PSYU3339 Week 7 - Child Sexual Abuse

Why are children vulnerable to sexual abuse?

- Children are powerless
- Uninformed children trust all adults
- young children are incapable of assessing adults' motives
- Taught to obey adults
- Curiosity about their own body
- Often deprived of info abt sexuality

how common is child sexual abuse (CSA)

issues of disclosure

Australian child maltreatment study
- Matthews et al., 2023
- Cross-sectional national survey using telephone interviews using random digit dialling
- retrospective self-report data
- ppl aged 16yrs +
- 8500 ppl

What was reported in Matthews 2023 study on CSA

percentages

- physical abuse was reported by 32% of respondents
- sexual abuse 28.5%
- emotional abuse 30%
- neglect 8.9%
- exposure to DV by 39%

What was reported in Matthews 2023 study on CSA

- child maltreatment common in Aus
- larger % of women than men report having experienced sexual abuse, emotional abuse, neglect during childhood
- physical/sexual abuse declined - public health policy may have had positive effects justifying monitoring and prevention activities

Australian prevalence study
Scott 2023

- compared w/ non-maltreated Australians
- maltreated participants had 3x the odds of any mental disorder
- alcohol use, depression, anxiety, 5x PTSD
- associations b/w experiences of child maltreatment and mental disorders strongest for sexual abuse, emotional abuse, multi-type maltreatment

what are the prevalence estimates in australia of CSA

- Australia - studies on prevalence of child sexual abuse, 2017
- penetrative abuse:
- males = 1-7%
- females = 4-12%

non-penetrative
- males = 5-12%
- females = 14-26%

what are prevalence estimates in NSW of CSA

- ROSH reports
- have incr. every year since 2011-12 by 6.1% in 2019-20

Kids Helpline CSA

- suggests CSA no. for 2021 will incr
- reports incr for nearly 50% nationally in SA by family members
- VIC - incr of 70%
- NSW - 495

USA Child Maltreatment, 2016

- decline in neglect, physical abuse, sexual abuse
- 1990-2016

CSA - Australian context

- Incr awareness and reporting expected from:
- intro of mandatory reporting of CSA in 1998
- Royal Commission into Institutional CSA (2012-2017)
- Media coverage may have led to more ppl coming forward

What is online CSA

- Incr acess to internet seen upward trend in cases of online child sexual exploitation
- Incl. grooming, live streaming, consuming CSA material, coercing children for sexual purposed
- Nearly 50% children b/w ages of 9-16 experience regular exposure to sexual images

NCMEC - US Online CSA

- National Centre for Missing and Exploited Children
- receives reports related to suspected child sexual exploitation from public/electronic providers
- 29.3m reports recieved in 2021
- 35% incr in reports of worldwide suspected child sexual abuse online in 2021

ACCCE - Online CSA

- Australian Center to Counter Child Exploitation
- 2020 - received more than 21,000 reports of online child sexual exploitation
- contained videos of children being SA/exploited
- AFP charged 191 ppl w/ alleged child-abuse related offences in 2020
- intercepted 250,000+ child abuse material files
- works w/ law enforcement agencies to counter exploitation of children

Identifying CSA

Bosschaart, 2017

- qualitative study
- Bosschaart, 2017
- study w/ independent experts on interpretation of psychosocial symptoms conducted to identify CSA in young children

Identifying CSA

Bosschaart, 2017

Results

- 125 children
- involved in Amsterdam SA case (ASAC)
- had been examined for strongly suspected CSA
- daycare employee in Amsterdam suspected of having sexually abused young children (mainly boys)
- case came to light through child pornography investigation in US
- largest confirmed CSA case involving one perpetrator
- admitted sexual abuse of 87 children

What four themes were identified in ASAC

- 4 themes among psychosocial symptoms of children
- problems concerning
1. emotions
2. behaviour
3. toilet training
4. development

ASAC - why was it difficult to identify CSA?

- clear symptom was lacking
- half of confirmed severe victims of CSA didnt display any psychosocial problems
- difficult for experts to identify confirmed CSA victims on basis of symptoms

what are effects of CSA - what is an abuse dichotomy

- child who is victimised by caregiver is forced into an abuse dichotomy
- when attempting to understand perpetrator's behaviour
- "either they are bad or i am the bad one"
" it must be my fault that i am being hurt"
- no single universal/uniform impact of SA, no guarantee any person will develop PTSD to SA

what % of children dont develop abuse-related problems?

