Sexual abuse

Sexual abuse, also referred to as molestation, is usually undesired sexual behavior by one person upon another. It is often perpetrated using force or by taking advantage of another.[1] When force is immediate, of short duration, or infrequent, it is called sexual assault. The offender is referred to as a sexual abuser or (often pejoratively) molester.[2] The term also covers any behavior by an adult or older adolescent towards a child to stimulate any of the involved sexually. The use of a child, or other individuals younger than the age of consent, for sexual stimulation is referred to as child sexual abuse or statutory rape.

Victims

Spouses

Spousal sexual abuse is a form of domestic violence. When the abuse involves threats of unwanted sexual contact or forced sex by a woman's husband or ex-husband, it may constitute rape, depending on the jurisdiction, and may also constitute an assault[3].

Children

Child sexual abuse is a form of child abuse in which a child is abused for the sexual gratification of an adult or older adolescent.[4][5] It includes direct sexual contact, the adult or otherwise older person engaging indecent exposure (of the genitals, female nipples, etc.) to a child with intent to gratify their own sexual desires or to intimidate or groom the child, asking or pressuring a child to engage in sexual activities, displaying pornography to a child, or using a child to produce child pornography.[4][6][7]

Effects of child sexual abuse include shame and self-blame,[8] depression, anxiety, post-traumatic stress disorder, self-esteem issues, sexual dysfunction, chronic pelvic pain, addiction, self-injury, suicidal ideation, borderline personality disorder, and propensity to re-victimization in adulthood.[9] Child sexual abuse is a risk factor for attempting suicide.[10] Additionally, some studies have shown childhood sexual abuse to be a risk factor of the perpetration of intimate partner violence in men.[11] Much of the harm caused to victims becomes apparent years after the abuse happens. With specific regard to addiction, a study by Reiger et al supports previous findings that adverse life events increase sensitivity to drug rewards and bolster drug reward signaling by exposing an association between heightened limbic response to cocaine cues.[12]

Sexual abuse by a family member is a form of incest, and results in more serious and long-term psychological trauma, especially in the case of parental incest.[13]

Globally, approximately 18–19% of women and 8% of men disclose being sexually abused when they were children.[14][15] The gender gap may be caused by higher victimization of girls, lower willingness of men to disclose abuse, or both.[14] Most sexual abuse offenders are acquainted with their victims; approximately 30% are relatives of the child, most often fathers, uncles or cousins; around 60% are other acquaintances such as friends of the family, babysitters, or neighbors; strangers are the offenders in approximately 10% of child sexual abuse cases. Most child sexual abuse is committed by men; women commit approximately 14% of offenses reported against boys and 6% of offenses reported against girls.[16] Child sexual abuse offenders are not pedophiles unless they have a primary or exclusive sexual interest in prepubescent children.[17]

People with developmental disabilities

People with developmental disabilities are often victims of sexual abuse. According to research, people with disabilities are at a greater risk for victimization of sexual assault or sexual abuse because of lack of understanding (Sobsey & Varnhagen, 1989).

People with dementia

Elderly people, especially those with dementia, can be at risk of abuse. There were over 6,000 "safeguarding concerns and alerts" at UK care homes from 2013 to 2015. These included alleged inappropriate touching and worse allegations. Offenders were most often other residents but staff also offended. It is suspected some care homes may deliberately overlook these offenses.[18]

Sometimes abuse victims are not believed because they are not seen as credible witnesses due to their dementia. Perpetrators frequently target victims who they know are unlikely to be believed. Spouses and partners sometimes continue to pursue sexual relations, without realising they no longer have this right, because the person with dementia can no longer consent.[19]

Elders

Sex abuse is one of the most common forms of abuse in nursing homes. If a nursing home fails to do proper background checks on an employee who subsequently abuses residents, the home can be liable for negligence. If nursing homes fail to supervise staff or train staff to recognise signs of abuse, the home can also be liable for negligence.[20] Sexual activity by care givers may be a crime. Victims may not report abuse or cooperate with investigations due to associated stigma and/or reluctance to mention body parts.[19]

Treatment

In the emergency department, contraceptive medications are offered to women raped by men because about 5% of such rapes result in pregnancy.[21] Preventative medication against sexually transmitted infections are given to victims of all types of sexual abuse (especially for the most common diseases like chlamydia, gonorhea, trichomoniasis and bacterial vaginosis) and a blood serum is collected to test for STIs (such as HIV, hepatitis B and syphilis).[21] Any survivor with abrasions are immunized for tetanus if 5 years have elapsed since the last immunization.[21] Short-term treatment with a benzodiazepine may help with acute anxiety and antidepressants may be helpful for symptoms of PTSD, depression and panic attacks.[21]

