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Child sexual abuse



 
 
Child sexual abuse is a form of child abuse
Child abuse

Child abuse is the physical abuse, psychological abuse or child sexual abuse maltreatment of children. The Centers for Disease Control and Prevention defines child maltreatment as any act or series of acts or commission or omission by a parent or other caregiver that results in harm, potential for harm, or threat of harm to a child....
 in which a child is abused for the sexual gratification of an adult or older adolescent. In addition to direct sexual contact, child sexual abuse also occurs when an adult indecently exposes their genitalia
Indecent exposure

Indecent exposure is the deliberate exposure by a person of a portion or portions of his or her own body under circumstances where such an exposure is likely to be seen as contrary to the local commonly accepted standards of decency , and may in fact be a violation of law....
 to a child, asks or pressures a child to engage in sexual activities, displays pornography
Pornography

Pornography or porn is the explicit depiction of sexual subject matter with the sole intention of sexually exciting the viewer. It is to a certain extent similar to erotica, which is the use of sexually arousing imagery....
 to a child, or uses a child to produce child pornography.

Effects of child sexual abuse include depression
Clinical depression

Major depressive disorder is a mental disorder characterized by a pervasive depression , low self-esteem, and anhedonia in normally enjoyable activities....
, post-traumatic stress disorder
Post-traumatic stress disorder

Posttraumatic stress disorder is an anxiety disorder that can develop after exposure to one or more traumatic events that threatened or caused grave physical harm....
, anxiety
Anxiety

Anxiety is a psychological and physiological state characterized by cognitive, somatic, emotional, and behavioral components. These components combine to create an unpleasant feeling that is typically associated with uneasiness, fear, or worry....
, propensity to re-victimization in adulthood, and physical injury to the child, among other problems. Sexual abuse by a family member is a form of incest
Incest

Incest refers to any sexual activity between closely related persons that is illegal or socially taboo. The type of sexual activity and the nature of the relationship between persons that constitutes a breach of law or social taboo vary with culture and jurisdiction....
, and can result in more serious and long-term psychological trauma, especially in the case of parental incest.

Approximately 15% to 25% of women and 5% to 15% of men were sexually abused when they were children.






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Encyclopedia


Child sexual abuse is a form of child abuse
Child abuse

Child abuse is the physical abuse, psychological abuse or child sexual abuse maltreatment of children. The Centers for Disease Control and Prevention defines child maltreatment as any act or series of acts or commission or omission by a parent or other caregiver that results in harm, potential for harm, or threat of harm to a child....
 in which a child is abused for the sexual gratification of an adult or older adolescent. In addition to direct sexual contact, child sexual abuse also occurs when an adult indecently exposes their genitalia
Indecent exposure

Indecent exposure is the deliberate exposure by a person of a portion or portions of his or her own body under circumstances where such an exposure is likely to be seen as contrary to the local commonly accepted standards of decency , and may in fact be a violation of law....
 to a child, asks or pressures a child to engage in sexual activities, displays pornography
Pornography

Pornography or porn is the explicit depiction of sexual subject matter with the sole intention of sexually exciting the viewer. It is to a certain extent similar to erotica, which is the use of sexually arousing imagery....
 to a child, or uses a child to produce child pornography.

Effects of child sexual abuse include depression
Clinical depression

Major depressive disorder is a mental disorder characterized by a pervasive depression , low self-esteem, and anhedonia in normally enjoyable activities....
, post-traumatic stress disorder
Post-traumatic stress disorder

Posttraumatic stress disorder is an anxiety disorder that can develop after exposure to one or more traumatic events that threatened or caused grave physical harm....
, anxiety
Anxiety

Anxiety is a psychological and physiological state characterized by cognitive, somatic, emotional, and behavioral components. These components combine to create an unpleasant feeling that is typically associated with uneasiness, fear, or worry....
, propensity to re-victimization in adulthood, and physical injury to the child, among other problems. Sexual abuse by a family member is a form of incest
Incest

Incest refers to any sexual activity between closely related persons that is illegal or socially taboo. The type of sexual activity and the nature of the relationship between persons that constitutes a breach of law or social taboo vary with culture and jurisdiction....
, and can result in more serious and long-term psychological trauma, especially in the case of parental incest.

Approximately 15% to 25% of women and 5% to 15% of men were sexually abused when they were children. 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. Most offenders who abuse pre-pubescent children are pedophiles, however a small percentage do not meet the diagnostic criteria for pedophilia.

Under the law, "child sexual abuse" is an umbrella term
Umbrella term

An umbrella term is a word that provides a superset or wikt:grouping of related concepts, also called a hypernym.For example, cryptology is an umbrella term that encompasses cryptography and cryptanalysis, among other fields....
 describing criminal and civil offenses in which an adult engages in sexual activity with a minor
Minor (law)

In law, the term minor is used to refer to a person who is under the age in which one legally assumes adulthood and is legally granted rights afforded to adults in society....
 or exploits a minor for the purpose of sexual gratification. The American Psychiatric Association
American Psychiatric Association

The American Psychiatric Association is the main professional organization of psychiatrists and trainee psychiatrists in the United States, and the most influential world-wide....
 states that "children cannot consent to sexual activity with adults", and condemns any such action by an adult: "An adult who engages in sexual activity with a child is performing a criminal and immoral act which never can be considered normal or socially acceptable behavior."

Effects


Psychological harm

Child sexual abuse can result in both short-term and long-term harm, including psychopathology
Psychopathology

Psychopathology is a term which refers to either the study of mental illness or mental distress, or the manifestation of behaviours and experiences which may be indicative of mental illness or psychological impairment, such as abnormal, maladaptive behavior or mental activity....
 in later life. Psychological, emotional, physical, and social effects include depression
Clinical depression

Major depressive disorder is a mental disorder characterized by a pervasive depression , low self-esteem, and anhedonia in normally enjoyable activities....
, post-traumatic stress disorder
Post-traumatic stress disorder

Posttraumatic stress disorder is an anxiety disorder that can develop after exposure to one or more traumatic events that threatened or caused grave physical harm....
, anxiety
Anxiety

Anxiety is a psychological and physiological state characterized by cognitive, somatic, emotional, and behavioral components. These components combine to create an unpleasant feeling that is typically associated with uneasiness, fear, or worry....
, eating disorders, poor self-esteem, dissociative and anxiety disorders; general psychological distress and disorders such as somatization
Somatization

Somatization is currently defined as "a tendency to experience and communicate somatic distress in response to psychosocial stress and to seek medical help for it"....
, neurosis
Neurosis

Neurosis , also known as psychoneurosis or neurotic disorder, is a term that refers to any mental imbalance that causes distress, but, unlike a psychosis or some personality disorders, does not prevent or affect rational thought....
, chronic pain, sexualized behavior, school/learning problems; and behavior problems including substance abuse
Substance abuse

Substance abuse is the overindulgence in and dependence of a drug or other chemical leading to effects that are detrimental to the individual's physical and mental health, or the Quality of life of others....
, destructive behavior, criminality in adulthood and suicide. A specific characteristic pattern of symptoms has not been identified and there are several hypotheses on the causality of these associations.

