A Rapid Review on Complaint Mechanisms for Interpersonal Violence: Integrating Research-Based Recommendations from Multiple Sectors to Inform Sport Settings.

Past studies have highlighted the lack of independent formal complaint mechanisms as one of the most significant barriers to reporting interpersonal violence (IV) in sport. Some countries have since implemented complaint mechanisms specific to sport settings. Evaluations of similar mechanisms in other sectors could inform the development and implementation of complaint mechanisms for IV in sport. This rapid review included studies inside and outside the sport context to document the characteristics of complaint mechanisms of IV, barriers or limitations related to such mechanisms, and recommendations resulting from their evaluation. Following the Cochrane Rapid Reviews Interim Guidance, six databases were searched for peer-reviewed references in English or French, published between 2012 and 2022, and pertaining to the evaluation of formal reporting mechanisms of IV. The 35 references covered mechanisms mainly targeting IV in general (any type) or sexual violence specifically. Complaint mechanisms varied in scope and as a function of their setting, including work, university, military, and medical. We identified barriers and limitations concerning fear of consequences, lack of knowledge, lack of efficiency, lack of trust, and unsupportive culture. Finally, we documented 18 recommendations to improve complaint mechanisms of IV, spanning four categories: (a) organizational accountability, (b) awareness and accessibility, (c) adapted process, and (d) ongoing evaluation. This rapid review draws recommendations from various research disciplines and types of mechanisms to offer a comprehensive portrait of best practices. The findings show that numerous aspects of complaint mechanisms at multiple levels should be considered when developing and implementing complaint mechanisms of IV.

Profiles of Teenage Athletes' Exposure to Violence in Sport: An Analysis of Their Sport Practice, Athletic Behaviors, and Mental Health.

Violence in sport is a major social issue generating great interest in research over the last 10 years. Studies to date highlight various forms and manifestations of violence in the lives of teenagers practicing individual or team sports, in competitive and recreational contexts. Although allegations of sexual violence involving coaches most often reach media attention, psychological and physical violence involving teammates, parents, and coaches are also prevalent. While profiles of offenders in the sport context have contributed to a better understanding of the issue, similar profiles need to be elaborated for young victims to delineate varying degrees of risk, adaptation, and needs. Latent class analyses were conducted to empirically identify different patterns of exposure to violence in sport from a sample of 1057 athletes aged 14-17 years. Teenagers participated in an online survey assessing their experiences of violence using the Violence Toward Athletes Questionnaire. Results highlighted three different profiles of victimization in the sport context: (a) a non-victimized profile constituting only 37% of the sample; (b) a profile representing 52% of the sample that is mainly exposed to psychological violence by teammates, coaches, and parents; and (c) a "poly-victimized" profile, representing 10% of the sample, that is exposed to all forms of violence at the hands of various perpetrators (teammates, coaches, and parents). The identified profiles were compared according to different indicators of sport practice, athletic behaviors, and mental health. This study delineates the influence of single and multiple forms of violence and its compound consequences on mental health and sport-related behaviors, thus portraying various degrees of need for tailored prevention and intervention measures.

The disclosure of children who exhibit problematic sexual behaviors.

BACKGROUND: Practitioners mandated to protect child development are sometimes dealing with children's inappropriate sexual behaviors. This set of behaviors presents a potential hindering impact on the child's development and important consequences for all children involved. Denial during the questioning of the child complicates the investigation of these cases. OBJECTIVE: The objective of this study was to explore and to identify the different contexts of questioning in which children disclose or deny having committed a sexual behavior that appears to be problematic for his/her development as well as identifying the individual and contextual variables that influence the outcome of the questioning. PARTICIPANTS AND SETTING: The sample comprised of 120 instances of inappropriate sexual behavior exhibited by 85 children aged between 5 and 17 years old and reported to the Youth Protection Department at the Integrated Health and Social Services University Network in the province of Quebec, Canada. METHODS: Bivariate statistical analyses were performed to investigate the association between the outcome of disclosure or non-disclosure, and contextual factors (questioning person's role, parents' reaction to the child's behavior, the child's expression of remorse, presence of a witness, use of coercion during the sexual behavior). Logistical regression (GLMM) was then used to determine the strength of the association between the covariates and the outcome of the questioning. RESULTS: Results show that disclosure appears to be influenced by a combination of contextual variables, namely the role/status of the person questioning the child, expression of remorse reported by the child, and the presence of a witness to the behavior/s. CONCLUSIONS: Our findings point to the importance of developing more comprehensive and specialized knowledge about the questioning context that favors the disclosure of children who are thought to have exhibited inappropriate sexual behaviors.

A Longitudinal Examination of Developmental Covariates of Sexual Behavior Problems among Youth Referred to Child Protection Services.

