Chapter 7 – Sexual Abuse

1. In the 1970s, which was true about publications regarding child sexual abuse?

a. there were no publications b. there were published experiments with good control groups c. some case studies were published d. there were correlational studies

Answer: C

2. Within the United States each state identifies an age at which an individual can consent to sexual conduct. This age is between: a. 13 – 17 years old b. 14 – 18 years old c. 16 – 18 years old d. 16 – 20 years old

Answer: C a. two years b. four years c. five years d. eight years

3. Acts can be considered abusive even when the perpetrator is not over 18. Experts generally state that an age difference of years is sufficient to indicate abuse.

Answer: C

4. Flashing would be considered: a. molestation b. contact abuse c. non-contact abuse d. penetration

Answer: C

5. With regard to the incidence of child sexual abuse, the NIS found a. Significantly lower rates in 2005-6 than in 1993 b. Significantly higher rates in 2005-6 than in 1993 c. The same rates in 2005-6 and 1993 d. Rates of sexual abuse were not measured in 1993, so comparisons cannot be made.

Answer: A a. 1 in 20; 1 in 5 b. 1 in 5; 1 in 10 c. 1 in 10; 1 in 5 d. 1 in 5; 1 in 20

6. The National Center for Victims of Crime estimates that approximately adult women and adult men recall a history of CSA.

Answer: D

7. When comparing the rates of sexual abuse according to retrospective data and according to the NIS a. the rates are nearly identical b. the NIS rates are significantly higher c. the rates from retrospective studies are much higher

Answer: C a. incidence b. prevalence c. both incidence and prevalence d. neither incidence nor prevalence

8. Which term describes the proportion of people in a population who have ever experienced sexual abuse?

Answer: B

10. Williams (1994) interviewed 129 women with a documented history of child sexual abuse. She found a. All of the women disclosed the previous abuse b. 38% of women failed to disclose the abuse c. None of the women reported the past abuse d. The women refused to discuss the abuse even though they clearly recalled the abuse

Answer: B a. acquaintance, friend or family friend b. stranger

12. Which of the following explains the less common relationship between pedophiles and their victims?

Answer: B a. father b. extended family member c. stranger d. acquaintance

13. Which relationship marks the most common perpetrator of sexual abuse?

Answer: D a. 6% b. 14% c. 22% d. 29%

14. Approximately what percentage of sexual abuse perpetrators are under the age of 18 years?

Answer: D

14. The greatest number of sexual abuse perpetrators are between the ages of peak a. 18 and 29-years old b. 28 and 30-years old c. 35 and 45-years old d. 45 and 55-years old

Answer: A a. When the victim is female, most perpetrators are also female b. When the victim is a female, most perpetrators are male c. When victims are male, almost all perpetrators are female d. None of the above are true

15. What did data from the ChildLine study reveal about the sex of victims and perpetrators?

Answer: B a. 10-20% b. 20-40% c. 50-70% d. 80-90%

16. What percentage of identified cases of CSA are female victims?

Answer: D a. they are more likely to be male b. they are more likely to be female c. they are equally likely to be male or female d. they are all female

17. Which of the following is true with regard to reported sexual abuse victims?

Answer: B a. 1% b. 4% c. 10% d. 22% Answer B

19. According to the report by the researchers at John Jay College, approximately what percentage of priests and deacons were guilty of child sexual abuse between 1950 and 2002?

20. According to the report by the researchers at John Jay College, the rates of sexual abuse cases in the Catholic Church were highest in a. 1950s and 1960s b. 1970s and 1980s c. 1990s and 2000s d. abuse was equally high across all decades studied

Answer B

21. According to research by Mercado, Tallon, and Terry (2008) most sexually abusive priests had a. one victim b. two to three victims c. 4 to 9 victims d. 10 or more victims

Answer A a. a large staff b. centers run by multiple members of the same family c. both of the above are risk factors d. neither of these are risk factors

22. According to research by Schumacher and Carlson (1999) which of the following is a risk factor for sexual abuse within a daycare setting?

Answer: B

23. When high school students were asked to identify which, if any, of the teachers was a “letch,” a. nearly all male faculty were listed b. the students said that none of their teachers behaved inappropriately c. the majority of students identified the same teacher d. students were equally likely to name female and male teachers

Answer: C a. 10% b. 25% c. 50% d. 70%

24. A review of known images of child pornography by Cooper (2009) showed that what percentage of images were taken by close relatives or family friends?

