Solicitation and Sexualized Interactions of Minors with Adults: Prevalence, Overlap with Other Forms of Cybervictimization, and Relationship with Quality of Life / [La solicitud sexual y las interacciones sexualizadas de menores con adultos: su prevalencia, solapamiento con otras formas de cibervictimización y relación con la calidad de vida]

Sexual solicitation and sexualized interaction with minors by adults constitute one of the most pernicious risks of the Internet. Little is known about the age range in which this phenomenon is most prevalent or the relationship and overlap of this problem with other risks, such as peer-to-peer cybervictimization and cyber dating abuse. Additionally, little empirical evidence exists on whether the overlap between these types of online victimization affects health-related quality of life (HRQoL). This study aimed to: 1) analyze the prevalence of sexual solicitation and interaction according to sex and stage of adolescence; 2) relate this problem to other forms of online victimization (cybervictimization and cyber dating abuse); 3) analyze the overlap between these forms of online victimization and differences in HRQoL scores. A cross-sectional and analytical study with 3,578 adolescents (52.7% girls) aged between 10-15 years was carried out. Of the adolescents in the study sample, 12.6% (n = 448) had received sexual requests and 6.4% (n = 230) had interacted sexually with adults. Sexual solicitation was most common among girls in middle adolescence. Of the participants, 33.9% (n = 1,216) had been involved in some form of online victimization. Peer cybervictimization and cyber dating abuse were positively and significantly correlated with sexualized solicitation/interactions with adults. Victims with the overlapping of all three types of online victimization (2.7%, n = 98) presented the lowest HQRoL scores (p < .001).(AU)

La solicitación e interacción sexual con menores por parte de adultos constituyen uno de los riesgos más perniciosos de Internet. Se sabe poco sobre la franja de edad en el que es más frecuente o sobre la relación y el solapamiento de este problema con otros riesgos, como la cibervictimización entre iguales y el abuso online en la pareja. Además, existen pocas evidencias empíricas sobre si el solapamiento entre estos tipos de victimización afecta a la calidad de vida relacionada con la salud (CVRS). Los objetivos de este estudio fueron: 1) analizar la prevalencia de la solicitación/interacción sexual en función del sexo y la etapa de la adolescencia, 2) relacionar esta problemática con la cibervictimización entre iguales y el abuso online en la pareja, 3) analizar el solapamiento entre estas formas de victimización online y sus diferencias en las puntaciones de CVRS. Se trata de un estudio transversal y analítico con 3,578 adolescentes (52.7% chicas) entre 10-15 años. El 12.6% (n = 448) habían recibido solicitaciones sexuales y el 6.4% (n = 230) había interactuado sexualmente con adultos. La solicitación sexual fue más frecuente en chicas en la adolescencia media. Un 33.9% (n = 1,216) había sufrido algún tipo de victimización online. La cibervictimización entre iguales y el abuso online en la pareja correlacionaron positiva y significativamente con solicitaciones/interacciones sexualizadas con adultos. Las víctimas que solaparon los tres tipos de victimización online (2.7%, n = 98) presentaron las puntuaciones de CVRS más bajas (p < .001).(AU)

Revisão integrativa sobre o perfil da vítima de abuso sexual infantil masculina e as consequências desse abuso / Integrative review on the profile of the male child sexual abuse victim and the consequences of that abuse

O objetivo geral deste trabalho é descrever o perfil da vítima de abuso sexual infantil (ASI) mascu-lina e as consequências desse abuso. Trata-se de uma revisão bibliográfica integrativa dos últimos 10 anos, utilizando as bases de dados Literatura Latino Americana e do Caribe em Ciências da Saúde (Lilacs), Medical Literature Analysis and Retrieval System on-line (Medline) e Scientific Eletronic Library Online (Scielo). A equação de busca utilizada foi "masculino" e "abuso sexual". Os critérios de inclusão foram artigos relacionados diretamente ao tema, excluindo-se artigos re-petidos e/ou publicados antes de 2010. Ao final, foram selecionados 24 artigos. O estereótipo de força e virilidade relacionado ao gênero masculino representa um obstáculo na revelação do abuso. Foi notório que os meninos abusados sofreram inúmeras consequências emocionais e comporta-mentais. O perfil do menino abusado sexualmente não difere significativamente do das meninas. Já com relação à comparação das consequências do ASI, a literatura apontou que meninos sofrem mais com comportamentos externalizadores. São necessários mais estudos focando a problemática do ASI masculino a fim de quebrar estigmas sociais, conscientizar o meio acadêmico e a sociedade, aprimorar a prevenção e o tratamento de consequências emocionais e comportamentais e melhorar o combate e a identificação dessa violência.

