Child Sexual Abuse and Criminal Offending: Gender-Specific Effects and the Role of Abuse Characteristics and Other Adverse Outcomes

What are the Experiences of and Interventions for Adult Survivors of Childhood Sexual Abuse in South Asia? A Systematic Review and Narrative Synthesis

Adult survivors of childhood sexual abuse (CSA) may experience emotional, social, and psychological difficulties, heightened due to the interpersonal nature of harm. Despite the demonstrated effectiveness of trauma-focused treatments in the West, a culturally specific understanding of the needs of and treatments for survivors in South Asia is still in its infancy. The study aimed to systematically review research findings on the mental health impacts of CSA on adult survivors and current treatment approaches and their efficacy and acceptability in South Asia. Seven databases (Scopus, Ovid, CINAHL, ProQuest, EThOS, Google Scholar, and Dogpile) and five peer-reviewed South Asian journals were searched from inception until March 30, 2023. Searches included participants who were adult survivors of CSA of South Asian origin residing in South Asia. Studies on their mental health, different treatments, and the efficacy and acceptability of these treatments were included. Quality assessment tools were used to appraise the quality of included studies. The results were synthesized narratively. A total of 3,362 records were retrieved, and 24 articles were included in the final review. Twenty studies reported mental health impacts of CSA on adult survivors, four studies reported current treatments offered, and two studies were on recovery. However, no study focused on the efficacy or acceptability of the treatments being delivered. Even though the needs of adult CSA survivors in South Asia have been partly identified, there is very little research into the treatments for them.

Empowering Young People with Special Educational Needs to Recognize and Report Child Sexual Exploitation and Abuse: A Mixed-Methods Review

Young people with special educational needs (SEN), such as intellectual disability and/or autism, are particularly vulnerable to child sexual exploitation and abuse (CSEA). This mixed-methods systematic literature review consolidates findings in respect to how young people with SEN are currently being taught about CSEA in the UK, incorporating empirical and practice-based findings to counteract publication bias. Key databases were searched, and relevant organizations were contacted regarding studies published between 2015 and 2022 (inclusive). Thirteen articles met the inclusion criteria. Of these, 10 adopted a qualitative methodology, and three a mixed-methods approach. The thematic synthesis of the qualitative studies identified the following themes: (a) beliefs and stereotypes about CSEA, vulnerability. and risk have led to young people with SEN being misinformed and misunderstood, and (b) anxiety about the topic of sex and abuse creates polarized views regarding CSEA education in adult guardians of young people with SEN. Themes are discussed in the context of societal biases in respect to vulnerability and risk, and these biases are considered to have a negative effect on how young people with SEN are supported. The findings of this review encourage providers of CSEA awareness education to be mindful of not endorsing harmful stereotypes, and to involve parent-carers as much as possible. This review additionally encourages services and organizations to increase focus on practitioner reflexivity and regular training to counteract potential biases in respect to gender, vulnerability, and risk.

Early childhood memories of individuals convicted of sexual offences

This study used innovative transdisciplinary methods to describe the nature and extent of early childhood memories recalled by 84 adults convicted of sexual offences. The timing of the memories, level of detail recalled and way memories were recollected were largely consistent with extant memory research. One important finding, however, was that more than 30% of our participants recalled particularly traumatic and distressing childhood experiences - a much higher proportion than previously observed in nonoffending samples. The extent to which these memories laid the foundation for subsequent emotional content and feature in the evolution of cognitive schemata is not yet well understood. With that in mind, we consider the implications of our findings for the event centrality in self-narratives. We recommend the inclusion of treatment modalities that maximise as yet unrecognised and undervalued narrative inclinations and story-telling abilities of a complicated population of individuals with rich lived experience that stands to benefit greatly from such approaches.

Validation and measurement invariance of the childhood trauma questionnaire short form among incarcerated men and women in Spain

BACKGROUND

Childhood trauma is highly prevalent among incarcerated individuals and contributes to a range of negative outcomes. Assessing traumatic childhood events in prison settings requires valid, reliable, and effective instruments.

