Child sexual abuse in religiously affiliated and secular institutions: a retrospective descriptive analysis of data provided by victims in a government-sponsored reappraisal program in Germany.

BACKGROUND: The disclosure of widespread sexual abuse committed by professional educators and clergymen in institutions in Germany ignited a national political debate, in which special attention was paid to church-run institutions. We wanted to find out whether the nature of the abuse and its effect on victims differed depending on whether the abuse had been experienced in religiously affiliated versus secular institutions. METHODS: In 2010, the German government established a hotline that victims could contact anonymously to describe their experiences of sexual abuse. The information provided by callers was documented and categorized. Our analysis looked at a subset of the data collected, in order to compare the nature of the abuse experienced at three types of institutions: Roman Catholic, Protestant, and non-religiously affiliated. Non-parametric tests were used to compare frequency distributions, and qualitative data were analyzed descriptively. RESULTS: Of the 1050 victims in our sample, 404 had been in Roman Catholic, 130 in Protestant, and 516 in non-religious institutions. The overall mean age at the time of reporting was 52.2 years. Males (59.8%) outnumbered females. Victims who had been in religiously affiliated institutions were significantly older than those who had been in secular institutions. Almost half the victims had been abused physically as well as sexually, and most victims reported that the abuse had occurred repeatedly and that the assaults had been committed by males. Patterns of abuse (time, type, and extent), and the gender of the offenders did not differ between the three groups. Intercourse was more frequently reported by older victims and by females. Similar percentages of victims in all groups reported current psychiatric diagnoses (depression, anxiety disorders, PTSD). Significantly more victims from Protestant institutions reported having current psychosocial problems. CONCLUSION: The results suggest that child sexual abuse in institutions is attributable to the nature of institutional structures and to societal assumptions about the rights of children more than to the attitudes towards sexuality of a specific religion. The exploratory data arising from this study may serve as a starting point for building hypotheses, and may point the way toward improvements in prevention and intervention strategies.

[Assessment of suicidal ideation in adolescents: comparison of two instruments]. / Erhebung von Suizidgedanken bei Jugendlichen: Vergleich zweier Instrumente.

Standardized instruments are crucial for a valid assessment of suicidal behavior. In questionnaire assessments the wording of questions can influence the results. In this study we compared the congruence of the Self-Harm Behavior Questionnaire (SHBQ) and the Ottawa Self-Injury Inventory (OSI) as measures of prevalence of suicidal ideation in an adolescent sample (n = 665, mean age: 14.8, SD: 0.66). We found a life-time prevalence of 36.4 % in the SHBQ and a one-year-prevalence of 27.8 % in the OSI. There was good agreement between the two instruments in terms of the prevalence of suicidal ideation and the association with suicide attempts. The observed rates are comparable with other studies in adolescents; differences arise with varying study designs.

[Children's Depression Rating Scale-Revised (CDRS-R): development of a German version and psychometric properties in a clinical sample]. / Children's Depression Rating Scale - Revised (CDRS-R).

OBJECTIVE: The Children's Depression Rating Scale - Revised (CDRS-R) is a semistructured, clinician-rated interview for the assessment of depression in children and adolescents. While the CDRS-R is frequently used in clinical studies to evaluate the treatment of juvenile depression, no validated German version is yet available. METHOD: The CDRS-R was translated into German and tested on 60 inpatients (26 female, 34 male) between 7.5 to 17.9 years (mean = 13.8, standard deviation = 2.9) who were interviewed within the first week of treatment. K-SADS-PL and BDI-II resp. DIKJ were additionally used for validation. RESULTS: The German version of the CDRS-R shows a high internal consistency (α = 0.90), and the item-total correlations are good. Correlations between CDRS-R and self-report questionnaires (DIKJ and BDI-II) are high. The mean CDRS-R score of patients with major depressive disorder is similar to the prior results of international studies. CONCLUSIONS: The German translation of CDRS-R shows good psychometric properties. Its application may be helpful in diagnosing and monitoring depressive disorders in children and adolescents.

[Attention Deficit Hyperactivity Disorder (ADHD) and road traffic - special considerations for the treatment of adolescents with ADHD]. / Aufmerksamkeitsdefizit-Hyperaktivitätsstörung (ADHS) und Strassenverkehr: Was gibt es in der Behandlung Jugendlicher mit ADHS zu beachten?

Attention Deficit Hyperactivity Disorder (ADHD) is not only a childhood disorder but symptoms persist into adolescence and adulthood in approximately one third of the patients. Especially inattention and poor concentration impair driving performance in road traffic. Adolescents and young adults with ADHD are twice as likely to be involved in traffic accidents as people of the same age. This review sums up the legal situation in Germany and provides an overview of the current existing experimental studies on driving performance of adolescents and young adults with ADHD. Psychostimulant therapy seems to improve driving performance in ADHD patients. At the same time psychostimulants are prohibited, according to the road traffic act. Atomoxetine as a non-stimulant is not mentioned there. Therefore it could be unproblematically prescribed, however, the evidence for improved driving is not as unequivocal as for methylphenidate. The psychoeducation of adolescents and young adults with ADHD concerning their increased risk in road traffic often seems to be insufficient in clinical practice. Given the high number of traffic deaths in these young age groups consulting regarding this matter should be of high priority.