Long term negative effects on development leading to re-victimization in adulthood are also associated with child sexual abuse. Studies have established a causal relationship between childhood sexual abuse and certain specific areas of adult psychopathology, including suicidality, antisocial behavior, PTSD, anxiety and alcoholism. Adults with a history of abuse as a child, especially sexual abuse, are more likely than people with no history of abuse to become frequent users of emergency and medical care services. A study comparing middle-aged women who were abused as children with non-abused counterparts found significantly higher health care costs for the former.

Sexually abused children suffer from more psychological symptoms than children who have not been abused; studies have found symptoms in 51% to 79% of sexually abused children. The risk of harm is greater if the abuser is a relative, if the abuse involves intercourse or attempted intercourse, or if threats or force are used. The level of harm may also be affected by various factors such as penetration, duration and frequency of abuse, and use of force. The social stigma of child sexual abuse may compound the psychological harm to children, and adverse outcomes are less likely for abused children who have supportive family environments.

Young children who are abused sexually by adult females may incur double traumatization due to the widespread denial of female-perpetrated child sexual abuse by non-abusing parents, professional caregivers and the general public. Turner and Maryanski in Incest: Origins of the Taboo (2005), suggest that mother-son incest causes the most serious damage to children in comparison to mother-daughter, father-daughter and father-son child incest. Crawford asserts that our socially repressed view of female and maternal sexuality conceals both the reality of female sexual pathologies and the damage done by female sexual abuse to children.

Dissociation and PTSD
Child abuse
Child abuse

Child abuse is the physical abuse, psychological abuse or child sexual abuse maltreatment of children. The Centers for Disease Control and Prevention defines child maltreatment as any act or series of acts or commission or omission by a parent or other caregiver that results in harm, potential for harm, or threat of harm to a child....
, including sexual abuse, especially chronic abuse starting at early ages, has been found to be related to the development of high levels of dissociative symptoms, which includes amnesia for abuse memories. The level of dissociation has been found to be related to reported overwhelming sexual and physical abuse. When severe sexual abuse (penetration, several perpetrators, lasting more than one year) had occurred, dissociative symptoms were even more prominent.

Child sexual abuse independently predicts the number of symptoms for PTSD a person displays, after controlling for possible confounding variables, according to Widom (1999), who wrote "sexual abuse, perhaps more than other forms of childhood trauma, leads to dissociative problems ... these PTSD findings represent only part of the picture of the long-term psychiatric sequelae associated with early childhood victimization ... antisocial personality disorder, alcohol abuse, and other forms of psychopathology." Children may develop symptoms of post traumatic stress disorder resulting from child sexual abuse, even without actual or threatened injury or violence.

Research factors
Because child sexual abuse often occurs alongside other possibly confounding variables, such as poor family environment and physical abuse, some scholars argue it is important to control for those variables in studies which measure the effects of sexual abuse. In a 1998 review of related literature, Martin and Fleming, state "The hypothesis advanced in this paper is that, in most cases, the fundamental damage inflicted by child sexual abuse is due to the child's developing capacities for trust, intimacy, agency and sexuality, and that many of the mental health problems of adult life associated with histories of child sexual abuse are second-order effects." Other studies have found an independent association of child sexual abuse with adverse psychological outcomes.

Kendler et al. (2000) found that most of the relationship between severe forms of child sexual abuse and adult psychopathology in their sample could not be explained by family discord, because the effect size
Effect size

In statistics, effect size is a measure of the strength of the relationship between two variables. In scientific experiments, it is often useful to know not only whether an experiment has a statistical significance effect, but also the size of any observed effects....
 of this association decreased only slightly after they controlled for possible confounding variables. Their examination of a small sample of CSA-discordant twins also supported a causal link between child sexual abuse and adult psychopathology; the CSA-exposed subjects had a consistently higher risk for psychopathologic disorders than their CSA non-exposed twins.

A 1998 meta-analysis by Rind et al generated controversy by suggesting that child sexual abuse does not always cause pervasive harm; that some college students reported such encounters as positive experiences; and that the extent of psychological damage depends on whether or not the child described the encounter as "consensual." The study was criticized in published reviews by scientists for flawed methodology and conclusions, though its publication by peer-review has been tacitly or implicitly defended. Following extensive publicity, the US Congress condemned the study for its conclusions and for providing material used by pedophile organizations to justify their activities. Russell (1999) speculated that the perception of a sexually abusive event as 'positive' could stem from a mechanism for coping with traumatic experiences, a form of rationalization
Rationalization (psychology)

In psychology and logic, rationalization is the process of constructing a logical justification for a belief, decision, action or lack thereof that was originally arrived at through a different mental process....
.

Physical harm


Injury
Depending on the age and size of the child, and the degree of force used, child sexual abuse may cause internal lacerations and bleeding
Bleeding

Bleeding, technically known as hemorrhaging or haemorrhaging is the loss of blood from the circulatory system. Bleeding can occur internally, where blood leaks from blood vessels inside the body or externally, either through a natural opening such as the vagina, Mouth , nose, or anus, or through a break in the skin....
. In severe cases, damage to internal organs may occur, which, in some cases, may cause death. Herman-Giddens et al. found six certain and six probable cases of death due to child sexual abuse in North Carolina between 1985–1994. The victims ranged in age from 2 months to 10 years. Causes of death included trauma to the genitalia or rectum and sexual mutilation.

