It can be very difficult to talk about sexual abuse and even more difficult to acknowledge that sexual abuse happens to children of all ages including infants every day. According to the NCANDS (National child abuse and neglect data system), an estimated 9.3% of confirmed or sustained child abuse and neglect cases in 2005 involved sexual abuse. This figure translates into over 83,800 victims in 2005 alone. Other studies suggest that even more children suffer abuse and neglect than what is reported to child protective service agencies. Statistics indicate that girls are more frequently the victims of sexual abuse, but the number of boys is also significant.
What is sexual abuse?
At the extreme end of spectrum, sexual abuse includes sexual intercourse or its deviations. Yet all offences that involve sexually touching a child, as well as non-touching offences that involve sexually touching a child, as well as non-touching offences and sexual exploitation, are just as harmful and devastating to a child’s well being. Touching sexual offenses include:
* Fondling (Stroke or caress lovingly or erotically)
* Making a child touch a sexual organ belonging to an adult. * Penetrating a child’s vagina or anus no matter how slight with a penis or any other non medical object. Non-touching sexual offences include:
* Engaging in indecent exposure.
* Exposing children to pornographic material.
* Deliberately exposing a child to the act of sexual intercourse. * Masturbating in front of a child.
Sexual exploitation can include:
* Engaging a child or soliciting a child for the purpose of prostitution. * Using a child to film, photograph, or model pornography
What are the effects of child sexual abuse?
The effects of child sexual abuse extend far beyond childhood. Sexual abuse robs children of their childhood and creates loss of trust, feelings of guilt, and self abusive behaviour. It can also lead to antisocial behaviour, and other serious problems. It can also lead to difficulty with intimate relationships later in life. The sexual victimization of children is ethically and morally wrong.
A specialist called Paul E Mullen did research on ‘Child sexual abuse’ and found out the following;
The manner in which the long-term effects of child sexual abuse have come to be conceptualised reflects, in no small measure, the very particular circumstances that surrounded the revelation of child sexual abuse as an all too common event in the lives of our children. The first phase of modern research into child sexual abuse was not triggered by observations on child victims, but by the self-disclosures of adults who had the courage to publicly give witness to their abuse as children. These early self-revealed victims, exclusively women, had often been the victims of incestuous abuse of the grossest kind, and plausibly attributed many of their current personal difficulties to their sexual abuse as children. This contrasts with the emergence of child abuse as a public health and research issue that has been driven by the observations of professionals caring for abused children. Implications
The way child sexual abuse was placed on the public and health agendas put a stronger emphasis on the adult consequences of abuse than on the immediate implications for an abused child. It also emphasised the psychiatric implications of abuse because self-declared victims tended to focus on these, and these revelations often occurred in a broadly therapeutic context with mental health professionals. Early research into the effects of child sexual abuse frequently employed groups of adult psychiatric patients (Carmen et al. 1984; Mills et al. 1984; Bryer et al. 1987; Jacobson and Richardson 1987; Craine et al. 1988; Oppenheimer et al. 1985) which further reinforced the emergence of an adult-focused psychiatric discourse about child sexual abuse. It should also be noted that the manner in which child sexual abuse was rediscovered (for it had been well recognised in the 19th century) and the nature of the advocacy movement which placed child sexual abuse firmly on the social agenda also provided an almost exclusive emphasis on female victims and incestuous abuse. The implications remain largely unexplored of the abuse of boys (which for abuse of the most intrusive kinds involving penetration rivals in frequency that of girls), and of the fact that the majority of abuse is not incestuous.
