Child sexual abuse
Child sexual abuse, also called child molestation, is a form of child abuse in which an adult or older adolescent uses a child for sexual stimulation. Forms of child sexual abuse include engaging in sexual activities with a child (whether by asking or pressuring, or by other means), indecent exposure (of the genitals, female nipples, etc.), child grooming, and child sexual exploitation, including using a child to produce child pornography.
Child sexual abuse can occur in a variety of settings, including home, school, or work (in places where child labor is common). Child marriage is one of the main forms of child sexual abuse; UNICEF has stated that child marriage "represents perhaps the most prevalent form of sexual abuse and exploitation of girls". The effects of child sexual abuse can include depression, post-traumatic stress disorder, anxiety, complex post-traumatic stress disorder, propensity to further victimization in adulthood, and physical injury to the child, among other problems. Sexual abuse by a family member is a form of incest and can result in more serious and long-term psychological trauma, especially in the case of parental incest.
The global prevalence of child sexual abuse has been estimated at 19.7% for females and 7.9% for males. Most sexual abuse offenders are acquainted with their victims; approximately 30% are relatives of the child, most often brothers, fathers, uncles, or cousins; around 60% are other acquaintances, such as "friends" of the family, babysitters, or neighbors; strangers are the offenders in approximately 10% of child sexual abuse cases. Most child sexual abuse is committed by men; studies on female child molesters show that women commit 14% to 40% of offenses reported against boys and 6% of offenses reported against girls.
The word pedophile is commonly applied indiscriminately to anyone who sexually abuses a child, but child sexual offenders are not pedophiles unless they have a strong sexual interest in prepubescent children. Under the law, child sexual abuse is often used as an umbrella term describing criminal and civil offenses in which an adult engages in sexual activity with a minor or exploits a minor for the purpose of sexual gratification. The American Psychological Association states that "children cannot consent to sexual activity with adults", and condemns any such action by an adult: "An adult who engages in sexual activity with a child is performing a criminal and immoral act which never can be considered normal or socially acceptable behavior."
Child sexual abuse can result in both short-term and long-term harm, including psychopathology in later life. Indicators and effects include depression, anxiety, eating disorders, poor self-esteem, somatization, sleep disturbances, and dissociative and anxiety disorders including post-traumatic stress disorder. While children may exhibit regressive behaviours such as thumb sucking or bedwetting, the strongest indicator of sexual abuse is sexual acting out and inappropriate sexual knowledge and interest. Victims may withdraw from school and social activities and exhibit various learning and behavioural problems including cruelty to animals, attention deficit/hyperactivity disorder (ADHD), conduct disorder, and oppositional defiant disorder (ODD). Teenage pregnancy and risky sexual behaviors may appear in adolescence. Child sexual abuse victims report almost four times as many incidences of self-inflicted harm.
A well-documented, long-term negative effect is repeated or additional victimization in adolescence and adulthood. A causal relationship has been found between childhood sexual abuse and various adult psychopathologies, including crime and suicide, in addition to alcoholism and drug abuse. Males who were sexually abused as children more frequently appear in the criminal justice system than in a clinical mental health setting. A study comparing middle-aged women who were abused as children with non-abused counterparts found significantly higher health care costs for the former. Intergenerational effects have been noted, with the children of victims of child sexual abuse exhibiting more conduct problems, peer problems, and emotional problems than their peers.
Studies have found that 51% to 79% of sexually abused children exhibit psychological symptoms. The risk of harm is greater if the abuser is a relative, if the abuse involves intercourse or attempted intercourse, or if threats or force are used. The level of harm may also be affected by various factors such as penetration, duration and frequency of abuse, and use of force. The social stigma of child sexual abuse may compound the psychological harm to children, and adverse outcomes are less likely for abused children who have supportive family environments.
Posttraumatic stress disorder
Child abuse, including sexual abuse, especially chronic abuse starting at early ages, has been found to be related to the development of high levels of dissociative symptoms, which includes amnesia for abuse memories. When severe sexual abuse (penetration, several perpetrators, lasting more than one year) had occurred, dissociative symptoms were even more prominent. Recent research showed that females with high exposure to child sexual abuse (CSA) suffer PTSD symptoms that are associated with poor social functioning, which is also supported by prior research studies. The feeling of being “cut-off” from peers and “emotional numbness” are both results of CSA and highly inhibit proper social functioning. Furthermore, PTSD is associated with higher risk of substance abuse as a result of the “self-medication hypothesis” and the “high-risk and susceptibility hypothesis." Prolonged exposure therapy (PE) was found to decrease PTSD and depressive symptoms in female methadone using CSA survivors.
Besides dissociative identity disorder (DID), posttraumatic stress disorder (PTSD), and complex post-traumatic stress disorder (C-PTSD), child sexual abuse survivors may present borderline personality disorder (BPD) and eating disorders such as bulimia nervosa.
Because child sexual abuse often occurs alongside other possibly confounding variables, such as poor family environment and physical abuse, some scholars argue it is important to control for those variables in studies which measure the effects of sexual abuse. In a 1998 review of related literature, Martin and Fleming state "The hypothesis advanced in this paper is that, in most cases, the fundamental damage inflicted by child sexual abuse is due to the child's developing capacities for trust, intimacy, agency and sexuality, and that many of the mental health problems of adult life associated with histories of child sexual abuse are second-order effects." Other studies have found an independent association of child sexual abuse with adverse psychological outcomes.
Kendler et al. (2000) found that most of the relationship between severe forms of child sexual abuse and adult psychopathology in their sample could not be explained by family discord, because the effect size of this association decreased only slightly after they controlled for possible confounding variables. Their examination of a small sample of CSA-discordant twins also supported a causal link between child sexual abuse and adult psychopathology; the CSA-exposed subjects had a consistently higher risk for psychopathologic disorders than their CSA non-exposed twins.
A 1998 meta-analysis by Bruce Rind et al. generated controversy by suggesting that child sexual abuse does not always cause pervasive harm, that girls were more likely to be psychologically harmed than boys, that some college students reported such encounters as positive experiences and that the extent of psychological damage depends on whether or not the child described the encounter as "consensual." The study was criticized for flawed methodology and conclusions. The US Congress condemned the study for its conclusions and for providing material used by pedophile organizations to justify their activities.
Depending on the age and size of the child, and the degree of force used, child sexual abuse may cause internal lacerations and bleeding. In severe cases, damage to internal organs may occur, which, in some cases, may cause death.
Child sexual abuse may cause infections and sexually transmitted diseases. Due to a lack of sufficient vaginal fluid, chances of infections can heighten depending on the age and size of the child. Vaginitis has also been reported.
Research has shown that traumatic stress, including stress caused by sexual abuse, causes notable changes in brain functioning and development. Various studies have suggested that severe child sexual abuse may have a deleterious effect on brain development. Ito et al. (1998) found "reversed hemispheric asymmetry and greater left hemisphere coherence in abused subjects;" Teicher et al. (1993) found that an increased likelihood of "ictal temporal lobe epilepsy-like symptoms" in abused subjects; Anderson et al. (2002) recorded abnormal transverse relaxation time in the cerebellar vermis of adults sexually abused in childhood; Teicher et al. (1993) found that child sexual abuse was associated with a reduced corpus callosum area; various studies have found an association of reduced volume of the left hippocampus with child sexual abuse; and Ito et al. (1993) found increased electrophysiological abnormalities in sexually abused children.
