Child sexual abuse: causes, effects, and prevention

¶ … sexual abuse of children is among the most heinous crimes that exist. Such a crime not only affects the child at the time the abuse occurs but also well into the future. For the purposes of this discussion we will investigate how the sexual abuse of children has an affect on at-risk youth behavior. The research will explain the relationship between being sexually abused as a child and youth behavior and how this problem is being addressed by the family, school, social service agencies, and/or the government. The research will also focus on the solutions to assist children who have been sexually abused avoid at-risk behaviors. Let us begin this research by defining and discussing this problem.

The sexual abuse of children and its impacts

According to the American Psychological Association sexual abuse is Characteristic of any abuse in which the dominant position of an adult allows him or her to force or coerce a child into sexual activity. Child sexual abuse may include fondling a child's genitals, masturbation, oral-genital contact, digital penetration, and vaginal and anal intercourse. Child sexual abuse is not solely restricted to physical contact; such abuse could include noncontact abuse, such as exposure, voyeurism, and child pornography (Understanding Child Sexual Abuse)."

There are many different affects associated with the sexual abuse of children. These affects are inclusive of both social and academic problems (Jones et al. 2004). Problems and disruptive behavior in the school environment can be rather detrimental to an adolescent and have a profound impact on their lives well into the future (Jones et al. 2004). Children that are disruptive in school are often suspended, expelled or sent to alternative skills. Children that do not complete high school are more likely to live in poverty, and abuse drugs (Jones et al. 2004).

Over the last few years there has been a marked increase in the sexual abuse of children. In addition there have been many adults that have come forward to disclose that they were sexually abused as children. The most publicized cases in recent years have involved the Catholic Church and abusive priests. In addition there is some correlation made between child sexual abuse and parental drug abuse. That is children whose parents are drug addicts are at an increased risk of being sexually abused. Additionally, Webster (2001) reports families in which child sexual abuse occurs often have many other significant problems. These problems include neglect, the child being witness to the physical or sexual abuse of a parent and general neglect associated with food, shelter and clothing (Webster 2001).

The American Psychological Association also explains that children experience different reactions to sexual abuse.

The article contends that children that have experienced more severe abuse involving a great deal of physical force or those that have been abused by members of their families often have posttraumatic stress disorder and separation anxiety (Understanding Child Sexual Abuse). In addition the article explains that many children that have been abused sexually have other environmental and familial issues to deal with. These issues include parental drug abuse. As a result of such additional issues the sexual abuse is only a part of the equation that may contribute to the negative behaviors of a child (Understanding Child Sexual Abuse).

The combination of these issues can also make it difficult to diagnose child sexual abuse. This difficulty is compounded by the fact that physical evidence may not exist (Understanding Child Sexual Abuse).

How sexual abuse of children has an affect on at-risk youth behavior

Indeed there are definite consequences associated with the sexual abuse of children as it relates to at risk youth behavior. According to an article found in the Journal of Child Psychology and Psychiatry one of the affects of child sexual abuse is self blame and internalizing behavior problems (Quas et al. 2003). The study sought to uncover why some children have particularly adverse affects associated with sexual abuse while other children do not. This particular study involved 218 victims of sexual abuse and participants ranged in age from 4 to 17 (Quas et al. 2003). The article asserts that children that had been sexually abused for long periods of time or when the abuse involved penetration were more likely to experience increased attributions of self blame (Quas et al. 2003). The article also explains that the age, gender and the relationship of the perpetrator (Quas et al. 2003). The article explains that younger children tended to experiences higher levels of self blame (Quas et al. 2003). Self blame can be very dangerous as it relates to sexual abuse because it often makes victims less likely to reveal the abuse and may lead to an abused individual being involves in other self-destructive behaviors in the future.