Male child sexual abuse (CSA) is poorly addressed by the academic community, which helps the victim to remain confidential and prevents the reception and treatment of possible psychic disor-ders. Confidentiality on this topic also raises doubts about CSA statistics against boys, as it makes reporting difficult. The general objective of this study is to describe the consequences of male CSA. This is an integrative bibliographic review of the last 10 years, conducted using the databases Lat-in American and Caribbean Literature on Health and Science (Lilacs), Online Medical Literature Analysis and Retrieval System (Medline), and Scientific Electronic Library Online (Scielo). The search used the equation "masculine and sexual abuse". The criterion included articles directly related to the topic, excluding repeated articles or the ones published before 2010. We selected 24 articles. The stereotype of strength and virility related to the male gender represents an obstacle in revealing the abuse. It was notorious that the abused boys suffered numerous emotional and behav-ioral consequences. The profile of the sexually abused boy does not differ from the girls' history. Regarding the comparison of the consequences of CSA, literature has pointed out that boys suffer more with externalizing behavior. More studies focusing on the issue of male CSA are needed to break social stigmas, raise awareness among the academic environment and society, improve the prevention and treatment of emotional and behavioral consequences, and improve the fight and identification of this violence.

Association between different types of childhood trauma and parental bonding with antisocial traits in adulthood: A systematic review.

BACKGROUND: ASPD describes individuals with a pervasive pattern of disregard for the rights of others that begins in childhood and continues into adulthood. The relationship between parental bonding, trauma, and ASPD is well established, however, it remains unclear what types of trauma or which patterns of bonding are more associated with ASPD. OBJECTIVES: Review the literature regarding what types of trauma and bonding characteristics were related to antisocial personality traits. METHOD: Systematic searches of PubMed, Embase, Web of Science, and Scielo for studies about the relationship between antisocial personality traits and the Childhood Trauma Questionnaire (CTQ) and/or the Parental Bonding Instrument (PBI). RESULTS: 357 abstracts were selected, and 18 studies met the inclusion criteria. Regarding CTQ, the most consistent finding was the association between physical abuse and neglect to antisocial traits. Sexual abuse was the variable least related to antisocial traits. Regarding PBI, the most consistent finding was the inverse relationship between maternal and paternal care and antisocial traits. Concerning overprotection, the data is less consistent. Also, there was a considerable heterogenity between studies. CONCLUSIONS: The literature little explores how these variables interact with each other. Thus, more studies are important to aidpolitical,educational, and public health programs to create preventive initiatives for ASPD.

Comparing the onset of child sexual abuse perpetration from adolescence into adulthood: Are there unique risks, and what does this mean for prevention?

BACKGROUND: There are no known studies that have directly compared factors associated with the onset of child sexual abuse (CSA) perpetration during emerging adulthood, with CSA perpetration in other life-stages. OBJECTIVE: This study investigated common and distinct factors associated with the onset of CSA perpetration (i.e., age at first child sexual offense) across the life course to inform, and tailor, current prevention efforts. PARTICIPANTS AND SETTING: The sample comprised 354 males, from custodial and community corrections, and sentenced for sexual offenses against children. METHODS: Using self-report and official data, the sample was stratified into three age groups: adolescence (n = 214; 10-17 years), emerging adulthood (n = 39; 18-25 years) and later adulthood (n = 101; 26+ years). Bivariate analyses were conducted to compare developmental and contextual factors associated with CSA perpetration. A multinomial logistic regression was then performed to examine distinct risk factors for CSA-onset in emerging adulthood, compared to the other onset age groups. RESULTS: Bivariate analyses identified similarities and differences among the groups. The multinomial regression identified several factors distinguishing the emerging-adulthood group from the adolescence and later-adulthood onset groups. The combined results point to some notable differences in the emerging-adulthood group, including the disproportionate number of offenses perpetrated against male children, strangers, and in public. CONCLUSIONS: Implications for existing prevention and rehabilitation strategies are discussed in light of these findings, especially the need for a developmental lens to prevention and intervention efforts. Research to further delineate risks unique to onset of CSA in emerging adulthood is also warranted.