Infections
Child sexual abuse may cause infections and sexually transmitted diseases. Depending on the age of the child, due to a lack of sufficient vaginal fluid, chances of infections are higher. Vaginitis
Vaginitis

Vaginitis is an inflammation of the vaginal mucosa and often associated with an irritation or infection of the vulva leading to vulvovaginitis....
 has also been reported.

Neurological damage
Research has shown that traumatic stress, including stress caused by sexual abuse, causes notable changes in brain functioning and development. Various studies have suggested that severe child sexual abuse may have a deleterious effect on brain development. Ito et al. (1998) found "reversed hemispheric asymmetry and greater left hemisphere coherence in abused subjects;" Teicher et al. (1993) found that an increased likelihood of "ictal temporal lobe epilepsy-like symptoms" in abused subjects; Anderson et al. (2002) recorded abnormal transverse relaxation
Relaxation (NMR)

In Nuclear magnetic resonance spectroscopy and Magnetic resonance imaging the term relaxation describes several processes by which nuclear magnetization prepared in a non-equilibrium state return to the equilibrium distribution....
 time in the cerebellar vermis of adults sexually abused in childhood; Teicher et al. (1993) found that child sexual abuse was associated with a reduced corpus callosum
Corpus callosum

The corpus callosum is a structure of the mammalian brain in the longitudinal fissure that connects the left and right cerebral hemispheres. It also facilitates communication between the two hemispheres....
 area; various studies have found an association of reduced volume of the left hippocampus with child sexual abuse; and Ito et al. (1993) found increased electrophysiological abnormalities in sexually abused children.

Some studies indicate that sexual or physical abuse in children can lead to the overexcitation of an undeveloped limbic system
Limbic system

The limbic system is a set of brain structures including the hippocampus, amygdala, anterior thalamic nuclei, and limbic cortex, which support a variety of functions including emotion, behavior, long term memory, and olfactory....
. Teicher et al. (1993) used the "Limbic System Checklist-33" to measure ictal temporal lobe epilepsy-like symptoms in 253 adults. Reports of child sexual abuse were associated with a 49% increase to LSCL-33 scores, 11% higher than the associated increase of self-reported physical abuse. Reports of both physical and sexual abuse were associated with a 113% increase. Male and female victims were similarly affected.

Navalta et al. (2006) found that the self-reported math Scholastic Aptitude Test scores of their sample of women with a history of repeated child sexual abuse were significantly lower than the self-reported math SAT scores of their non-abused sample. Because the abused subjects verbal SAT scores were high, they hypothesized that the low math SAT scores could "stem from a defect in hemispheric integration." They also found a strong association between short term memory impairments for all categories tested (verbal, visual, and global) and the duration of the abuse.

Incest

Incest between a child or adolescent and a related adult has been identified as the most widespread form of child sexual abuse with a huge capacity for damage to a child. One researcher stated that more than 70% of abusers are immediate family members or someone very close to the family. Another researcher stated that about 30% of all perpetrators of sexual abuse are related to their victim, 60% of the perpetrators are family acquaintances, like a neighbor, babysitter or friend and 10% of the perpetrators in child sexual abuse cases are strangers. Child sexual abuse offenses where the perpetrator is related to the child, either by blood or marriage, is a form of incest
Incest

Incest refers to any sexual activity between closely related persons that is illegal or socially taboo. The type of sexual activity and the nature of the relationship between persons that constitutes a breach of law or social taboo vary with culture and jurisdiction....
 described as intrafamilial child sexual abuse.

The most-often reported form of incest is father-daughter and stepfather-daughter incest, with most of the remaining reports consisting of mother/stepmother-daughter/son incest. Father-son incest is reported less often, however it is not known if the prevalence is less, because it is under-reported by a greater margin. Prevalence of parental child sexual abuse is difficult to assess due to secrecy and privacy; some estimates show 20 million Americans have been victimized by parental incest as children.

Types of child sexual assault

Child sexual abuse includes a variety of sexual offenses, including:
  • sexual assault
    Rape

    Rape, also referred to as sexual assault, is an assault by a person involving sexual intercourse with or sexual penetration of another person without that person's consent....
     – a term defining offenses in which an adult touches a minor for the purpose of sexual gratification; for example, rape
    Rape

    Rape, also referred to as sexual assault, is an assault by a person involving sexual intercourse with or sexual penetration of another person without that person's consent....
     (including sodomy
    Sodomy

    Sodomy is a term used today predominantly in law to describe the act of anal intercourse, oral intercourse, as well as bestiality. When used in a religious context, it has a negative connotation....
    ), and sexual penetration with an object. Most U.S. states include, in their definitions of sexual assault, any penetrative contact of a minor’s body, however slight, if the contact is performed for the purpose of sexual gratification.
  • sexual molestation – a term defining offenses in which an adult engages in non-penetrative activity with a minor for the purpose of sexual gratification; for example, exposing a minor to pornography or to the sexual acts of others.
  • sexual exploitation
    Commercial sexual exploitation of children

    Commercial sexual exploitation of children constitutes a form of coercion and violence against children and amounts to forced labour and a contemporary form of slavery....
     – a term defining offenses in which an adult victimizes a minor for advancement, sexual gratification, or profit; for example, prostituting a child, and creating or trafficking in child pornography.
  • sexual grooming
    Child grooming

    Child grooming, in the context of this article, refers to actions deliberately undertaken with the aim of befriending and establishing an emotional connection with a child, in order to lower the child's inhibitions in preparation for child sexual abuse....
     - defines the social conduct of a potential child sex offender who seeks to make a minor more accepting of their advances, for example in an online chat room
    Chat room

    The term chat room, or chatroom, is primarily used by mass media to describe any form of synchronous conferencing, occasionally even asynchronous conferencing....


Disclosure

Children who received supportive responses following disclosure had less traumatic symptoms and were abused for a shorter period of time than children who did not receive support. In general, studies have found that children need support and stress-reducing resources after disclosure of sexual abuse. Negative social reactions to disclosure have actually been found to be harmful to the survivor’s well being. One study reported that children who received a bad reaction from the first person they told, especially if the person was a close family member, had worse scores as adults on general trauma symptoms, post traumatic stress disorder symptoms, and dissociation. Another study found that in most cases when children did disclose abuse, the person they talked to did not respond effectively, blamed or rejected the child, and took little or no action to stop the abuse. Although hearing a victim’s disclosure might be uncomfortable, for the sake of the victim’s well-being, it is important to be able to respond effectively. Showing that you understand and take seriously what the child is saying is an important first step.

