Technical Assistance Partnership for Child and Family Mental Health

HOLIDAY2002

Question: What is sexual abuse and is it a risk factor for emotional disorders?

A: The American Academy of Pediatric defines sexual abuse as the engaging of a child in sexual activities that the child cannot comprehend, for which the child is developmentally unprepared and cannot give informed consent, and/or that violate the social and legal taboos of society. Sexual abuse includes a spectrum of activities ranging from violent rape to gentle seduction. Most victims of sexual abuse are female and most sexual abusers are male. The vast majority of sexual abusers are known to the abused child. They are usually the immediate biological father, stepfather- or extended family members (uncles, grandfathers, and cousins), or acquaintances.

There are clinical and legal definitions for sexual abuse. A. Clinical Definition 1. Sexual Abuse - A form of child abuse in which contacts (such as fondling, sodomy, penetration by animate or inanimate objects) between a child - with or without consent - and an adult occur. The child is being used for sexual stimulation of that adult or another person. Sexual abuse may also be committed by a person under the age of 18 when that person is at least five years older than the victim. 2. Sexual Exploitation - A form of abuse in which a child's parent, caretaker, or other adult allows, permits, encourages, or requires the child to engage in any of the following activities: a. Sexual acts for the stimulation/gratification of adults b. Prostitution c. Sexually explicit conduct for the purpose of producing any visual or print medium d. Exposure to sexually explicit visual or print medium for the purpose of sexually gratifying the adult e. Exposure to sexually explicit verbal statements for the purpose of gratifying the adult f. Observation or view of sexually provocative behavior B. Legal Definition - A form of child abuse in which an adult knowingly engages in sexual conduct with a minor 16 years of age or younger.

Most children who are sexually abused experience some degree of emotional damage and express negative changes in their behaviors. However, there are internal and external factors which influence the child's behavioral and emotional responses to sexual abuse. Age, gender, pre-existing emotional health, and culture are important internal characteristics. While the severity and duration - whether it's a one-time event or repeated abuse- the perpetrator's relationship to the child, and the response of significant adults to the abuse are external variables which impact on the overall effect of the abuse.

Common DSM IV Diagnoses 1. Anxiety Disorders - especially Posttraumatic Stress Disorder(PTSD) 2. Depressive Disorders 3. Disruptive Behavior Disorders especially Oppositional Defiant/Conduct Disorders 4. Substance-Related Disorders 5. Dissociative Disorders 6. Eating Disorders

Common Behavioral Changes 1. Striking fear of a person or certain places 2. Uncalled for response from the child when asked if she/he was touched by someone 3. Unreasonable fear of a physical exam 4. Drawings that are scary or use a lot of black and red 5. Abrupt change in conduct of any sort 6. Sudden awareness of genitals and sexual and sexually precocious words 7. Attempts to get other children to perform sexual acts 8. Unusual interest in or avoidance of all things of a sexual nature 9. Sleep problems or nightmares 10. Depression or withdrawal from friends or family 11. Statements that their bodies are dirty or damaged, or fear that there is something wrong with them in the genital area 12. Refusal to go to school, delinquency, or running away from home 13. Secretiveness 14. Aspects of sexual molestation in drawings, games, fantasies 15. Unusual aggressiveness 16. Self-destructive, mutilating behavior 17. Suicidal behavior

Source: "Facts for Families" (Vol. IV. No.8) American Academy of Child and Adolescent Psychiatry, Washington D.C. Child Abuse. Health Education Consultants. P.O, Box 22593. Kansas City, MO 64113; (913) 831-1393

What Can You Do? A. Parent/Family/Friend 1. Listen. 2. Praise and reassure the child that she/he did the right thing in telling. 3. Tell the child that she/he is the victim and that the perpetrator committed a crime. 4. Grieve with the child. 5. Encourage/permit expressions of feelings - sadness/anger /fear. 6. Recommend individual/group/family counseling focused on the sexual abuse. 7. Immediately report any suspicion of child abuse to the local Child Protection Agency and/or the police.

