Mother-daughter incest: A brief review of literature and case report.

Parent-child incest is a traumatic event that causes long-term psychological consequences for victims. Although paternal incest is the most common form, it is known that mothers can also sexually abuse their children. Mother-daughter incest is a type of abuse that is thought to be rare. This article discusses a case of a mother who abused one of her 4-year-old twin daughters for masturbation and used them in a sexual fantasy with her partner. She was sent to the forensic psychiatric observation unit by the court to determine her criminal responsibility. In the literature on mother-daughter incest, the abuser's childhood traumas, early marriage, low self-esteem, and sense of worthlessness are frequently seen. Our case, who did not have a history of psychiatric illness, was referred to us with suspicion of mental illness simply because she abused her daughters. Researchers have found out that in most cases, contrary to common expectations, mothers did not have a severe mental illness. A gender-based approach to incest cases may contribute to the cycle of the abuse continue, and it makes it difficult for victims to speak up and seek help. More studies focused on perpetrators will expand our perception of mother-daughter incest.

Action research improves services for child sexual abuse in one Caribbean nation: An example of good practice.

BACKGROUND: Child sexual abuse (CSA) is a multi-dimensional problem. The search for best practice must consider the complexities surrounding CSA and its management in any particular society. OBJECTIVE: Data previously gathered from service providers on CSA service provision in Trinidad and Tobago identified key deficient issues in policy and practice. In this paper, researchers aimed to bridge the gaps identified, and effect changes to improve services for CSA using an action research methodology. PARTICIPANTS AND SETTING: Service providers from all sectors in governmental and non-governmental organizations in Trinidad and Tobago, who work with children at risk of CSA were involved in the process. METHODS: Researchers led the service providers into an awareness of their own practice through critical discussion of, and reflection on, the key deficient issues. The new knowledge generated, with guided input from evidenced-based best practice, led to the development of guidelines for management. Discussion of the practicability of the guidelines by service providers in multiple sectors generated more new knowledge that refined the management approach. RESULTS: The contextual knowledge obtained from service providers resulted in best practice guidelines for service providers that were culturally relevant and context-sensitive, adaptive and implementable, and allowed a seamless multidisciplinary response to CSA in Trinidad and Tobago within prevailing constraints. CONCLUSIONS: Action research offers an effective approach to improve services for CSA through mobilization of service providers and changes in policy and practice. It is applicable in any setting and likely to be effective in any socio-cultural context.

Are all abortions equal? Should there be exceptions to the criminalization of abortion for rape and incest?

Politics, public discourse, and legislation restricting abortion has settled on a moderate orthodoxy: restrict abortion, but leave exceptions for pregnancies that result from rape and incest. I challenge that consensus and suggest it may be much harder to defend than those who support the compromise think. From both Pro-Life and Pro-Choice perspectives, there are good reasons to treat all abortions as equal.

Alleged biological father incest: a forensic approach.

Paternal incest is one of the most serious forms of intrafamilial sexual abuse with clinical, social, and legal relevance. A retrospective study was performed, based on forensic reports and judicial decisions of alleged cases of biological paternal incest of victims under 18 years old (n = 215) from 2003 to 2008. Results highlight that in a relevant number of cases: victims were female; the abuse begun at an early age with reiteration; the alleged perpetrator presented a history of sexual crimes against children; sexual practices were physically poorly intrusive, which associated with a forensic medical evaluation performed more than 72 h after the abuse, explain partially the absence of physical injuries or other evidence-these last aspects are different from extrafamilial cases. In conclusion, observations about paternal incest are likely to exacerbate the psychosocial consequences of the abuse and may explain the difficulty and delay in detect and disclose these cases. Few cases were legally prosecuted and convicted.

Sex, lies, and statistics: inferences from the child sexual abuse accommodation syndrome.