The American Academy of Child and Adolescent Psychiatry
American Academy of Child and Adolescent Psychiatry

The American Academy of Child and Adolescent Psychiatry is a medical professional membership association representing the majority of child and adolescent psychiatrists in the United States....
 provides guidelines for what to say to the victim and what to do following the disclosure. Dr. Asa Don Brown has indicated: "A minimization of the trauma and its effects is commonly injected into the picture by parental caregivers to shelter and calm the child. It has been commonly assumed that focusing on children’s issues too long will negatively impact their recovery. Therefore, the parental caregiver teaches the child to mask his or her issues."

Treatment

The initial approach to treating a person who has been a victim of sexual abuse is dependant upon several important factors:
  • Age at the time of presentation
  • Circumstances of presentation for treatment
  • Co-morbid conditions


The goal of treatment is not only to treat current mental health issues, but to prevent future ones.

Children and adolescents

Children often present for treatment in one of several circumstances, including criminal investigations, custody battles, problematic behaviors, and referrals from CPS.

The three major modalities for therapy with children and teenagers are family therapy
Family therapy

Family therapy, also referred to as couple and family therapy and family systems therapy, is a branch of psychotherapy that works with family and couples in intimate relationships to nurture change and development....
, group therapy, and individual therapy
Psychotherapy

Psychotherapy is an intentional interpersonal relationship used by trained psychotherapists to aid a wiktionary:Client in problems of living. It aims to increase the individual's sense of health and reduce their subjective sense of discomfort....
. Which course is used depends on a variety of factors that must be assessed on a case by case basis. For instance, treatment of young children generally requires strong parental involvement, and can benefit from family therapy. Adolescents tend to be more independent, can benefit from individual or group therapy. The modality also shifts during the course of treatment, for example group therapy is rarely used in the initial stages, as the subject matter is very personal and/or embarrassing.

Major factors that affect both the pathology and response to treatment include the type and severity of the sexual act, its frequency, the age at which it occurred, and the child’s family of origin.

Adult survivors

Adults with a history of sexual abuse often present for treatment with a secondary mental health issue, which can include substance abuse, eating disorders, personality disorders, depression, and conflict in romantic or interpersonal relationships.

Generally the approach is to the present problem, rather than the abuse itself. Treatment is highly varied and depends on the person’s specific issues. For instance, a person with a history of sexual abuse suffering from severe depression would be treated for depression. However, there is often an emphasis on cognitive restructuring due to the deep-seated nature of the trauma. Some newer techniques such as Eye Movement Desensitization and Reprocessing
Eye Movement Desensitization and Reprocessing

Eye movement desensitization and reprocessing is a form of psychotherapy that was developed to resolve symptoms resulting from disturbing and unresolved life experiences....
 (EMDR) have been shown to be effective to this end.

Sexual abuse is associated with many sub-clinical behavioral issues as well, including re-victimization in the teenage years, a bipolar-like switching between sexual compulsion and shut-down, and distorted thinking on the subject of sexual abuse (for instance, that it is common and happens to everyone). When first presenting for treatment, the patient can be fully aware of their abuse as an event, but their appraisal of it is often distorted, such as believing that the event was unremarkable (a form of isolation
Defence mechanism

In Freudian psychoanalytic theory, defence mechanisms or defense mechanisms are psychological strategies brought into play by various entities to cope with reality and to maintain self-image....
). Frequently, victims do not make the connection between their abuse and their present pathology.

Female victims who were abused before age 12 also will sometimes have a curious vocal inflection recognizable by clinicians, reminiscent of a child speaking, though at present this has not been studied or explained.

Offenders


Adult offenders


Demographics
Offenders are more likely to be relatives or acquaintances of their victim than strangers. A 2006–2007 Idaho study of 430 cases found that 82% of juvenile sex offenders were known to the victims (acquaintances 46% or relatives 36%).

More offenders are male than female, though the percentage varies between studies. The percentage of incidents of sexual abuse by female perpetrators that come to the attention of the legal system is usually reported to be between 1% and 4%. Studies of sexual misconduct in US schools with female offenders have shown mixed results with rates between 4% to 43% of female offenders. Maletzky (1993) found that, of his sample of 4,402 convicted pedophilic offenders, 0.4% were female. Another study of a non-clinical population found that, among those in the their sample that had been molested, as much as a third were molested by women.

In U.S. schools, educators who offend range in age from "21 to 75 years old, with an average age of 28" with teachers, coaches, substitute teachers, bus drivers and teacher's aides (in that order) totaling 69% of the offenders.

Psychological aspects
Offenses may be facilitated by cognitive distortion
Cognitive distortion

Cognitive distortions are inaccurate thoughts or ideas identified in cognitive therapy and its variants, which maintain negative thinking and help to maintain negative emotions....
s of the offender, such as minimization of the abuse, victim blaming
Victim blaming

Victim blaming is holding the victims of a crime, an accident, or any type of abusive maltreatment to be entirely or partially Moral responsibility for the unfortunate incident that has occurred in their life, often when the victim had performed no actions to facilitate the incident....
, and excuses.

Early research in the 1970s and 80s began to classify offenders based on their motivations and traits. Groth and Birnbaum (1978) categorized child sexual offenders into two groups, "fixated" and "regressed." Fixated were described as having a primary attraction to children, whereas regressed had largely maintained relationships with other adults, and were even married. This study also showed that adult sexual orientation
Sexual orientation

Sexual orientation refers to "an enduring pattern of emotional, romantic, and/or sexual attractions to men, women, or both sexes." According to the American Psychological Association, "it also refers to an individual?s sense of personal and social identity based on those attractions, behaviors expressing them, and membership in a community of...
 was not related to the sex of the victim targeted, e.g. men who molested boys had previously had adult heterosexual relationships.

Later work (Holmes and Holmes, 2002) expanded on the types of offenders and their psychological profiles. They are divided thus:
  • Situational - does not prefer children, but offend under certain conditions.
    • Regressed - Typically has relationships with adults, but a stressor causes them to seek children as a substitute.
    • Morally Indiscriminate - All-around sexual deviant, who may commit other sexual offenses unrelated to children.
    • Naive/Inadequate - Often mentally disabled in some way, finds children less threatening.
  • Preferential - has true sexual interest in children.
    • Mysoped - Sadistic and violent, target strangers more often than acquaintances.
    • Fixated - Little or no activity with own age, described as an "overgrown child."


