A Study of Attitudes Toward Teacher-Student Sexual Misconduct Cases Based on Student Age, Student Gender, and Teacher Gender.

Teacher-student sexual misconduct is a serious instance of child sexual abuse that impacts an estimated 10% of students. We tested whether two effects seen in research about these types of cases replicated across online American adult and undergraduate samples: (1) sympathy toward younger students who experience sexual abuse compared to older students and (2) leniency in cases of female teachers engaging with male students compared to other gender dyads. Participants (N = 525) reviewed a mock teacher-student sexual encounter and then answered questions about their views and case-related outcomes. Student age emerged as the most influential factor across all our variables of interest, where cases with younger students were viewed as more egregious than those involving older students. Incidents involving boys who experienced abuse were perceived as more "normal" than those involving girls. We found some support for the idea that there is leniency toward women teachers, but limited support for a female teacher-male student leniency effect. While these cases were viewed to be more normal and acceptable than other gender dyads, there were no effects on the other dependent variables. Sample type effects were also minimal, as our adult sample viewed the teachers involved to be more responsible and student complainants as more credible versus the undergraduate sample.

Examining and Comparing the First Public Olympic and Competitive Sports Misconduct Registry with the National Sex Offense Registry.

In 2017, the U.S. Center for SafeSport launched the first public disciplinary sports registry listing individuals accused of engaging in harmful behavior against child and adult athletes. Our study reviews information from 1,161 individuals on SafeSport's sports registry. Of the individuals on the sports registry, 22% were concurrently listed on the national registry for sexual offenses. Relative to individuals listed only on the sports registry, those on both registries were 4.5 and 1.4 times more likely to have sexual misconduct allegations and allegations involving a child, respectively. Of those on both registries, 31% were on the national registry approximately seven years before appearing on the sports registry. We discuss whether and how public registries represent effective strategies for crime prevention.

Child sexual abuse knowledge and attitudes of Syrian refugee parents and related factors.

BACKGROUND: Child sexual abuse is an important health problem that disrupts the physical and mental health of children. In order to protect children from abuse, the knowledge and attitude levels of their families need to be increased. PURPOSE: This study was to determine the knowledge and attitude levels of Syrian refugee parents regarding child sexual abuse who lived in Turkey. DESIGN AND METHODS: The study was carried out using a cross-sectional, descriptive, relationship-seeking design. A personal information form and the Child Sexual Abuse Knowledge/Attitude Scale for Parents (CSAKAS) were used. RESULTS: In the study, the mean age of the participants was 33.0 ± 8.2; 74.7% were women; 93.7%. It was also found that the mean scores of the participants regarding such sub-dimensions of CSAKAS as myths/facts, belief, information, attitudes, services and reporting information and preventive attitudes differed statistically significantly with respect to their education level, income level, family type, employment status and having a disabled child (p < 0,05). CONCLUSION: Based on the results, it could be stated that the parents who were university graduates, who had good levels of perceived income, who had a nuclear family, who were employed and who had disabled children had better levels of knowledge and attitude regarding child sexual abuse, and it could also be stated that the participants had moderate levels of knowledge and attitudes regarding child sexual abuse. PRACTICE IMPLICATIONS: This study shows that pediatric nurses can play an important role in protecting, developing and improving the physical and mental health of children by increasing the knowledge and attitude levels of families in order to prevent child sexual abuse.

Child Sexual Abuse Victimization Amongst Detained Adolescents and Incarcerated Young Adults: Findings from an Australian Population-Based Birth Cohort Study.

To guide prevention and intervention efforts, the prevalence and impact of child sexual abuse (CSA) victimization among detained and incarcerated populations requires further examination, particularly with consideration of multi-type maltreatment experiences and sex-based variations. This longitudinal population-based study explores these relationships in an Australian birth cohort comprising all individuals born in Queensland in 1983 and 1984 (n = 82,409; 48.68% female). Data include all notified and substantiated harm(s) from child protection services (0 to 17 years), and sentences to youth detention and/or adult incarceration between ages 10 and 30. Findings indicate greater prevalence of CSA amongst detained/incarcerated individuals compared to the general population but emphasize the impact of cooccurring maltreatment (particularly neglect) on the likelihood of custodial outcomes. Important sex-based differences were noted in the intersection of CSA victimization and detention/incarceration. Findings reinforce the need for trauma-informed practices when working with custodial populations, particularly females, and highlight opportunities for prevention of detention/incarceration in at-risk populations, in line with a broader public health approach to child protection.