- 40% across multitude of studies
- e.g. child who experiences a single incident/less intrusive SA and discloses it to supportive parents - unlikely to develop outcomes

when are effects worse of CSA?

- when penetration is involved
- violence
- closer relo to perpetrator
- multiple offenders
- long duration/ more freq. contact
- these factors heighten negative impact

What was Cutajar 2010 study

- data linkage for 2,700 victims of child SA
- sig. higher rate of suicide/accidental fatal od among child sexual abuse victims than in general population

Martin, Bergin, richardson, Roeger, Allison (2004)

- cross-sectional community survey w/ 2,500 adolescents at 27 SA schools
- strong association b/w sexual abuse and suicidal ideation and behaviour, esp. for boys

CSA Effects: Issues to consider

- uniform effects across all CSA victims?
- contribution of family - support vs dysfunction
- severity of abuse - abuse duration, use of force, relo to perpetrator, age when abuse first occurred
- context in which abuse occurs
- interpretation of the abuse
- coping w/ the abuse

What are co-effects of CSA

- effects of CSA coexists with other life circumstances
- e.g. negative home environ, other forms of abuse which may account for poor long-term adjustment
- often associated w/ low levels of parental support and high levels of parental conflict

What did Rind 1998 find?

- both CSA and poor family environ. associated w. psychological dysfunction
- family environ. effect was substantially stronger and controlling - family environ. reduced % of significant CSA-symptom relationships
- highlight importance of considering family dysfunction when assessing effects of CSA

What did Merrill (2001) find?

- assessed whether CSA and family support were related
- independent effects of CSA and parental support on range of psychological symptoms
- whether parental support and CSA interact to predict long-term adjustment
- CSA victims reported less parental support
- found no interaction b/w CSA and parental support
- those w/ high support reported fewer trauma symptoms
- those w/ CSA history reported more trauma symptoms

how to describe csa victims

- majority of CSA involved intercourse, threats and force
- measures of abuse severity were highly intercorrelated

what were moderators

- strongest predictor of maladjustment among CSA victims was use of self-destructive coping mechanisms
- followed by avoidant strategies

what can be concluded from these results

- CSA sig. predictor of long-term psychological difficulties across 10 symptoms
- direct effect of abuse severity on symptoms wasnt sig.
- suggests that relo b/w severity of CSA and adult impairment was largely mediated by coping strategies used to deal w/ the abuse

CSA effects explored by Humphreys, 2020

- explored association b/w total scores and scores from specific forms of child maltreatment (e.g. emotional, physical, sexual abuse), and depression using meta-analysis

CSA effects explored by Humphreys, 2020

Results

- higher child maltreatment scores associated w/ diagnosis of depression and higher depression scores
- emotional abuse and emotional neglect having strongest associations

what are risk factors for CSA victimisation

- Assink et al., 2019 found that strongest effects found for prior victimisation of child and its family members
- risks were intimate partner violence between child's parents, other parental relationship problems, parental substance, psychiatric problems of parents, low level of parent education

analysis of risk factors for CSA victimisation

Routine activities theory

- Routine activities theory posed by Cohen and Felson, 1979
- Place emphasis on environmental contributors (highly related to child's age)
- framework is built around 4 concepts and states that crime victimisation occurs in an
a) interaction
b) a potential offender
c) a suitable target in absence of
d) capable guardianship

risk factors for csa victimisation - Belsky

- framework built around broader range of child characteristics and environ. factors that incr a child's risk for child abuse victimisation
- based theory on Bronfenbrenner's ecological perspective on child development

risk factors for csa victimisation - Bolan, 2011

- updated model is ecological, transactional, developmental model of child sexual abuse
- risk for CSA can only be grasped in context of child's developmental stage
- children's developmental (Cognitive, affective, physiological) maturity is related to risk of abuse
- depending on age - children are differentially accessible or vulnerable to potential offenders

mechanisms linking risk domains to CSA victimisation

parents with mental health issues

- parents w/ mental health or substance abuse issues may be too occupied w/ their own problems to adequately supervise/protect their children
- incr child's vulnerability to CSA victimisation
- may hold for parents with history of child abuse victimisation, who may have trauma-related issues that interfere with adequate parenting

mechanisms linking risk domains to CSA victimisation

overprotective parents?