OBJECTIVES AND METHODS

This study evaluated the performance of the Childhood Trauma Questionnaire - Short Form (CTQ-SF), originally developed and validated in English, within a sample of incarcerated men and women (n = 1118 and n = 207, respectively) in six Spanish prisons.

RESULTS

The results indicated that the CTQ-SF had an acceptable fit in our sample. However, the internal consistency of the Physical Neglect subscale was found to be deficient (α = 0.57), especially among women (α = 0.43). This finding aligns with previous research across different contexts, which may signal weaknesses in the original construction of this subscale. The CTQ-SF demonstrated limited invariance between men and women, with only configural invariance being achieved, constraining the comparisons that can be made across sexes. In the absence of scalar invariance, comparisons of factor means to assess severity may be misleading, and caution is recommended when comparing prevalence estimates for men and women in Spanish prisons. Nonetheless, our findings support the convergent validity of the CTQ-SF, as trauma severity showed moderate correlations with depression, anxiety, stress, and aggression.

CONCLUSIONS

These results underscore the importance of evaluating the performance of instruments across various cultural contexts and populations to ensure the validity of study conclusions.

The experience of childhood sexual abuse: An exploratory description of psychological and adaptive functioning in Canadian men

BACKGROUND

Childhood sexual abuse (CSA) affects a number of men yet knowledge gaps remain around comprehensively describing psychological and adaptive outcomes for this population.

OBJECTIVE

Examine how a Canadian sample of men with and without CSA histories compares on broader areas of psychological and adaptive functioning.

PARTICIPANTS AND SETTING

This exploratory study included 109 adult men aged 25-60 years who were grouped according to whether they experienced CSA (n = 69) or not (n = 40). Participants were recruited from Ottawa, Ontario, Canada.

METHOD

Using a multi-method approach, we conducted an exploratory and comprehensive examination of how CSA contributes to various areas of psychological (e.g., depression, anxiety, stress, dissociation, anger, PTSD) and adaptive functioning (e.g., friendship quality, employment) using self-report and clinician-administered measures.

RESULTS

CSA men were an average of 8.5 years old at abuse onset. Most (62.3 %) had disclosed their CSA experience, waiting an average of 13.6 years before disclosure. After controlling for covariates (i.e., other types of maltreatment, non-maltreatment adversities, education, income), results indicated a significant association between CSA and men's psychological functioning, but not their adaptive functioning.

CONCLUSIONS

Findings highlight the importance of broadening our understanding of how the experience of CSA, controlling for important covariates, can contribute to the well-being of men in order to better respond to their psychological needs.

Trauma-Informed Sentencing: How South Australian Sentencing Judges Use Information About defendants' Child Sexual Abuse Victimization and Subsequent Trauma

This article explores how South Australian judges use information about child sexual abuse (CSA) victimization history and its potentially traumatic impact, when sentencing adult defendants. Past research indicates that sentencing outcomes may significantly improve if judicial officers are "trauma-informed." "Trauma" is the distressing impact of adversity on an individual's social and emotional well-being. Drawing from a sample of 33 sentencing remarks within which judicial officers have identified defendants with histories of CSA, this article applies a trauma-informed practice framework to explore the degree to which the sentencing of these defendants may be trauma-informed. Finally, the paper discusses potential initiatives to better achieve community safety when sentencing people with trauma from CSA. The findings are highly transferable, given the parallels in the sentencing calculus across countries that have a Westminster system of law.

