Sexual Victimization of Children and Adolescents: A Qualitative Study with Brazilian Undergraduates on Disclosure, Detection, Outcomes, and Consequences.

This qualitative study aimed to discover whether experiences of sexual violence suffered by a sample of adolescents and young-adults at a Brazilian public health had been disclosed or detected, why or why not, and what happened after disclosure or detection. Seventy-one (8.3%) students were victims of sexual violence, and 52 (73.2%) were females. The researchers interviewed 22 participants to obtain an oral history of these abuse experiences. The 22 interviewees had experienced 29 episodes of violence. Acquaintances had perpetrated 26 of these attacks, and of these 26 only four (15.4%) occurrences were never disclosed. Twenty-two experiences were disclosed or detected, of which four (18.2%) were promptly revealed (days after the event), resulting in a discontinuation of the violence. Unfortunately, molestation continued without intervention in nine (41.0%) of the revealed situations, despite disclosure or detection. The authors find that children or adolescents disclosing their experiences of sexual violence cannot end the attacks. This study identifies an urgent need to educate society about how to respond appropriately to revelations of sexual violence. Children or adolescents must be oriented to disclose their abuse and seek help from as many people as necessary until they are heard, believed and the violence is ended.

Dental care of patients exposed to sexual abuse: Need for alliance between staff and patients.

The aim was to explore the experiences of sexually abused individuals as dental patients. Purposively selected were 13 informants (11 women) aged 19-56. All had experienced sexual abuse as children or adults and memories of this abuse had been triggered and expressed during a dental appointment. They were encouraged to relate in their own words their experiences of the dental appointment. The interviews were recorded digitally, transcribed verbatim, and analysed according to Qualitative Content Analysis. The overall theme illustrating the latent content was The dental appointment - a volatile base requiring predictability and a secure working alliance. The first category covering the manifest content was The dental care provider "assumes responsibility," with two subcategories: (i) contradictory disclosure, and (ii) alliance formation - a levelling of power. The second category was The patient is "in focus," with two subcategories: (i) alertness to signs of discomfort, and (ii) attention to obvious but subtle expressions of needs. On an understanding that the patient has been sexually abused, an individually tailored, patient-centered approach to treatment is suggested. Dental care providers may also need to be aware of and reflect on their position of power, in relation to the patient and its possible chairside implications.

Untold Stories: Male Child Sexual Abusers' Accounts of Telling and Not Telling about Sexual Abuse Experienced in Childhood.

With evidence suggesting that females are more likely to be victims of child sexual abuse (CSA), much of the literature - including that on disclosure - focuses on females. Thus, male victims remain "under-studied". Given this, the aim here is to contribute to the scant knowledge base on the sexual abuse of males and disclosure by focusing on males whose voices are even more rarely heard than those in the general male population: those who have perpetrated CSA. The men whose stories are told here had been convicted of, and imprisoned for, CSA in the United Kingdom (UK). They were part of a sample of 101 incarcerated males, 40 of whom reported at interview that they had been sexually abused in childhood. Eighteen of those 40 men are focused on here as they provided some detail as to whether they had disclosed that abuse in childhood or adulthood, the responses they had received, and also why they had not disclosed. Their narratives shed some much-needed light on the nature of sexual abuse experienced by males, its onset and duration, sexual re-victimization, relationships with perpetrators, the diverse nature of disclosure, the extent to which victims disclose and when, the responses received, and why they do not tell. Little is known of these aspects of male CSA. The implications of the findings are considered together with future research directions.

Suffering whether You Tell or Don't Tell: Perceived Re-Victimization as a Barrier to Disclosing Child Sexual Abuse in Zimbabwe.

Disclosing child sexual abuse (CSA) is a necessary first step to access the legal, health, and psycho-social services that survivors and their families need. However, disclosure rates are low: of young women who experienced CSA in Zimbabwe, only 9% disclosed the first incident. The purpose of this qualitative study was to explore and describe perceived barriers to disclosing CSA in Zimbabwe. We conducted focus group discussions with children aged 10-14 years (n = 40) and their parents/caregivers aged 20-62 years (n = 40), participating in an intervention trial in Chitungwiza, Zimbabwe. We found that potential retaliation against survivors and their families is a major barrier to disclosing CSA. These retaliatory acts, which we refer to as "re-victimization," arise from stigma or the victim feeling blamed or doubted and manifest through physical violence, emotional violence, and deprivation of family life and education. Our findings suggest that addressing social and cultural norms related to sex and strengthening legal protection for CSA survivors and their families could encourage CSA disclosure and could help end this violence. Our findings also highlight a need to increase children's awareness of their rights and to create safe systems for disclosure of sexual abuse.