Some studies indicate that sexual or physical abuse in children can lead to the overexcitation of an undeveloped limbic system. Teicher et al. (1993) used the "Limbic System Checklist-33" to measure ictal temporal lobe epilepsy-like symptoms in 253 adults. Reports of child sexual abuse were associated with a 49% increase to LSCL-33 scores, 11% higher than the associated increase of self-reported physical abuse. Reports of both physical and sexual abuse were associated with a 113% increase. Male and female victims were similarly affected.
Navalta et al. (2006) found that the self-reported math Scholastic Aptitude Test scores of their sample of women with a history of repeated child sexual abuse were significantly lower than the self-reported math SAT scores of their non-abused sample. Because the abused subjects' verbal SAT scores were high, they hypothesized that the low math SAT scores could "stem from a defect in hemispheric integration." They also found a strong association between short-term memory impairments for all categories tested (verbal, visual, and global) and the duration of the abuse.
Incest between a child or adolescent and a related adult is known as child incestuous abuse, and has been identified as the most widespread form of child sexual abuse with a highly significant capacity to damage the young person. One researcher stated that more than 70% of abusers are immediate family members or someone very close to the family. Another researcher stated that about 30% of all perpetrators of sexual abuse are related to their victim, 60% of the perpetrators are family acquaintances, like a neighbor, babysitter or friend and 10% of the perpetrators in child sexual abuse cases are strangers. A child sexual abuse offense where the perpetrator is related to the child, either by blood or marriage, is a form of incest described as intrafamilial child sexual abuse.
The most-often reported form of incest is father–daughter and stepfather–daughter incest, with most of the remaining reports consisting of mother/stepmother–daughter/son incest. Father–son incest is reported less often; however, it is not known if the actual prevalence is less or it is under-reported by a greater margin. Similarly, some argue that sibling incest may be as common, or more common, than other types of incest: Goldman and Goldman reported that 57% of incest involved siblings; Finkelhor reported that over 90% of nuclear family incest involved siblings; while Cawson et al. show that sibling incest was reported twice as often as incest perpetrated by fathers/stepfathers.
Prevalence of parental child sexual abuse is difficult to assess due to secrecy and privacy; some estimates state that 20 million Americans have been victimized by parental incest as children.
Child sexual abuse includes a variety of sexual offenses, including:
- sexual assault – a term defining offenses in which an adult uses a minor for the purpose of sexual gratification; for example, rape (including sodomy), and sexual penetration with an object. Most U.S. states include, in their definitions of sexual assault, any penetrative contact of a minor's body, however slight, if the contact is performed for the purpose of sexual gratification.
- sexual exploitation – a term defining offenses in which an adult victimizes a minor for advancement, sexual gratification, or profit; for example, prostituting a child, live streaming sexual abuse, and creating or trafficking in child pornography.
- sexual grooming – a term defining the social conduct of a potential child sex offender who seeks to make a minor more accepting of their advances, for example in an online chat room.
Commercial sexual exploitation
Commercial sexual exploitation of children (CSEC) is defined by the Declaration of the First World Congress against Commercial Sexual Exploitation of Children, held in Stockholm in 1996, as "sexual abuse by an adult accompanied by remuneration in cash or in kind to the child or third person(s)." CSEC usually takes the form of child prostitution or child pornography, and is often facilitated by child sex tourism. CSEC is particularly a problem in developing countries of Asia. In recent years, new innovations in technology have facilitated the trade of Internet child pornography.
In the United Kingdom, the term child sexual exploitation covers any form of sexual abuse which includes an exchange of a resource for sexual activity with a child. Prior to 2009, the term commonly used to describe child sexual exploitation was child prostitution. The term child sexual exploitation first appeared in government guidance in 2009 as part of an attempt to promote an understanding that children involved in exploitation were victims of abuse rather than criminals. Because early definitions of child sexual exploitation were created to foster a move away from use of the term child prostitution, the concept of exchange, which made child sexual exploitation different from child sexual abuse, referred to financial gain only. However, in the years since the birth of the concept of child sexual exploitation, the notion of exchange has been widened to include other types of gain, including love, acquisition of status and protection from harm.
Children who received supportive responses following disclosure had less traumatic symptoms and were abused for a shorter period of time than children who did not receive support. In general, studies have found that children need support and stress-reducing resources after disclosure of sexual abuse. Negative social reactions to disclosure have been found to be harmful to the survivor's well-being. One study reported that children who received a bad reaction from the first person they told, especially if the person was a close family member, had worse scores as adults on general trauma symptoms, post traumatic stress disorder symptoms, and dissociation. Another study found that in most cases when children did disclose abuse, the person they talked to did not respond effectively, blamed or rejected the child, and took little or no action to stop the abuse. Non-validating and otherwise non-supportive responses to disclosure by the child's primary attachment figure may indicate a relational disturbance predating the sexual abuse that may have been a risk factor for the abuse, and which can remain a risk factor for its psychological consequences.
The American Academy of Child and Adolescent Psychiatry provides guidelines for what to say to the victim and what to do following the disclosure. Asa Don Brown has indicated: "A minimization of the trauma and its effects is commonly injected into the picture by parental caregivers to shelter and calm the child. It has been commonly assumed that focusing on children’s issues too long will negatively impact their recovery. Therefore, the parental caregiver teaches the child to mask his or her issues."
In many jurisdictions, abuse that is suspected, not necessarily proven, requires reporting to child protection agencies, such as the Child Protection Services in the United States. Recommendations for healthcare workers, such as primary care providers and nurses, who are often suited to encounter suspected abuse are advised to firstly determine the child's immediate need for safety. A private environment away from suspected abusers is desired for interviewing and examining. Leading statements that can distort the story are avoided. As disclosing abuse can be distressing and sometimes even shameful, reassuring the child that he or she has done the right thing by telling and that they are not bad and that the abuse was not their fault helps in disclosing more information. Anatomically correct dolls are sometimes used to help explain what happened, although some researchers consider the dolls too explicit and overstimulating, which might contribute to non-abused children behaving with the dolls in one or more ways that suggest they were sexually abused. For the suspected abusers, it is also recommended to use a nonjudgmental, nonthreatening attitude towards them and to withhold expressing shock, in order to help disclose information.
The initial approach to treating a person who has been a victim of sexual abuse is dependent upon several important factors:
- Age at the time of presentation
- Circumstances of presentation for treatment
- Co-morbid conditions
The goal of treatment is not only to treat current mental health issues, and trauma related symptoms, but also to prevent future ones.
Children and adolescents
Children often present for treatment in one of several circumstances, including criminal investigations, custody battles, problematic behaviors, and referrals from child welfare agencies.
The three major modalities for therapy with children and adolescents are family therapy, group therapy, and individual therapy. Which course is used depends on a variety of factors that must be assessed on a case-by-case basis. For instance, treatment of young children generally requires strong parental involvement and can benefit from family therapy. Adolescents tend to be more independent; they can benefit from individual or group therapy. The modality also shifts during the course of treatment; for example, group therapy is rarely used in the initial stages, as the subject matter is very personal and/or embarrassing. In a 2012 systematic review, cognitive behavior therapy showed potential in treating the adverse consequences of child sexual abuse.