Causal factors of child sex offenders are not known conclusively. The experience of sexual abuse as a child was previously thought to be a strong risk factor, but research does not show a causal relationship, as the vast majority of sexually abused children do not grow up to be adult offenders, nor do the majority of adult offenders report childhood sexual abuse. The US Government Accountability Office
Government Accountability Office

The Government Accountability Office is the audit, evaluation, and investigative arm of the United States Congress. It is located in the Legislative branch of the Federal government of the United States....
 concluded, "the existence of a cycle of sexual abuse was not established." Prior to 1996, there was greater belief in the theory of a "cycle of violence," because most of the research done was retrospective—abusers were asked if they had experienced past abuse. Even the majority of studies found that most adult sex offenders said they had not been sexually abused during childhood, but studies varied in terms of their estimates of the percentage of such offenders who had been abused, from 0 to 79 percent. More recent prospective longitudinal
Longitudinal

The term, longitudinal means "along the major axis" as opposed to latitudinal which means "along the width", transverse, or across.*In automotive engineering, a longitudinal engine is an engine in which the crankshaft is oriented along the long axis of the vehicle, front to back....
 research—studying children with documented cases of sexual abuse over time to determine what percentage become adult offenders—has demonstrated that the cycle of violence theory is not an adequate explanation for why people molest children.

Pedophilia
The term "pedophilia" refers to persistent feelings of attraction in an adult or older adolescent toward prepubescent children, whether the attraction is acted upon or not. A person with this attraction is called a "pedophile".

According to the Mayo Clinic, approximately 95% of child sexual abuse incidents are committed by the 88% of child molestation offenders who meet the diagnostic criteria for pedophilia; and pedophilic child molestors commit ten times more sexual acts against children than non-pedophilic child molestors. This report was confined to victims 12 and under with offenders over 18. On the other hand, when offenses against adolescents and teenagers were included, Okami and Goldberg (1992), and Kevin Howells (1981), state that most data they had reviewed suggest that pedophiles make up a minority of incarcerated child sex offenders.

In law enforcement
Police

Police are agents or agencies, usually of the executive , empowered to enforce the law and to ensure public and social order through the legitimized use of force....
, the term "pedophile" is generally used to describe those accused or convicted of child sexual abuse under sociolegal definitions of child
Minor (law)

In law, the term minor is used to refer to a person who is under the age in which one legally assumes adulthood and is legally granted rights afforded to adults in society....
 (including both prepubescent children and adolescents younger than the local age of consent
Age of consent

While the phrase age of consent typically does not appear in legal statutes, when used in relation to human sexual behavior, the age of consent is the minimum age at which a person is considered to be legally competent of consenting to sexual acts....
); however, not all child sexual offenders are pedophiles and not all pedophiles engage in sexual abuse of children. Law enforcement and legal professionals have begun to use the term predatory pedophile, a phrase coined by children's attorney Andrew Vachss
Andrew Vachss

Andrew Henry Vachss is an United States crime fiction author, child protection consultant, and Lawyer exclusively representing children and youths....
, to refer specifically to pedophiles who engage in sexual activity with minors. The term emphasizes that child sexual abuse consists of conduct chosen by the perpetrator.

Child and young adolescent offenders


When a prepubescent child is sexually abused by one or more other children or adolescent youths, and no adult is directly involved, it is defined as child-on-child sexual abuse
Child-on-child sexual abuse

Child-on-child sexual abuse refers to a form of child sexual abuse in which a prepubescent child is sexually abused by one or more other children or adolescent youths, and in which no adult is directly involved....
. The definition includes any sexual activity between children that occurs without consent, without equality, or as a result of coercion
Coercion

Coercion is the practice of compelling a person or manipulating them to behave in an involuntary way by use of threats, intimidation, trickery, or some other form of pressure or force....
, whether the offender uses physical force, threats, trickery or emotional manipulation to compel cooperation. When sexual abuse is perpetrated by one sibling upon another, it is known as "intersibling abuse", a form of incest
Incest

Incest refers to any sexual activity between closely related persons that is illegal or socially taboo. The type of sexual activity and the nature of the relationship between persons that constitutes a breach of law or social taboo vary with culture and jurisdiction....
.

Unlike research on adult offenders, a strong causal relationship has been established between child and adolescent offenders and these offenders' own prior victimization, by either adults or other children.

Prevalence


United States and Europe

Child sexual abuse occurs frequently in Western society. The rate of prevalence can be difficult to determine. In the UK it is estimated at about 8% for boys and 12% for girls. The estimates for the United States vary widely. A literature review of 23 studies found rates of 3% to 37% for males and 8% to 71% for females, which produced an average of 17% for boys and 28% for girls, while a statistical analysis based on 16 cross-sectional studies estimated the rate to be 7.2% for males and 14.5% for females. The US Department of Health and Human Services reported 83,600 substantiated reports of sexually abused children in 2005. Including incidents which were not reported would make the total number even larger.

Surveys have shown that one fifth to one third of all women reported some sort of childhood sexual experience with a male adult. A 1992 survey studying father-daughter incest in Finland reported that of the 9,000 15-year old high school girls who filled out the questionnaires, of the girls living with their biological fathers, 0.2% reported father-daughter incest experiences; of the girls living with a stepfather, 3.7% reported sexual experiences with him. The reported counts included only father-daughter incest and did not include prevalence of other forms of child sexual abuse. The survey summary stated, "the feelings of the girls about their incestual experiences are overwhelmingly negative." Others argue that prevalence rates are much higher, and that many cases of child abuse are never reported. One study found that professionals failed to report approximately 40% of the child sexual abuse cases they encountered. A study by Lawson & Chaffin indicated that many children who were sexually abused were "identified solely by a physical complaint that was later diagnosed as a venereal disease...Only 43% of the children who were diagnosed with venereal disease made a verbal disclosure of sexual abuse during the initial interview." It has been found in the epidemiological literature on CSA that there is no identifiable demographic or family characteristic of a child that can be used to bar the prospect that a child has been sexually abused.

