Heather Y. Swanston

Nine years after child sexual abuse

OBJECTIVE During 1988-1990, 103 children presented to Child Protection Units (CPU) at two childrens hospitals in Sydney, Australia. Nine years later, the psychological adjustment of these young people (mean age=19.1 years, SD=3.4 years; range=14-25 years) was compared with that of non-abused young people of similar age and gender to assess group differences and examine potential risk factors. METHOD At intake, data on the nature of the index sexual abuse, demographics and the family environment were collected by clinicians. A comparison group, of similar age and gender, was selected from schools in the catchment area of the CPUs. Six years after presentation for the abuse, records of the statutory child protection authority were checked to determine any further notifications for abuse and/or neglect. Nine years after intake, 49 of the abused young people and 68 of the non-abused young people and/or their parents were interviewed and assessed. RESULTS The sexually abused young people performed more poorly than non-abused young people on psychometric tests of depression (p=.001), self-esteem (p<.001), anxiety (p<.001), behavior (Child Behavior Checklist: p=.01; Youth Self Report: p=.01; Young Adult Self Report: p<.001), and despair (p=.001). They were also more likely to have a history of bingeing (p=.002), self-inducing vomiting (p=.02), smoking cigarettes (p=.01), and using amphetamines (p=.002), ecstasy (p=.002) and cocaine (p=.004). Potential risk factors were in two groups, family and child. Family factors: family functioning, parental drug/alcohol problems, mothers sexual abuse history, mothers depression and socio-economic status. Child factors: despair and hopefulness, number of negative life events, ratings of their fathers care, previous notifications for child sexual abuse and placements in out-of-home care by the statutory child protection authority. In the presence of other risk factors, child sexual abuse was a significant predictor of self-esteem, behavior and bingeing. CONCLUSIONS Rather than focusing only on the individuals child sexual abuse, treatment may also need to address the familys functioning and the individuals feelings of despair.

Five Years After Child Sexual Abuse: Persisting Dysfunction and Problems of Prediction

OBJECTIVE To assess change in behavior, depression, and self-esteem in sexually abused children after 5 years and to determine which factors predict later functioning. METHOD Sixty-eight of 84 children and their nonoffending parents were reassessed after 5 years for depression, self-esteem, and behavior problems in the children; parental mental health; and family functioning. RESULTS There were no significant changes in depression, self-esteem, or behavior over 5 years. Forty-three percent of the children were now sad or depressed, 43% had low self-esteem, and 46% had behavioral dysfunction. While some children improved, a nearly equal number deteriorated, with no clear pattern of change. The only abuse-related variables associated with 5-year functioning were further contact with the abuser, which was significantly associated with depression and self-esteem, and sexual abuse prior to intake, which was related to an increased incidence of behavior problems. Older children showed more depression and lower self-esteem but less behavioral dysfunction. Poor family functioning at 5 years was associated with low self-esteem and behavior problems. Treatment had no effect on depression, self-esteem, or behavior. Multivariate analysis showed that depression and self-esteem at intake were prognostic indicators of 5-year outcome. CONCLUSION Many sexually abused children have continuing problems with behavior, self-esteem, and depression. Family and abuse-related variables do not appear to be good predictors of outcome, although sexually abused children who are sad or depressed and have low self-esteem at intake are likely to have continuing problems in these areas.

Suicide Risk Following Child Sexual Abuse

OBJECTIVE To determine the suicide rate and prevalence of suicide attempts and suicidal ideation in 183 young people who had experienced child sexual abuse and to examine variables related to the abuse, which may correlate with suicide attempts or suicidal ideation. METHODS Adolescents and young adults who had experienced child sexual abuse and individuals from a nonabused comparison group were asked about suicide attempts and suicidal ideation 5 and 9 years after intake to the study. Nine years after the abuse, a national death search was carried out to ascertain the number and causes of death in the 2 groups. Logistic regression was used to assess information on demographic and family functioning variables, the sexual abuse, notifications for other child abuse, criminal convictions, and out-of-home placements that were related to the outcome variables. RESULTS Young people who had experienced child sexual abuse had a suicide rate that was 10.7 to 13.0 times the national Australian rates. There were no suicides in the control group. Thirty-two percent of the abused children had attempted suicide, and 43% had thought about suicide since they were sexually abused. CONCLUSIONS Little information seems to be available to clinicians at the time of investigations for child sexual abuse in children that may identify those who are at increased risk of suicide. Abuse by an acquaintance, parental denial, or being angry with the child and not the abuser may predispose to suicide attempts but not necessarily to a completed suicide.

