School-aged children with sexual behavior problems: Untangling the relationship between externalizing behavior problems and non-sexual victimization on the variety and severity of sexual behaviors.

BACKGROUND: Sexual behavior problems (SBP) in school-aged children is a social concern that draws increased attention amongst child protection services and practitioners. Past research that highlighted the variety in profiles and in behavioral manifestations of children with SBP emphasizes the importance of a well-informed and sensitive approach for appropriate intervention. However, studies validating the theoretically hypothesized vulnerability of children with SBP remains scarce. OBJECTIVE: This study aimed to further our understanding of the risk factors that influence the variety and severity of SBP. PARTICIPANTS AND SETTING: Eighty-eight child-adult dyads (35.2% girls, Mage = 9.1 years; SD = 2.2 years) referred for SBP by child protection services or public services between 2006 and 2010 participated in the study. Participants completed a series of questionnaires as part of their assessment in a specialized therapeutic center for SBP. METHODS: A theoretical model of risk factors was examined using multiple linear regression analysis. RESULTS: Amongst the factors identified, externalizing behavior problems were the most strongly associated with the variety (ß = .50; p < 0.001) and severity of SBP (ß = .40; p < .001). Non-sexual victimization experiences (e.g., exposure to family violence) were also associated with a greater variety (ß = .30; p < .001) and severity of SBP (ß = .36; p < .001), while sexual abuse alone was not. CONCLUSIONS: This study outlines the high co-occurrence of SBP, externalizing behaviors and non-sexual victimization, which should raise concern for the assessment of the children and to further adapt treatment strategies and goals.