Examining the Effects of a Service-Trained Facility Dog on Stress in Children Undergoing Forensic Interview for Allegations of Child Sexual Abuse.

Disclosure of child sexual abuse can be a stressful experience for the child. Gaining a better understanding of how best to serve the child, while preserving the quality of their disclosure, is an ever-evolving process. The data to answer this question come from 51 children aged 4-16 (M = 9.1, SD = 3.5), who were referred to a child advocacy center in Virginia for a forensic interview (FI) following allegations of sexual abuse. A repeated measures design was conducted to examine how the presence of a service-trained facility dog (e.g. animal-assisted intervention (AAI) may serve as a mode of lowering stress levels in children during their FIs. Children were randomized to one of the two FI conditions: experimental condition (service-trained facility dog present-AAI) or control condition (service-trained facility dog not present- standard forensic interview). Stress biomarkers salivary cortisol, alpha-amylase, immunoglobulin A (IgA), heart rate, and blood pressure, and Immunoglobulin A were collected before and after the FI. Self-report data were also collected. Results supported a significant decrease in heart rate for those in the experimental condition (p = .0086) vs the control condition (p = .4986). Regression models revealed a significant decrease in systolic and diastolic blood pressure in the experimental condition (p = .03285) and (p = .04381), respectively. Statistically significant changes in alpha-amylase and IgA were also found in relation to disclosure and type of offense. The results of this study support the stress reducing effects of a service-trained facility dog for children undergoing FI for allegations of child sexual abuse.

Colonized Silence: Confronting the Colonial Link in Rural Alaska Native Survivors' Non-Disclosure of Child Sexual Abuse.

Though there is evidence linking the history of colonialism and oppression of Indigenous people to the high rates of rape and child sexual abuse experienced by this population today, it is less understood how colonial processes, past and present, condition the decision to disclose or report victimization. Drawing on a survivorship storytelling study of rural Alaska Native survivors of child sexual abuse, this paper underscores the importance of centering colonialism in understanding the culture of silence surrounding sexual victimization among Indigenous people. Results show that reasons for non-disclosure are quite embedded within larger social, historical and political themes of colonialism, oppression, and marginalization. Implications for policy and praxes are discussed, as well as a broader mandate of social change to remove barriers to disclosure.

The Stability of Retrospective Child Sexual Abuse Reports and its Association With Problem Avoidance.

Due to reliability problems, use of retrospective measurement to assess child sexual abuse has long concerned researchers. Possible psychosocial causes of these reliability issues-including problem avoidance-have not been thoroughly studied. We tested the reliability of retrospective child sexual abuse measurement in a nationally representative sample of 12,438 adults over two periods (2001-2002, 2007-2008), assessed sex differences in reliability, and examined whether reliability depends on problem avoidance tendencies. Nearly three-fourths of child sexual abuse cases in the former wave were not again reported, and two-thirds of child sexual abuse cases in the latter wave were not previously reported. Females were more likely to report CSA later if reported previously (OR = 5.11). Participants who reported child sexual abuse in the former wave but not the latter were more avoidant than consistent reporters (3.13 versus 2.77). Our findings suggest that females may report child sexual abuse more consistently. Furthermore, inconsistent reporting may indicate problem avoidance. Suggestions for researchers and practitioners are discussed.

Does Information About Neuropsychiatric Diagnoses Influence Evaluation of Child Sexual Abuse Allegations?