Answer: D

25. When Quayle et al. (2018) examined images of child pornography, they found that a. the majority of images were of males b. over 44% of images were self-taken c. images of the youngest children were almost all taken by strangers d. children under 11 were more likely to be in self-taken images than were older children

Answer: B

25. The average age at entrance into sex trafficking is estimated to be a. 10-years-old b. 13-years-old c. 15-years-old d. 18-years-old

Answer: B

26. Roland et al. (1989) found that victims of sexual abuse had the highest (worst) scores on the MMPI if they were a. abused by a stranger b. abused by a father or stepfather c. abused by a family friend d. the relationship with the perpetrator did not determine MMPI scores

Answer: B a. PTSD b. anxiety c. depression d. bulimia

27. Which symptom is the most frequently reported among adult victims of CSA?

Answer: C

28. People who suffer from excessive watchfulness or wariness and who constantly scan their environment for signs of danger are said to be a. depressed b. antisocial c. hypervigilant d. dissociating

Answer: C a. noncontact victims b. molestation victims c. rape victims d. rate of PTSD symptoms does not vary with type of abuse

29. Which types of victims report the highest level of PTSD symptoms?

Answer: C a. Antisocial Personality Disorder b. Borderline Personality Disorder c. Histrionic Personality Disorder d. Narcissistic Personality Disorder

30. Which personality disorder is most strongly associated with a history of child sexual abuse?

Answer: B a. Depression b. PTSD c. Dissociation d. Anxiety

31. is a way for the mind to defend against full awareness of abuse.

Answer: C

32. The ability of the mind to reject unacceptable thoughts, desires, or memories and force them into the unconscious is a. Psychosis b. Depression c. PTSD d. Repression

Answer: D

33. A person’s belief that he or she is capable of doing what is necessary to produce the desired result in a given situation is a. attitude b. attribution c. self-efficacy d. self-esteem

Answer: C a. masturbation b. looking at each other’s genitals c. drawing genitals d. simulating intercourse

34. Which type of sexual behavior is not common among children?

Answer: D

35. Based on a meta-analysis, Rind, Tromovitch, and Bauserman (1998) concluded that a. the effects of childhood sexual abuse are not typically intense or pervasive. b. sexually abused children have significant difficulties functioning in a wide range of domains. c. about half of sexual abuse victims have no problems while the other half have serious problems. d. none of the above

Answer: A a. most children are traumatized by the abuse at the time it is occurring b. most children are not traumatized by the abuse at the time it is occurring c. sexual abuse does not lead to any problems during adulthood d. none of the above

36. What was Clancy’s (2009) main finding about sexual abuse victims?

Answer: B a. less than 5% b. 25% c. 75% d. 100%

37. According to Clancy (2009) what percentage of sexual abuse victims attempted to stop the abuse from happening?

Answer: A a. males and females have dramatically different responses to being sexually abused b. males show more externalizing symptoms following abuse than do girls c. males show more internalizing symptoms following abuse than do girls d. there are no differences between how boys and girls react to sexual abuse

38. Which of the following statements is true?

Answer: B

True/False

1. The sexual abuse of children appears to be a relatively new phenomenon; the product of modern times.

Answer: False

2. All 50 states include sexual abuse in their definitions of child maltreatment.

Answer: True

3. Female perpetrators are as likely to be reported to the authorities as are male perpetrators.

Answer: False

4. In most cases of sexual abuse, the sexual behavior is introduced slowly.

Answer: True

5. Perpetrators of sexual abuse are more likely to use threats than bribes or treats to induce compliance in their victims.

Answer: False

6. Lack of parental supervision increases the risk of child sexual abuse.

Answer: True

7. The majority of Catholic Priests who were guilty of child sexual abuse between 1950 and 2002 had more than 10 victims each.

8. Historically, children who engage in prostitution have been treated as criminals.

Answer: True

9. Adults with a history of child sexual abuse are less compliant than are their non-abused peers.

Answer: False

10. Researchers have established a set of symptoms that are unique to victims of sexual abuse.

Answer: False

11. Victims of childhood sexual abuse are at an increased risk for suicidal ideation.

Answer: True

12. Victims of child sexual abuse are up to five times more likely to be diagnosed with some type of anxiety disorder than are non-victims.