Monitoring recent trends: The prevalence of disclosure of sexual abuse in a representative sample of the German population based on indicator 16.2.3 of the UN Sustainable Development Goals (SDG).

BACKGROUND: The monitoring of trends is important. The United Nations (UN) have defined indicators to monitor the proportion of young men and women who have experienced sexual abuse before the age of 18 (Indicator 16.2.3) as part of their global agenda, the Sustainable Development Goals (SDG). OBJECTIVE: To examine recent trends in the disclosure of sexual abuse based on the indicator 16.2.3 of the SDG. PARTICIPANTS AND SETTING: A total of 7530 participants across Germany (51.1% female) were included. The participants were between 14 and 94 years old. METHODS: Three representative surveys were conducted using identical methods in 2010 (N = 2504), 2016 (N = 2510) and 2018 (N = 2516). A history of child sexual abuse (CSA) was assessed using the Childhood Trauma Questionnaire (CTQ). The prevalence rates of CSA among the age cohort of 18 to 29-year olds (indicator 16.2.3) were compared across the three waves. RESULTS: There was no significant increase of rates in males in this specific age cohort (2010: 7.6%; 2016: 8.5%; 2018: 6.1%), but there was a significant increase among the females of this age cohort (2010: 12.8%; 2016: 13.5%; 2018: 26.1%). The increase was entirely between the survey in 2016 and 2018. CONCLUSIONS: This is the first study to report on indicator 16.2.3 of UN's SDGs in Germany. The identified increase in rates of sexual abuse among 18-29 year old females might have been triggered by the attention the topic received in the time between 2016 and 2018, especially via social media and the #MeToo debate.

Systematic review of social norms, attitudes, and factual beliefs linked to the sexual exploitation of children and adolescents.

BACKGROUND: Despite growing interest in the role of social norms in perpetuating the harmful practice of sexual exploitation of children and adolescents (SECA), little is known about the state of the literature on this issue. OBJECTIVE: This systematic review aims to summarize what associated norms, attitudes and factual beliefs have been identified by the SECA literature worldwide. METHODS: Multiple database searches were conducted using controlled vocabulary and keywords referring to SECA. RESULTS: Our searches identified 3690 unique references. After applying our exclusion criteria, 49 studies, including over 14,000 participants from 37 countries and most world regions, were included. Across studies we identified six injunctive norms perpetuating SECA: owning goods as a social status marker ; being sexually active; exchanging sex for favors; contributing financially to the household; stigma and discrimination against young people who experienced SECA; and lack of social sanctions for SECA perpetrators. These norms were supported by enhanced tolerance of SECA when it involved older or more physically developed adolescents and when it occurred in poverty-affected contexts. Beliefs around markers that denote adolescents' readiness for sex; men's entitlement to sex; and the perceived benefits of intergenerational relationships, also contributed to the maintenance and reproduction of SECA. Findings from all regions suggested that marginalized young people are particularly vulnerable to SECA. CONCLUSIONS: Interventions to reduce SECA must consider individual, social, and structural factors and how they interrelate. Context-specific social norms interventions are needed to address harmful norms, promote protective norms, and improve services for those who have experienced SECA.

The Decline of Child Sexual Abuse in Canada: Evidence From the 2014 General Social Survey.