Does Trauma Exacerbate Criminal Behavior? An Exploratory Study of Child Maltreatment and Chronic Offending in a Sample of Chinese Juvenile Offenders

(1) Background: Maltreated children are at increased risk for juvenile delinquency. Extant research has explored the effect of child maltreatment on either the initial risk of juvenile delinquency or general juvenile recidivism. However, little is known regarding the effect of child maltreatment on chronic offending. (2) Methods: Using a sample of 695 male juvenile offenders incarcerated in a centralized juvenile reformatory of the province X located in Southwest China, this study investigates both the prevalence of child maltreatment and the effect of child maltreatment on chronic offending among the juvenile offenders. Descriptive statistical analyses and multinomial logistic regression were utilized to conduct the analyses. (3) Results: A vast majority of the juvenile offenders experienced at least one type of child maltreatment. Moreover, maltreatment was generally found to be more prevalent in chronic offenders than in one-time offenders and recidivists. Results from a series of logistic regression analyses revealed that among five specific maltreatment types, only physical abuse exerted a statistically significant and positive impact on chronic offending. (4) Conclusions: The findings highlight the importance of providing early prevention and intervention programs to juvenile offenders who were physically abused in order to reduce general chronic offending as well as chronic violent offending.

Five year cost savings of a multimodal treatment program for child sexual abuse (CSA): a social return on investment study

BACKGROUND

Specialized mental health services for the treatment of Child Sexual Abuse (CSA) are generally expensive and labour intensive. They require a trauma-informed approach that may involve multiple services and therapeutic modalities, provided over the course of several months. That said, given the broad-ranging, long term negative sequelae of CSA, an evaluation of the cost-benefit analysis of treatment is clearly justified.

METHODS

We performed a Social Return on Investment (SROI) analysis of data gathered as part of the treatment program at the Be Brave Ranch in Edmonton, Canada to determine the value-for-money of the services provided. We endeavoured to take a conservative, medium-term (5 year) perspective; this is in contrast to short term (1-2 year) effects, which may rapidly dissipate, or long term (15-20 year) effects, which are likely diffuse and difficult to measure. As such, our analysis was based on an average annual intake of 100 children/adolescents (60:40 split) and their families, followed over a five-year timeframe. Financial proxies were assigned to benefits not easily monetized, and six potential domains of cost savings were identified.

RESULTS

Our analyses suggest that each dollar spent in treatment results in an average cost savings of $11.60 (sensitivity analysis suggests range of 9.20-12.80). The largest value-for-money was identified as the domain of crisis prevention, via the avoidance of rare but costly events associated with the long term impacts of CSA. Somewhat surprisingly, savings related to the area of criminal justice were minimal, compared to other social domains analysed. Implications are discussed.

CONCLUSIONS

Our results support the cost effectiveness of the investment associated with specialized, evidence-based early interventions for CSA. These approaches alleviate severe, negative outcomes associated with CSA, resulting in both economic savings and social benefits. These findings rest upon a number of assumptions, and generalizability of these results is therefore limited to similar programs located in comparable areas. However, the SROI ratio achieved in this analysis, in excess of $11:1, supports the idea that, while costly, these services more than pay for themselves over time.

Adverse childhood experiences in Australian youth adjudicated for sexual offences and non-sexual violent offences

This study examines the differential childhood adversities experienced by two samples of Australian adolescents involved in the juvenile justice system: male youth who had been adjudicated for sexual offences and their counterparts who had been adjudicated for nonsexual violence. The sample is comprised of clients referred to a service that explicitly prioritises cases identified to be high risk, high need, and living in rural or remote areas. Male youth who had committed a sexual offence were more likely than their counterparts to have experienced emotional and sexual abuse and neglect in their childhoods. Alternatively, the childhoods of the comparison group were marked by characteristics of more general household dysfunction. Potential explanations for these findings are provided. The onset of sexual offending is presented as a possible consequence of poor attachment and emotional dysregulation and the impact of vicarious violence, and a chaotic family life are considered in the development of subsequent nonsexual violence. The implications of these findings for both clinical practice and future research are discussed.