Evaluation of Pediatric HIV Postexposure Prophylaxis Guideline Following Child Sexual Assault in Western Australia.

BACKGROUND: HIV postexposure prophylaxis (PEP) following child sexual assault (CSA) is recommended in select cases. High rates of poor adherence to PEP are reported. We evaluated adherence to the recommended management of children following CSA at the tertiary pediatric facility in Western Australia and compared our approach with international guidelines. METHODS: Medical records were reviewed for all children <16 years old assessed at Perth Children's Hospital between October 1, 2016 and November 30, 2020 following alleged CSA. Data, including exposure type, PEP adherence and follow-up, were collected. A review of contemporary national and international PEP guidelines was undertaken in parallel. RESULTS: There were 511 alleged CSA events over the study period; 62/511 (12%) were appropriately risk-assessed as requiring PEP by the treating clinician. PEP was not prescribed in 8/62 (13%) events, with a reason documented for 6/8 (75%). Overall, less than half of children who were eligible for PEP were adherent to the 28-day regimen (23/54, 43%). Gastrointestinal upset contributed to early cessation in 5/54 (9%). Final 3-month blood-borne virus serology results were available in less than one in 3 children. A review of international clinical practice revealed significant heterogeneity of criteria for the provision of PEP and a paucity of pediatric-specific data. CONCLUSIONS: We identified several areas of our PEP management that required strengthening, with limited direction available in current international guidelines. We have adopted a broader use of fixed drug combinations and implemented a multifaceted follow-up program. It will be essential to review the impact of these changes.

Introduction to Special Section: CSA Victimization in Incarcerated Populations.

Research suggests that individuals involved in the criminal justice system have higher rates of childhood trauma, including experiences of child sexual abuse (CSA). Studies also suggest that childhood victimization has an impact on the success of mental health treatment for offenders which may contribute to recidivism rates. Accordingly, policymakers and correctional staff can be better informed in choosing appropriate assessments and intervention approaches when they understand the ways in which prior experiences of CSA impact individuals in correctional settings. This special section highlights four novel studies that advance the research examining CSA in incarcerated populations.

Dissociation and Sexual Concerns in Male Survivors of Childhood Sexual Abuse: The Role of Identity Cohesion.

Research on male survivors of childhood sexual abuse is notably deficient when it comes to addressing their sexual concerns, such as experiences of sexual distress, negative thoughts, and feelings related to their sexuality. Dissociation, a known consequence of childhood sexual abuse, could be associated with higher sexual concerns through identity cohesion. Precisely, dissociation can potentially be related to lower identity cohesion (e.g., not knowing what you want or need). In return, lower identity cohesion may be related to higher sexual concerns by impeding the capacity to know and accept oneself, which tends to promote a positive and healthy sexuality. This study aimed to examine the role of identity cohesion in the link between dissociation and sexual concerns in 105 men consulting for their history of childhood sexual abuse. Men completed questionnaires assessing dissociation, sexual concerns, and identity cohesion at admission in a community setting. Results of a path analysis revealed an indirect association between dissociation and higher sexual concerns through lower identity cohesion. The model explained 27.6% of the variance in sexual concerns. This study highlights the relevance of interventions targeting dissociative symptoms to improve identity cohesion and sexual health in male survivors of childhood sexual abuse.

Making a Bad Situation Worse: Current and Potential Unintended Consequences of Juvenile Registration for Sexual Offences.

Within the US, children and adolescents who engage in sexually abusive behavior are often subjected to sex offender registration and notification requirements, which contribute to stigmatization and forfeiture of their civil rights without empirical basis (Lancaster, 2011; Pickett et al., 2023; Zilney & Zilney, 2009). To date, 39 states subject children with adjudicated sexual offenses to sex offender registration requirements, with most recent estimates revealing that approximately 200,000 youth have been placed on sex offender registries within the US and many are now on the registry as adults (Pickett et al., 2020). This severe response-by both members of the public and policymakers-toward children who engage in inappropriate sexual behavior is imposed upon children and adolescents with adjudicated sexual offenses in an effort to meet goals of reducing sexual violence and increasing community safety. Within the current discourse, we review the history of registration and notification practices for adolescents with sexual offenses, describe what registration and notification policies entail, and then present empirical and theoretical evidence of the harmful outcomes associated with implementation of registration and notification requirements for sexual offenses. Thus, the predominant aim of this discourse is to encourage thoughtful and critical examination of registration and notification policies and their iatrogenic impacts.

Global trends and differences in the burden of alcohol use disorders attributable to childhood sexual abuse by sex, age, and socio-demographic index: Findings from the Global Burden of Disease Study 2019.

