Child Sexual Abuse

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Child Sexual Abuse

• Wenar, C. (1990). Risks in the Interpersonal
  Context Child Maltreatment and Divorce
• Kendall-Tackett, K., Williams, L.M., Finkelhor,
  D. (1993). Impact of sexual abuse on children ...

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Definition Description

• Definition of sexual abuse "any act with sexual
  overtones perpetrated on a child who is unable to
  fully consent to the activity
• Child unable to consent due to age, lack of
  knowledge relationship context
• Different forms
• Incest perpetrated by a needed and or trusted
  adult
• Extrafamilial abuse Commercial abuse

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Sexual abuse in SA

• Extremely difficult to estimate prevalence
• Girls 14 ?
• Boys 18 ?
• Stereotypes about HIV/AIDS
• Awareness on the increase

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Course of Incest

• Engagement Phase
• Sexual Interaction Phase
• Secrecy Phase
• Disclosure Phase (accidental or purposeful)
• Intervention (Hopefully!)

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Physical effects of sexual abuse

• Sexually transmitted diseases HIV / AIDS
• Pregnancy
• Frequent urinary tract infections
• Frequent abdominal pains

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Psychological Effects

• Show more symptoms than non-abused children but
  no specific syndrome
• Frequent global symptoms
• Fear lack of basic trust
• Behaviour problems internalising/ externalising
• Low self esteem
• Lack of social skills
• Depression
• Aggression
• School problems

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Psychological Effects 2

• Specific symptoms
• Sexualised behaviour
• Sexualised play with dolls
• Inserting objects in vagina or anus
• Excessive or public masturbation
• Seductive behaviour
• Age-inappropriate sexual knowledge
• May show developmental trend
• Post Traumatic Stress Disorder
• Guilt ...

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Psychological Effects 3

• Guilt
• believe they are responsible for the abuse
• believe betraying others
• feel responsible for the family well-being
• for keeping the secret of the abuse
• at pleasure on stimulation of sexual organs
• Often this is focus in adult treatment
• Powerlessness which in turn permeates most
  aspects of child's self concept.

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Psychological Effects 4

• Significant numbers (21-49) of sexually abused
  children do not display obvious symptoms
• Why?
• Research methodology
• May yet develop symptoms
• Some children may be less effected
• Less damaging abuse
• Resilient child

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Intervening Variables

• Greater number of symptoms associated with
• Close perpetrator
• High frequency of sexual contact
• Long duration
• Sexual acts that involved the use of force and/or
  included penetration
• Lack of maternal support
• Victims negative outlook or coping style

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Long Term Effects

• Suicide and parasuicide
• Anxiety Disorders
• Severe problems with establishing intimate
  relationships with others
• Sexual difficulties promiscuity, prostitution,
  frigidity, flashbacks
• Substance Use Disorders
• Re-victimisation

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Etiological factors Perpetrator

• Immature socially inadequate
• Difficulty relating to members of the opposite
  sex
• Disturbed relationship with parents
• Substance abuser especially alcohol

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Etiological factors Perpetrator 2

• Finkelhor's Four Factor Model
• Emotional Congruence
• Sexual arousal
• Blockage
• Disinhibition

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Etiological factors Family

• Incest is an expression of family dysfunction
• Incest occurs in
• The multi-problem or "chaotic" family
• The other prototypical incest family is
  frequently financially and socially middle class
  and on the surface appear to be very stable
• Socially isolated families
• Difficulties in parental relationship

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Etiological factors Social context

• Patriarchy - father is in an elevated position
  and it his right to have his needs satisfied by
  the family .
• Media
• Depiction of sexuality gt feel inadequate as
  people and sexually
• Advertisements often use very young girls in
  sexually seductive and provocative poses