OBJECTIVE: To provide evidence of trends in child sexual abuse (CSA) in Canada. METHODS: Using data from 15,801 males and 18,669 females who responded to the 2014 General Social Survey (GSS), we compared the prevalence of CSA by age cohorts. Age cohort patterns were examined for several sub-populations including males, females, Indigenous peoples, and people living in low-income households. RESULTS: After an increase in the post-World War II period, there has been a decline in CSA in Canada since the early 1990s. Findings indicate a decline for both sexes; although, the evidence is more compelling for females. There is also evidence of a decline for Indigenous peoples, for those living in low-income households, and regardless of the relationship to the perpetrator (i.e., family member, a teacher/professor/tutor, a babysitter, a nanny, other non-family member but known to the respondent, or a stranger). CONCLUSIONS: In Canada, evidence from 3 retrospective population surveys suggests a decline in CSA since the early 1990s. However, given the associated harm, continued progress to the eradication of CSA is essential.

Altered default mode network connectivity in adolescents with post-traumatic stress disorder.

Post-traumatic stress disorder (PTSD) is characterized by intrusions, re-experiencing, avoidance and hyperarousal. These symptoms might be linked to dysfunction in core neurocognitive networks subserving self-referential mental processing (default mode network, DMN), detection of salient stimuli (salience network, SN) and cognitive dysfunction (central executive network, CEN). Resting state studies in adolescent PTSD are scarce and findings are inconsistent, probably due to differences in patient symptom severity. Resting state brain activity was measured in 14 adolescents with severe PTSD and 24 age-matched controls. Seed-based connectivity analyses were used to examine connectivity between the DMN and the whole brain, including regions from other networks (SN and CEN). The relationships of network properties with symptom dimensions (severity, anxiety and depression) and episodic memory were also examined. Analyses revealed decreased within-DMN connectivity (between PCC and occipital cortex) in patients compared to controls. Furthermore, within-DMN connectivity (between PCC and hippocampus) correlated negatively with symptom dimensions (severity and anxiety), while increased connectivity (DMN-SN and DMN-CEN) correlated positively with episodic memory measures. These abnormal network properties found in adolescent PTSD corroborate those previously reported in adult PTSD. Decreased within-DMN connectivity and disrupted DMN-SN and DMN-CEN coupling could form the basis for intrusive trauma recollection and impaired episodic autobiographical recall in PTSD.

Alexithymia as a mediator of the relationship between child sexual abuse and psychological distress in adolescence: A short-term longitudinal study.

BACKGROUND: Understanding factors influencing mental health of sexually abused teenagers is essential to orient treatment with this vulnerable population. The purpose of this study was to explore alexithymia as a mediator of the relationship between child sexual abuse and psychological distress using a representative sample of teenagers, while considering gender as a potential moderator. METHODS: Teenagers participating in the Quebec Youths' Romantic Relationships Survey completed measures evaluating a history of child sexual abuse and alexithymia at baseline while psychological distress was evaluated 6 months later. RESULTS: A moderated mediated model revealed a partial mediation effect of alexithymia in the relationship between child sexual abuse and psychological distress. Gender acted as a moderator as the conditional indirect effects of child sexual abuse on mental health via alexithymia were stronger for boys. CONCLUSION: Findings underscore the relevance of assessing and targeting sexually abused victims' capacity to identify and communicate emotions to promote well-being.

Getting evidence into action to tackle institutional child abuse.

The Australian Royal Commission into Institutional Responses to Child Sexual Abuse is an example of a government response to survivors' demands to address the harm they suffered. It is also a major response by a national government to improve child safety in the future. Facing up to child abuse is difficult and in other countries similar inquiries have suffered delays and derailing. This commentary uses an evidence-to-action lens to explore why clear evidence of child sexual abuse may be ignored and side-lined. It argues that where evidence challenges the powerful, is surprising and shocking, or undercuts current institutional and policy arrangements, then that evidence is likely to be ignored, undermined or refuted - all factors which are present in the case of historical institutional child sexual abuse.

Abuso sexual infantil: saber escuchar. Introducción / Child sexual abuse: knowing how to listen. Introduction

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Reports of child sexual abuse of boys and girls: Longitudinal trends over a 20-year period in Victoria, Australia.