Sexual Trauma Informed Understanding of Longitudinal Depression among Repeat Juvenile Offenders

Childhood sexual assault (CSA) victimization and depression are global public health concerns that disproportionately affect youths involved in the juvenile justice system. Little research has examined the influence of CSA on the stability of depressive symptoms among repeat juvenile offenders. The present study tested a gendered model of the association between lifetime CSA victimization and depression for three time points: baseline juvenile assessment entry; second reentry; and third reentry. Further, covariate analyses were conducted to explore the impact of socio-demographics on CSA victimization and depression. Results indicate that CSA victimization was associated directly with baseline depression and indirectly with depression at second reentry for both male and female justice-involved youths. For white, male youth, there were significantly higher rates of depression over time, than other males. However, age, African American or Hispanic race/ethnicity, living situation, and urbanity were not significantly associated with CSA victimization at baseline or depression over time. These findings underscore the need for juvenile justice services that address exposure to childhood trauma and mental illness more effectively.

Sexual Violence and Its Associated Psychosocial Effects in Ireland

Current data on the prevalence and psychosocial correlates of sexual violence in the Republic of Ireland is lacking, with the most recent sexual abuse and violence survey dating back to 2001. The current study sought to identify what proportion of Irish adults have experienced sexual violence, if there are sex differences in exposure to different forms of sexual violence, and to what extent different forms of sexual violence are associated with adverse psychosocial outcomes. To achieve these objectives, we carried out a nationally representative sample of Irish adults (N = 1,020) completed self-report measures of history of sexual violence and mental health. Results suggest that approximately one-in-three (34.4%) Irish adults experienced some form of sexual violence, including 14.8% who were sexually assaulted (raped) and 31.1% who were sexually harassed. Women were significantly more likely than men to have experienced all forms of sexual violence (ps < .001), with the exception of sexual assault by a parent or guardian. All forms of sexual violence were associated with an increased likelihood of serious mental health problems, with sexual assault by a parent/guardian associated with several other psychosocial outcomes in life, including education achievement, history of being taken into state care, salary, and employment status. Sexual violence is a common experience in the general population and women are disproportionately affected (1-in-2 women versus 1-in-5 men). Additional resources to increase mental health care among survivors of sexual violence is urgently needed. How our findings compare to Ireland's previous sexual abuse and violence survey and the implications of our findings for policy are discussed.

Emotion Regulation and Mental Health among Men with Childhood Sexual Abuse Histories

Childhood sexual abuse (CSA) is a form of child maltreatment which has been increasingly recognized as a common experience among men. Research on male CSA remains under-developed but suggests many negative mental health impacts. The current study examined the link between mental health outcomes and different emotion regulation strategies among 69 adult men. Men completed measures on their current mental well-being, and participated in a clinical interview about emotion regulation strategies used to manage memories about their sexual victimization. Results indicated that the most frequently used emotion regulation strategies were expressive suppression, rumination, and cognitive avoidance. For perceived effectiveness, men identified cognitive avoidance, self-medication, and behavioral avoidance as being most helpful in managing their CSA-related distress. Finally, greater use of deliberate self-harm, rumination, and behavioral avoidance was associated with more internalizing difficulties, while greater use of deliberate self-harm and self-medication was linked with more externalizing difficulties. Greater perceived efficacy of positive reappraisal was associated with fewer externalizing behaviors. Although these findings require replication through larger mixed-methods studies, they suggest the importance of incorporating emotion regulation strategies into interventions aimed at improving mental well-being among men with CSA histories.

Identification With the Aggressor and Inward and Outward Aggression in Abuse Survivors

Childhood abuse survivors may display both inward and outward aggression manifested in self-injurious behavior (SIB) and violent acts toward others. Scrutinizing the literature reveals that the relational dynamics between victims and their perpetrators might be involved in these phenomena. Yet, research on this subject matter has been sparse. Filling this gap, this study investigated the contribution of the singular bonds between victims and their perpetrators, known as identification with the aggressor, in explaining survivors' aggression. The study was conducted among 306 Israeli college/university students who reported a history of childhood abuse. Results revealed that levels of adopting the perpetrator's experience, identifying with the perpetrator's aggression, and replacing one's agency with that of the perpetrator were significantly associated with survivors' inward and outward aggression. Moreover, profile type-that is, having high versus low levels of identification with the aggressor-was implicated in participants' SIBs, urge to harm others, and violent acts toward others, above and beyond the effects of gender and posttraumatic stress disorder (PTSD) symptoms. The present findings suggest that identification with the aggressor might make survivors prone to the re-enactment of past abusive dynamics, which, in turn, could eventuate in aggression toward themselves and others.