Post-traumatic stress model
The relationship between child sexual abuse and adult psychopathology tended initially to be conceptualised in terms of a chronic form of post traumatic stress disorder (Lindberg and Distad 1985; Bryer et al. 1987; Craine et al. 1988). This model focused on trauma-induced symptoms, most particularly dissociative disorders such as desensitisation, amnesias, fugues and even multiple personality. The idea was that the stress induced symptoms engendered in the process of the abuse and have reverberated down the years to produce a post-abuse syndrome in adult life. In its more sophisticated formulation, this model attempts to integrate the damage inflicted at the time to the victims' psychological integrity, by the child sexual abuse and the need to repress the trauma, with resultant psychological fragmentation. The latter manifests itself in adult life in mental health problems, and in problems of interpersonal and sexual adjustment (Rieker and Carmen 1986). The post-traumatic stress model found its strongest support in the observations of clinicians dealing with individuals with histories of severe and repeated abuse. It was also often linked to notions of a highly specific post-abuse syndrome in which dissociative disorders were prominent. Traumatogenic model
In the United States, a less medical model for the mediation of the long term effects of child sexual abuse was proposed by Finkelhor (1987) with his 'traumatogenic model'. This suggested that child sexual abuse produced a range of psychological effects at the time and, secondarily, behavioural changes. This model predicts a disparate range of psychological impairments and behavioural disturbances in adult life which contrasts with the post traumatic syndrome model with its specific range of symptoms. Finkelhor's model, though less medical and symptom-bound, pays only scant attention to the developmental perspective. It cedes primacy to the psychological ramifications of the abuse with little acknowledgment of the social dimensions. Only in recent years have attempts been made to articulate the long-term effects of child sexual abuse within a developmental perspective (Cole and Putnam 1992), and to attend to the interactions between child sexual abuse and the child victims' overall psychological, social and interpersonal development. Dangers of post-traumatic stress model
The belief that child sexual abuse is not only a potent cause of adult psychopathology but can be understood and treated within a post-traumatic stress disorder framework has spawned a minor industry in sexual abuse counselling. Though many working in this area have shifted, on the basis of their clinical experience, to broader conceptualisations, there remains a considerable vested interest in a specific post-abuse syndrome. There are also political agendas linked to seeing child sexual abuse as a product of misdirected and ill controlled male sexuality (which it is), and as independent of social circumstances and family background (which it isn't). Herman's (1992) description of child sexual abuse as one of the combat neurosis women suffer from as a result of the sex war neatly conflates the post-traumatic stress model with the political agenda of some feminists. The understandable wish to avoid repeating the deplorable error made in domestic violence of blaming the victim (Snell et al. 1964) can lead to an insistence on looking no further than the perpetrator (and often just his maleness) for an understanding of why abuse occurs. This potentially impoverishes research aimed at identifying the social and family correlates of child sexual abuse that constitute risk factors for such abuse. The knowledge of such risk factors is essential to the development of programs aimed at primary prevention. Family risk factors
Child sexual abuse is not randomly distributed through the population. It occurs more frequently in children from socially deprived and disorganised family backgrounds (Finkelhor and Baron 1986; Beitchman et al. 1991; Russell 1986; Peters 1988; Mullen et al. 1993). Marital dysfunction, as evidenced by parental separation and domestic violence, is associated with higher risks of child sexual abuse, and involves interfamilial and extra familial perpetrators (Mullen et al 1996; Fergusson et al. 1996; Fleming et al. 1997). Similarly, there are increased risks of abuse with a stepparent in the family, and when family breakdown results in institutional or foster care. Poor parent child attachment is associated with increased risk of child sexual abuse, though it is not always easy to separate the impact of abuse on intimate family relationships from the influence of poor attachments on vulnerability to abuse (Fergusson et al. 1996; Fleming et al. 1997). Disrupted family function could, in theory, be related to child sexual abuse because of the disruptive influence of a perpetrator in the family. However, given the majority of abusers are not immediate family members, it is more likely that the linkage reflects a lack of adequate care, supervision and protection that leaves the child exposed to the approaches of molesters, and vulnerable to offers of apparent interest and affection (Fergusson and Mullen in press). It could be that family circumstances conducive to child sexual abuse are also productive of other forms of abuse. This hypothesis is supported by the clear overlap between the risk factors for all three types of abuse. The second possibility is that the apparent co morbidity could reflect a data collection artefact created by individuals who are prepared to disclose one type of abuse being prepared to disclose other forms of abuse (Fergusson and Mullen in press). Relationships and intimacy