In schools
In US schools, according to the US Department of Education, "nearly 9.6% of students are targets of educator sexual misconduct sometime during their school career." In studies of student sex abuse by male and female educators, male students were reported as targets in ranges from 23% to 44%. In U.S. school settings same-sex (female and male) sexual misconduct against students by educators "ranges from 18-28% of reported cases, depending on the study"

Under reported forms
Significant under reporting of sexual abuse of boys by both women and men is believed to occur due to sex stereotyping, social denial, the minimization of male victimization, and the relative lack of research on sexual abuse of boys. Sexual victimization of boys by their mothers or other female relatives is especially rarely researched or reported. Sexual abuse of girls by their mothers, and other related and/or unrelated adult females is beginning to be researched and reported despite the highly taboo nature of female-female child sex abuse. In studies where students are asked about sex offenses, they report higher levels of female sex offenders than found in adult reports. This under-reporting has been attributed to cultural denial of female-perpetrated child sex abuse, because "males have been socialized to believe they should be flattered or appreciative of sexual interest from a female" and because female sexual abuse of males is often seen as 'desirable' and/or beneficial by judges, mass media pundits and other authorities.

Africa

The prevalence of child sexual abuse in Africa is compounded by a belief that sexual intercourse with a virgin will cure a man of HIV
HIV

Human immunodeficiency virus is a lentivirus that can lead to AIDS , a condition in humans in which the immune system begins to fail, leading to life-threatening opportunistic infections....
 or AIDS
AIDS

Acquired immune deficiency syndrome or acquired immunodeficiency syndrome is a disease of the human immune system caused by the HIV ....
. This belief is especially common in South Africa
South Africa

The Republic of South Africa, also known by Official names of South Africa, is a country located at the southern tip of the continent of Africa....
, which has the highest number of HIV-positive citizens in the world. According to official figures, one in eight South Africans are infected with the virus. Eastern Cape
Eastern Cape

The Eastern Cape is a Provinces of South Africa of South Africa. Its capital is Bhisho. It was formed in 1994 out of the "independent" homelands of Transkei and Ciskei, as well as the eastern portion of the Cape Province....
 social worker Edith Kriel notes that "child abusers are often relatives of their victims - even their fathers and providers." More than 67,000 cases of sexual assaults against children were reported in 2000 in South Africa. Child welfare groups believe that the number of unreported incidents could be up to 10 times that number. Researcher Suzanne Leclerc-Madlala states that the myth that sex with a virgin is a cure for AIDS is not confined to South Africa: "Fellow AIDS researchers in Zambia
Zambia

The Republic of Zambia is a landlocked country in Southern Africa. The neighbouring countries are the Democratic Republic of the Congo to the north, Tanzania to the north-east, Malawi to the east, Mozambique, Zimbabwe, Botswana, and Namibia to the south, and Angola to the west....
, Zimbabwe
Zimbabwe

Zimbabwe , is a landlocked country located in the southern part of the continent of Africa, between the Zambezi and Limpopo River rivers. It is bordered by South Africa to the south, Botswana to the southwest, Zambia to the northwest and Mozambique to the east....
 and Nigeria
Nigeria

Nigeria, officially the Federal Republic of Nigeria, is a federation constitutional republic comprising States of Nigeria and one Federal Capital Territory, Nigeria....
 have told me that the myth also exists in these countries and that it is being blamed for the high rate of sexual abuse against young children."

Asia

In one survey, 2.5% of Taiwanese adolescents report having experienced childhood sexual abuse.

India
Nineteen percent of the world's children live in India, which constitutes 42 percent of India’s total population.

In 2007 the Ministry of Women and Child Development
Ministry of Women and Child Development (India)

The Ministry of Women and Child Development, a branch of the Government of India, is the apex body for formulation and administration of the rules and regulations and laws relating to women and child development in India....
 published the "Study on Child Abuse: India 2007." It sampled 12447 children, 2324 young adults and 2449 stakeholders across 13 states. It looked at different forms of child abuse: Physical Abuse
Physical abuse

Physical abuse is abuse involving contact intended to cause feelings of intimidation, pain, injury, or other physical suffering or harm.Basic forms include:...
, Sexual Abuse
Sexual abuse

Sexual abuse, also referred to as molestation, is the forcing of undesired sexual acts by one person upon another. The offender is referred to as a molester/molestor/ abuser/sexual abuser....
 and Emotional Abuse
Psychological abuse

Psychological abuse, also referred to as emotional abuse is a form of abuse characterized by a person subjecting or exposing another to behaviour that is psychologically harmful....
 and Girl Child Neglect in five evidence groups, namely, children in a family environment, children in school, children at work, children on the street and children in institutions.

The study's main findings included: 53.22% of children reported having faced sexual abuse. Among them 52.94% were boys and 47.06% girls. Andhra Pradesh
Andhra Pradesh

Andhra Pradesh , abbreviated A.P.,is a state situated on eastern coast of India. It is India's List of states of India by area and List of states of India by population....
, Assam
Assam

Assam ) is a North-East India state of India with its capital at Dispur, in the outskirts of the city Guwahati. Located south of the eastern Himalayas, Assam comprises the Brahmaputra and the Barak River river valleys and the Karbi Anglong District and the North Cachar Hills with an area of 30,285 square miles ....
, Bihar
Bihar

Bihar is a States and territories of India in East India. Bihar is the 12th largest state in terms of geographical size 38,202 square mile and 3rd largest by population....
 and Delhi
Delhi

Delhi , sometimes referred to as Dilli , is the List of most populous cities in India metropolis in India and, with over 11 million residents, the List of metropolitan areas by population....
 reported the highest percentage of sexual abuse among both boys and girls, as well as the highest incidence of sexual assaults. 21.90% of child respondents faced severe forms of sexual abuse, 5.69% had been sexually assaulted and 50.76% reported other forms of sexual abuse. Children on the street, at work and in institutional care reported the highest incidence of sexual assault. The study also reported that 50% of abusers are known to the child or are in a position of trust and responsibility and most children had not reported the matter to anyone.