Although prevalence studies show girls are more frequently sexually abused than boys, a significant proportion of boys also experience child sexual abuse (CSA). The challenges for public policy are amplified for boys due to less developed public and professional sensitisation to boys' experiences, conceptions of masculinity, and less research on boys including into reporting trends and outcomes. We conducted a 20-year longitudinal time-trend analysis of government data to identify reporting trends and report outcomes for CSA in Victoria, Australia from 1993 to 2012. We stratified by child gender and reporter status. Results indicate a new sensitisation to CSA, especially for boys, although this trend was not stable. Marked change occurred in the last five years, likely influenced by major social and political events. Comparison over time revealed that from 1993 to 2012, the rate of reporting of boys increased 2.6-fold whereas there was a 1.5-fold increase for girls. Comparing genders, with regards to rate of reporting, in 1993, the sex ratio of girls to boys was 2:1, while by 2012 this ratio changed to 1.14:1. Reports by police and other mandated reporters accounted for the majority of the increase in reports over the 20-year period, suggesting unequal sensitisation. Positive report outcomes (i.e. substantiations, findings of harm, and referral to services) increased twelve-fold for boys, and nearly five-fold for girls, indicating the increased levels of reports were based in actual clinical need. Most of this increase occurred from 2009 to 2012, influenced by a compound of social, political and agency-related factors.

Child Maltreatment and Adult Living Standards at 50 Years.

BACKGROUND AND OBJECTIVE: Child maltreatment (abuse and neglect) has established effects on mental health. Less is known about its influence on adult economic circumstances. We aimed to establish associations of child maltreatment with such outcomes and explore potential pathways. METHODS: We used 1958 British birth cohort data (N = 8076) to examine associations of child neglect and abuse with adult (50 years) long-term sickness absence, not in employment, education or training (NEET), lacking assets, income-related support, poor qualifications, financial insecurity, manual social class, and social mobility. We assessed mediation of associations by 16-year cognition and mental health. RESULTS: Abuse prevalence varied from 1% (sexual) to 10% (psychological); 16% were neglected. A total of 21% experienced 1 maltreatment type, 10% experienced ≥2 types. Sexual and nonsexual abuse were associated with several outcomes; eg, for sexual abuse, adjusted odds ratio (aOR) of income-related support was 1.75 (95% confidence interval [CI], 1.12-2.72). Associations were little affected by potential mediating factors. Neglect was associated with several adult outcomes (eg, aOR of NEET was 1.43 [95% CI, 1.10-1.85]) and associations were mediated by cognition and mental health (primarily by cognition): percent explained varied between 4% (NEET) to 70% (poor qualifications). In general, the risk of poor outcome increased by number of maltreatment types (eg, aOR for long-term sickness absence increased from 1.0 [reference] to 1.76 [95% CI, 1.32-2.35] to 2.69 [95% CI, 1.96-3.68], respectively, for 0, 1, and ≥2 types of maltreatment. CONCLUSIONS: Childhood maltreatment is associated with poor midadulthood socioeconomic outcomes, with accumulating risk for those experiencing multiple types of maltreatment. Cognitive ability and mental health are implicated in the pathway to outcome for neglect but not abuse.

Pattern of unnatural deaths among children: An autopsy study.

This study was conducted at the M. S. Ramaiah Medical College, Bangalore, between October 2007 and September 2009 to analyse the age and sex distribution of unnatural deaths in children, patterns and manner of death. Detailed information regarding the circumstances of death was sought from the relatives, friends and police. The scene of occurrence was visited, and photographs of the scene of occurrence were examined in relevant cases. Unnatural deaths in children constituted 6.62% of the total autopsies conducted. The majority of childhood deaths were in the age group of 15-18 years of both sexes constituting 46.88%. Males constituted 55.22% of cases. Suicide accounted for 40.63% of the cases. Most children committed suicide by hanging (82.05%). The main reason was academic failure and some of the cases were accidental (48.96%). Road traffic accidents accounted for 26.04% of the cases, where most children were pedestrians (56%). Drowning accounted for 15.63% of the cases. Most of the children drowned while playing near ponds (83.33%). Homicide accounted for 9.36% of the cases - either killed by their mother as part of a pedicide-suicide event or by the father, and in two cases the children were sexually abused before being killed.

Is child sexual abuse declining in Canada? Results from nationally representative retrospective surveys. / La violence sexuelle envers les enfants est-elle en baisse au Canada? Résultats d'enquêtes rétrospectives représentatives à l'échelle nationale.