Major factors that affect both the pathology and response to treatment include the type and severity of the sexual act, its frequency, the age at which it occurred, and the child's family of origin. Roland C. Summit, a medical doctor, defined the different stages the victims of child sexual abuse go through, called child sexual abuse accommodation syndrome. He suggested that children who are victims of sexual abuse display a range of symptoms that include secrecy, helplessness, entrapment, accommodation, delayed and conflicted disclosure and recantation.
Adults who have been sexually abused as children often present for treatment with a secondary mental health issue, which can include substance abuse, eating disorders, personality disorders, depression, and conflict in romantic or interpersonal relationships.
Generally, the approach is to focus on the present problem, rather than the abuse itself. Treatment is highly varied and depends on the person's specific issues. For instance, a person with a history of sexual abuse suffering from severe depression would be treated for depression. However, there is often an emphasis on cognitive restructuring due to the deep-seated nature of the trauma. Some newer techniques such as eye movement desensitization and reprocessing (EMDR) have been shown to be effective.
Although there is no known cure for pedophilia, there are a number of treatments for pedophiles and child sexual abusers. Some of the treatments focus on attempting to change the sexual preference of pedophiles, while others focus on keeping pedophiles from committing child sexual abuse, or on keeping child sexual abusers from committing child sexual abuse again. Cognitive behavioral therapy (CBT), for example, aims to reduce attitudes, beliefs, and behaviors that may increase the likelihood of sexual offenses against children. Its content varies widely between therapists, but a typical program might involve training in self-control, social competence and empathy, and use cognitive restructuring to change views on sex with children. The most common form of this therapy is relapse prevention, where the patient is taught to identify and respond to potentially risky situations based on principles used for treating addictions.
The evidence for cognitive behavioral therapy is mixed. A 2012 Cochrane Review of randomized trials found that CBT had no effect on risk of reoffending for contact sex offenders. Meta-analyses in 2002 and 2005, which included both randomized and non-randomized studies, concluded that CBT reduced recidivism. There is debate over whether non-randomized studies should be considered informative. More research is needed.
Sexual abuse is associated with many sub-clinical behavioral issues as well, including re-victimization in the teenage years, a bipolar-like switching between sexual compulsion and shut-down, and distorted thinking on the subject of sexual abuse (for instance, that it is common and happens to everyone). When first presenting for treatment, the patient can be fully aware of their abuse as an event, but their appraisal of it is often distorted, such as believing that the event was unremarkable (a form of isolation). Frequently, victims do not make the connection between their abuse and their present pathology.
Child sexual abuse prevention programmes were developed in the United States of America during the 1970s. Some programme are delivered to children and can include one-to-one work and group work. Programmes delivered to parents were developed in the 1980s and took the form of one-off meetings, two to three hours long. In the last 15 years, web-based programmes have been developed. School-based education programs were evaluated in 2015 by Cochrane that demonstrated improvements in protective behaviors and knowledge among children.
Offenders are more likely to be relatives or acquaintances of their victim than strangers. A 2006–07 Idaho study of 430 cases found that 82% of juvenile sex offenders were known to the victims (acquaintances 46% or relatives 36%).
More offenders are male than female, though the percentage varies between studies. The percentage of incidents of sexual abuse by female perpetrators that come to the attention of the legal system is usually reported to be between 1% and 4%. Studies of sexual misconduct in US schools with female offenders have shown mixed results with rates between 4% to 43% of female offenders. Maletzky (1993) found that, of his sample of 4,402 convicted child sex offenders, 0.4% were female.
According to research conducted in Australia by Kelly Richards on child sexual abuse, 35.1% of female victims were abused by another male relative and 16.4% of male victims were abused by another male relatives. Male relatives were found to be the most relevant predators in the case of both gender.
In U.S. schools, educators who offend range in age from "21 to 75 years old, with an average age of 28".
According to C.E. Dettmeijer-Vermeulen, Dutch national spokeswoman on human traffic and sexual violence against children, in the Netherlands, 3% of the convicted perpetrators are women, 14.58% of the victims are boys and "most victims were abused by a family member, friend or acquaintance." One in six perpetrators are underage.
Early research in the 1970s and 1980s began to classify offenders based on their motivations and traits. Groth and Birnbaum (1978) categorized child sexual offenders into two groups, "fixated" and "regressed". Fixated were described as having a primary attraction to children, whereas regressed had largely maintained relationships with other adults, and were even married. This study also showed that adult sexual orientation was not related to the sex of the victim targeted, e.g. men who molested boys often had adult relationships with women.
Later work (Holmes and Holmes, 2002) expanded on the types of offenders and their psychological profiles. They are divided as follows:
- Situational – does not prefer children, but offend under certain conditions.
- Regressed – Typically has relationships with adults, but a stressor causes them to seek children as a substitute.
- Morally Indiscriminate – All-around sexual deviant, who may commit other sexual offenses unrelated to children.
- Naive/Inadequate – Often mentally disabled in some way, finds children less threatening.
- Preferential – has true sexual interest in children.
- Mysoped – Sadistic and violent, target strangers more often than acquaintances.
- Fixated – Little or no activity with own age, described as an "overgrown child".
Causal factors of child sex offenders are not known conclusively. The experience of sexual abuse as a child was previously thought to be a strong risk factor, but research does not show a causal relationship, as the vast majority of sexually abused children do not grow up to be adult offenders, nor do the majority of adult offenders report childhood sexual abuse. The US Government Accountability Office concluded, "the existence of a cycle of sexual abuse was not established." Before 1996, there was greater belief in the theory of a "cycle of violence", because most of the research done was retrospective—abusers were asked if they had experienced past abuse. Even the majority of studies found that most adult sex offenders said they had not been sexually abused during childhood, but studies varied in terms of their estimates of the percentage of such offenders who had been abused, from 0 to 79 percent. More recent prospective longitudinal research—studying children with documented cases of sexual abuse over time to determine what percentage become adult offenders—has demonstrated that the cycle of violence theory is not an adequate explanation for why people molest children.
Pedophilia is a condition in which an adult or older adolescent is primarily or exclusively attracted to prepubescent children, whether the attraction is acted upon or not. A person with this attraction is called a pedophile.
In law enforcement, the term pedophile is sometimes used to describe those accused or convicted of child sexual abuse under sociolegal definitions of child (including both prepubescent children and adolescents younger than the local age of consent); however, not all child sexual offenders are pedophiles and not all pedophiles engage in sexual abuse of children. For these reasons, researchers recommend against imprecisely describing all child molesters as pedophiles.
The term pedocriminality (De: Pädokriminalität; Fr: pédocriminalité) is a controversial term which originated in the 1980s and has been used by organisations such as UNICEF, UNHRC, the World Health Organization and the Council of Europe to refer to child sexual abuse and sexual violence used against children, child prostitution, child trafficking and the use of child pornography. The term "cyber-pedocriminality" has been used to refer to the activities of viewers of child pornography online.