BACKGROUND: Childhood sexual abuse (CSA) is a severe global problem associated with alcohol use disorder (AUD). Previous studies have confirmed this relationship; however, there is a lack of research on the disease burden of AUD attributable to CSA. OBJECTIVE: To analyze global spatiotemporal trends and differences in the disease burden of AUD attributable to CSA and its relationship with age, sex, and the sociodemographic index (SDI). PARTICIPANTS AND SETTING: Data from the Global Burden of Disease 2019 Public Database. METHODS: Summary exposure value (SEV) was used to evaluate CSA. Disability-adjusted life year (DALY), years lived with disability (YLD), years of life lost (YLL), and their annual rates of change were used to evaluate disease burden. Cluster analysis based on Ward's method was used to examine the global burden associated with age, sex, and SDI. A 95 % uncertainty intervals (UI), excluding 0, was considered statistically significant. RESULTS: In 2019, 1.63 million (95 % UI 0.23-3.90 million) DALYs of AUD were caused by CSA and the age-standardized rates (ASRs) of DALY was 19.77 (95 % UI 2.78-47.46) globally. Annual rates of change in DALY of people over 65 years of age increased from 1990 to 2019 in all regions except the High-middle SDI regions. The ASRs of DALY of females in High SDI regions, were always at a much higher level than other SDI regions, and showed an upward trend from 1990 to 2019 (DALY 1990: 20.38 [95 % UI 2.87-47.77], 2019: 23.61 [95 % UI 3.55-54.94]). CONCLUSIONS: Substantial geographical differences were observed in the burden of AUD attributable to CSA. The level of CSA exposure was inconsistent with the related burden of AUD in different regions according to the sociodemographic index. The burden of disease increased in the elderly population and in females in high sociodemographic index regions.

Why do users continue to contribute to darknet Child Sexual Abuse Material forums? Examining social exchange, social capital, and social learning explanations using digital forensic artifacts.

BACKGROUND: The darknet hosts an increasing number of hidden services dedicated to the distribution of child sexual abuse material (CSAM). Given that by contributing CSAM to the forum members subject themselves to criminal prosecution, questions regarding the motivation for members contributing to darknet CSAM forums arise. OBJECTIVE: Building on insights gained from research into clearnet communities, here we examine the extent to which social incentives generated by the online CSAM community may explain members' posting behavior on darknet CSAM forums. PARTICIPANTS AND SETTING: We analyze digital forensic artifacts on the online behavior of members of a darknet CSAM forum that was shut down by law enforcement agencies in July 2015. METHODS: We apply group-based trajectory modelling (GBTM), social network analysis, and mixed-effect survival models. RESULTS: Applying GBTM three posting trajectories can be distinguished. Social network analyses finds the reply network to be more centralized than predicted by chance. Mixed-effect survival models show positive associations between the length of members' first post and the time since members' first registration on the forum and subsequent posting. Contrarily, the number of replies received appears to mitigate subsequent posting. CONCLUSIONS: Findings show posting activity on the forum to be concentrated in a minority of forum members who show posting trajectories that are both frequent and persistent. Results further suggest persistence in posting is motivated by social identity and, to a lesser extent, differential association processes.

Posttraumatic growth, spiritual damage, and psychosocial and mental health problems in survivors of clergy-perpetrated child sexual abuse: A mixed methods approach.

INTRODUCTION: Although clergy-perpetrated child sexual abuse (CSA) implies severe traumatic repercussions for the victims, they may also experience posttraumatic growth (PTG) deriving from the need to deal with the trauma suffered. This PTG is associated with the processes of recovery, healing, and empowerment. OBJECTIVE: Applying a mixed methods approach to analyse PTG outcomes and to explore experiences of PTG in survivors of Spanish clergy-perpetrated CSA and its relation with psychosocial, mental and spiritual suffering. PARTICIPANTS: Thirty-one survivors (M = 51.6 years; SD = 12.4) in the quantitative stage of the research, and seven (M = 49.3; SD = 8.9) in the qualitative stage. METHODS: A sequential explanatory mixed methods study design was applied using standardized questionnaires and semi-structured interviews. Descriptive, correlation and thematic analyses were conducted. The quantitative and qualitative data were integrated. RESULTS: Positive associations were found between PTG and psychosocial and mental health problems (r = 0.53; p < .01), damage to faith in God (r = 0.43; p < .05) and damage to faith in the Church (r = 0.48; p < .01). Three themes emerged from the qualitative data that explained, expanded, and complemented the quantitative results, highlighting the relationship between damage and growth and the specific meanings of PTG from the perspectives of the survivors. CONCLUSIONS: This study shows that survivors may develop PTG in the course of the processes of psychological suffering, spiritual transformation, and meaning-making of traumatic experiences.