[How valid are student self-reports of bullying in schools?]. / Wie zuverlässig sind Selbsteinschätzungen von Schülern zum Vorkommen von Bullying?

In this study we examine the reliability and validity of students' self-reports about bullying and victimization in schools. 208 5th class students of four "middle schools" in Southern Germany filled in the Bully-Victim-Questionnaire (Olweus, 1989, adapted by Lösel, Bliesener, Averbeck, 1997) and the School Climate Survey (Brockenborough, 2001) to assess the prevalence of bullying/victimization, and to evaluate attitudes towards aggression and support for victims. By using reliability and validity criteria, one third (31%) of the questionnaires was classified as "unreliable/invalid". Mean comparisons of the "unreliable/invalid" group and the "valid" group of the subscales concerning bullying/victimization found significant differences. The "unreliable/invalid" group stated higher values of bullying and victimization. Based on the "unreliable/invalid" questionnaires more students could be identified as bullies/victims or bully-victims. The prevalence of bullying/victimization in the whole sample was reduced if "unreliable/invalid" questionnaires were excluded. The results are discussed in the framework of theories about the presentation of the self ("impression management', "social desirability") and systematic response patterns ("extreme response bias").

Child sexual abuse in the Roman Catholic Church in Germany: comparison of victim-impact data collected through church-sponsored and government-sponsored programs.

At around the same time in 2010, the German government and the Roman Catholic Church in Germany each set up a critical incident reporting system (CIRS) to gather information on child sexual abuse that had taken place within the Church. The objective in both cases was to solicit stories from victims and former victims and allow them to have input into a review process. The existence of these two similar systems, one initiated by the institution involved in the abuse and the other by an independent entity, provided an opportunity to compare the background and motivation of victims who chose to communicate through one channel or the other. Data were obtained on a total of 927 individuals, 571 through the church CIRS and 356 through the government CIRS, who had reported that they had experienced childhood sexual abuse within the Roman Catholic Church. Some differences were found between the two groups in terms of gender, the reported frequency of abuse, and the desire for compensation. These differences highlight the need for an effective complaint management system to offer not just one but complementary channels of communication. In addition, the findings confirm the feasibility and value of a CIRS approach and the use of so-called 'citizen science' in politically driven review processes.

Listening to victims: use of a Critical Incident Reporting System to enable adult victims of childhood sexual abuse to participate in a political reappraisal process in Germany.

Recent revelations about the scope and severity of past child sexual abuse in German institutions set off a broad public debate on this issue, and led to the establishment of a politically appointed Round Table committee and an Independent Commissioner whose mandates were to reappraise the issue and develop recommendations for future policies. A media campaign was launched to publicize the establishment of a Critical Incident Reporting System (CIRS) whereby now-adult victims of past abuse could anonymously provide testimonials and let policy makers know what issues were important to them. Respondents could either call a hotline number or communicate by mail or email. The information collected was documented and analyzed by a research team, and the results of interim reports were included in the recommendations of the Independent Commissioner and the Round Table committee. Most of the respondents described severe and repeated occurrences of childhood sexual abuse. For many, priorities were improvements in therapy and counseling services, the abolishment of the statute of limitations on prosecuting offenders, and financial compensation. Based on the recommendations of the Round Table and the Independent Commissioner, two new laws were adopted as well as an action plan and some guidelines. In addition to rules for recompensation of victims in an institutional context a fund for victims of sexual abuse in intrafamilial context was established by the Federal Government. Another effect of this process was raising societal sensitivity to the problem of child sexual abuse. The use of a CIRS enabled those directly affected by childhood sexual abuse to have some input into a political process designed to address this issue. Such an approach could have applicability in other countries or in other domains of public health and other forms of societal conflict as well.

Convergence of Children's Depression Rating Scale-revised Scores and Clinical Diagnosis in Rating Adolescent Depressive Symptomatology.

The Children's Depression Rating Scale-Revised (CDRS-R) is a widely used instrument for research on depression in minors. A raw score of ≥40 has often been used as indicator of depressive symptomatology. As a validated German version of the CDRS-R has recently became available, we assessed CDRS-R raw summary scores of a video taped interview session in two different rater groups and compared them with clinical ratings of International Classification of Diseases (ICD-10) depression diagnosis as observed by a third independent group. We found that for the German version a raw score between 35 and 40 is indicative for mild depressive symptomatology as described by the ICD-10. CDRS-R scores show potential clinical applicability to deduct levels of depression.