International law

Child sexual abuse is outlawed in every developed country
Developed country

The term developed country is used to describe countries that have a high level of development according to some criteria. Which criteria, and which countries are classified as being developed, is a contentious issue and there is fierce debate about this....
, generally with severe criminal penalties, including in some jurisdictions, life imprisonment or capital punishment
Capital punishment

Capital punishment, the death penalty or execution, is the killing of a person by procedural law for Punishment#Retribution and Punishment#Incapacitation....
. An adult's sexual intercourse with a child below the legal age of consent
Age of consent

While the phrase age of consent typically does not appear in legal statutes, when used in relation to human sexual behavior, the age of consent is the minimum age at which a person is considered to be legally competent of consenting to sexual acts....
 is defined as statutory rape
Statutory rape

The phrase statutory rape is a term used in some legal jurisdictions to describe consensual sexual relations that take place when an individual has sexual relations with an individual not old enough to legally consent to the behavior....
, based on the principle that a child is not capable of consent and that any apparent consent by a child is not considered to be legal consent.

The United Nations Convention on the Rights of the Child
Convention on the Rights of the Child

The United Nations Convention on the Rights of the Child, often referred to as CRC or UNCRC, is an International human rights instruments setting out the civil, political, economic, social and cultural rights of children....
 (CRC) is an international treaty
Treaty

A Treaty is an agreement under international law entered into by actors in international law, namely states and international organizations. A Treaty may also be known as: agreement, protocol, covenant, convention, exchange of letters, etc....
 that legally obliges states to protect children's rights. Articles 34 and 35 of the CRC require states to protect children from all forms of sexual exploitation and sexual abuse. This includes outlawing the coercion of a child to perform sexual activity, the prostitution of children, and the exploitation of children in creating pornography
Child pornography

Child pornography refers to images or films depicting sexually explicit activities involving a child; as such, child pornography is a visual record of child sexual abuse....
. States are also required to prevent the abduction, sale, or trafficking of children. As of November 2008, 193 countries are bound by the CRC, including every member of the United Nations
United Nations

The United Nations is an international organization whose stated aims are to facilitate cooperation in international law, international security, economic development, Social change, human rights and achieving world peace....
 except the United States
United States

The United States of America is a Federal government constitutional republic comprising U.S. state and a federal district. The country is situated mostly in central North America, where its Contiguous United States and Washington, D.C., the Capital districts and territories, lie between the Pacific Ocean and Atlantic Oceans, Borders of the U...
 and Somalia
Somalia

Somalia , officially the Republic of Somalia and formerly known as the Somali Democratic Republic, is a country located in the Horn of Africa....
.

History

Child sexual abuse has gained public attention in the past few decades and has become one of the most high-profile crimes. Since the 1970s the sexual abuse of children and child molestation has increasingly been recognized as deeply damaging to children and thus unacceptable for society as a whole. While sexual use of children by adults has been present throughout history, it has only become the object of significant public attention in recent times.

Early writings

The first published work dedicated specifically to child sexual abuse appeared in France in 1857: Medical-Legal Studies of Sexual Assault (Etude Médico-Légale sur les Attentats aux Mœurs), by Auguste Ambroise Tardieu, the noted French pathologist and pioneer of forensic medicine (Masson, 1984, pp. 15–25).

The rise of public concern

Child sexual abuse became a public issue in the 1970s and 1980s. Prior to this point in time sexual abuse remained rather secretive and socially unspeakable. Studies on child molestation were nonexistent until the 1920s and the first national estimate of the number of child sexual abuse cases was published in 1948. By 1968 44 out of 50 U.S. states had enacted mandatory laws that required physicians to report cases of suspicious child abuse. Legal action began to become more prevalent in the 1970s with the enactment of the Child Abuse Prevention and Treatment Act
Child Abuse Prevention and Treatment Act

The Child Abuse Prevention and Treatment Act provides Federal government of the United States funding to States in support of prevention, assessment, investigation, prosecution, and treatment activities and also provides grants to public agencies and nonprofit organizations for demonstration programs and projects....
 in 1974 in conjunction with the creation of the National Center for Child Abuse and Neglect. Since the creation of the Child Abuse and Treatment Act, reported child abuse cases have increased dramatically. Finally, the National Abuse Coalition was created in 1979 to create pressure in congress to create more sexual abuse laws.

Second wave feminism brought greater awareness of child sexual abuse and violence against women, and made them public, political issues. Judith Lewis Herman
Judith Lewis Herman

Judith Lewis Herman is a psychiatrist, researcher, teacher, and author who has focussed on the understanding and treatment of incest and traumatic stress....
, Harvard professor of psychiatry, wrote the first book ever on father-daughter incest when she discovered during her medical residency that a large number of the women she was seeing had been victims of father-daughter incest. Herman notes that her approach to her clinical experience grew out of her involvement in the civil rights movement. Her second book Trauma and Recovery, considered a classic and ground-breaking work coined the term complex post-traumatic stress disorder
Complex post-traumatic stress disorder

Complex post-traumatic stress disorder is a psychological injury that results from protracted exposure to prolonged social and/or interpersonal Psychological trauma with lack or loss of control, disempowerment, and in the context of either captivity or entrapment, i.e....
." In it she defines this concept not only in terms of prolonged trauma, but in terms of what she calls "subjection to totalitarian control." Examples of this concept include:
...hostages, prisoners of war, concentration-camp survivors, and survivors of some religious cults
Cult

This article does not discuss "cult" in the original sense of "veneration" or "religious practice"; for that usage see Cult . See Cult for more meanings of the term "cult"....
. Examples also include those subjected to totalitarian systems in sexual and domestic life, including survivors of domestic battering
Domestic violence

Domestic violence occurs when a family member, partner or ex-partner attempts to physically or psychologically dominate another. Domestic violence often refers to violence between spouses, or spousal abuse but can also include cohabitants and non-married intimate partners....
, childhood physical or sexual abuse
Sexual abuse

Sexual abuse, also referred to as molestation, is the forcing of undesired sexual acts by one person upon another. The offender is referred to as a molester/molestor/ abuser/sexual abuser....
, and organized sexual exploitation
Sexual exploitation

Sexual exploitation may refer to:*Sexual slavery*Sexual exploitation and abuse in humanitarian response...
.


In 1986, Congress passed the Child Abuse Victims' Rights Act, giving children a civil claim in sexual abuse cases. The number of laws created in the 1980s and 1990s began to create greater prosecution and detection of child sexual abusers. During the 1970s a large transition began in the legislature related to child sexual abuse. Megan's Law
Megan's Law

Megan's Law is an informal name for laws in the United States requiring law enforcement authorities to make information available to the public regarding registered sex offenders....
 which was enacted in 2004 gives the public access to knowledge of sex offenders nationwide.