Answer: True

13. It is clear that a history of child sexual abuse significantly increases the risk of developing anorexia in female victims.

Answer: False

14. There is widespread agreement among professionals that people can repress and later accurately recover memories.

Answer: False

15. There is strong evidence that it is possible to create false memories for negative childhood events, even among healthy adults.

Answer: True

16. The FBI has been able to uncover a good deal of evidence supporting claims of satanic sexual abuse.

Answer: False

17. Sexual curiosity and sex play are common among children.

Answer: True

18. Sexual problems related to a history of childhood sexual abuse disappear by early adulthood.

Answer: False

19. Researchers have found more similarities than differences between male and female responses to sexual abuse.

Answer: True

20. Between one quarter and one third of sexual abuse victims do not seem to experience any negative effects from their abuse.

Answer: True

Short Answer Questions

1. Define “child sexual abuse.”

Answer: Child sexual abuse is the involvement of a child in any sexual activity where consent is not or cannot be given.

2. What are the consequences of having a broad definition of CSA?

Answer: A broad definition leads to very high incidence estimates. It also means that a large range of acts are covered by the same term. A broad definition also makes it more difficult to assess effects. Finally, broad definitions do not address the context of the act.

3. Define sexual exploitation.

Answer: use of a child (under the age of 18 years) for the purpose of prostitution or pornography.

4. Provide four reasons why a child might not disclose sexual abuse.

Answer: Any 4 of these: 1. The perpetrator may have threatened the child not to tell;

2. the child may want to protect the perpetrator; 3. The child may fear they will be blamed; 4. The child may lack the necessary language skills; 5. The child may not realize that what is happening is wrong; 6. The child may fear that others will not believe them.

5. What are the possible explanations for the decline in reports of sexual abuse between 1994 and 2001?

Answer: Sexual abuse may have been over-reported in the late 1980s. It might reflect a true decline in abuse. It might be that more stringent definitions were instituted.

6. In the context of child sexual abuse, what is meant by the term “grooming”?

Answer: Grooming is preparing the situation and the child for the abuse. The perpetrator needs to gain the trust of the guardians and the child. They then need to build an exclusive relationship with the child. Finally, the perpetrator slowly introduces sexuality into the relationship.

7. How might a priest or other religious person use their faith to excuse their sexual abuse of children?

Answer: A priest may believe that “As a priest, everything is alright” or that because God called them, knowing their inclinations, it must be alright. Others may argue that God would not allow the abuse if He thought it was bad or that God will protect the children they victimize. Finally, some may think that by doing other good works they will be forgiven for their molestation of children.

8. What was accomplished by the U.S. Trafficking Victim Protection Act?

Answer: In passing this legislation, the federal government recognized trafficking as a form of slavery wherein the children who were forced to perform sexually for money were victims, not criminals. The act also provides substantial penalties for those who use children in this manner.

9. Define hypervigilance and explain how it is related to child sexual abuse.

Answer: Hypervigilance is excessive watchfulness or wariness; constant scanning of the environment for signs of danger. A history of sexual abuse is associated with hypervigilance that, in turn, leads to anxiety.

10. How do recovered memories differ from normal memories?

Answer: The recovered memories tend to be overly detailed, the include memories from very young ages, they are bizarre, and they are not supported by physical evidence.

11. According to Clancy (2009), why does childhood sexual abuse have negative consequences if children are not traumatized by it when it is occurring?

Answer: Dr. Clancy says that as the children grow and learn about sexuality, they realize that what happened to them was sexual abuse and that it was terribly wrong. These teenagers and young adults then suffer from the betrayal they only now understand. They feel manipulated and gullible. Furthermore, because child sexual abuse is "supposed to be traumatic" they think there is something wrong with them for the way they reacted. They don't understand why they did not fight the abuse or why there were aspects of the encounters they enjoyed. They suffer from a great deal of self-blame and guilt for not fighting or trying to get help; they feel ashamed.

Additional Case Studies for Chapter 7

1. Bryn Ostrager outlines a three tiered response to teen sexting. He then presents three case studies and guides the ready to apply the three-tiered system to each case. In addition to discussing the cases, students can talk about the three-tiered system.