INTRODUCTION: Numerous data sources suggest a decline in child sexual abuse (CSA) in the United States since the early 1990s. Some evidence also indicates that an earlier period of higher CSA incidence began following World War II. This study examines prevalence estimates of sexual abuse reported retrospectively as having occurred in childhood (ChSA) in two nationally representative surveys of the Canadian population. METHODS: Data are from 13 931 respondents aged 18 to 76 years from the 2004/2005 Canadian Gender, Alcohol, and Culture: An International Study (GENACIS), and from 22 169 household residents aged 18 years or older who participated in the 2012 Canadian Community Health Survey-Mental Health (CCHS-MH). We present inter- and intrasurvey comparisons of ChSA prevalence specific to sex and age groups. RESULTS: Findings from both surveys suggest a decline in CSA since 1993, consistent with declines observed in the United States. Results also suggest that 1946 to 1992 was a period of higher risk of CSA, relative to the period before 1946. The evidence was more robust for women. CONCLUSION: Evidence of a decline in CSA in Canada since the early 1990s is encouraging, given the long-term debilitating effects with which it is associated. Continued monitoring is critical. The long-term negative effects associated with CSA underscore the importance of continuing to move from lower risk to zero risk.

Selon de nombreuses sources de données, la violence sexuelle envers les enfants (VSE) est en baisse aux États-Unis depuis le début des années 1990. Il semble par ailleurs qu'elle ait connu une hausse après la Seconde Guerre mondiale. Cette étude a pour but de faire l'examen des estimations de prévalence des cas de violence sexuelle durant l'enfance (VSdE) signalés rétrospectivement dans le cadre de deux enquêtes nationales représentatives menées auprès de la population canadienne.

Impact of a new mandatory reporting law on reporting and identification of child sexual abuse: A seven year time trend analysis.

Child sexual abuse is widespread and difficult to detect. To enhance case identification, many societies have enacted mandatory reporting laws requiring designated professionals, most often police, teachers, doctors and nurses, to report suspected cases to government child welfare agencies. Little research has explored the effects of introducing a reporting law on the number of reports made, and the outcomes of those reports. This study explored the impact of a new legislative mandatory reporting duty for child sexual abuse in the State of Western Australia over seven years. We analyzed data about numbers and outcomes of reports by mandated reporters, for periods before the law (2006-2008) and after the law (2009-2012). Results indicate that the number of reports by mandated reporters of suspected child sexual abuse increased by a factor of 3.7, from an annual mean of 662 in the three year pre-law period to 2448 in the four year post-law period. The increase in the first two post-law years was contextually and statistically significant. Report numbers stabilized in 2010-2012, at one report per 210 children. The number of investigated reports increased threefold, from an annual mean of 451 in the pre-law period to 1363 in the post-law period. Significant decline in the proportion of mandated reports that were investigated in the first two post-law years suggested the new level of reporting and investigative need exceeded what was anticipated. However, a subsequent significant increase restored the pre-law proportion, suggesting systemic adaptive capacity. The number of substantiated investigations doubled, from an annual mean of 160 in the pre-law period to 327 in the post-law period, indicating twice as many sexually abused children were being identified.

Gender Differences in Homicide of Neonates, Infants, and Children under 5 y in South Africa: Results from the Cross-Sectional 2009 National Child Homicide Study.