Little is known about the development of childhood sexual behavior problems (SBP) in terms of continuity and discontinuity into adolescence. Prior studies have espoused a nondevelopmental approach focusing on the clinical profiles of these youths at the time of their referral. To address this gap, the current study proposes an examination of the developmental covariates involved in the continuity of SBP among a sample of 340 children and adolescents referred to Child Protection Services (CPS) in Quebec, Canada. Children's CPS contacts from birth up to age 17 were inspected, allowing to recreate the life history of social and familial adversities during that period. Logistic regression models were performed and helped to identify developmental covariates of childhood-onset SBP and its persistence into adolescence. Findings suggest that children with childhood-onset SBP that persisted into adolescence have experienced various life adversities. The study findings provide some preliminary evidence of the developmental pathways of SBP.

Correlates and Predictors of Mothers' Adaptation and Trauma Symptoms Following the Unveiling of the Sexual Abuse of Their Child.

Child sexual abuse (CSA) can severely affect the mental health of children and their parents. While correlates of recovery have been documented in children, factors exacerbating parents' adaptation to their child's unveiling of CSA deserves further attention. Parents' history of abuse has been inconsistently identified as a predictor of their distress in reaction to their child's abuse disclosure. This study proposes a mediation model that explores various processes underlying mother's psychological distress (posttraumatic stress disorder [PTSD], dissociation, and their comorbidity) following their children's unveiling of CSA. It investigates the influence of mother's own CSA, as well as of her exposure to additional forms of past and current victimization, on her reaction to the child's CSA disclosure, while considering coping mechanisms as mediators (avoidance, problem solving, search for social support, and feeling of guilt). Data were collected through self-report measures completed by 298 mothers of children who had recently disclosed CSA. Path analyses revealed that mother's exposure to interparental violence as a child acted as a primary predictor of dissociation and of its comorbidity with PTSD, while a history of CSA was directly and exclusively linked to dissociation. Being exposed to recent partner violence was indirectly related to trauma symptoms, with coping mechanisms acting as mediators. This study outlines the relationship between mother's psychological distress and her cumulative, past, and current exposure to various forms of victimization. Exposure to interparental violence as a child represents a particularly important factor for identifying mothers most in need of support, as it is a significant predictor of dissociation and of its comorbidity with PTSD.

School-aged children with sexual behavior problems: Untangling the relationship between externalizing behavior problems and non-sexual victimization on the variety and severity of sexual behaviors.

BACKGROUND: Sexual behavior problems (SBP) in school-aged children is a social concern that draws increased attention amongst child protection services and practitioners. Past research that highlighted the variety in profiles and in behavioral manifestations of children with SBP emphasizes the importance of a well-informed and sensitive approach for appropriate intervention. However, studies validating the theoretically hypothesized vulnerability of children with SBP remains scarce. OBJECTIVE: This study aimed to further our understanding of the risk factors that influence the variety and severity of SBP. PARTICIPANTS AND SETTING: Eighty-eight child-adult dyads (35.2% girls, Mage = 9.1 years; SD = 2.2 years) referred for SBP by child protection services or public services between 2006 and 2010 participated in the study. Participants completed a series of questionnaires as part of their assessment in a specialized therapeutic center for SBP. METHODS: A theoretical model of risk factors was examined using multiple linear regression analysis. RESULTS: Amongst the factors identified, externalizing behavior problems were the most strongly associated with the variety (ß = .50; p < 0.001) and severity of SBP (ß = .40; p < .001). Non-sexual victimization experiences (e.g., exposure to family violence) were also associated with a greater variety (ß = .30; p < .001) and severity of SBP (ß = .36; p < .001), while sexual abuse alone was not. CONCLUSIONS: This study outlines the high co-occurrence of SBP, externalizing behaviors and non-sexual victimization, which should raise concern for the assessment of the children and to further adapt treatment strategies and goals.

Child sexual abuse victims as witnesses: The influence of testifying on their recovery.

Victims of child sexual abuse (CSA) are likely to show a wide range of adaptation difficulties. In addition, some children and their families are involved in legal proceedings following the child's disclosure. However, little is known about the effects of legal involvement on CSA victim's mental health and recovery. In this longitudinal study, the effects of testifying were examined in a sample of 344 children at initial assessment (67% of girls) receiving services in a Child Advocacy Centre, of which 130 children testified. The participants' age ranged from 6 to 14 years old (M = 9.42 SD = 2.14). Children and their parents completed a series of measures to evaluate the child's mental health (e.g. depression, anxiety, PTSD) at four points in time over a 2-year period. Multilevel analysis indicates that all the children showed significant improvement over time but the group who testified more than once shows higher levels of emotional distress 2 years after the initial assessment. This study highlights the importance of documenting the experience of CSA victims in the justice system in order to establish the adequate conditions to support child witnesses.