B. Therapist/Counselor 1. All of the above 2. Expressive/Cathartic techniques 3. Individual/family/group cognitive behavioral techniques

Home About Us About Systems of Care Contact Us Events & Presentations Newsletter Consultant Pool Special Topics Column Grantee Locator Webinars Resource Specialties Child Welfare Education Family Involvement Juvenile Justice Mental Health Primary Care Substance Abuse Sustainability Youth Involvement Regional Technical Assistance Region I Region II Region III Region IV Region V Region VI Communities of Practice Cultural and Linguistic Competence Early Childhood Transition-Aged Youth	Mental Health and Systems of Care Frequently Asked Questions
	HOLIDAY2002 Question: What is sexual abuse and is it a risk factor for emotional disorders? A: The American Academy of Pediatric defines sexual abuse as the engaging of a child in sexual activities that the child cannot comprehend, for which the child is developmentally unprepared and cannot give informed consent, and/or that violate the social and legal taboos of society. Sexual abuse includes a spectrum of activities ranging from violent rape to gentle seduction. Most victims of sexual abuse are female and most sexual abusers are male. The vast majority of sexual abusers are known to the abused child. They are usually the immediate biological father, stepfather- or extended family members (uncles, grandfathers, and cousins), or acquaintances. There are clinical and legal definitions for sexual abuse. A. Clinical Definition 1. Sexual Abuse - A form of child abuse in which contacts (such as fondling, sodomy, penetration by animate or inanimate objects) between a child - with or without consent - and an adult occur. The child is being used for sexual stimulation of that adult or another person. Sexual abuse may also be committed by a person under the age of 18 when that person is at least five years older than the victim. 2. Sexual Exploitation - A form of abuse in which a child's parent, caretaker, or other adult allows, permits, encourages, or requires the child to engage in any of the following activities: a. Sexual acts for the stimulation/gratification of adults b. Prostitution c. Sexually explicit conduct for the purpose of producing any visual or print medium d. Exposure to sexually explicit visual or print medium for the purpose of sexually gratifying the adult e. Exposure to sexually explicit verbal statements for the purpose of gratifying the adult f. Observation or view of sexually provocative behavior B. Legal Definition - A form of child abuse in which an adult knowingly engages in sexual conduct with a minor 16 years of age or younger. Most children who are sexually abused experience some degree of emotional damage and express negative changes in their behaviors. However, there are internal and external factors which influence the child's behavioral and emotional responses to sexual abuse. Age, gender, pre-existing emotional health, and culture are important internal characteristics. While the severity and duration - whether it's a one-time event or repeated abuse- the perpetrator's relationship to the child, and the response of significant adults to the abuse are external variables which impact on the overall effect of the abuse. Common DSM IV Diagnoses 1. Anxiety Disorders - especially Posttraumatic Stress Disorder(PTSD) 2. Depressive Disorders 3. Disruptive Behavior Disorders especially Oppositional Defiant/Conduct Disorders 4. Substance-Related Disorders 5. Dissociative Disorders 6. Eating Disorders Common Behavioral Changes 1. Striking fear of a person or certain places 2. Uncalled for response from the child when asked if she/he was touched by someone 3. Unreasonable fear of a physical exam 4. Drawings that are scary or use a lot of black and red 5. Abrupt change in conduct of any sort 6. Sudden awareness of genitals and sexual and sexually precocious words 7. Attempts to get other children to perform sexual acts 8. Unusual interest in or avoidance of all things of a sexual nature 9. Sleep problems or nightmares 10. Depression or withdrawal from friends or family 11. Statements that their bodies are dirty or damaged, or fear that there is something wrong with them in the genital area 12. Refusal to go to school, delinquency, or running away from home 13. Secretiveness 14. Aspects of sexual molestation in drawings, games, fantasies 15. Unusual aggressiveness 16. Self-destructive, mutilating behavior 17. Suicidal behavior Source: "Facts for Families" (Vol. IV. No.8) American Academy of Child and Adolescent Psychiatry, Washington D.C. Child Abuse. Health Education Consultants. P.O, Box 22593. Kansas City, MO 64113; (913) 831-1393 What Can You Do? A. Parent/Family/Friend 1. Listen. 2. Praise and reassure the child that she/he did the right thing in telling. 3. Tell the child that she/he is the victim and that the perpetrator committed a crime. 4. Grieve with the child. 5. Encourage/permit expressions of feelings - sadness/anger /fear. 6. Recommend individual/group/family counseling focused on the sexual abuse. 7. Immediately report any suspicion of child abuse to the local Child Protection Agency and/or the police. B. Therapist/Counselor 1. All of the above 2. Expressive/Cathartic techniques 3. Individual/family/group cognitive behavioral techniques

Mental Health and Systems of Care Frequently Asked Questions