Sexual abuse has been linked to the development of psychotic symptoms in abused children. Treatment for psychotic symptoms may also be involved in sexual abuse treatment.[22]

In regards to long term psychological treatment, prolonged exposure therapy has been tested as a method of long-term PTSD treatment for victims of sexual abuse.[23]

Prevention

Child sexual abuse prevention programmes were developed in the United States of America during the 1970s and originally delivered to children. Programmes delivered to parents were developed in the 1980s and took the form of one-off meetings, two to three hours long [24][25][26][27][28][29]. In the last 15 years, web-based programmes have been developed.


Survivor

The term survivor is sometimes used for a living victim, including victims of usually non-fatal harm, to honor and empower the strength of an individual to heal, in particular a living victim of sexual abuse or assault.[30] For example, there are the Survivors Network of those Abused by Priests and The Survivors Trust.

Positions of power

Sexual misconduct can occur where one person uses a position of authority to compel another person to engage in an otherwise unwanted sexual activity. For example, sexual harassment in the workplace might involve an employee being coerced into a sexual situation out of fear of being dismissed. Sexual harassment in education might involve a student submitting to the sexual advances of a person in authority in fear of being punished, for example by being given a failing grade.

Several sexual abuse scandals have involved abuse of religious authority and often cover-up among non-abusers, including cases in the Southern Baptist Convention,[31] Catholic Church, Episcopalian religion,[32] Islam,[33] Jehovah's Witnesses, Lutheran church,[34] Methodist Church,[35] The Church of Jesus Christ of Latter-day Saints,[36] the Fundamentalist Church of Jesus Christ of Latter Day Saints, Orthodox Judaism,[37] other branches of Judaism,[38] and various cults.

Minorities

Sexual abuse is a problem in some minority communities. In 2007, a number of Hispanic victims were included in the settlement of a massive sexual abuse case involving the Los Angeles archdiocese of the Catholic Church.[39] A qualitative study by Kim et al. discusses the experiences of sexual abuse in the US population of Mexican immigrant women, citing immigration, acculturation, and several other social elements as risk factors for abuse.[40] To address the issue of sexual abuse in the African-American community, the prestigious Leeway Foundation[41] sponsored a grant to develop www.blacksurvivors.org,[42] a national online support group and resource center for African-American sexual abuse survivors. The non-profit group was founded in 2008 by Sylvia Coleman, an African-American sexual abuse survivor and national sexual abuse prevention expert.

Other animals

Sexual abuse has been identified among animals as well; for example, among the Adélie penguins.[43]

