conditions may influence health issues such as medical adherence, emotional adjustment to illness, and pain management. This article reviews and delineates the current state of the literature on the impact of complex traumatic stress in childhood on mental and physical health as well as on these pediatric health-related issues. To date, few empirical studies have directly addressed this association. Several features associated with complex traumatic stress, such as emotion regulation difficulties, disruptive behavior, and family conflict, have indirectly been demonstrated to interfere with pediatric adherence, medical coping, and pain management. This demonstrates the need for more focused research in this area.

Entwicklung, Implementierung und erste Ergebnisse eines webbasierten Erhebungsrasters für die telefonische Anlaufstelle der Unabhängigen Beauftragten zur Aufarbeitung des sexuellen Kindesmissbrauchs in Deutschland

Im Rahmen der Aufarbeitung des sexuellen Missbrauchs von Kindern wurde durch die Unabhängige Beauftragte eine telefonische Anlaufstelle eingerichtet. Anrufer haben die Möglichkeit, Erfahrungen, Kritik und Anregungen an die Politik zu äußern; diese sollen in die Empfehlungen der Unabhängigen Beauftragten an den Runden Tisch „Sexueller Kindesmissbrauch in Abhängigkeits- und Machtverhältnissen in privaten und öffentlichen Einrichtungen und im familiären Bereich“ und an die Bundesregierung einfließen. Um die Informationen der Betroffenen für die Arbeit der Unabhängigen Beauftragten nutzbar zu machen, wurde ein webbasiertes Dokumentationsraster zur anonymen Erfassung der Anliegen der Anrufenden entwickelt. Von den Ende Mai bis Mitte Juli 2010 eingegangenen Anrufen (N = 962) liegen N = 510 auswertbare Datensätze vor. Neben der Darstellung des Dokumentationsrasters, werden die ersten deskriptiven und qualitativen Ergebnisse vorgestellt und hinsichtlich ihrer Anforderungen an die Politik diskutiert. Das am häufigsten genannte Anliegen der Anrufenden ist eine Verbesserung der Qualität von Traumatherapien und eine Ausweitung der psychotherapeutischen Angebote (z. B. auf ältere Menschen, Männer). Weitere zentrale Themen waren Entschädigung/Strafverfolgung, Fortbildung/Weiterbildung von Fachpersonen, Enttabuisierung/Prävention und das Thema Vertrauen in die Politik.

Psychological impact of trauma on developing children and youth

All too often, children and adolescents are exposed to traumatic events that lead to physical injury in many cases, psychological perturbation in most cases, and enduring psychological reactions, notably posttraumatic stress disorder, in a minority of individuals. This sequence of events can affect later development, learning, emotions, and behavior. In the process of caring for the physical injury, it is important for the primary care practitioner (PCP) to correctly interpret these presentations and anticipate the need for specific assessments, immediate intervention, referral, and follow-up. This report provides the foundation for such actions on the part of the PCP.