The sexual problems linked to child sexual abuse could be an entirely specific effect related to traumatic sexualisation, or could be contributed to by a wider constellation of disruption of interpersonal and intimate relatedness. Child sexual abuse involves a breach of trust or an exploitation of vulnerability, and frequently both. Sexually abused children not only face an assault on their developing sense of their sexual identity, but a blow to their construction of the world as a safe enough environment and their developing sense of others as trustworthy. In those abused by someone with whom they had a close relationship, the impact is likely to be all the more profound. A history of child sexual abuse is reported to be associated in adult life with insecure and disorganised attachments (Alexander 1993; Briere and Runtz 1988; Jehu 1989). Increased rates of relationship breakdown have also been reported in those exposed to child sexual abuse (Beitchman et al. 1991; Bagley and Ramsey 1986; Mullen et al. 1988). Mullen et al. (1994) found that their subjects reporting child sexual abuse were more likely to evince a general instability in their close relationships. Though those with histories of child sexual abuse were just as likely as controls to be currently in a close relationship, they were more likely in the past to have experienced divorce or separation. When asked about the level of satisfaction with their current relationship, those with abuse histories expressed significantly lower levels of satisfaction. The level of current satisfaction was lowest for intercourse victims. Relationship problems were also reflected in the evaluations of the quality of their communication with their partners. Less than half of the victims felt able to confide personal problems to their partner, and nearly a quarter reported no meaningful communication with their partners on a more intimate level, whereas only 6 per cent of controls took an equally negative view of their partner’s receptivity to their concerns. This perceived gap in communication at a deeper level rose to 36 per cent in that reporting child sexual abuse involving penetration. In this study, those reporting child sexual abuse were more likely to rate their partners as low on care and concern, and high on intrusive control. Interestingly, the deficiencies perceived in their partners as sources of emotional support by those with histories of child sexual abuse was not generalised to peer relationships where they were just as likely to report they had friends in whom to confide and with whom to share their troubles. A community study of Australian women found similar results with a history of child sexual abuse adversely affecting the quality of women's relationships in adult life, and increasing the likelihood of divorce and separation (Fleming, 1997, Fleming et al, in press). Women who reported a history of child sexual abuse were more likely to report their current partner to be uncaring and highly controlling, and to be dissatisfied with the relationship. Child sexual abuse appears to affect a woman's ability to maintain intimate relationships by interfering with her capacity to develop her sexuality and trust in others. The results of this study also found that women with histories of child sexual abuse who found difficulty in forming satisfying intimate relationships did not, however, report an inability to form close friendships or to receive emotional support from friends. It is tempting to suggest that the experience of child sexual abuse at a vulnerable moment in the child's development of trust in others predisposes to a specific deficit in forming and maintaining intimate relationships. The attribution of a lack of concern and a tendency to be intrusive and over controlling to their partners could be a product of these partners' actual attitudes and behaviour, or could reflect primarily the expectations, interpretations and projections directed at the partner by these women with histories of child sexual abuse. Conversely, those who have been abused may be more prone to enter relationships with emotionally detached and domineering partners because their lowered self-esteem and reduced initiative limits their choices, or from some neurotic compulsion to repeat. Self-esteem
Self-esteem encompasses the extent to which individuals feel comfortable with the sense they have of themselves (the self for self) and, to a lesser extent, their accomplishments, and how they believe they are viewed by others (the self for others). Robson (1988) wrote that self-esteem is 'the sense of contentment and self acceptance that stems from a person's appraisal of his (or her) own worth, significance, attractiveness, competence and ability to satisfy aspirations'. A number of studies have implicated child sexual abuse in lowering self esteem in adults (for review, see Beitchman et al. 1992), but the most sophisticated examination of the issue to date is that of Romans et al. (1996). This study showed a clear relationship between poor self-esteem in adulthood and a history of child sexual abuse in those who reported the more intrusive forms of abuse involving penetration. It was, however, those aspects of self-esteem involved with an increased expectation of unpleasant events (pessimism) and a sense of inability to influence external events (fatalism) that were affected, not those involved with a sense of being attractive, having determination, or being able to relate to others. Victim characteristics
The possibility has been raised that characteristics such as physical attractiveness, temperament or physical maturity might increase the risks of children being sexually abused (Finkelhor and Baron 1986). Child molesters are reported to selectively target pretty and trusting children (Elliot et al. 1995). A recent study suggested early sexual maturation in girls may be associated with increased vulnerability to abuse (Fergusson et al. in press). Fleming et al. (1997) reported girls who were socially isolated with few friends of their own age were almost twice as likely to report having been sexually abused.
What should you look for if you suspect sexual abuse?
* Children up to age 3 may exhibit:
* Fear or excessive crying.
* Feeding problems
* Bowel problems
* Sleep disturbances
* Failure to thrive.
* Children 2 – 9 may exhibit:
* Fear particular people, places or activities
* Regression to earlier behaviours such as bed wetting
* Victimization of others
* Excessive masturbation
* Feelings of guilt and shame
* Nightmares or sleep disturbances
* Withdrawal from family and friends
* Fear of attack reoccurring
* Eating disturbances
* Symptoms of sexual abuse in older children and adolescents include:
* Nightmare/Sleep disturbances
* Poor school performances
* Substance abuse
* Running away from home
* Eating disturbances
* Early pregnancy or marriage
* Suicidal gestures
* Anger about being forced into a situation beyond control * Pseudo-mature behaviours
Protect your children
* Teach your child what appropriate sexual behaviour is and when too say “No.” If somebody touches a sexual part of their body or touches them in any way that makes them feel uncomfortable
* Observe your Children when they are around others to see if they are comfortable around them.