Profiles of school adaptation: social, behavioral and academic functioning in sexually abused girls.

OBJECTIVES: The short-term outcomes of child sexual abuse (CSA) on academic, behavioral and social adaptation at school were examined in order to: (1) document the proportion of sexually abused (SA) girls struggling in school and define the nature of their difficulties, (2) explore whether different profiles of school adaptation could be identified, and (3) examine the different constellations of contextual, personal, and familial correlates of abuse for each profile. METHOD: The sample consisted of 100 French-speaking mother-daughter dyads. Girls (aged 7-12, M= 8.64) were administered cognitive functioning tests and completed self-report measures to assess symptomatology, perception of abuse, and support provided. Mothers and teachers completed questionnaires to assess child's emotional, social, behavioral, and academic functioning in school. RESULTS: Descriptive analyses showed that a substantial number of girls (54%) presented clinical school adaptation difficulties in at least one of the three domains evaluated. Cluster analysis revealed four distinctive school functioning profiles: (1) academic-specific, (2) acting out/withdrawn, (3) polyclinical, and (4) resilient. These were distinguished by degree of school functioning difficulties and number of domains affected. The profiles were further discriminated by elements of the CSA experience and contextual, familial, and personal factors. The number of spheres of functioning affected was proportional to the number of risk factors to which girls were exposed. DISCUSSION: Results suggest the need for a systematic and thorough assessment of SA child functioning at school and may guide mental health professionals in providing differential treatment on the basis of the emerged typology. PRACTICE IMPLICATIONS: Sexually abused children demonstrate a wide variability of responses, rendering the elaboration of a "one size fits all" treatment rather difficult. The emerged typology underscores the complex heterogeneity of school adjustment profiles and suggest that secondary effects of abuse on child's level of school functioning require specific assessment and close monitoring. This study raises practical questions as to whether such secondary effects could best be addressed as a primary treatment objective, or in addition to a trauma-focused approach, or as the sole treatment objective.

Disclosure of sexual abuse, and personal and familial factors as predictors of post-traumatic stress disorder symptoms in school-aged girls.

OBJECTIVE: The aim of the present study was to analyze predictive factors of post-traumatic stress disorder (PTSD) symptoms in school-aged girls. METHODS: A group (n=67) of seven- to 12 year-old girls consulting a paediatric hospital following disclosure of sexual abuse were compared with a group (n=67) of nonabused girls. The girls answered questionnaires related to PTSD, coping, sense of hope, self-esteem, sibling relationships and perceived social support. Mothers answered questionnaires related to family relationships, family violence, perceived support given and psychological distress. RESULTS: The mean +/- SD age of the girls was 9+/-1.5 years. In the sexual abuse group, single-parent families were more frequent (53.7% versus 32.3%; P<0.01), mothers were less educated (10.8% versus 13.1%; P<0.0001) and socioeconomic level was lower (36.8% versus 47.9%; P<0.0001). A history of sexual abuse in childhood was reported by 50% of mothers of sexually abused children and 37% of mothers of the comparison group children. A higher prevalence of PTSD clinical scores was found for the girls reporting sexual abuse (46.3% versus 18.5%; P<0.001). Regression analyses controlling for parental education level and family structure revealed that group membership (sexual abuse group versus comparison group) was predictive of the level of PTSD symptoms. In addition, the mother's level of support, the child's perception of parental support and the child's reliance on avoidance coping predicted PTSD symptoms. Sense of hope and the child witnessing interparental physical violence were marginally associated with the level of PTSD symptoms. CONCLUSIONS: PTSD was common in the present study's sample of sexually abused girls. Because predictive factors relate to both child-related variables and familial context, interventions for this population should target not only the child, but also the family.

A typological analysis of behavioral profiles of sexually abused children.

A cluster analysis is used to explore differential outcomes in 123 French Canadian children reporting sexual abuse contrasted with 123 control children. Mothers' reports of behavioral problems on the Child Behavior Checklist, abuse-related variables, personal factors, and family characteristics are used as potential variables discriminating clusters. Results reveal four clusters: (a) anxiety constellation group refers to children displaying behavior problems on a subset of scales, (b) the severe distress group refers to children showing a broader array of behavior problems, (c) victims of less severe sexual abuse (SA) group consists of children disclosing mostly extrafamilial SA, and (d) resilient children refers to children who, while disclosing severe abuse, rely less on avoidance coping. Findings underscore the need to go beyond abuse-related variables to orient treatment for children disclosing sexual abuse and for tailoring interventions to distinct subgroups.