One such behavior is drug abuse, which is often linked to sexual abuse in early childhood. A study found in the American Journal of Drug and Alcohol Abuse, victims of child sexual abuse of engage in drug usage as a way to self-medicate. This problem often manifests itself during adolescents and early adulthood. This particular study consisted of adult females seeking were seeking treatment for drug abuse. These participants were asked if they had been sexually abused before the age of 12 and/or during adolescents. The research found that nearly 40% of sample women had been the victim of some type of sexual abuse during childhood and almost 39% had experienced some type of sexual abuse during adolescence. The study found that Over one-quarter (27.4%) of sample women reported that they had been forced to observe someone's sexual private parts or to reveal their own in childhood; slightly fewer (20.7%) reported such victimization in adolescence (Table 2). Close to one-fifth (17.7%) of the sample reported that someone had talked "dirty" to them or shown them "dirty" pictures, magazines or videos in childhood (item not measured for adolescence). Forced sexual touching, reported by 33.2% of sample women as occurring in childhood and 26.8% in adolescence, was the most commonly reported early life abusive act in this sample. In addition, many of these women reported victimization by rape in childhood (16.8%) or in adolescence (23.8%), while nearly one-third (31.0%) were the victims of attempted rape in adolescence (item not measured for childhood). Sample women were more likely to have been sexually abused in both childhood and adolescence (21.7%) than to have been victimized in childhood-only (17.2%) or in adolescence-only (17.2%) (Freeman et al. 2003)."

The research found that the average age at which abuse occurred was 10 and the abuse occurred during a 4-year period. There were also some cases in which abuse occurred for less than one year (Freeman et al. 2003). The average number of years between that last experience of sexual abuse and the first time the individual used crack cocaine for the first time was 13 years (Freeman et al. 2003). Almost 60% of the abused women asserted that a family member was the first person to perpetrate abuse. In addition in about 35% of the cases the women had received some counseling to deal with the abuse.

Overall this particular study found that all forms of sexual abuse during childhood were associated with the use of crack cocaine. Such findings are in congruence with the observations of other researchers who have found that "Cocaine may be self-administered as a means of preventing recollection of a past traumatic event or to reduce the psychological and physiological symptoms caused by the event"(Freeman et al. 2003). It has also been suggested that crack cocaine might be used as a preventative measure because victims of child sexual abuse anticipate that they are going to encounter situations that might stimulate symptoms related to past sexual abuse. The researchers also contend that there is a substantial possibility that many of the participants in this particular study may have also been suffering form post traumatic stress disorder (PTSD).

Indeed there is evidence to suggest that child sexual abuse can be linked to drug abuse during adolescence and later in life. The aforementioned research seems to indicate that people that are sexually abused use drugs to escape the memories associated with the abuse. The memories are both psychological and physiological.

Along with the use of drugs youth that have been victims of child sexual abuse also have the tendency to be promiscuous. There is research that suggests that this promiscuity leads to both unwanted teenage pregnancy and the contracting of AIDS/HIV (Sadowsi et al. 2003). Addy et al. (2003) explains that a great deal of prior research has revealed that there is a correlation between child sexual abuse and high risk sexual behaviors in adolescents. For instance results from the 1997 Massachusetts Youth Risk Behavior Surveillance Survey found that out of a group of 1,610 sexually experienced teenage girls and 831 sexually experienced teenage boys in the 9th through 12th grades, 30% of the girls and 9% boys reported some type of sexual contact that occurred against their will (Addy et al. 2003). Previous studies have also found that girls who were sexually abused were more likely than those who had not experienced sexual abuse to report early sexual activity, multiple partners, and to have gotten pregnant (Raj, Silverman, & Amaro, 2000; Addy et al. 2003). In addition

Fergusson, Horwood, and Lynsky (1997) also examined the extent to which exposure to CSA was associated with increased rates of sexual risk-taking behaviors among 520 young women (aged 18) in New Zealand. Retrospective reports of CSA indicated that females who experienced sexual abuse (intercourse) were 4.4 times more likely to engage in sexual activity and be pregnant, 9.3 times more likely to have had five or more sexual partners, and 6.6 times more likely to have had sexual intercourse before age 16. The association remained significant even after controlling for other adverse childhood experiences. Further, Brown, Lourie, Zlotnick, and Cohn (2000) conducted a study of 208 adolescent patients who attended psychiatric day schools and residential programs, and found that more than half reported a history of sexual abuse (Addy et al. 2003)."

Prior research has also found that students that were sexually abused as children were times more likely than their peers to be inconsistent as it relates to using condoms during sexual activity (Addy et al. 2003). In addition sexually abused adolescents had less condom self-efficacy, a reduced understanding of HIV / AIDS, less impulse control, less frequent purchase and use of condoms, and higher rates of sexually transmitted diseases (STDs), when compared to adolescents that were not sexually abused as children (Addy et al. 2003).

In the present research Addy et al. (2003) investigated the Impact of a History of Sexual Abuse on High-Risk Sexual Behaviors among Females Attending Alternative Schools.