This study aimed at investigating if attitudes toward children with neuropsychiatric disorders influence evaluations concerning allegations of child sexual abuse. Law students (n = 107) at Stockholm University, Sweden, were presented a transcript of a mock police interview with a girl, 11 years of age. This interview was based on a real case, selected as a "typical" example from these years concerning contributions from the interviewer and the alleged victim. After having read the transcript, the students responded to a questionnaire concerning degree of credibility, if the girl talked about events that had really occurred, richness of details, and if the narrations were considered truthful and age-adequate. Fifty-four of the students were also told that the girl had been given the diagnoses of attention deficit/hyperactivity disorder and Asperger syndrome. Students who were informed about the diagnoses gave significantly lower scores concerning credibility of the interviewee. To a lesser degree they regarded her narrations as expressions of what had really occurred and considered her statements less truthful. Furthermore, they found that the narrations contained fewer details. Finally, they found the girl less competent to tell about abuse. We conclude that a neuropsychiatric disorder may infer risks of unjustified skeptical attitudes concerning trustworthiness and cognitive capacity.

The Continuum of Disclosure: Exploring Factors Predicting Tentative Disclosure of Child Sexual Abuse Allegations During Forensic Interviews and the Implications for Practice, Policy, and Future Research.

When a child sexual abuse investigation ensues, many children do not disclose readily to professionals. Defining disclosure beyond the disclosure versus nondisclosure dichotomy is essential, yet little research exists on factors associated with a continuum of disclosure, including active and tentative disclosure. Through the coding of 196 forensic interviews using content analysis and subsequent regression analysis, findings suggest that children of color, children abused by adults, unintentional initial disclosure, and those lacking family support were more likely to tentatively disclose in this study. Implications include a need to understand tentative disclosure as part of a normal continuum of disclosure within court proceedings and investigations of abuse allegations.

Perceptions of the Role of Mothers in the Disclosure and Nondisclosure of Child Sexual Abuse: A Qualitative Study.

One of the aims of this research was to develop an understanding of the role mothers were perceived to play during the process of disclosure of child sexual abuse. Using narrative inquiry methodology, face-to-face in-depth interviews were conducted with 22 men and women who had an early sexual experience. Even though a mother's support and protection is known to be important, this study showed that many mothers were seen as unable to offer such support, which had an important influence on nondisclosure. The heterogeneity of perceptions of mothers among adults who experienced child sexual abuse and gender differences are described. Health professionals need to manage complex relational dynamics between adult survivors and their mothers.

Disclosure of sexual abuse among youth in residential treatment care: a multiple informant comparison.

This exploratory study describes the child sexual abuse experiences of 53 youth (ages 14-17) in child protective services residential treatment care using three informants: youth (via the Childhood Trauma Questionnaire), residential treatment workers (via the Child Welfare Trauma Referral Tool), and the child protective services record. Child sexual abuse was self-reported by 38% of youth, with reporting by females almost four times higher. Child sexual abuse co-occurred with physical abuse, emotional abuse, and neglect in 75% of cases. Agreement between youth and residential treatment worker reports was high, while agreement between youth reports and their child protective services record was low. The study suggests systematic child sexual abuse screening among residential treatment care youth through self-reports and residential treatment worker reports. Case studies are provided, and implications for practice, policy, and future research are discussed.

Through the eyes of the wounded: a narrative analysis of children's sexual abuse experiences and recovery process.

Numerous children receive counseling for sexual abuse, yet their personal perspectives related to the abuse, the impact of making the disclosure, and the recovery process are noticeably absent from the scholarly literature. This study addressed this gap by analyzing trauma narratives written by children as part of a counseling intervention. Qualitative analysis revealed three themes: memories of the abuse, the disclosure and subsequent events, and the healing journey. Children's descriptions of their thoughts, feelings, and beliefs about their experiences are delineated and recommendations are provided for counseling professionals to increase the efficacy of care provided.

"Pay Attention! Pay Attention! Pay Attention!!!": The Pivotal Role of Educators and the Educational System as Experienced by Survivors of Child Sexual Abuse.

