Louanne Lawson

False Negatives in Sexual Abuse Disclosure Interviews Incidence and Influence of Caretaker's Belief in Abuse in Cases of Accidental Abuse Discovery by Diagnosis of STD

Verbal disclosure of abuse in a specialized interview was studied in a sample of 28 children, ages 3 to menarche, who presented with purely physical complaints later diagnosed as a sexually transmitted disease, in the absence of any known prior disclosure or suspicion of sexual abuse. Only 43% gave any verbal confirmation of sexual contact. Fifty-seven percent were “false negatives.” Disclosure was strongly associated with the attitude taken by the childs caretaker toward the possibility of abuse. Children whose caretakers accepted the possibility that their child might have been sexually abused disclosed at a rate almost 3.5 times as great as those whose caretakers denied any possibility of abuse (63% vs. 17%). The results suggest that caretaker attitude and support is a critical variable in the childs disclosure process and a valuable target for intervention and prevention efforts. In addition, it was found that, aside from their STD, many of these abused children presented as free from any specifically suspicious abuse symptoms, suggesting that reliance on single interviews and identification of “red flags” cannot be expected to identify many hidden victims.

Use of optical glass binocular magnifiers in the examination of sexually abused children

Abstract A pilot survey designed to determine attitudes toward magnification and optical glass binocular magnifiers was administered to resident physicians for whom evaluation of sexually abused children was part of their training program. Approximately two-thirds of those who had used the instruments considered them to be helpful, easy to use, and a source of magnification they would recommend for future practice settings.

Treatment of females convicted of molesting children.

&NA; The purpose of this study was to determine what kind of treatment women convicted of molesting children thought they should receive and what they hoped to achieve in treatment. Data were collected from 14 offenders in individual and focused group interviews. The data were analyzed by constant comparison. During the interviews, offenders defined treatment in terms of what they expected it to do and how they would benefit. They described the context, process, and outcomes of treatment, ways in which people could help them and they could change themselves, and the kind of treatment that would help them deal better with men. These women wanted treatment to focus on alleviating the psychological suffering they experienced as a result of their convictions. They had limited insight into societal expectations regarding treatment‐related behavioral changes.

The scientific foundations of SANE education.

Last winter (February 28 & 29, 2008) a group of Sexual Assault Nurse Examiner (SANE) coordinators met in New Orleans to discuss issues in the sustainability of SANE practice, standardization of education, and ways to support each others’ efforts. The event was supported by the National Sexual Violence Resource Center, and the venue they chose was breathtaking. There were SANEs and SANE coordinators from Arkansas, Louisiana, West Virginia, Mississippi, Florida, Maryland, Kentucky, Tennessee, and Virginia. The range and depth of the contributions these accomplished nurses have made and continue to make are quite impressive! It was a huge honor to be involved in the project. Our agenda was built on the topics addressed in a Tampa Regional Brainstorming Session:

Changing the Child Abuse Potential of Substance Abusing Pregnant and Parenting Women

&NA; This study was designed to determine if treatment for substance abuse has an impact on child abuse potential. Sixty-three pregnant and parenting substance abusing women were tested using the Child Abuse Potential Inventory (CAP) at approximately 3-month intervals from intake into treatment through post-discharge follow-up. Growth curve analysis revealed an improvement in CAP scores from Time 1 to Time 2, but the improvement was not sustained. When participants were in the initial phases of substance abuse treatment and receiving considerable support, their CAP scores dropped from the elevated range into the normal range. However, as they progressed through and left the program, their CAP scores gradually rose. The results of the study argue for continuing substance abuse treatment until child abuse potential stabilizes to within the normal range

Forensic Nursing Science in 2008

The editorial board and I are very pleased to offer the Journal of Forensic Nursing in a whole new way. IAFN proposed that we change publishers and I agreed. This was a very difficult decision, primarily because I consider AJ Janetti’s work to be exemplary. The managing editor, Janet D’Alesandro, and the assistant managing editors shepherded JFN through its inaugural issues and demonstrated excellence in professionalism, communication, and conflict resolution. Wiley-Blackwell has a global reach and can take JFN to places beyond Janetti’s capacity. Contracting with Wiley-Blackwell adequately addresses the Association’s financial concerns: Wiley-Blackwell has an attractive fee mechanism, which protects IAFN from the financial burden of the Journal. The contract between Wiley-Blackwell and IAFN started January 2008 and the transition has gone very smoothly. As you renew your memberships you will see that you have a number of options for accessing JFN. You will be able to hold, carry (fold, spindle, and mutilate) a paper copy of the Journal for a nominal fee—and the membership manager tells me that about half of you are taking that option. All of you will be able to access the Journal directly online, an option many of you requested in our last survey. The 2008 volume of JFN will offer a little something for everybody. Educators, program administrators, and researchers will be pleased to see teaching tools, program evaluation projects and theory development research. Offender-focused literature reviews on risk prediction and cognitive distortion will be offered. Sexual assault nurse examiners will see exciting new research on types of injuries related to sexual trauma. You will see articles on injury pattern identification, how forensic nurses can retrieve DNA from children’s faces and use DNA for human identity testing, and the nursing care of child victims of abuse and undocumented women and children. The year 2008 is shaping up to be a very productive year! You will recall that the mission of IAFN is to provide leadership in forensic nursing practice by developing, promoting, and disseminating information internationally about forensic nursing science. The Journal supports the Association’s mission by publishing scholarly manuscripts and expanding empirical evidence important to the practice of forensic nursing worldwide. I am pleased to report that forensic nursing science is alive and well. In the United States, the National Institute of Nursing Research has funded 12 violence-related scientific projects (refer to Table 1). Three of them support dissertation research; one supports a new investigator’s IPV screening and intervention and development project; and one more grant is being used for infrastructure and career development support. There are seven major research projects focusing on sexual, interpersonal, and community violence. These projects are designed to develop theories, interventions, and measurement tools. We would like to hear from those of you with other sources of funding as we begin the next phase of support for forensic nursing research. The president of IAFN, Susan Chasson, has identified a number of research priorities. The two main priorities are research that could serve as the evidence base for care of victims and those accused or convicted of committing crimes and a public health initiative that would focus on primary, secondary, and tertiary prevention of violence. Connecting investigators with clinicians would make it possible for the investigators to gain access to important patient populations and for clinicians to implement research findings quickly. To that end, Susan would like to build on the research dissemination mechanism offered by the Journal of Forensic Nursing by creating a clearinghouse of Forensic Nurse Researchers and Research.