Recidivism rates for sex offenders are lower than for the general criminal population. Estimated rates among child sex offenders vary. One study found that 42% of offenders re-offended (either a sex crime, violent crime, or both) after they were released. Risk for re-offense was highest in the first 6 years after release, but continued to be significant even 10–31 years later, with 23% offending during this time. A study done in California in 1965 found an 18.2% recidivism rate for offenders targeting the opposite sex and a 34.5% recidivism rate for same-sex offenders after 5 years.
Because recidivism is defined and measured differently from study to study, one can arrive at inaccurate conclusions being made based on comparison of two or more studies that are not conducted with similar methodology.
When a prepubescent child is sexually abused by one or more other children or adolescent youths, and no adult is directly involved, it is defined as child-on-child sexual abuse. The definition includes any sexual activity between children that occurs without consent, without equality, or due to coercion, whether the offender uses physical force, threats, trickery or emotional manipulation to compel cooperation. When sexual abuse is perpetrated by one sibling upon another, it is known as "intersibling abuse", a form of incest.
Unlike research on adult offenders, a strong causal relationship has been established between child and adolescent offenders and these offenders' own prior victimization, by either adults or other children.
According to a 2010 UNICEF report, 46% of Congolese schoolgirls confirmed that they had been victims of sexual harassment, abuse, and violence committed by their teachers or other school personnel. In Mozambique, a study by the Ministry of Education found that 70 percent of female respondents reported knowing teachers who use sexual intercourse as a necessary condition to advance students to the next grade. A survey by Promundo found that 16% of girls in North Kivu said they had been forced to have sex with their teachers. According to UNICEF, teachers in Mali are known to use "La menace du bic rouge" ("the threat of the red pen") or bad marks if girls do not accept sexual advances. According to Plan International, 16% of children in Togo, for instance, named a teacher as responsible for the pregnancy of a classmate.
Based on self-disclosure data, a 2011 meta-analysis of 217 studies estimated a global prevalence of 12.7%–18% for girls and 7.6% for boys. The rates of self-disclosed abuse for specific continents were as follows:
A 2009 meta-analysis of 65 studies from 22 countries found a global prevalence of 19.7% for females and 7.9% for males. In that analysis, Africa had the highest prevalence rate of child sexual abuse (34.4%), primarily because of high rates in South Africa; Europe showed the lowest prevalence rate (9.2%); and America and Asia had prevalence rates between 10.1% and 23.9%.
A ten-country school-based study in southern Africa in 2007 found 19.6% of female students and 21.1% of male students aged 11–16 years reported they had experienced forced or coerced sex. Rates among 16-year-olds were 28.8% in females and 25.4% in males. Comparing the same schools in eight countries between 2003 and 2007, age-standardised on the 2007 Botswana male sample, there was no significant decrease between 2003 and 2007 among females in any country and inconsistent changes among males.
The prevalence of child sexual abuse in Africa is compounded by the virgin cleansing myth that sexual intercourse with a virgin will cure a man of HIV or AIDS. The myth is prevalent in South Africa, Zimbabwe, Zambia and Nigeria and is being blamed for the high rate of sexual abuse against young children.
Child rape is on the rise[when?] in the war-ravaged eastern Democratic Republic of the Congo. Aid workers blame combatants on all sides, who operate with much impunity, for a culture of sexual violence. South Africa has some of the highest incidences of child rape (including the rape of babies) in the world (also see sexual violence in South Africa). A survey by CIET found around 11% of boys and 4% of girls admitted to forcing someone else to have sex with them. In a related survey conducted among 1,500 schoolchildren, a quarter of all the boys interviewed said that "jackrolling", a term for gang rape, was fun. More than 67,000 cases of rape and sexual assaults against children were reported in 2000 in South Africa, compared to 37,500 in 1998. Child welfare groups believe that the number of unreported incidents could be up to 10 times that number. The largest increase in attacks was against children under seven. The virgin cleansing myth is especially common in South Africa, which has the highest number of HIV-positive citizens in the world. Eastern Cape social worker Edith Kriel notes that "child abusers are often relatives of their victims – even their fathers and providers."
A number of high-profile baby rapes appeared since 2001 (including the fact that they required extensive reconstructive surgery to rebuild urinary, genital, abdominal, or tracheal systems). In 2001, a 9-month-old was raped and likely lost consciousness as the pain was too much to bear. In February 2002, an 8-month-old infant was reportedly gang-raped by four men. One has been charged. The infant has required extensive reconstructive surgery. The 8-month-old infant's injuries were so extensive, increased attention on prosecution has occurred.
In Bangladesh, child prostitutes are known to take the drug Oradexon, an over-the-counter steroid, usually used by farmers to fatten cattle, to make child prostitutes look larger and older. Charities say that 90% of prostitutes in the country's legalized brothels use the drug. According to social activists, the steroid can cause diabetes and high blood pressure and is highly addictive.
In 2007, the Ministry of Women and Child Development published the "Study on Child Abuse: India 2007." It sampled 12447 children, 2324 young adults and 2449 stakeholders across 13 states. It looked at different forms of child abuse: physical abuse, sexual abuse and emotional abuse and girl child neglect in five evidence groups, namely, children in a family environment, children in school, children at work, children on the street and children in institutions. The study's main findings included: 53.22% of children reported having faced sexual abuse. Among them, 52.94% were boys and 47.06% girls. Andhra Pradesh, Assam, Bihar and Delhi reported the highest percentage of sexual abuse among both boys and girls, as well as the highest incidence of sexual assaults. 21.90% of child respondents faced severe forms of sexual abuse, 5.69% had been sexually assaulted and 50.76% reported other forms of sexual abuse. Children on the street, at work and in institutional care reported the highest incidence of sexual assault. The study also reported that 50% of abusers are known to the child or are in a position of trust and responsibility and most children had not reported the matter to anyone. Despite years of lack of any specific child sexual abuse laws in India, which treated them separately from adults in case of sexual offense, the 'Protection of Children Against Sexual Offences Bill, 2011' was passed the Indian parliament on May 22, 2012, which came into force from 14 November 2012.
In 2019, Pakistan's Human Rights Minister, Shirin Mazari has said that Pakistan was ranked as the country with the largest numbers of child pornography viewers. Geo Pakistan, the Federal Investigation Agency, cyber-crime chief has said, "Child pornography is a business . . with those involved in the crime linked to international child pornography rings."
According to UNICEF, nearly half of reported rape victims in Papua New Guinea are under 15 years of age and 13% are under 7 years of age while a report by ChildFund Australia citing former Parliamentarian Dame Carol Kidu stated 50% of those seeking medical help after rape are under 16, 25% are under 10 and 10% are under 8.
Additionally, a study found that men with a history of victimization, especially having been raped or otherwise sexually coerced themselves, were more likely than otherwise to have participated in both single-perpetrator and multiple-perpetrator non-partner rape. 57·5% (587/1022) of men who raped a non-partner committed their first rape as teenagers.