Educational institutions and educators are significant in children's lives, and they have a crucial role in implementing policies, practices, and sexual education to enhance children's safety. Such policies and practices should be based on the voices of CSA survivors. This study explored child sexual abuse (CSA) survivors' viewpoints on their past experiences with educators and the educational system. A qualitative thematic approach was used to analyze 61 written testimonies collected in 2020-2021 by the Israeli Independent Public Inquiry on CSA. Two interrelated themes arose: (1) CSA survivors' retrospective perspectives of educators and the educational system's responses to signs of their CSA, described as ranging from abusive to life-saving. Specifically, they shared three types of responses: (a) harmful and hurtful; (b) dismissive and ignoring; and (c) accepting and attending. (2) The second theme described the survivors' messages to educators to promote constructive change. The survivors conveyed expectations that educators should play a central role in CSA prevention, detection, and intervention and, specifically, the need for educators to receive professional training, provide beneficial sexual education, and identify and respond to CSA. The findings promoted moving beyond individual-level interventions to focus on improving educational institutional and organizational cultures related to CSA in both national and international contexts.

"One Day It Will Be Over, and You Will See Other Landscapes. . . You Are Not Alone": Adult Survivors' Messages to Children Undergoing Child Sexual Abuse.

Child sexual abuse (CSA) has received considerable attention from scholars, contributing to policy, intervention, and prevention efforts worldwide. However, survivors' involvement in this research is limited. This study was designed to delve into the messages of adult CSA survivors to abused children. In all, 371 written testimonies were provided to the Israeli Independent Public Inquiry on CSA by survivors from diverse communities in Israel. The Inquiry aimed to promote change in policies related to CSA. The testimonies were analyzed using the qualitative thematic analysis method. The results revealed five main messages emphasized by survivors to children experiencing CSA: (a) transferring the responsibility and guilt from children to perpetrators and society; (b) turning toward the light and continuing on; (c) disclosure is essential; (d) a happy life is possible; and (e) together we can survive. The discussion emphasizes how various systems in survivors' lives have profound impacts following the abuse. Although survivors were from diverse backgrounds, their messages to abused children were consistent. Through their messages to the children, the survivors emphasized their wish to transfer responsibility and guilt from children experiencing abuse to the society that is supposed to see, listen, protect, and validate. Implications for practice are discussed, focusing on the importance of making room for survivors' voices and experiences in the processes of shaping policies in the area of CSA. Moreover, the survivors' desire to be there for the children emphasized the urgent need to promote the perception of survivors as key stakeholders in the field of child abuse and to integrate their experiences and perceptions into the formal and informal systems for children.

Test balloons? Small signs of big events: a qualitative study on circumstances facilitating adults' awareness of children's first signs of sexual abuse.

This research examined caregivers' awareness of children's first signs of sexual abuse. The aim was to explore circumstances that facilitate adults' awareness of first signs in everyday natural settings. Data were obtained from a Norwegian university hospital's outpatient specialty mental health clinic. Included were all cases (N=20) referred during a two-year period for treatment after the disclosure of sexual abuse that was reported to the police and child protective service. Nonabusing caregivers' awareness of first signs were recollected in hindsight as part of therapy. Qualitative analysis was conducted to capture caregivers' experiences. As identified by caregivers, all children gave signs. Thereafter, children either stopped, delayed, or immediately disclosed sexual abuse. At first signs, each child had time and attention from trusted adults, connection to the abuser, and exhibited signs of reservation against that person or related activities. Then, if met with closed answers, first signs were rebuffed as once-occurring events. If met with open answers and follow-up questions, children continued to tell. Unambiguous messages were prompted only in settings with intimate bodily activity or sexual abuse related content. In sum, when trusted adults provided door-openings, children used them; when carefully prompted, children talked; when thoughtfully asked, children told. The study suggests that children's signs of sexual abuse can be understood as "test balloons" to explore understanding and whether anything is to be done. A disclosing continuation hinges on the trusted adult's dialogical attunement and supplementary door-openings. Divergent from an idea of behavioural markers, or purposeful versus accidental disclosures, this study calls for a broader attention: Moments of first signs are embedded in dialogue. A uniqueness at moments of first signs appears: Both to form such moments and to transform them into moments of meeting for joint exploration and telling, hinge upon how trusted caregivers scaffold opportunities for the child to disclose. Subsequently, support offers need to be addressed not only to strengthen children to tell, but also for caregivers and professionals to take into account the necessity of a dialogically oriented sensitivity towards children, both for telling to occur and for hearing to take place.