-overprotective parents may lead children to develop "victim schema" - view their parents as controlling, and themselves as weak and helpless
- children w/ such conceptions may become too dependent on adults and behave in ways so that they become easy target
- more work on these mechanisms --> what psychological processes are involved

Sexual self-efficacy

- belief in one's ability to engage in desired and to refuse unwanted, sexual activities and behaviours
- important feature in promoting adolescent sexual health and wellbeing

Sexual Self-Efficacy Study

- Longitudinal data, 740 adolescent girls and boys
- Vaillancourt-Morel, 2019
- Examined meditational role of two "silencing the self" attitudes and behaviours in romantic relo
- Self-silencing - inhibiting fulfilling one's own needs
- Divided self - presenting an outer compliant self

Results of Valliancourt-Morel 2019 Study

- results showed that child sexual abuse was associated w/ more self-silencing and more divided self
- self-silencing was associated w/ lower protection use self-efficacy
- divided self associated w/ lower limit setting and protection use self-efficacy

what is limit setting self-efficacy?

- assess belief's in one's ability to set clear sexual limits and refuse sexual activity if not desired

what is protection use self-efficacy?

- concerned perceived ability to use condoms or sexual protection

analysis of sexual self-efficacy

- sheds light on what factors may affect adolescents' self-efficacy in sexual situation
- major finding is that silencing the self attitudes and behaviours in intimate relo played a meditational role in negative association b/w child sexual abuse severity and sexual self-efficacy in adolescents
- early interventions targeting coordination of an integrated sense of individuality and continuity allows for assertive strategies in intimate relo
- may reduce victims' difficulties w/ sexual self-efficacy and high risk of re-victimisation and at-risk sexual behaviours

why do some victims develop symptoms and others not?

- characteristics of abuse experience
- context during and following abuse
- child's construal of the abusive experience

child sexual abuse victims as witnesses

- CSA cases are heard in criminal court
- cases involving alleged sexual abuse, child is often the only witness
- crucial that child testifies to enable prosecution of case
- child victims serve as witnesses to their own alleged abuse

what is children's evidence?

- child sexual abuse cases hampered by lack of corroborative evidence to substantiate that abuse has occurred
- child's word is crucial
- concern over reliability and truthfulness of children's evidence

question about children's testimonial competence: two strands of research

- memory-related research leading to focus on questioning styles and later interview protocols
- children's competence to distinguish b/w lies and truths
- understand importance of telling the truth

memory research

- research established reliability of info reported by child witnesses
- Goodman - focuses on children's recall of personal events
- concerns over children's suggestibility

Goodman and colleagues

- investigate children's memory for stressful medical procedure
- used anatomically detailed dolls
- voiding cystourethrogram fluoroscopy (VCUG)
- VCUG when children have freq/ incontinence/UTI
- composed of 46 children
- most children relatively accurate when asked free recall questions
- the amount of accurate info prov. in free recall incr sig. w/ age

Goodman and colleagues results for 3-4 yo

- recalled sig. less correct info than older children
- recalled sig. more correct than incorrect info in free recall
- made more errors than older children when answering direct questions
- amount of correct info provided during doll was not diff from amount of incorrect info
- when interviewing children about procedure - employment of doll can increase amount of incorrect info given

Goodman and colleagues results for 5-6

- performance of 5-6yo didnt dig. differ from 7-10yo in terms of errors
- findings of age-related errors in response to misleading questions consistent with large body of evidence showing heightened suggestibility

Goodman and colleagues results and analysis

- anatomically correct doll helped older children recount more info about VCUG than these children recounted in free call w/ little risk of incr. incorrect responding
- pattern evident in 5+ yrs, and 7-10yrs
- though, younger children made sig. more errors than older children when dolls used
- children of all ages more likely to reveal explicitly that their genitals has been contacted/penetrated during VCUG test when they were questioned, than when asked only free recall questions

in forensic settings

- more limited reporting of info by younger children can jeopardise the prosecution case b/c of insufficient info
- practitioners resort to asking suggestive and leading questions to enable sufficient info to be obtained for prosecution to proceed

double jeopardy for young children

- young children report less info about an event during open-ended recall than do older children/adults
- more limited amount of info reported - asked additional questions to icnr. their reporting of info
- questions often suggestive
- young children more vulnerable to suggestive questioning than older children/adults - reliability of this info is questionable

solution - retrieval bias?