Ostrager, B. (2010). SMS. OMG! TTYL: Translating the law to accommodate today’s teens and the evolution from texting to sexting. Family Court Review, 48 (4), 712-726. https://doi.org/10.1111/j.1744-1617.2010.01345.x

2. The web site, Creating Safer Havens links to articles many articles on recent sexual abuse cases. The cases are categorized as: church, teacher, coaches, daycare, pediatrician/therapist, and other. They can be found at http://creatingsaferhavens.com/. Click on the link “Child Sexual Abuse Cases.”

3. This web link is to case studies of two people, Margaret and Rob who survived child sexual abuse and thrived and to the case of Mike who sexually abused his step-daughter (5 pages long). https://www.cascw.org/wpcontent/uploads/2013/12/Select-Illustrative-Case-Studies.pdf

4. This article provides research on the public response to the case of pediatrician who victimized children.

Abstract: https://doi.org/10.1016/j.childyouth.2013.12.005

Popular discourse provides a window into predominant social beliefs. To assess predominant beliefs about child sexual abuse, this exploratory, descriptive study examines the discourse surrounding a high-profile child abuse case that involved over 100 victims and culminated in the arrest of a well-known Delaware pediatrician in 2009. The Dr. Earl Bradley case, dominated local news media for more than a year. Online comments from the state's primary newspaper were collected and analyzed to identify themes. Coding analysis found that popular discourse overwhelmingly explained the abuse as the fault of the victims' parents, putatively, the mothers. Commenters engaged in direct blaming of parents, thus, at least to some extent, shifting blame from the offender and the institutional systems that failed to adequately react to the allegations of abuse to the victims' parents. Newspaper comments also demonstrated social distancing which, in addition to the comments attributing blame to the parents, served to excuse and distract from the responsibility of authority figs. or structural change. Although comments that defended parents did appear, these instances were far less frequent than comments blaming the parents, which illustrates a trend to individualize rather than activate collective challenges, therefore putting the onus on victims to police the powerful. Overall, institutional malfeasance eclipsed the well-being of children, and public commentary displayed an implicitly gendered parent-bashing, diminishing the responsibility of the professionals.

Miller, S. L., Hefner, M. K., and Leon, C. S. (2014). Diffusing responsibility: A case study of child sexual abuse in popular discourse. Children and Youth Services Review, 37, 55-63.

5. Children & Family Health posted a brief case study of a 12 year old girl who was sexually abused by a family friend. They note what problems the child was having and what was done to help her. Written at a level that is appropriate for a child. Discuss what impact this information might have on child victims. Would it be helpful? https://childrenandfamilyhealthdevon.nhs.uk/camhs/case-studies/childsexual-abuse-case-study/ file:///C:/Users/Jud/Downloads/ijerph-15-00094-v2.pdf https://www.parliament.scot/S4_PublicPetitionsCommittee/Inquiries/CSE__Barnardos_Scotland_22.11.13.pdf

6. This 2018 case study presents the physical consequences of CSA and the failure of the medical community to provide appropriate services. The information is based on 7 interviews with a female victim of severe CSA.

Abstract: Stressful early life experiences cause immune dysregulation across the lifespan. Despite the fact that studies have identified childhood sexual abuse (CSA) survivors as a particularly vulnerable group, only a few attempts have been made to study their lived-experience of the physical health consequences of CSA. The aim of this study was to explore a female CSA survivor’s lived-experience of the physical health consequences of CSA and how she experienced the reactions of healthcare providers. Seven interviews were conducted with this 40-year-old woman, Anne, using a phenomenological research approach. Anne was still a young child (two to three years old) when her father started to rape her. Since her childhood, she has experienced complex and widespread physical health consequences such as repeated vaginal and abdominal infections, widespread and chronic pain, sleeping problems, digestive problems, chronic back problems, fibromyalgia, musculoskeletal problems, repeated urinary tract infections, cervical dysplasia, inflammation of the Fallopian tubes, menorrhagia, endometrial hyperplasia, chlamydia, ovarian cysts, ectopic pregnancies, uterus problems, severe adhesions, and ovarian cancer. Anne disclosed her CSA experience to several healthcare providers but they were silent and failed to provide traumainformed care. Anne’s situation, albeit unique, might reflect similar problems in other female CSA survivors.

7. This web link lists 11 case studies of children involved in child sexual abuse including online grooming, gangs, peer pressure, running away, and trafficking. Each case study is 1 or 2 pages long.