The global impact of adverse childhood experiences on criminal behavior: A cross-continental study

BACKGROUND

Adverse Childhood Experiences (ACEs) have been associated with a greater risk of later criminal offending. However, existing research in this area has been primarily conducted in Western developed countries and cross-cultural studies are rare.

OBJECTIVES

This study examined the relationship between ACEs and criminal behaviors in young adults living in 10 countries located across five continents, after accounting for sex, age, and cross-national differences.

PARTICIPANTS AND SETTING

In total, 3797 young adults aged between 18 and 20 years (M = 18.97; DP = 0.81) were assessed locally in community settings within the 10 countries.

METHOD

The ACE Questionnaire was used to assess maltreatment and household dysfunction during childhood and a subset of questions derived from the Deviant Behavior Variety Scale (DBVS) was used to determine past-year criminal variety pertaining to 10 acts considered crime across participating countries.

RESULTS

Physical and sexual abuse, physical neglect, and household substance abuse were related to criminal variety, globally, and independently across sexes and countries ranked differently in the United Nations Human Development Index (HDI). In addition, three out of five experiences of household dysfunction were related to criminal variety, but subsequent analyses indicate that some forms of household dysfunction only hold statistical significance among males or females, or in countries ranking lower in the HDI.

CONCLUSIONS

This research strengthens the finding that there are cross-cultural mechanisms perpetuating the cycle of violence. It also indicates that forms of household dysfunction have an impact on criminal behavior that is shaped by gender and the country's levels of social well-being.

The Centrality of Child Maltreatment to Criminology

Despite sufficient evidence to conclude that maltreatment exposure affects the risk of crime and delinquency, we conclude that the unique effects of child maltreatment on crime and delinquency, and the mechanisms through which those effects operate, remain poorly identified. Key challenges include insufficient attention to the overlap of child maltreatment with various forms of family dysfunction and adversity and a lack of comprehensive measurement of the multiple, often comorbid, forms of child maltreatment. We then consider potential impacts of the child welfare system on the maltreatment-crime link. Because the child welfare system typically provides voluntary, short-term services of unknown quality, it likely neither increases nor reduces risks of delinquency and crime for most children who encounter it. For the comparatively small subset of children experiencing foster care, impacts on delinquency and crime likely vary by the quality of environments within and after their time in care - issues that, to date, have received too little attention.

Knowing the Abuser Inside and Out: The Development and Psychometric Evaluation of the Identification With the Aggressor Scale

Identifying with the aggressor is a process wherein victims of abuse, particularly during childhood, take on their perpetrator's experience. The victim defers to the perpetrator and adopts the perpetrator's experience, learns the perpetrator's desires and needs, and gratifies them. Although the clinical and theoretical literature suggests that identification with the aggressor occurs in the aftermath of abuse and has negative long-term implications, to date this concept has not been empirically investigated. To facilitate an exploration of this subject, the current study evaluated the psychometric properties of a new measure: the Identification With the Aggressor Scale (IAS). The study was conducted among convenience samples of students using online surveys. In Study 1, the IAS was administered to 318 students. In Study 2, the IAS, and a battery of questionnaires assessing features of abuse, dissociation, posttraumatic stress disorder (PTSD) symptoms, and posttraumatic guilt were administered to a convenience sample of 368 students. Four reliable IAS factors emerged from Study 1: Adopting the perpetrator's experience concerning the abuse, identifying with the perpetrator's aggression, replacing one's agency with that of the perpetrator, and becoming hypersensitive to the perpetrator. In Study 2, a confirmatory factor analysis confirmed the scale's underlying factor structure. A history of childhood abuse, recurrence and severity of abuse, and the perpetrator being a parental figure were all associated with higher IAS scores. In addition, IAS scores were correlated with dissociation, PTSD symptoms, and posttraumatic guilt. The present findings indicate that the IAS has good psychometric properties, making it useful as an assessment tool in future research.