Experiences of child sex trafficking identification among Ontario pediatric emergency department healthcare providers: A qualitative study.

BACKGROUND AND OBJECTIVE: More than 60 % of people exposed to sex trafficking access hospital emergency departments (ED), making the ED a critical setting for child sex trafficking identification. Children exposed to sex trafficking (CEST) do not always recognize that they are being exploited. With many ED leaders confirming that there are no formal processes or assessment tools to screen for human trafficking in EDs, it is especially challenging for healthcare providers to identify CEST. Accordingly, the following study sought to examine healthcare providers' child sex trafficking identification practices in Ontario pediatric EDs. METHODS: We conducted interviews with healthcare providers (N = 12) who work in an Ontario pediatric ED and have provided services to CEST. Thematic analysis and intersectionality theory guided our analytic approach. RESULTS: Participants underscored the key role of Registered Nurses for identifying presentations of child sex trafficking in Ontario pediatric EDs. Although white, feminine presenting youth are the predominantly identified demographic of CEST in Ontario pediatric EDs, healthcare providers also described key intersections between race, poverty, child welfare agency system involvement, and adverse childhood life experiences as factors that heightened vulnerability to child sex trafficking. Common presentations to the ED were for non-specific concerns, injuries, following a sexual assault, or for mental health concerns. Suggested methods for identification varied but were centred around the principles of trauma- and violence-informed care. CONCLUSION: Identifying child sex trafficking in Ontario pediatric EDs is a complex practice, requiring human trafficking training and education for healthcare providers. The interrelated indicators of child sex trafficking, including the sociodemographic and clinical profile of the patient, must be considered jointly, using a trauma- and violence-informed approach.

First, do no harm: Critically revisiting contemporary approaches to child sexual abuse prevention.

Crime prevention is typically presented in a tripartite model that includes primary, secondary, and tertiary domains. Almost every criminal justice intervention constitutes tertiary prevention and occurs reactively, in the aftermath of an offence. Child sexual abuse is no exception, and prevention science has long recommended we focus our intervention efforts further upstream. Such an approach would include earlier detection and disclosure (secondary prevention), or-even better-reducing the risks of early exposure to the environmental forces which facilitate sexual abuse in the first place (primary prevention). What is missing from the field, however, is a coherent framework through which to critique the unintended consequences of our well-intentioned responses to child sexual abuse. Such consequences include secondary trauma for victim survivors and vicarious trauma for families and practitioners. In this article, we reflect on prevention from a critical perspective that centres the principle of "first, do no harm." In doing so, we introduce the notion of 'quaternary prevention' for child sexual abuse. Public health has long recognised the risks of medicalisation, overdiagnosis, and unnecessary intervention. We encourage our field to engage within a framework of quaternary prevention to consider the iatrogenic effects of many contemporary practices and to take seriously the "do no harm" principle to improve practice across all levels of prevention.

Childhood sexual abuse and cholesterol risk: Testing body mass index as a mediator across gender in a national sample of adults.

BACKGROUND: Childhood sexual abuse (CSA) is associated with health problems, including cardiometabolic outcomes. Findings directly linking CSA to cholesterol levels are mixed, and identifying mediating pathways is the next logical step. Body mass index (BMI) is one possible mediator, given its association with both CSA and cardiometabolic outcomes. Gendered effects of CSA indicates that BMI may operate differently in men and women. OBJECTIVE: We tested BMI as a mediator linking CSA to high-density lipoprotein (HDL) and low-density lipoprotein (LDL) using a multiple group structural equation model stratified across gender to test the indirect effects. PARTICIPANTS AND SETTING: We utilized a sample of 1054 adults (54.7 % women) from the study of Midlife Development in the United States, who were drawn from the general population. METHODS: Using two waves of data, participants responded to a questionnaire assessing CSA, provided measurements from which to calculate BMI, and a fasting blood sample from which cholesterol levels were measured. RESULTS: The indirect effects in the overall sample yielded a significant effect from CSA to HDL via BMI (ß = -0.03, 95 % CI [-0.050, -0.010]), but not LDL (ß = 0.006, 95 % CI [-0.002, 0.014]). The indirect effect from CSA to HDL cholesterol was significant among women (ß = -0.04, 95 % CI [-0.066, -0.012]) only. Indirect effects to LDL among both genders were both non-significant. CONCLUSIONS: BMI appears to be a possible mediator linking CSA to lower HDL cholesterol among women suggesting BMI could be a point of trauma-informed prevention and intervention especially impactful.