See also

References

  1. "Sexual abuse". American Psychological Association. 2018 American Psychological Association. Retrieved 28 January 2018.
  2. "Peer commentaries on Green (2002) and Schmidt (2002)". Archives of Sexual Behavior. 31 (6): 479. 2002. doi:10.1023/A:1020603214218. Child molester is a pejorative term applied to both the pedophile and incest offender.
  3. Patricia, Mahoney. "The Wife Rape Fact Sheet". National Violence Against Women Prevention Research Center. National Violence Against Women Prevention Research Center. Retrieved 28 January 2018.
  4. 1 2 "Child Sexual Abuse". Medline Plus. U.S. National Library of Medicine,. 2008-04-02.
  5. Committee on Professional Practice and Standards (COPPS); Board of Professional Affairs (BPA); American Psychological Association (APA); Catherine Acuff; Steven Bisbing; Michael Gottlieb; Lisa Grossman; Jody Porter; Richard Reichbart; Steven Sparta; C. Eugene Walker (August 1999). "Guidelines for Psychological Evaluations in Child Protection Matters". American Psychologist. 54 (8): 586–593. doi:10.1037/0003-066X.54.8.586. PMID 10453704. Retrieved 2008-05-07. Lay summary APA PsycNET (2008-05-07). Abuse, sexual (child): generally defined as contacts between a child and an adult or other person significantly older or in a position of power or control over the child, where the child is being used for sexual stimulation of the adult or other person.
  6. Martin, J.; Anderson, J.; Romans, S.; Mullen, P; O'Shea, M (1993). "Asking about child sexual abuse: methodological implications of a two-stage survey". Child Abuse and Neglect. 17 (3): 383–392. doi:10.1016/0145-2134(93)90061-9. PMID 8330225.
  7. Child sexual abuse definition from the NSPCC
  8. Whiffen, V. E.; MacIntosh, H. B. (2005). "Mediators of the link between childhood sexual abuse and emotional distress: a critical review". Trauma, Violence, & Abuse. 6 (1): 24–39. doi:10.1177/1524838004272543.
  9. Maniglio, R. (2009). "The impact of child sexual abuse on health: A systematic review of reviews". Clinical Psychology Review. 29 (7): 647–657. doi:10.1016/j.cpr.2009.08.003.
  10. Maniglio, R. (2011). "The role of child sexual abuse in the etiology of suicide and non-suicidal self-injury". Acta Psychiatrica Scandinavica. 124 (1): 30–41. doi:10.1111/j.1600-0447.2010.01612.x. PMID 20946202.
  11. Teitelman AM, Bellamy SL, Jemmott JB 3rd, Icard L, O'Leary A, Ali S, Ngwane Z, Makiwane M. Childhood sexual abuse and sociodemographic factors prospectively associated with intimate partner violence perpetration among South African heterosexual men. Annals of Behavioral Medicine. 2017;51(2):170-178
  12. Regier PS, Monge ZA, Franklin TR, Wetherill RR, Teitelman AM, Jagannathan K, et al. Emotional, physical and sexual abuse are associated with a heightened limbic response to cocaine cues. Addiction Biology. 2017 Nov;22(6):1768-177. doi: 10.1111/adb.12445
  13. Courtois, Christine A. (1988). Healing the Incest Wound: Adult Survivors in Therapy. W. W. Norton & Company. p. 208. ISBN 0-393-31356-5.
  14. 1 2 Stoltenborgh, M.; van IJzendoorn, M. H.; Euser, E. M.; Bakermans-Kranenburg, M. J. (2011). "A global perspective on child sexual abuse: meta-analysis of prevalence around the world". Child Maltreatment. 16 (2): 79–101. doi:10.1177/1077559511403920. PMID 21511741.
  15. Pereda, N.; Guilera, G.; Forns, M.; Gómez-Benito, J. (2009). "The prevalence of child sexual abuse in community and student samples: A meta-analysis". Clinical Psychology Review. 29 (4): 328–338. doi:10.1016/j.cpr.2009.02.007.
  16. Whealin, Julia Whealin (2007-05-22). "Child Sexual Abuse". National Center for Post Traumatic Stress Disorder, US Department of Veterans Affairs. Archived from the original on 2009-07-30.
  17. Seto, Michael (2008). Pedophilia and Sexual Offending Against Children. Washington, DC: American Psychological Association. p. vii.
  18. Sex crimes against the elderly - are they being ignored? BBC
  19. 1 2 CHALLENGES WHEN INVESTIGATING ELDER SEXUAL ABUSE Archived 2016-10-08 at the Wayback Machine.
  20. Sexual Abuse in Nursing Homes
  21. 1 2 3 4 Varcarolis, Elizabeth (2013). Essentials of psychiatric mental health nursing. St. Louis: Elsevier. pp. 439–442.
  22. Crush E, Arseneault L, Jaffee SR, Danese A, Fisher HL. Protective factors for psychotic symptoms among poly-victimized children. Schizophrenia Bulletin. 2017 Aug 31. doi: 10.1093/schbul/sbx111. [Epub ahead of print]
  23. Schiff M, Nacasch N, Levit S, Katz N, Foa EB. Prolonged exposure for treating PTSD among female methadone patients who were survivors of sexual abuse in Israel. Social Work & Health Care. 2015; 54(8): 687-707. DOI: 10.1080/00981389.2015.1058311
  24. Babatsikos, Georgia (2010). "Parents' knowledge, attitudes and practices about preventing child sexual abuse: a literature review". Child Abuse Review. Wiley. 19 (2): 107–129. doi:10.1002/car.1102. ISSN 0952-9136.
  25. Hébert, Martine; Lavoie, Francine; Parent, Nathalie (2002-06-01). "An Assessment of Outcomes Following Parents' Participation in a Child Abuse Prevention Program". Violence and Victims. Springer Publishing Company. 17 (3): 355–372. doi:10.1891/vivi.17.3.355.33664. ISSN 0886-6708.
  26. Wurtele, Sandy K.; Moreno, Tasha; Kenny, Maureen C. (2008). "Evaluation of a Sexual Abuse Prevention Workshop for Parents of Young Children". Journal of Child & Adolescent Trauma. Springer Nature. 1 (4): 331–340. doi:10.1080/19361520802505768. ISSN 1936-1521.
  27. Wurtele, Sandy K.; Kenny, Maureen C. (2010). "Partnering with parents to prevent childhood sexual abuse". Child Abuse Review. Wiley. 19 (2): 130–152. doi:10.1002/car.1112. ISSN 0952-9136.
  28. Williams, Mike (2018). "Four Steps to the Prevention of Child Sexual Abuse in the Home" (PDF). NSPCC.
  29. Williams, Mike (2018). "Working with a community to prevent child sexual abuse in the home" (PDF). NSPCC. Retrieved 1 August 2018.
  30. "Dean of Students Office | Clark University". Clarku.edu. Archived from the original on 2012-05-19. Retrieved 2012-06-02.
  31. Stop Baptist Predators
  32. Episcopalian Ministers Archived 2010-02-14 at the Wayback Machine.
  33. Joe Murphy (2012-05-18). "Baroness Warsi: Some Pakistani men think young white girls are "fair game" for sex abuse - Politics - News - Evening Standard". Thisislondon.co.uk. Retrieved 2012-06-02.
  34. The Lutheran Archived 2010-01-21 at the Wayback Machine.Lutheran abuse Archived 2010-01-10 at the Wayback Machine.
  35. Methodist abuse Archived 2009-06-25 at the Wayback Machine.
  36. Anderson, Lavina (1995). Case Reports of the Mormon Alliance Volume 1. ISBN 0-10-878835-0.
  37. Abuse Scandal Plagues Hasidic Jews In Brooklyn by Barbara Bradley Hagerty. All Things Considered, National Public Radio. 2 February 2009.
  38. Amy, Neustein, ed. (2009). Tempest in the Temple: Jewish Communities and Child Sex Scandals. Brandeis Series in American Jewish History, Culture, and Life. Waltham, Massachusetts: Brandeis University Press. ISBN 978-1-58465-671-5.
  39. NPR.org
  40. Kim T, Draucker CB, Bradway C, Grisso JA, Sommers MS. Somos Hermanas Del Mismo Dolor (We Are Sisters of the Same Pain): intimate partner sexual violence narratives among Mexican immigrant women in the United States. Violence Against Women. 2017; 23(5):623–642. DOI: 10.1177/1077801216646224
  41. Leeway.org
  42. Blacksurvivors.org
  43. McKie, Robin (9 June 2012). "'Sexual depravity' of penguins that Antarctic scientist dared not reveal". Guardian.co.uk.