Child pornography possession/receipt offenders: developing a forensic profile

Child pornography possession/receipt offenders are a controversial offender group due to mixed and occasionally divergent evidence about their risk profile, offending history and psychopathology. Using a population of male offenders who ever perpetrated a sexual offense from a federal jurisdiction in the central United States, the current study developed an exploratory post hoc empirical profile of these offenders. The profile has some success in the validation component of our study and showed significant associations with self-reported sexual abuse of child victims ages 3-12 years, but non-significant associations to adolescent and adult victims. It significantly linked to the conceptually expected victim group and the significant statistical effect withstood controls for generally robust indicators of antisocial conduct including antisocial personality disorder, arrest onset, total adverse childhood experiences, age and race. We view the findings as exploratory and encourage additional empirical study of this important offender group.

The Role of Low Self-Control as a Mediator between Trauma and Antisociality/Criminality in Youth

Trauma exposure and low self-control are robustly associated with youth antisocial/criminal problems, but the interrelation of these constructs is unclear when taking into account both traumatic events and reactions. The objective of the present study is to examine self-control mediation effects related to trauma and juvenile delinquency, conduct disorder, crime seriousness, and aggression outcomes. The sample consisted of N = 388 male youth from Portugal (age, M = 16.01 years, SD = 1.03, age range = 13–18 years). Path analysis procedures revealed that self-control partially mediates the relation between trauma events and the examined outcomes and fully mediates the relation between trauma reactions and the examined outcomes. Research on youth trauma should examine both trauma events and trauma reactions because they have differential effects on low self-control and antisocial/criminal outcomes.

The Impact of Different Types of Abuse on Depression

Despite a large amount of research on depression and abuse, there is still a controversy on how abuse is measured and on childhood trauma's effect on the physiological function of adults. Here, we attempt to clarify the relationship between different types of abuse and depression while focusing on childhood abuse. This article, unlike prior research, provides an overview that addresses physical, psychological, and sexual abuse and their psychological impact on the victims. Results show that abuse is a vulnerability factor for a variety of mental and physical health problems and that psychological abuse is strongly associated with depression. More research is needed to understand (a) the role of abuse in the development and maintenance of depression and, in particular, longitudinal studies that also account for the large number of risk and protective factors that influence this relationship and (b) how different types of abuse can influence response to treatment among survivors with depression, in order to provide effective trauma-focused approaches to manage depressive symptoms.

Revisiting the link between childhood sexual abuse and adult sexual aggression

BACKGROUND

Childhood maltreatment poses a risk factor for adult sexual aggression among men.

OBJECTIVE

Efforts were made to examine links between childhood sexual abuse (CSA) and sexual aggression after controlling variance associated with other forms of abuse.

PARTICIPANTS AND SETTING

This sample was comprised of men (n = 489) who completed a national survey regarding their history of possible abuse and/or sexual aggression.

METHODS

Maltreatment indices included CSA, parental and sibling physical abuse, exposure to domestic violence, peer bullying, and family emotional abuse. Self-report indicators of sexual frotteurism, coercion and rape were provided by the Sexual Experiences Survey-Short Form Perpetration.

RESULTS

CSA links with the criterion indicators were relatively stronger (r = 0.36, d = 0.65, p <  .001) than those found for non-sexual forms of abuse. CSA accounted for unshared variance in sexual aggression with these effects magnified by the addition of parental physical abuse (d = 2.1) or exposure to domestic violence (d = 2.2). The relative risks of prior acts of rape were elevated by CSA (RR = 4.39, p <  .001), parental physical abuse (RR = 3.85, p < 0.001), exposure to domestic violence (RR = 3.81, p <  .001), or sibling physical abuse (RR = 2.56, p = 0.007). These risks of completed rape were higher as well among respondents polyvictimized by two (RR = 4.92, p <  .001) or more (RR = 8.94, p < 0.001) forms of abuse.