Hyperbaric oxygen therapy vs. pharmacological intervention in adults with fibromyalgia related to childhood sexual abuse: prospective, randomized clinical trial.

Fibromyalgia syndrome (FMS) is a chronic pain syndrome characterized by disruptions in pain processing within the central nervous system. It exhibits a high prevalence among patients with a history of traumatic experiences, notably childhood sexual abuse (CSA). This study compared the efficacy of hyperbaric oxygen therapy (HBOT) to the current pharmacological standard of care for individuals suffering from CSA-related FMS. Forty-eight participants diagnosed with FMS and a history of CSA were randomly assigned to either the HBOT group (60 sessions of 100% oxygen at 2 ATA for 90 min, with air breaks every 5 min) or the medication (MED) group (FDA-approved medications, Pregabalin and Duloxetine). The primary endpoint was the Fibromyalgia impact questionnaire (FIQ) score, while secondary endpoints encompassed emotional status and daily functioning questionnaires, as well as pain thresholds and conditioned pain modulation tests. Brain activity was evaluated through single photon emission computed tomography (SPECT). Results revealed a significant group-by-time interaction for the FIQ score favoring HBOT over MED (p < 0.001), with a large effect size (Cohen's d = - 1.27). Similar findings were observed in emotional symptoms and functional measures. SPECT imaging demonstrated an increase in activity in pre-frontal and temporal brain areas, which correlated with symptoms improvement. In conclusion, HBOT exhibited superior benefits over medications in terms of physical, functional, and emotional improvements among FMS patients with a history of CSA. This associated with increased activity in pre-frontal and temporal brain areas, highlighting the neuroplasticity effect of HBOT.

Adaptation of the Child sexual abuse myth scale to Turkish culture: A reliability and validity study.

This study aims to analyze the reliability and validity of the Child Sexual Abuse Myth Scale (CSAMS) in Turkish society. This methodological and cross-sectional study was conducted with 334 individuals between the ages 19 to 65. Data were collected through the Personal Information Form and the Child Sexual Abuse Myth Scale. Content Validity Ratio values of the scale items in the study ranged between 0.500 and 1.00, and the Content Validity Index was found to be 0.68. Exploratory Factor Analysis was appropriate based on Kaiser-Meyer-Olkin Measure of Sampling Adequacy (KMO = 0.809) and Barlett's Test of Sphericity (X2 = 1269, p < 0.001). Factor Analysis resulted in 4 sub-scales (Accusation, Causality, Normalization, and Sexist Approach). Item factor loads of the scale were found to range between 0.501 and 0.839, and the total explained variance was 59.4 %. Pearson correlation coefficients of all the items ranged between 0.32 and 0.60, and Cronbach's alpha coefficient was 0.81. Accusation, Normalization, and Sexist Approach sub-scale scores were found to increase with age. Sub-scale scores were found to demonstrate significant differences by gender, marital status, education level, working or not, income level, family type, number of siblings, and number of children (p < 0.05). The findings of this study show that the CSAMS is valid and reliable for Turkish culture in its 14-item and 4 sub-scale form.

A STUDY ON THE INFORMATION TRANSFER AND LONG-TERM PSYCHOLOGICAL IMPACT OF CHILD SEXUAL ABUSE.

Children who experience sexual abuse often face severe challenges in seeking help and disclosing their traumatic experiences. Objectives - to investigate critical aspects of information transfer, help-seeking behavior and the long-term psychological impact of child sexual abuse. This was a pilot study done on 114 victims of child sexual abuse. The study participants filled a semi-structured proforma through social media using Google forms. It was a descriptive cross-sectional study carried out using SPSS (Statistical Package for Social Sciences) version 28. This pilot study on 114 child sexual abuse victims reveals critical insights. Only 15.8% confided in parents, while 37.7% turned to friends. Shockingly, 46.5% kept their ordeal hidden. Disturbingly, only 8.8% sought professional help. The impact on adult life was profound, with 70.2% reporting personal effects. Regrettably, 24.6% resorted to self-harm. Insights on reasons were stark: 63.1% felt defenseless, 23.7% lacked awareness, and 5.3% blamed lax legislation. Encouragingly, 86% actively raised awareness. The study provides a compelling view of child sexual abuse survivors, and emphasizes the need for improved communication within families, accessible support services, and educational initiatives.