United States and Europe
Child sexual abuse occurs frequently in Western society, although the rate of prevalence can be difficult to determine. Research in North America has concluded that approximately 15% to 25% of women and 5% to 15% of men were sexually abused when they were children. In the UK, a 2010 study estimated prevalence at about 5% for boys and 18% for girls (not dissimilar to a 1985 study that estimated about 8% for boys and 12% for girls). More than 23,000 incidents were recorded by the UK police between 2009 and 2010. Girls were six times more likely to be assaulted than boys with 86% of attacks taking place against them. Barnardo's charity estimates that two thirds of victims in the United Kingdom are girls and one third are boys. Barnardo's is concerned that boy victims may be overlooked. A firm of solicitors that acts in many cases of child abuse has published a list of over twenty Children's Homes and group actions that they have an interest in or for which they are lead solicitors.
The estimates for the United States vary widely. A literature review of 23 studies found rates of 3% to 37% for males and 8% to 71% for females, which produced an average of 17% for boys and 28% for girls, while a statistical analysis based on 16 cross-sectional studies estimated the rate to be 7.2% for males and 14.5% for females. The US Department of Health and Human Services reported 83,600 substantiated reports of sexually abused children in 2005, while state-level child protective services reported 63,527 sexual abuse incidents in 2010. Including incidents which were not reported would make the total number even larger. According to Emily M. Douglas and David Finkelhor, "Several national studies have found that black and white children experienced near-equal levels of sexual abuse. Other studies, however, have found that both blacks and Latinos have an increased risk for sexual victimization".
Surveys have shown that one fifth to one third of all women reported some sort of childhood sexual experience with a male adult. A 1992 survey studying father-daughter incest in Finland reported that of the 9,000 15-year-old high school girls who filled out the questionnaires, of the girls living with their biological fathers, 0.2% reported father-daughter incest experiences; of the girls living with a stepfather, 3.7% reported sexual experiences with him. The reported counts included only father-daughter incest and did not include prevalence of other forms of child sexual abuse. The survey summary stated, "the feelings of the girls about their incestual experiences are overwhelmingly negative." Others argue that prevalence rates are much higher, and that many cases of child abuse are never reported. One study found that professionals failed to report approximately 40% of the child sexual abuse cases they encountered. A study by Lawson & Chaffin indicated that many children who were sexually abused were "identified solely by a physical complaint that was later diagnosed as a venereal disease ... Only 43% of the children who were diagnosed with venereal disease made a verbal disclosure of sexual abuse during the initial interview." It has been found in the epidemiological literature on CSA that there is no identifiable demographic or family characteristic of a child that can be used to bar the prospect that a child has been sexually abused.
Child marriage is often considered to be another form of child sexual abuse. Over 200,000 marriages involving minors were allowed between 2000 and 2015 in the US. These marriages were most often between an adult male and female minor. Child marriage in the United States is allowed in the majority of states as long as parental consent or judicial approval (typically for pregnancy) is given.
In US schools, according to the United States Department of Education, "nearly 9.6% of students are targets of educator sexual misconduct sometime during their school career." In studies of student sex abuse by male and female educators, male students were reported as targets in ranges from 23% to 44%. In U.S. school settings same-sex (female and male) sexual misconduct against students by educators "ranges from 18 to 28% of reported cases, depending on the study"
Significant underreporting of sexual abuse of boys by both women and men is believed to occur due to sex stereotyping, social denial, the minimization of male victimization, and the relative lack of research on sexual abuse of boys. Sexual victimization of boys by their mothers or other female relatives is especially rarely researched or reported. Sexual abuse of girls by their mothers, and other related and/or unrelated adult females is beginning to be researched and reported despite the highly taboo nature of female–female child sex abuse. In studies where students are asked about sex offenses, they report higher levels of female sex offenders than found in adult reports. This underreporting has been attributed to cultural denial of female-perpetrated child sex abuse, because "males have been socialized to believe they should be flattered or appreciative of sexual interest from a female." Journalist Cathy Young writes that under-reporting is contributed to by the difficulty of people, including jurors, in seeing a male as a "true victim".
In the United Kingdom, reported child sex abuse has increased, but this may be due to greater willingness to report. Police need more resources to deal with it. Also parents and schools need to give children and adolescents regular advice about how to spot abuse and about the need to report abuse. Software providers are urged to do more to police their environment and make it safe for children.
Child sexual abuse is outlawed nearly everywhere in the world, generally with severe criminal penalties, including in some jurisdictions, life imprisonment or capital punishment. An adult's sexual intercourse with someone below the legal age of consent is defined as statutory rape, based on the principle that a child is not capable of consent and that any apparent consent by a child is not considered to be legal consent.
The United Nations Convention on the Rights of the Child (CRC) is an international treaty that legally obliges states to protect children's rights. Articles 34 and 35 of the CRC require states to protect children from all forms of sexual exploitation and sexual abuse. This includes outlawing the coercion of a child to perform sexual activity, the prostitution of children, and the exploitation of children in creating pornography. States are also required to prevent the abduction, sale, or trafficking of children. As of November 2008, 193 countries are bound by the CRC, including every member of the United Nations except the United States and South Sudan.
The Council of Europe has adopted the Council of Europe Convention on the Protection of Children against Sexual Exploitation and Sexual Abuse in order to prohibit child sexual abuse that occurs within home or family.
Child sexual abuse has gained public attention since the 1970s and has become one of the most high-profile crimes. While sexual use of children by adults has been present throughout history, public interest in prevention has tended to fluctuate. Initially, concern centered around children under the age of ten, but over time, advocates have attracted attention toward the sexual abuse of children between the ages of 11 and 17. Up until the 1930s, the psychological impact of sexual abuse was not emphasized, instead emphasis was placed on the physical harm or the child's reputation. Widespread public awareness of children's sexual abuse did not occur until the 1970s in the West.
The first published work dedicated specifically to child sexual abuse appeared in France in 1857: Medical-Legal Studies of Sexual Assault (Etude Médico-Légale sur les Attentats aux Mœurs), by Auguste Ambroise Tardieu, the noted French pathologist and pioneer of forensic medicine.
The examples and perspective in this section deal primarily with the United States and do not represent a worldwide view of the subject. (October 2015)
Child sexual abuse became a public issue in the 1970s and 1980s. Prior to this point in time, sexual abuse remained rather secretive and socially unspeakable. Studies on child molestation were nonexistent until the 1920s and the first national estimate of the number of child sexual abuse cases was published in 1948. By 1968 44 out of 50 U.S. states had enacted mandatory laws that required physicians to report cases of suspicious child abuse. Legal action began to become more prevalent in the 1970s with the enactment of the Child Abuse Prevention and Treatment Act in 1974 in conjunction with the creation of the National Center for Child Abuse and Neglect. Since the creation of the Child Abuse and Treatment Act, reported child abuse cases have increased dramatically. Finally, the National Abuse Coalition was created in 1979 to create pressure in congress to create more sexual abuse laws.
Second wave feminism brought greater awareness of child sexual abuse and violence against women, and made them public, political issues. Judith Lewis Herman, Harvard professor of psychiatry, wrote the first book ever on father-daughter incest when she discovered during her medical residency that a large number of the women she was seeing had been victims of father-daughter incest. Herman notes that her approach to her clinical experience grew out of her involvement in the civil rights movement. Her second book Trauma and Recovery coined the term complex post-traumatic stress disorder and included child sexual abuse as a cause.