BACKGROUND: Homicide of children is a global problem. The under-5-y age group is the second largest homicide age group after 15-19 y olds, but has received little research attention. Understanding age and gender patterns is important for assisting with developing prevention interventions. Here we present an age and gender analysis of homicides among children under 5 y in South Africa from a national study that included a focus on neonaticide and infanticide. METHODS AND FINDINGS: A retrospective national cross-sectional study was conducted using a random sample of 38 medico-legal laboratories operating in 2009 to identify homicides of children under 5 y. Child data were abstracted from the mortuary files and autopsy reports, and both child and perpetrator data data were collected from police interviews. We erred towards applying a conservative definition of homicide and excluded sudden infant death syndrome cases. We estimated that 454 (95% CI 366, 541) children under the age of 5 y were killed in South Africa in 2009. More than half (53.2%; 95% CI 46.7%, 59.5%) were neonates (0-28 d), and 74.4% (95% CI 69.3%, 78.9%) were infants (under 1 y), giving a neonaticide rate of 19.6 per 100,000 live births and an infanticide rate of 28.4 per 100,000 live births. The majority of the neonates died in the early neonatal period (0-6 d), and abandonment accounted for 84.9% (95% CI 81.5%, 87.8%) of all the neonates killed. Distinct age and gender patterns were found, with significantly fewer boy children killed in rural settings compared to urban settings (odds ratio 0.6; 95% CI 0.4, 0.9; p = 0.015). Abuse-related killings and evidence of sexual assault were more common among older girls than in all other age and gender groups. Mothers were identified as the perpetrators in all of the neonaticides and were the most common perpetrators overall (71.0%; 95% CI 63.9%, 77.2%). Abandoned neonates were mainly term babies, with a mean gestational age of 38 wk. We did not have information on abandonment motives for all newborns and did not know if babies were abandoned with the intention that they would die or with the hope that they would be found alive. We therefore considered all abandoned babies as homicides. CONCLUSIONS: Homicide of children is an extreme form or consequence of violence against children. This national study provides one of the first analyses of neonaticide and infanticide by age and gender and shows the failure of reproductive and mental health and social services to identify and help vulnerable mothers. Multi-sectoral prevention strategies are needed.

Child maltreatment in Taiwan for 2004-2013: A shift in age group and forms of maltreatment.

Cases of child maltreatment are being increasingly reported in Taiwan. However, the trend or changes of child maltreatment in Taiwan are fragmentary and lack empirical evidence. This study analyzed the epidemiological characteristics of substantiated child maltreatment cases from the previous decade, using mortality as an indicator to investigate the care of children who experienced substantiated maltreatment in the past to determine any new developments. Data for analysis and estimates were retrieved from the Department of Statistics in the Ministry of the Interior from 2004 to 2013. Trend analyses were conducted using the Joinpoint Regression Program. The child maltreatment rate in Taiwan was found to have nearly tripled from 2004 to 2013. A greater increase in the maltreatment of girls than boys and the maltreatment of aboriginal children than non-aboriginal children was noted from 2004 to 2013. When stratified by age group, the increase in maltreatment was most pronounced in children aged 12-17 years, and girls aged 12-17 years experienced the greatest increase in maltreatment. In terms of the proportional changes of different maltreatment forms among substantiated child maltreatment cases, child neglect was decreasing. The increase in sexual abuse was higher than for any other form of maltreatment and surpassed neglect by the end of 2013. Furthermore, the mortality rate of children with substantiated maltreatment record is increasing in Taiwan, whereas the mortality rate among children without any substantiated maltreatment record is decreasing. The results of this study highlight the need for policy reform in Taiwan regarding child maltreatment.

Trends in child sexual abuse cases referred for forensic examination in Southern Denmark from 2000 to 2011 - Did the 'Tønder-case' have an impact?

In 2005 a serious case of child sexual abuse from the region of Southern Denmark was revealed to the Danish public. The case became known as the 'Tønder-case'. It was the first in a series of 4-5 serious cases of child maltreatment in Denmark, cases which spurred heavy public debate. In this study all the cases of child sexual abuse referred for forensic examination in a 12 year period, a total of 368 cases, were systematically evaluated. In order to identify any trends that could be correlated to an impact of the 'Tønder-case', cases from 2000 to 2002 and cases from 2009 to 2011 underwent an in-depth analysis. In the 12 year period there was a significant increase in numbers of cases. In the subgroups, comprised of 113 cases meeting the inclusion criteria, we found a significant increase in the frequency of cases involving incest and systematic abuse, as well as an uncorrelated increase in the frequency of cases where children were placed in foster care prior to the examination. These results were countered by a significant decrease in the number cases police reported child sexual abuse in the same period. The possible impact that cases like the 'Tønder-case' and the following press coverage may have on disclosure and the handling of this type of case by authorities is discussed, as well as further perspectives of extensive press coverage.