Further reading

  • Sorenson, Susan B. (1997). Violence and Sexual Abuse at Home: Current Issues in Spousal Battering and Child Maltreatment, New York: Haworth Press. ISBN 1-56024-681-2.
  • Leigh Ann Reynolds. "People with Mental Retardation & Sexual Abuse. The Arc Q & A", Arc National Headquarters, 1997
  • Baladerian, N. (1991). "Sexual abuse of people with developmental disabilities". Sexuality and Disability. 9 (4): 323–335. doi:10.1007/BF01102020.
  • Sobsey, D. (1994). Violence and Abuse in the Lives of People With Disabilities: The End of Silent Acceptance? Baltimore: Paul H. Brookes Publishing Co. ISBN 978-1-55766-148-7
  • Sobsey D. and Varnhagen, C. (1989). "Sexual abuse and exploitation of people with disabilities: Toward Prevention and Treatment". In M. Csapo and L. Gougen (Eds) Special Education Across Canada (pp. 199–218). Vancouver Centre for Human Developmental Research
  • Valenti-Hien, D. and Schwartz, L. (1995). "The sexual abuse interview for those with developmental disabilities". James Stanfield Company, Santa Barbara: California.
  • Baur, Susan (1997), The Intimate Hour: Love and Sex in Psychotherapy. Boston: Houghton-Mifflin Co. viii, 309 p. ISBN 0-395-82284-X
  • Walker, Evelyn, and Perry Deane Young (1986). A Killing Cure. New York: H. Holt and Co. xiv, 338 p. N.B.: Explanatory subtitle on book's dust cover: One Woman's True Account of Sexual and Drug Abuse and Near Death at the Hands of Her Psychiatrist. Without ISBN
  • White-Davis, Donna (2009). Lovers in the Time of Plague.
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