Victims of child sexual abuse often recant their complaints or do not report incidents, making prosecution of offenders difficult. The child with sexual abuse accommodation syndrome (CSAAS) has been used to explain this phenomenon by identifying common behavioral responses. Unlike PTSD but like rape trauma syndrome, CSAAS is not an official diagnostic term and should not be used as evidence of a defendant's guilt or to imply probative value in prosecutions. Courts have grappled with the ideal use of CSAAS in the evaluation of child witness testimony. Expert testimony should be helpful to the jurors without prejudicing them. The New Jersey Supreme Court ruled recently that statistical evidence about CSAAS implying the probability that a child is truthful runs the risk of confusing jury members and biasing them against the defendant. We review the parameters of expert testimony and its admissibility in this area, concluding that statistics about CSAAS should not be used to draw inferences about the victim's credibility or the defendant's guilt.

[Is there an association between intra-familiar sexual abuse and sexual offences in later life?]. / Gibt es eine Assoziation zwischen familiärem sexuellen Missbrauch und späteren Sexualstraftaten?

OBJECTIVE: 12-35% of all sexual delinquents report victimization through early sexual abuse. To date, studies are based on small samples and mostly come from English-language countries. METHODS: As part of an interdisciplinary study on the human rights situation in long-term imprisonment, we examined 1,055 prisoners from 11 countries in Europe with the posttraumatic stress diagnostic scale (PDS) concerning their traumas in relation to their offences. RESULTS: Sexual delinquents who reported own prior sexual abuse within the family had a fourfold increase in committing sexual offences later in their life compared to other offenders. CONCLUSIONS: A detailed trauma history which includes sexual offences within the family is essential for adequate therapy and relapse prevention.

[Assessment of a new law for sex offenders implemented in France in 1998]. / Loi du 17 juin 1998 : bilan de l'expérience des médecins coordonnateurs de Haute Normandie.

OBJECTIVES: Most people recognize that incarceration alone will not solve sexual violence. Treating the offenders is critical in an approach to preventing sexual violence and reducing victimization. The Law of June 17, 1998, on the prevention and repression of sexual offences, as well as the protection of minors, makes a provision for the possibility of medical and psychological monitoring adapted to these particular individuals. Sex offenders may well be constrained, after their incarceration, to social and judicial follow-up, which may include coerced treatment in order to reduce the risk of recidivism. In order to control this follow-up, the legislature has created the position of medical coordinator, who acts as an interface between justice and care in conjunction with the treating physician. This study is the first attempt to evaluate the activity of physician coordinators conducted in France since the implementation in 2004 of the 1998 law on monitoring sex offenders. METHODS: An interview of all the physician coordinators in Upper Normandy was conducted. The files of all sex offenders subjected to coerced treatment were studied. RESULTS: In our sample of 100 sex offenders who were subjected to coerced treatment (any kind of treatment) (99% men, 60% of sexual assaults on minors, 14% of cases of indecent exposure), minor victims of sexual assault were: 78% females; in 90% of cases the victim was aged under 14 years (under 10 in 52% of cases), 60% of cases were intrafamilial incest; the victim was an unknown aggressor in only one case out of 60. The constraint follow-up contributed to reducing the risk of recidivism (three cases of recidivism in 100 individuals over an average duration of follow-up of five years), although it remains difficult to assess the recidivism over a duration of time as short as five years. A diagnosis of paraphilia was only applied in 19% of cases (in 10 cases pedophilia, exhibitionism in nine cases). Only six subjects were receiving antiandrogen treatment. A diagnosis based on Axis I DSM was established in 57% of cases. Personality disorders were mentioned in the medical records in 65% of cases. An antisocial personality disorder was not prominent (20%). In 56 cases, the individuals had been victims of physical, psychological or sexual abuse. Nearly half of the individuals had a past history of sexual or non sexual offences, among those, 16 subjects had previously been convicted at least three times. The seniority of the prior conviction was more than 10 years in 43% of cases. Physician coordinators interviewed were satisfied with their work and felt they had contributed to improving the care of patients who had committed sexual offences. CONCLUSION: However, this study shows the need to create a national reference centre, which could enable a multidisciplinary evaluation of difficult cases and could also boost the development of research in this area where many questions remain unanswered, particularly regarding the determinants of deviant sexual behaviour and risk factors for recidivism.