The article explains that this particular study had as its foundation the secondary analysis of the Safer Choices 2 baseline data. Safer Choices 2 program is designed to prevent HIV, Sexually transmitted diseases, and pregnancy. This particular program was being used and evaluated in a total of ten alternative schools in a large city in Texas. The program received funding from the National Institute for Child Health and Human Development (Addy et al. 2003). The overall goal of the program was to create a multicomponent sexual education program to be used in alternative schools (Addy et al. 2003).

There were a total of 494 students that were considered for this study and from which data was collected from November of 2000 to January of 2001 (Addy et al. 2003). There were 212 male students involved in the study and 282 female students involved in the study (Addy et al. 2003). As a condition for participating in the study only students that had reported being sexually active were included in the study and ultimately only female students were chosen to participate in the study (Addy et al. 2003). In the end the final sample size was 184(Addy et al. 2003).

The study found that as it related to female students at alternative schools 26.6% reported that they had been raped (Addy et al. 2003). This percentage is more than twice the national average. The research also found that students that were racially classified as other (Asian, mixed ethnicity) had the highest levels of child sexual abuse prevalence (Addy et al. 2003).

The study also found that child sexual abuse significantly increased sexual risk behaviors in these adolescent girls (Addy et al. 2003). In addition sexually abused females were significantly more likely to report sexual initiation prior to the age of 14 (Addy et al. 2003). They were also more likely to have 3 or more partners (within a period of 3 months) and to have a history of STDs (Addy et al. 2003).

The aforementioned results are in congruence with previous findings related to this particular topic (Addy et al. 2003). However the scale of the associations related to CSA and subsequent high-risk sexual behaviors in these studies were varied from a twofold to a nine fold increase in risk (Addy et al. 2003). In addition, while prior studies found correlations between CSA and early pregnancy, substance use prior to most recent sexual encounter, and failure to use protection, the results of this study did not find these correlations (Addy et al. 2003). The authors assert that it can be conclude that these correlations were not found in this study because the sample was taken from alternative schools, made up of at-risk adolescents with low overall inconsistency in high-risk sexual behaviors (Addy et al. 2003). The author also asserts that, the small sample size may have decreased the capacity of the statistical analysis to detect significant differences (Addy et al. 2003).

Lastly this particular research also found that depression did not necessarily explain the correlation between child sexual abuse and high risk sexual behaviors. This finding is actually consistent with previous research which has evaluated the interaction effects of emotional status and sexual abuse as it related to high risk sexual behaviors. The study found there were no interaction effects of depression on the correlation between child sexual abuse and sexuality variables such as the amount of unwanted pregnancies (Addy et al. 2003). On the other hand, girls with high anxiety scores who also had experienced child sexual abuse had the most significant number of unwanted pregnancies (Addy et al. 2003). In addition, Morrill, Kasten, Urato, and Larson (2001) discovered that depression and problems with drug and alcohol addiction did not serve as a link between sexual abuse and sexual risk in a sample of both women and men in substance abuse facilities in Massachusetts (Addy et al. 2003). Overall such findings propose that the affects of child sexual abuse impact sexual behaviors through a social learning process (Addy et al. 2003). That is this process is developed as a result of modeling and reinforcement as opposed to indirect contributory factors such as depression (Addy et al. 2003).

One final affect that the sexual abuse of children has on at-risk youth behavior has to do with development of sexually abusive behavior in sexually victimized adolescents. This abusive behavior is most commonly seen in sexually abused boys but can also be present in females. Prior research has indicated that many child sexual abusers were also victims of child sexual abuse. However, most people who are abused do not become child sexual abusers (Itzin 2000). Many researchers believe that for an individual to go on to become a victimizer other risk factors must also be present. The study evaluated boys that were victims of sexual abuse that went on to become victimizers and boys that were victims of sexual abuse that did not become victimizers (Itzin 2000). The study found that several risk factors placed victimized boys in the position to become victimizers including violence, being a witness to intrafamilial violence, rejected by family and peers insufficient identification with father figure and the absence of a non-abusive male attachment figure (Itzin 2000). The study also found that male victims of sexual abuse who have abused other children can be discriminated from those who have not done so in terms of life events that are unrelated directly to the experience of sexual victimization. Accordingly the findings are applicable only to boys who have been sexually abused. In addition, as the study focused on adolescent perpetrators the findings may apply only to boys who began abusing before or during adolescence. It is perhaps surprising that witnessing rather than experiencing intrafamilial violence seemed to be the most potent risk factor, although many boys were exposed to both risks (Itzin 2000)."