In 1986, Congress passed the Child Abuse Victims' Rights Act, giving children a civil claim in sexual abuse cases. The number of laws created in the 1980s and 1990s began to create greater prosecution and detection of child sexual abusers. During the 1970s a large transition began in the legislature related to child sexual abuse. Megan's Law which was enacted in 1996 gives the public access to knowledge of sex offenders nationwide.
Anne Hastings described these changes in attitudes towards child sexual abuse as "the beginning of one of history's largest social revolutions."
According to John Jay College of Criminal Justice professor B.J. Cling,
"By the early 21st century, the issue of child sexual abuse has become a legitimate focus of professional attention, while increasingly separated from second wave feminism ... As child sexual abuse becomes absorbed into the larger field of interpersonal trauma studies, child sexual abuse studies and intervention strategies have become degendered and largely unaware of their political origins in modern feminism and other vibrant political movements of the 1970s. One may hope that unlike in the past, this rediscovery of child sexual abuse that began in the 70s will not again be followed by collective amnesia. The institutionalization of child maltreatment interventions in federally funded centers, national and international societies, and a host of research studies (in which the United States continues to lead the world) offers grounds for cautious optimism. Nevertheless, as Judith Herman argues cogently, 'The systematic study of psychological trauma ... depends on the support of a political movement.'"
In the United States growing awareness of child sexual abuse has sparked an increasing number of civil lawsuits for monetary damages stemming from such incidents. Increased awareness of child sexual abuse has encouraged more victims to come forward, whereas in the past victims often kept their abuse secret. Some states have enacted specific laws lengthening the applicable statutes of limitations so as to allow victims of child sexual abuse to file suit sometimes years after they have reached the age of majority. Such lawsuits can be brought where a person or entity, such as a school, church or youth organization, or daycare was charged with supervising the child but failed to do so with child sexual abuse resulting, making the individual or institution liable. In the Catholic sex abuse cases the various Roman Catholic Diocese in the United States have paid out approximately $1 billion settling hundreds of such lawsuits since the early 1990s. There have also been lawsuits involving the American Religious Right. Crimes have allegedly gone unreported and victims were pressured into silence. As lawsuits can involve demanding procedures there is a concern that children or adults who file suit will be re-victimized by defendants through the legal process, much as rape victims can be re-victimized by the accused in criminal rape trials. The child sexual abuse plaintiff's attorney Thomas A. Cifarelli has written that children involved in the legal system, particularly victims of sexual abuse and molestation, should be afforded certain procedural safeguards to protect them from harassment during the legal process.
In June 2008 in Zambia the issue of teacher-student sexual abuse and sexual assault was brought to the attention of the High Court of Zambia where a landmark case decision, with presiding Judge Philip Musonda, awarded $45million Zambian kwacha (US$13,000) to the plaintiff, a 13-year-old girl for sexual abuse and rape by her school teacher. This claim was brought against her teacher as a "person of authority" who, as Judge Musonda stated, "had a moral superiority (responsibility) over his students" at the time.
A 2000 World Health Organization – Geneva report, “World Report on Violence and Health (Chap 6 – Sexual Violence)” states, “Action in schools is vital for reducing sexual and other forms of violence. In many countries a sexual relation between a teacher and a pupil is not a serious disciplinary offence and policies on sexual harassment in schools either do not exist or are not implemented. In recent years, though, some countries have introduced laws prohibiting sexual relations between teachers and pupils. Such measures are important in helping eradicate sexual harassment in schools. At the same time, a wider range of actions is also needed, including changes to teacher training and recruitment and reforms of curricula, so as to transform gender relations in schools.”
- 17th-century sexual molestation at Naples school
- Abusive power and control
- Bacha Bazi
- Betrayal Trauma
- Cases of children imprisoned by relatives
- Catholic Church sex abuse cases
- Child erotica
- Child Exploitation Tracking System (CETS)
- Child marriage
- Child-on-child sexual abuse
- Child pornography
- Child sex tourism
- Child sexual abuse in Nigeria
- Child welfare
- Children's Bureau
- Commercial sexual exploitation of children
- Complex post-traumatic stress disorder
- False allegation of child sexual abuse
- Institutional abuse
- Isolation to facilitate abuse
- The International Centre for Missing & Exploited Children (ICMEC) combats child sexual exploitation, child pornography, and child abduction.
- National Society for the Prevention of Cruelty to Children – a UK organisation set up to combat child abuse, gained controversy in the 1980s–1990s over its dealings with Satanic ritual abuse amongst children.
- Online predator
- Penn State child sex abuse scandal
- Prostitution of children
- Rochdale child sex abuse ring
- Sexual harassment and abuse of students by teachers
- Statutory rape
- "Child Sexual Abuse". Medline Plus. U.S. National Library of Medicine. 2008-04-02.
- "Guidelines for psychological evaluations in child protection matters. Committee on Professional Practice and Standards, APA Board of Professional Affairs". The American Psychologist. 54 (8): 586–593. August 1999. doi:10.1037/0003-066X.54.8.586. PMID 10453704.
Abuse, sexual (child): generally defined as contacts between a child and an adult or other person significantly older or in a position of power or control over the child, where the child is being used for sexual stimulation of the adult or other person.
- Williams, Mike (2019). "The NSPCC's Protect & Respect child sexual exploitation programme: a discussion of the key findings from programme implementation and service use" (PDF). London: NSPCC. Archived from the original (PDF) on 29 March 2019. Retrieved 29 March 2019. Cite journal requires
- Williams, Mike (March 2019). "Evaluation of the NSPCC's Protect & Respect child sexual exploitation one-to-one work" (PDF). London: NSPCC. Retrieved 29 March 2019. Cite journal requires
- Williams, Mike (March 2019). "Evaluation of the NSPCC's Protect & Respect Child Sexual Exploitation Group Work Servic" (PDF). London: NSPCC. Retrieved 29 March 2019. Cite journal requires
- Martin J, Anderson J, Romans S, Mullen P, O'Shea M (1993). "Asking about child sexual abuse: methodological implications of a two stage survey". Child Abuse & Neglect. 17 (3): 383–92. doi:10.1016/0145-2134(93)90061-9. PMID 8330225.
- "What is sexual abuse?". NSPCC. Archived from the original on 24 January 2016. Retrieved 12 January 2016.
- "UNICEF" (PDF). unicef.org.
- Roosa MW, Reinholtz C, Angelini PJ (February 1999). "The relation of child sexual abuse and depression in young women: comparisons across four ethnic groups". Journal of Abnormal Child Psychology. 27 (1): 65–76. PMID 10197407.
- Widom CS (August 1999). "Posttraumatic stress disorder in abused and neglected children grown up". The American Journal of Psychiatry. 156 (8): 1223–1229. doi:10.1176/ajp.156.8.1223 (inactive 31 May 2021). PMID 10450264.CS1 maint: DOI inactive as of May 2021 (link)
- Levitan RD, Rector NA, Sheldon T, Goering P (2003). "Childhood adversities associated with major depression and/or anxiety disorders in a community sample of Ontario: issues of co-morbidity and specificity". Depression and Anxiety. 17 (1): 34–42. doi:10.1002/da.10077. PMID 12577276. S2CID 26031006.