Anne Hastings described these changes in attitudes towards child sexual abuse as "the beginning of one history's largest social revolutions."

According to John Jay College of Criminal Justice professor B.J. Cling,

"By the early 21st century, the issue of child sexual abuse has become a legitimate focus of professional attention, while increasingly separated from second wave feminism...As child sexual abuse becomes absorbed into the larger field of interpersonal trauma studies, child sexual abuse studies and intervention strategies have become degendered and largely unaware of their political origins in modern feminism and other vibrant political movements of the 1970s. One may hope that unlike in the past, this rediscovery of child sexual abuse that began in the 70s will not again be followed by collective amnesia. The institutionalization of child maltreatment interventions in federally funded centers, national and international societies, and a host of research studies (in which the United States continues to lead the world) offers grounds for cautious optimism. Nevertheless, as Judith Herman argues cogently, 'The systematic study of psychological trauma...depends on the support of a political movement.'"


Civil lawsuits

In the United States
United States

The United States of America is a Federal government constitutional republic comprising U.S. state and a federal district. The country is situated mostly in central North America, where its Contiguous United States and Washington, D.C., the Capital districts and territories, lie between the Pacific Ocean and Atlantic Oceans, Borders of the U...
 growing awareness of child sexual abuse has sparked an increasing number of civil lawsuits for monetary damages
Monetary damages

Monetary damages, in civil law , refers to Damages given to an injured party by a liable party. Monetary damages may be restitution, a penalty, or both....
 stemming from such incidents. Increased awareness of child sexual abuse has encouraged more victims to come forward, whereas in the past victims often kept their abuse secret. Some states have enacted specific laws lengthening the applicable statutes of limitations so as to allow victims of child sexual abuse to file suit sometimes years after they have reached the age of majority. Such lawsuits can be brought where a person or entity, such as a school, church or youth organization, was charged with supervising the child but failed to do so with child sexual abuse resulting. In the Catholic sex abuse cases the various Roman Catholic Diocese in the United States
United States

The United States of America is a Federal government constitutional republic comprising U.S. state and a federal district. The country is situated mostly in central North America, where its Contiguous United States and Washington, D.C., the Capital districts and territories, lie between the Pacific Ocean and Atlantic Oceans, Borders of the U...
 have paid out approximately $1 billion settling hundreds of such lawsuits since the early 1990s. As lawsuits can involve demanding procedures there is a concern that children or adults who file suit will be re-victimized by defendants through the legal process
Legal Process

The legal process school was a movement within American law that attempted to chart a third way between legal formalism and legal realism. Drawing its name from Hart & Sacks' textbook The Legal Process , it is associated with scholars such as Herbert Wechsler, Henry Hart, Albert Sacks and Lon Fuller, and their students such as John Hart Ely...
, much as rape
Rape

Rape, also referred to as sexual assault, is an assault by a person involving sexual intercourse with or sexual penetration of another person without that person's consent....
 victims can be re-victimized by the accused in criminal rape trials. The child sexual abuse plaintiff's attorney Thomas A. Cifarelli has written that children involved in the legal system, particularly victims of sexual abuse and molestation, should be afforded certain procedural safeguards to protect them from harassment during the legal process.

On June 30, 2008 in the nation of Zambia the issue of teacher-student sexual abuse and sexual assault was brought to the attention of the High Court of Zambia where a landmark case decision, with presiding Judge Philip Musonda, awarded $45million Zambian Kwacha ($13,000 USD) to the plaintiff, a 13 yr. old girl-student for sexual abuse and rape by her school teacher. This claim was brought against her teacher as a "person of authority" who, as Judge Musonda stated, "had a moral superiority (responsibility) over his students" at the time.

A 2000 World Health Organization – Geneva report, “World Report on Violence and Health (Chap 6 - Sexual Violence)” states, “Action in schools is vital for reducing sexual and other forms of violence. In many countries a sexual relation between a teacher and a pupil is not a serious disciplinary offence and policies on sexual harassment in schools either do not exist or are not implemented. In recent years, though, some countries have introduced laws prohibiting sexual relations between teachers and pupils. Such measures are important in helping eradicate sexual harassment in schools. At the same time, a wider range of actions is also needed, including changes to teacher training and recruitment and reforms of curricula, so as to transform gender relations in schools.”

See also

  • Catholic sex abuse cases
  • Child-on-child sexual abuse
    Child-on-child sexual abuse

    Child-on-child sexual abuse refers to a form of child sexual abuse in which a prepubescent child is sexually abused by one or more other children or adolescent youths, and in which no adult is directly involved....
  • Child pornography
    Child pornography

    Child pornography refers to images or films depicting sexually explicit activities involving a child; as such, child pornography is a visual record of child sexual abuse....
  • Child sex tourism
    Child sex tourism

    Child sex tourism is a travel to a foreign country for the purpose of engaging in Commercial sexual exploitation of children child sexual abuse of children....
  • Commercial sexual exploitation of children
    Commercial sexual exploitation of children

    Commercial sexual exploitation of children constitutes a form of coercion and violence against children and amounts to forced labour and a contemporary form of slavery....
  • Day care sexual abuse hysteria
    Day care sexual abuse hysteria

    Day care sex abuse hysteria occurred primarily in the 1980s and early 1990s. A prominent case in Kern County, California first brought the issue of day care sexual abuse to the fore in the public consciousness, and the issue figured prominently in news coverage for almost a decade....
  • False allegation of child sexual abuse
    False allegation of child sexual abuse

    A false allegation of child sexual abuse is an accusation by a child that a person committed one or more acts of child sexual abuse when in reality there was no perpetration of abuse by the accused person as alleged....
  • List of films portraying paedophilia or sexual abuse of minors
  • Prostitution of children
    Prostitution of children

    Prostitution of children refers to children having sexual intercourse for money. The definition of a "child prostitute" can vary depending on who is using the term....
  • Scouting sex abuse cases
    Scouting sex abuse cases

    Scouting sex abuse cases are situations where youth involved in Scouting programs have been child sex abuse by someone who is also involved in the scouting program ....
  • Sexual harassment and abuse of students by teachers
    Sexual harassment in education

    Sexual harassment in education is unwelcome behavior of a sexual nature that interferes with a student?s ability to learn, study, work or participate in school activities....


Further reading


External links