- narrative elaboration
- props and drawings
- Physical Context Reinstatement
- Cognitive Context Reinstatement
- children do prov. more info w/ aid of retrieval cues
- greater reliance on external cues - greater potential for inaccurate reporting

Interview protocols

- cognitive interview
- step-wise interview
- NICHD (National Institute of Child health and Human Development) Interview Protocol

Need for further interview protocol development - NICHD/Step-Wise

- interviewers have difficulty using these interview protocols even after substantial training
- retrieval aids arent integral part of StepWise or NICHD protocles
- place emphasis on question format, and use of funnel approach

Need for further interview protocol development - Cognitive Interview

- emphasis on use of retrieval aids
- less attention to questions asked

What is the SCI Interview protocol

- SocioCognitive Interview
developed on research on questioning procedures and retrieval aids, and professional interview guidelines
- Developed within theoretical framework of social cognitive theory

What are the phases of the sociocognitive interview protocol?

- rapport development
- pre-interview instructions and training - ground rules
- Cognitive Context Reinstatement
- Narrative free recall - open-ended narration
- Questioning and clarification phase
- Info abt specific ppl
- Evaluative questions
- Final memory search
- Closure: interview ending

What is narrative free recall?

- unconstrained narratives prov. more accurate info than info elicited by specific questions
- children asked to report abt what happened from "picture in their head"
- encouraged to report all events in sequential order

What are sociocognitive interview question types?

- encouragers
- elaborative prompts: temporal and specific
- directive prompts - temporal and specific
- summary statements
- incr amount of correct detailed info reported using sociocognitive compared to standard interview type
- decr amount of incorrect detailed info using sociocognitive compared to standard

conclusions on SCI

- not effective in eliciting info that children were reluctant to report
- disclosure not infl. by age, sex, interview type

What is NICHD Interview?

- first experimental evaluation of NICHD
- 128 5-7yo
- showed that invitation prompts (tell me more) elicited more detailed info than directive prompts (what colour was sword)
- children prov. more info when they received practice describing events in response to invitation prompts

limitations of NICHD interviews

- more errors for peripheral rather than central events
- no transgressive event used

NICHD Interview across countries

- used in many countries
- e.g. Netherland - children reported more info related to reported incident when they were interviewed w/ NICHD protocol compared to control interview
- after interview - children reported of positive mood state independent of how they were interviewed (NICHD or control interview)

what are new directions in interviewing?

- Pompedda 2022
- conducted series of experiments exploring efficacy of simulated avatar interview training programs
- indiv have interviewed child avatars and received feedback on questions used and correctness of elicited info
- set to mimic behavioural pattern of real children during interviews
- avatars have predefined memories
- respond to questions that are consistent w/ research on suggestibility of children

Proportion of CSA disclosures

- fewer than half of victims tell anyone at time of abuse
- large % never real abuse until asked for research purposed (goodman, 2006)
- not all children who are sexually abused disclose
- 60-70% delay disclosure into adulthood

what barriers do young people face in CSA disclosure?

- no. of barriers
- e.g. limited support, perceived negative consequences, feelings of self-blame, shame/guilt when choosing to disclose

analysis of disclosure of CSA

- qualitative analysis of children's perspective on context for disclosure
- children disclosed in situations where theme of CSA was addressed or activated
- children revealed they were sensitive to others' reactions
- whether their disclosures would be misinterpreted

Study on disclosure (Lahtinen 2018)

- study of 6th and 9th graders in Finland
- most children had disclosed to someone
- usually a friend (48%)
- only 26% had disclosed to adults
- fewer had reported their experience to authorities

Study on disclosure (Landberg, 2022)

- study conducted w/ 3,3000 third year students
- investigate their disclosure of CSA
- incl. all forms of SA
- 25% reported CSA

what were results of study (Landberg, 2022)

- substantial share of abused girls and boys hadnt told anyone about abuse
- unable to access protection/rehab
- participants who had disclosed abuse most often turned to a peer, rarely an adult/professional
- societal responses that participants perceived were mixed
- more severe abuse associated w/ more negative societal responses
- most participants stated they didnt need any professional support
- among minority who had sought help - half were satisfied, third dissatisfied

gender differences regarding disclosure

- boys less willing to disclose CSA than girls
- reduced disclosure in Kenyan sample was related to gender (boys), more sexual violence, and perpetrator being a family member

what are inhibitors to disclosure?

- findings from comprehensive review show that young people face no. of diff barriers:
- limited support
- perceived negative consequences
- feelings of self-blame, shame, guilt, when choosing to disclose

what are impediments to disclosure?