- Roth, Susan; Newman, Elana; Pelcovitz, David; Van Der Kolk, Bessel; Mandel, Francine S. (1997). "Complex PTSD in victims exposed to sexual and physical abuse: Results from the DSM-IV field trial for posttraumatic stress disorder". Journal of Traumatic Stress. 10 (4): 539–55. doi:10.1002/jts.2490100403. PMID 9391940.
- Messman-Moore, T. L.; Long, P. J. (2000). "Child Sexual Abuse and Revictimization in the Form of Adult Sexual Abuse, Adult Physical Abuse, and Adult Psychological Maltreatment". Journal of Interpersonal Violence. 15 (5): 489–502. doi:10.1177/088626000015005003. S2CID 145761598.
- Dinwiddie S, Heath AC, Dunne MP, et al. (January 2000). "Early sexual abuse and lifetime psychopathology: a co-twin-control study". Psychological Medicine. 30 (1): 41–52. doi:10.1017/S0033291799001373. PMID 10722174. S2CID 15270464.
- Courtois, Christine A. (1988). Healing the incest wound: adult survivors in therapy. New York: Norton. p. 208. ISBN 978-0-393-31356-7.
- Pereda, N.; Guilera, G.; Forns, M. & Gómez-Benito, J. (2009). "The prevalence of child sexual abuse in community and student samples: A meta-analysis". Clinical Psychology Review. 29 (4): 328–338. doi:10.1016/j.cpr.2009.02.007. hdl:2445/27746. PMID 19371992.
- "Raising Awareness About Sexual Abuse: Facts and Statistics". NSOPW. Archived from the original on 2019-03-10. Retrieved 18 October 2017.
- Julia Whealin (2007-05-22). "Child Sexual Abuse". National Center for Post Traumatic Stress Disorder, US Department of Veterans Affairs. Archived from the original on 2009-07-30.
- Finkelhor D (1994). "Current information on the scope and nature of child sexual abuse" (PDF). The Future of Children. 4 (2): 31–53. doi:10.2307/1602522. JSTOR 1602522. PMID 7804768.
- Dube SR, Anda RF, Whitfield CL, et al. (June 2005). "Long-term consequences of childhood sexual abuse by gender of victim". American Journal of Preventive Medicine. 28 (5): 430–438. CiteSeerX 10.1.1.189.5033. doi:10.1016/j.amepre.2005.01.015. PMID 15894146.
- Ames, M. Ashley; Houston, David A. (1990). "Legal, social, and biological definitions of pedophilia". Archives of Sexual Behavior. 19 (4): 333–42. doi:10.1007/BF01541928. PMID 2205170. S2CID 16719658.
- Laws, Richard; O'Donohue, William T. (1997). "H. E. Barbaree, M. C. Seto". Sexual Deviance: Theory, Assessment, and Treatment. Guilford Press. pp. 175–93. ISBN 978-1-57230-241-9.
- Blaney, Paul H.; Millon, Theodore (2009). Oxford Textbook of Psychopathology (Oxford Series in Clinical Psychology) (2nd ed.). Oxford University Press, USA. p. 528. ISBN 978-0-19-537421-6.
Some cases of child molestation, especially those involving incest, are committed in the absence of any identifiable deviant erotic age preference.
- The Sexual Exploitation of Children Archived November 22, 2009, at the Wayback Machine, Chart 1: Definitions of Terms Associated With the Sexual Exploitation (SEC) and Commercial Sexual Exploitation of Children (CSEC) (p. 4), University of Pennsylvania Center for Youth Policy Studies, U.S. National Institute of Justice, August 2001.
- "APA Letter to the Honorable Rep. DeLay (R-Tx)" (Press release). American Psychological Association. June 9, 1999. Archived from the original on October 10, 1999. Retrieved 2009-03-08.
- Nelson EC, Heath AC, Madden PA, et al. (February 2002). "Association between self-reported childhood sexual abuse and adverse psychosocial outcomes: results from a twin study". Archives of General Psychiatry. 59 (2): 139–145. doi:10.1001/archpsyc.59.2.139. PMID 11825135.
- Widom CS, DuMont K, Czaja SJ (January 2007). "A prospective investigation of major depressive disorder and comorbidity in abused and neglected children grown up". Archives of General Psychiatry. 64 (1): 49–56. doi:10.1001/archpsyc.64.1.49. PMID 17199054. Lay summary – ScienceDaily (January 3, 2007).
- Arnow BA (2004). "Relationships between childhood maltreatment, adult health and psychiatric outcomes, and medical utilization". The Journal of Clinical Psychiatry. 65 Suppl 12: 10–15. PMID 15315472. Archived from the original on 2016-05-16. Retrieved 2010-03-16.
- Walsh, K.; DiLillo, D. (2011). "Child sexual abuse and adolescent sexual assault and revictimization". In Paludi, Michael A. (ed.). The psychology of teen violence and victimization. 1. Santa Barbara, CA: Praeger. pp. 203–216. ISBN 978-0-313-39375-4.
- Noll, J. G., Trickett, P. K., Susman, E. J., & Putnam, F. W. (2006). "Sleep disturbances and childhood sexual abuse". Journal of Pediatric Psychology. 31 (5): 469–480. doi:10.1093/jpepsy/jsj040. PMID 15958722.CS1 maint: uses authors parameter (link)
- Steine, I. M., Krystal et al. (2012). "Insomnia, nightmare frequency, and nightmare distress in victims of sexual abuse: The role of perceived social support and abuse characteristics". Journal of Interpersonal Violence. 27 (9): 51827–51843. doi:10.1177/0886260511430385. PMID 22204947. S2CID 20268989.CS1 maint: uses authors parameter (link)
- Arehart-Treichel, Joan (2005-08-05). "Dissociation Often Precedes PTSD In Sexually Abused Children". Psychiatric News. American Psychiatric Association. 40 (15): 34. doi:10.1176/pn.40.15.00400034a. Archived from the original on 2006-03-03.
- Understanding child sexual abuse: education, prevention, and recovery. American Psychological Association Retrieved 30 October 2012
- Faller, Kathleen Coulborn (1993). Child Sexual Abuse: Intervention and Treatment Issues. Diane Publishing. p. 6. ISBN 978-0-7881-1669-8.
- Ascione, Frank R.; Friedrich, William N.; Heath, John; Hayashi, Kentaro (2003). "Cruelty to animals in normative, sexually abused, and outpatient psychiatric samples of 6- to 12-year-old children: Relations to maltreatment and exposure to domestic violence". Anthrozoös: A Multidisciplinary Journal of the Interactions of People and Animals. 16 (3): 194–212. doi:10.2752/089279303786992116. S2CID 145018287.
- Ascione, Frank R. (2005). "Child sexual abuse". Children and Animals: Exploring the Roots of Kindness and Cruelty. Purdue University Press. p. 46. ISBN 978-1-55753-383-8.
- McClellan, Jon; Adams, Julie; Douglas, Donna; McCurry, Chris; Storck, Mick (1995). "Clinical characteristics related to severity of sexual abuse: A study of seriously mentally ill youth". Child Abuse & Neglect. 19 (10): 1245–1254. doi:10.1016/0145-2134(95)00087-O. PMID 8556438.