Video Suggestions

1. Law and Order: Special Victims Unit Season 13, episode 2 is entitled “Personal Foul.” It deals with allegations of sexual abuse against a famous basketball coach. It originally aired on Sept. 28, 2011. It will certainly spark discussion of the recent Penn State case. The episode is available from Amazon.com for $2.99.

2. Boys and Men Healing from Childhood Sexual Abuse is a Big Voice Pictures Production. It is available from $9.99 from https://gumroad.com/l/boysandmenhealing

From their website: http://www.youtube.com/watch?v=S1fugttyvZk http://www.youtube.com/watch?v=63a-rU0DbOI http://www.youtube.com/watch?v=nxOUMbj8Egw http://www.youtube.com/watch?v=JsEOInE2NZE

Boys and Men Healing is a documentary about the impact male child sexual abuse has on both the individual and society, and the importance of male survivors healing and speaking out for the well being of individuals, families, and communities. This film digs deep into the effects of boyhood sexual abuse shame, intimacy problems, sexual identity confusion, post-traumatic stress, depression, substance abuse, the cycle of violence and anger that plagued their lives yet each man ultimately chose the arduous task of healing. Through counseling and support groups and taking action toward the prevention of other boys, each man is a testimony of hope and the ability for survivors to thrive. The film bursts forth with beauty and celebration of men’s emotions and voices too long veiled under masculinity stereotypes and silence. NOTE: *Viewing films are for personal use and for in-house, non-fee based training use only. For fee-based and public trainings, contact copyright holder, Big Voice Pictures, for educational and public performance licensing.Email kathy@bigvoicepictures.com for licensing info.)

3. This 4:48 minute video clip is available on youtube. It is entitled Brian on the Oprah Show and it was uploaded November 18, 2010. The clip deals with the impact of child sexual abuse on male victims.

4. This 3:18 minute video clip is available on youtube. Dr. Phyllis Gee appears on the show Crimes Against Kids Eliminated to discuss the symptoms and signs of child sexual abuse. The clip was uploaded on Oct. 19, 2010.

5. This 2:13 minute video clip is available on youtube. Erin Merryn, a victim of sexual abuse and the author of Stolen Innocence and Living for Today is profiled on the Oprah Winfrey Show.

6. This 1:53 minute video clip is available on youtube. The clip was produced by NY Daily News and is entitled Third Child Sexual Abuse Claim Made Against Elmo Puppeteer. The video was uploaded Nov. 27, 2012 and would be good for discussions about grooming victims.

7. This 3:38 minute video is available on youtube. The video is produced by a college station, TYT University for Rust College. The clip is entitled Sexual Assault by “Teacher of the Year?” and was aired on Oct. 31, 2012. While the production is not overly professional, it does show college students grappling with allegations that a well-respected professor raped a student who came to him for counseling about financial aid. http://www.youtube.com/watch?v=XdiO7c2NbQU https://www.youtube.com/watch?v=vnk0QC1BPOs The video was posted on July 25, 2019.

8. This 23 minute WRAL documentary, The Horrors of Child Sexual Assault and Abuse – “Speaking the Unspeakable,’ tells the stories of two male survivors.

9. This 28 minute PBS documentary aired on 4-24-2012. It is titled Out of Darkness, Into Light: Child Sexual Abuse. It tells the story of 3 adult survivors of CSA.

Discussion Topics

1. Singer, Hussy, and Strom (1992) present a letter written by a middle-aged man to teenaged boy. The letter was an attempt to groom/seduce the boy. The authors analyze the letter in light of the literature on grooming victims.

Singer, M. I., Hussey, D., & Strom, K. J. (1992). Grooming the victim: An analysis of a perpetrator’s seduction letter. Child Abuse & Neglect, 16, 877-886.

https://doi.org/10.1016/0145-2134(92)90089-A

2. Have students look up their state’s definition of child sexual abuse. What do they like and dislike about the definition presented? What wording would they suggest to define sexual abuse?

3. The chapter does not deal extensively with child exploitation/pornography/prostitution because these crimes are most often perpetrated outside of the family. However, students might be interested in researching these topics and presenting their findings to the class.

4. Have students discuss what they will do to protect their current or future children from becoming the victims of sexual abuse.

5. Clancy’s claim that child sexual abuse is not usually traumatic is very controversial. Have students discuss the pros and cons of thinking about sexual abuse as not being traumatic when it occurs.