- content of info to be reported
- relo of perpetrator to child
- promise to keep abuse secret
- threats by perpetrators abt revealing abuse
- fear of disbelief

boys as victims

- Hohendorff, 2017
- victims faced sig. levels of disbelief and discrimination
- practitioners unprepared to handle cases involving sexually abused boys
- underscores social invisibility of sexual violence against boys

what did Matthews 2017 find

- 1993-2012 - rate of reporting of boys incr 2.6 fold
- 1.5 fold incr for girls
- reports by police and other mandated reported accounted for majority of incr. in reports over 20yr period
- positive report outcomes (substantiations, findings of harm etc) incr 12fold for boys, 5 fold for girls

Competence and Truth Telling - Piaget Theory

- findings from "Moral Judgement of the Child" often used to render children below 7yrs as incompetent witnesses
- Used complicated methods to establish children's knowledge abt lying

How did Piaget underestimate children's competence?

- when children are asked in a developmentally appropriate way about lie and truth telling
- much more competent than posited by Piaget

how does anticipated punishment for truth telling effect outcomes

- more children anticipate punishment for truth-telling, less likely they are to tell truth (false denial)
- less positively truth telling is evaluated
- reassurances about telling truth are likely to incr. truth-telling

what are false allegations

- can be spontaneously generated or coached by other

what is spontaneous generation (false allegations)

- young children tell lies for fun
- readily detected
- whether children can make up complex event and make it plausible cannot be determined from research yet

what is coaching by others (false allegations)?

- types of lies more likely than spontaneously generated false allegations
- can result from malicious person or poor interviewing practices

what were results of study on false allegations?

- children asked if they remember experiencing fictional event
- asked to create visual picture of it in their head, told it did happen, then to tell if they remembered it
- involved parents - verifying none of these events occurred in child's life
- children interviewed indiv. each week for 30 mins
- over time children incr assented to fictional events
- attempt to disabuse children of flase events resulted in lowering of the final session
- children who consistently assented over many sessions - many of them believed their claims despite efforts of final interviewer to debrief them
- during debriefing - children who had consistently made false assents resisted recanting in varying degrees (source misattribution error)

How to obtain truthful testimony

- age or competence to testify wont guarantee truthful or reliable testimony
- factors contribute to reliable evidence
- poor interviewing practices, coaching by malicious parent
- trusted perpetrator who swears child to secrecy
- anticipated negative outcome for truth telling

plight of child witness/victims

- research on memory-related and truth-related competence has enabled children to testify in courts of law
- liberalisation of competency requirements in most common law countries enabled many young children to testify in court
- problems remain w/ their testimony

barrier to cross-examination

- questions asked are similar to suggestive questions
- leading, ambiguous, complex, irrelevant
- suggestive questions been disallowed from direct-examination due to their detrimental impact on children's testimony - permitted for use in cross-examination
- lack of modification to cross-examination is in part due to assumption that cross-examination is greatest legal engine invented for truth

Examining Wigmore's assumption - Zajac and Hayne (2003)

- validity of assumption that cross-examination greatest legal engine
- impact of cross-examination on children's reports of neutral events
- 5-6yo children participated in staged event and questioned
- underwent direct-examination, and cross-examination
- cross-examination led to overall reduction in accuracy of children's reports
- 85% children changed their responses

Zajac and Hayne, 2003

- results showed that older children made fewer changes to their responses from direct-to-cross examination
- 79% of children changed at least one of their responses under cross-examination
- accuracy was sig. reduced
- provided limited support for Wigmore's assumption

Limitations of Zajac and Hayne, 2003

- children undergoing direct then cross examination
- research shows that children often change their response in a second interview
- accuracy only assessed for neutral events

Cross-examination, Fogliati and Bussey (2014)

- examined cross-examination
- children underwent two direct examinations, or a direct followed by cross-examination
- transgressive event and neutral event used in a staged situation w. 120 children

Cross-examination, Fogliati and Bussey (2014)

Results

- children whose second interview was cross-examination were less accurate than direct
- grade 2 children prov. more truthful disclosures in direct examination compared with cross-examination

Royal Commission Recommendations Accepted in NSW

- max. life sentence for "persistent child sexual abuse"
- intr. of offences for failure to report or protect against child abuse
- historical cases to take account of current sentencing standards
- will intr. an offence of grooming to access a child