CONCLUSIONS

Multiple forms of child maltreatment, particularly CSA, were strongly associated with adult sexual aggression in this sample of men from the general population.

A follow-up study of mental health service utilisation in a cohort of 2433 sexually abused Australian children utilising five years of medical data

BACKGROUND AND OBJECTIVES

There are well established links between child sex abuse (CSA) and a range of mental health adversities in the literature. However, there has been very limited examination of mental health care needs of CSA survivors, indicated by contacts with mental health professionals. Similarly, no existing research has examined rates of prescription of psychopharmacology to CSA survivors. Service utilisation is a vital component of the health landscape, and a clear understanding of the mental health care needs of CSA survivors is central to policy formation regarding mental health funding. Therefore, this study aimed to assess differences in rates of mental health care utilisation and rates of prescription of psychopharmacology during adulthood between individuals with a history of CSA and a comparison sample from the general population without a known abuse history.

PARTICIPANTS, SETTING, AND METHOD

The forensic medical records of 2433 CSA victims identified between 1964 and 1995 were linked to Australian medical and medication-use data accessed between 2010 and 2015, when victims were, on average, aged between 28.78 and 33.78 years. CSA cases were compared to a matched comparison cohort on rates of contact with mental health professionals and prescriptions for mood stabilisers, anxiolytics, antipsychotics, stimulants, analgesics and addiction treatment medication.

RESULTS

CSA was associated with increased levels of attendance at psychiatrists (OR = 1.29, p < .001), psychologists and clinical social workers (OR = 6.68, p < .001) and general practitioners (OR = 1.76, p < .001) for mental health care. CSA was also associated with increased frequency of prescription of all categories of psychopharmacology (ORs ranging from 1.40 to 6.18). Outcomes differed by victim gender and age at abuse. Abused females demonstrated greater overall service and medication utilisation than abused males. Females abused after puberty (age 12 years) had more frequent contacts with general practitioners for mental health care and greater frequency of prescription of psychopharmacology than females abused under age 12 years, including elevated frequency of analgesic and mood stabiliser use. Males abused after puberty also demonstrated higher frequency of service utilisation, including inflated rates of antipsychotic and anxiolytic prescriptions and visits to psychiatrists.

CONCLUSIONS

Experiencing CSA was associated with increased use of psychopharmacology and contact with health professionals for mental health care. Abused females and participants abused after age 12 demonstrated most inflated use of services. These findings have important implications for policy decisions regarding the provision of mental health care to CSA survivors deemed to be at risk of developing mental health difficulties.

Early life adversities and polyvictimization in young persons with sexual behavior problems: A longitudinal study of child protective service referrals

There is scarce research on children and youth with sexual behavior problems (SBP) and their developmental antecedents and the research that does exist is mostly retrospective and correlational. While prior research focused on the central role of sexual victimization, recent research suggests that young persons with SBP are exposed to a series of adversities not limited to child sexual victimization and require multifaceted assessment and intervention using a developmental life course perspective. The current study includes an examination of the complete longitudinal sequence of child protective service (CPS) investigations involving young persons with SBP. The study is based on a sample of 957 youth referred to the CPS in Quebec, Canada. The data include their longitudinal sequence of referrals from birth to age 18. Semi-parametric analyses identified four trajectories of referrals with significant differences in terms of onset, frequency, types of life adversity, and polyvictimization. The trajectories suggest that a range of developmental profiles characterize young persons with SBP, with SBP often occurring after CPS contacts for compromising issues other than sexual victimization, especially parental neglect and serious behavior problems. Of importance, polyvictimization was relatively common for this group throughout childhood and adolescence, which highlights the multiintervention needs of this population.