[Background and psychological impact of organised and ritual child sexual abuse: Reports to the Independent Inquiry into Child Sexual Abuse in Germany]. / Hintergründe und psychische Folgen organisierter und ritueller Gewalt ­ Berichte an die Unabhängige Kommission zur Aufarbeitung sexuellen Kindesmissbrauchs.

OBJECTIVE: Organised child sexual abuse is characterised by commercial exploitation of children and adolescents by networking perpetrator groups. Ritual abuse is further characterised by ideological frameworks (e.g., cults). METHODS: Forty-one confidential hearings and written reports, gathered by the German Independent Inquiry into Child Sexual Abuse from individuals as well as contemporary witnesses subjected to organised and ritual abuse (ORA) were analysed by means of a quantitative content analysis. RESULTS: Right-wing extremist, Satanist and religious ideologies were most frequently described. The perpetrators were, next to unknown offenders, mostly described as fathers, and in half of the reports, besides also mothers of the victims. Dissociative identity disorders resulting from such traumatic violence present a challenge to psychosocial and psychiatric professionals. DISCUSSION: It is necessary to educate professionals in psychosocial care settings about ORA and the psychological consequences of extreme violence.

[Which Factors Impede the Uncovering of Organized and Ritual Child Sexual Abuse? - A Qualitative Content Analysis of Reports of Victims and Contemporary Witnesses]. / Was erschwert die Aufdeckung organisierter und ritueller Gewaltstrukturen?

OBJECTIVE: The study aims to investigate organized and ritual child sexual abuse (i. e. networking perpetrator groups with ideological frameworks). METHODS: A qualitative content analysis was conducted on 33 reports by victims and contemporary witnesses. Inductive categories were formed with regard to the question, which factors might impede the exposure of such structures. RESULTS: The results suggest that several interdependent factors of three interacting groups may play major roles in the deficient detection of those structures: the perpetrators, the survivors and other persons (e. g. in the vicinity of the survivors and in society). CONCLUSION: In order to influence the described system of interdependent factors positively in the sense of an improved exposure of those violent structures, the objective communication of knowledge in different societal institutions is necessary.

Demystifying ritual abuse - insights by self-identified victims and health care professionals.

Empirical evidence on organized and ritual child sexual abuse (ORA), that is, organized child sexual abuse with an ideological framework, is rare and definitions of the term "ritual" are often vague or inhomogeneous. The aim of the current study is to analyze contents, purposes and acts of violence in ORA.In a project of the Independent Inquiry into Child Sexual Abuse in Germany, 165 adults who identified themselves as ORA victims as well as 174 health care professionals who supported ORA victims were recruited via various sources and completed anonymous online surveys.Both samples report experiences with ideological frameworks in organized child sexual abuse contexts at the same ratio (88%). Ideologies are mostly perceived as a means to facilitate violent acts (e.g. commercial sexual exploitation). Positive correlations between the manifestation of ideologies and all violent acts suggest that organized and ritual perpetrator groups use the same violent strategies, but ritual or ideological groups, in which perpetrators are more often family members, use them to a greater extent.A modified narrative of "ritual abuse" as a (pseudo-)ideological, domestic and more violent subtype of organized child sexual abuse could enhance the credibility and visibility of ORA in science as well as in society.

Psychiatric Impact of Organized and Ritual Child Sexual Abuse: Cross-Sectional Findings from Individuals Who Report Being Victimized.

Organized and ritual child sexual abuse (ORA) is often rooted in the child's own family. Empirical evidence on possible associations between ORA and trauma-related symptoms in those who report this kind of extreme and prolonged violence is rare. The aim of our study was to explore socio-demographic and clinical characteristics of the individuals reporting ORA experiences, and to investigate protective as well as promotive factors in the link between ORA and trauma-related symptom severity. Within the framework of a project of the Independent Inquiry into Child Sexual Abuse in Germany, we recruited 165 adults who identified themselves as ORA victims via abuse- and trauma-specific networks and mailing lists, and they completed an anonymous online survey. We used variance analyses to examine correlations between several variables in the ORA context and PTSD symptoms (PCL-5) as well as somatoform dissociation (SDQ-5). Results revealed a high psychic strain combined with an adverse health care situation in individuals who report experiences with ORA. Ideological strategies used by perpetrators as well as Dissociative Identity Disorders experienced by those affected are associated with more severe symptoms (η²p = 0.11; η²p = 0.15), while an exit out of the ORA structures is associated with milder symptoms (η²p = 0.11). Efforts are needed to improve health care services for individuals who experience severe and complex psychiatric disorders due to ORA in their childhood.

[Healthcare situation for children, adolescent and adult victims of sexual violence in Germany : A critical overview]. / Versorgungssituation von Kindern, Jugendlichen und Erwachsenen mit sexuellen Gewalterfahrungen in Deutschland : Ein kritischer Überblick.

In Germany, since 2010 the debate regarding sexual assault victims, additionally due to extensive activities of the independent commissioner for questions regarding sexual abuse of children (Unabhängiger Beauftragter für Fragen des sexuellen Kindesmissbrauchs, UBSKM), has received increased attention from the public and the healthcare system. Sexual violence is a burdening experience regardless of age and can have a lasting impact on the physical, psychological and/or social life of victims. Empirically, it has been found that more than half of the adult population suffering from mental disorders have experienced sexual abuse in childhood and adolescence. In some of the affected the impact of the trauma experienced, which is often accompanied by neglect and physical violence, can negatively influence the course of disease. Early counseling and therapeutic support for affected children and adolescents should be taken more into account and focus on optimizing treatment for this patient group. This article discusses the prevalence of sexual violence, possible health and social consequences and the treatment situation of affected children, adolescents and adults in various areas of the help/aid system. In doing so, a discrepancy between scientific findings, recommendations from statutory health insurance companies (GKV), the current healthcare situation and the real needs of the affected are made clear.