Prior childhood sexual abuse in mothers of sexually abused children

OBJECTIVE To see if mothers who were sexually abused in their own childhood are at increased risk of their children being sexually abused and to see if prior sexual abuse in mothers affects their parenting abilities. METHOD Sixty-seven mothers whose children had been sexually abused by others and 65 control mothers were asked about sexual abuse in their own childhood. The sexually abused children of mothers who had been sexually abused in their own childhood were compared with the sexually abused children of mothers who had not suffered child sexual abuse as children. Comparisons were made on self-esteem, depression and behavior in the children. RESULTS Thirty-four percent of mothers of sexually abused children gave a history of sexual abuse in their own childhoods, compared with 12% of control mothers. Assessment of the sexually abused children for self-esteem, depression and behavior at the time of diagnosis, after 18 months and after 5 years showed no difference in any of these measures at any of the three time intervals between those whose mothers had suffered child sexual abuse and those whose mothers had not been abused. CONCLUSION In this study, sexual abuse in a mothers own childhood was related to an increased risk of sexual abuse occurring in the next generation, although prior maternal sexual abuse did not effect outcome in children who were sexually abused.

Hoping and coping in young people who have been sexually abused

SummaryBackground: Very little research has been conducted on the relationship between sexual abuse, reduced hopefulness and impaired coping. Method: The sample consisted of 22 abused young people (2 males (9%) and 20 females (91%)) and 29 nonabused young people (4 males (14%) and 25 females (86%)). Hopefulness, despair, depression, self-esteem, anxiety, number of negative life events and various parent, family and demographic variables were measured. The aim was to establish significant predictors of outcome, with outcome measured at the extreme end of the spectrum by self-injury and suicidal ideation and attempts. Results: Depression predicted hopefulness and despair. Depression, anxiety, number of caregiver changes, despair and global personal hopefulness were significant predictors of outcome. Child sexual abuse itself was not a significant predictor of self-injury, suicidal ideation or suicide attempts in this sample. Conclusions: Each of the significant predictors of outcome, other than caregiver changes, has been linked to the learned helplessness paradigm. Depression and anxiety may be mediated by despair and hopefulness in their prediction of self-injury and suicidal attempts and ideation. To modify young peoples long-term view of their futures and thereby reduce their vulnerability to depression and anxiety and in turn their tendency toward self-injury and suicide, something more than generic casework will be necessary. If self-injury, suicidal ideation and behaviour are to be effectively addressed, it is likely that anxiety and depression will need to be treated vigorously and attention will need to be paid to the perceived future.

Nonsex Offences Committed by Child Molesters: Findings From a Longitudinal Study

This study, which used a prospective as well as a retrospective methodology, examined the criminal records of 30 child molesters prior to, and up to 10 years after an index event of sexual abuse for which they were convicted: 73% had convictions for other offences, 60% had convictions for offences other than sex offences, 50% had convictions for property offences, 27% had convictions for offences involving violence, and 23% had convictions for drug offences. Offending levels for nonsex offences were significantly higher than the general adult male population. Any theory concerning the dynamics of sex offending against children needs to account for the level of nonsex offences committed by child molesters.

Statutory Compensation for Victims of Child Sexual Assault: Examining the Efficacy of a Discretionary System

The purpose of this study was to ascertain the relationship between certain victim and offence characteristics and the award of statutory compensation for victims of child sexual abuse, in a system which conferred a complete discretion concerning awards of compensation up to certain monetary limits.