- Friedrich, William N.; Urquiza, Anthony J.; Beilke, Robert L. (1986). "Behavior Problems in Sexually Abused Young Children". Journal of Pediatric Psychology. 11 (1): 47–57. doi:10.1093/jpepsy/11.1.47. PMID 3958867.
- Tyler, K.A. (2002). "Social and emotional outcomes of childhood sexual abuse: A review of recent research". Aggression and Violent Behavior. 7 (6): 567–589. doi:10.1016/S1359-1789(01)00047-7.
- J. G. Noll et al. (2003). "Revictimization and self-harm in females who experienced childhood sexual abuse: Results from a prospective study". Journal of Interpersonal Violence. 18 (12): 1452–1471. doi:10.1177/0886260503258035. PMID 14678616. S2CID 38994688.CS1 maint: uses authors parameter (link)
- Zickler, Patrick (April 2002). "Childhood Sex Abuse Increases Risk for Drug Dependence in Adult Women". NIDA Notes. National Institute of Drug Abuse. 17 (1): 5. doi:10.1151/v17i1CSAIRDDAW.
- Melissa A. Polusny; Victoria M. Follette (1995). "Long-term correlates of child sexual abuse: Theory and review of the empirical literature". Applied and Preventive Psychology. Elsevier Ltd. 4 (3): 143–166. doi:10.1016/s0962-1849(05)80055-1.
- Freyd JJ, Putnam FW, Lyon TD, et al. (April 2005). "Psychology. The science of child sexual abuse". Science. 308 (5721): 501. doi:10.1126/science.1108066. PMID 15845837. S2CID 70752683.
- Dozier, M., Stovall, K.C., & Albus, K. (1999). "Attachment and Psychopathology in Adulthood". In J. Cassidy; P. Shaver (eds.). Handbook of Attachment. NY: Guilford Press. pp. 497–519. ISBN 978-1-57230-826-8.CS1 maint: multiple names: authors list (link)
- Kendall-Tackett KA, Williams LM, Finkelhor D (January 1993). "Impact of sexual abuse on children: a review and synthesis of recent empirical studies". Psychological Bulletin. 113 (1): 164–80. doi:10.1037/0033-2909.113.1.164. PMID 8426874. S2CID 2512368. also published in Hertzig, Margaret E.; Ellen A. Farber (1994). Annual progress in child psychiatry and child development 1994. Psychology Press. pp. 321–56. ISBN 978-0-87630-744-1.
- Gauthier L, Stollak G, Messé L, Aronoff J (July 1996). "Recall of childhood neglect and physical abuse as differential predictors of current psychological functioning". Child Abuse & Neglect. 20 (7): 549–59. doi:10.1016/0145-2134(96)00043-9. PMID 8832112.
- Briere J (April 1992). "Methodological issues in the study of sexual abuse effects" (PDF). Journal of Consulting and Clinical Psychology. 60 (2): 196–203. doi:10.1037/0022-006X.60.2.196. PMID 1592948. Archived from the original (PDF) on 2008-09-11.
- Brown D (2000). "(Mis) representations of the long-term effects of childhood sexual abuse in the courts". Journal of Child Sexual Abuse. 9 (3–4): 79–107. doi:10.1300/J070v09n03_05. PMID 17521992. S2CID 20874393.
- Bonomi AE, Anderson ML, Rivara FP, et al. (March 2008). "Health care utilization and costs associated with childhood abuse". Journal of General Internal Medicine. 23 (3): 294–9. doi:10.1007/s11606-008-0516-1. PMC 2359481. PMID 18204885.
- Roberts, Ron; o’Connor, Tom; Dunn, Judy; Golding, Jean (2004). "The effects of child sexual abuse in later family life; mental health, parenting and adjustment of offspring". Child Abuse & Neglect. 28 (5): 525–545. doi:10.1016/j.chiabu.2003.07.006. PMID 15159068.
- Fergusson, D.M.; Mullen, P.E. (1999). Childhood sexual abuse: An evidence based perspective. Thousand Oaks, California: Sage Publications. ISBN 978-0-7619-1136-4.[page needed]
- Kendler KS, Bulik CM, Silberg J, Hettema JM, Myers J, Prescott CA (October 2000). "Childhood sexual abuse and adult psychiatric and substance use disorders in women: an epidemiological and cotwin control analysis". Archives of General Psychiatry. 57 (10): 953–9. doi:10.1001/archpsyc.57.10.953. PMID 11015813.
- Briere J, Elliott DM (April 1993). "Sexual abuse, family environment, and psychological symptoms: on the validity of statistical control". Journal of Consulting and Clinical Psychology. 61 (2): 284–8, discussion 289–90. doi:10.1037/0022-006X.61.2.284. PMID 8473582.
- Caffaro-Rouget, A.; Lang, R. A.; Van Santen, V. (1989). "The Impact of Child Sexual Abuse On Victims' Adjustment". Sexual Abuse: A Journal of Research and Treatment. 2: 29–47. doi:10.1177/107906328900200102. S2CID 145389337.
- Mannarino AP, Cohen JA (1986). "A clinical-demographic study of sexually abused children". Child Abuse & Neglect. 10 (1): 17–23. doi:10.1016/0145-2134(86)90027-X. PMID 3955424.
- Tong L, Oates K, McDowell M (1987). "Personality development following sexual abuse". Child Abuse & Neglect. 11 (3): 371–83. doi:10.1016/0145-2134(87)90011-1. PMID 3676894.
- Conte, J. R.; Schuerman, J. R. (1987). "The Effects of Sexual Abuse on Children: A Multidimensional View". Journal of Interpersonal Violence. 2 (4): 380–390. doi:10.1177/088626058700200404. S2CID 143952913.
- Bulik CM, Prescott CA, Kendler KS (November 2001). "Features of childhood sexual abuse and the development of psychiatric and substance use disorders". The British Journal of Psychiatry. 179 (5): 444–9. doi:10.1192/bjp.179.5.444. PMID 11689403.
- Beitchman JH, Zucker KJ, Hood JE, daCosta GA, Akman D, Cassavia E (1992). "A review of the long-term effects of child sexual abuse". Child Abuse Negl. 16 (1): 101–18. doi:10.1016/0145-2134(92)90011-F. PMID 1544021.
- Browne A, Finkelhor D (January 1986). "Impact of child sexual abuse: a review of the research". Psychological Bulletin. 99 (1): 66–77. doi:10.1037/0033-2909.99.1.66. hdl:10983/681. PMID 3704036.
- Holguin, G; Hansen, David J. (2003). "The 'sexually abused child': Potential mechanisms of adverse influences of such a label". Aggression and Violent Behavior. 8 (6): 645–670. doi:10.1016/S1359-1789(02)00101-5.
- Romans SE, Martin JL, Anderson JC, O'Shea ML, Mullen PE (January 1995). "Factors that mediate between child sexual abuse and adult psychological outcome". Psychological Medicine. 25 (1): 127–42. doi:10.1017/S0033291700028154. PMID 7792348.
- Spaccarelli S, Kim S (September 1995). "Resilience criteria and factors associated with resilience in sexually abused girls". Child Abuse & Neglect. 19 (9): 1171–82. doi:10.1016/0145-2134(95)00077-L. PMID 8528822.
- Chu JA, Frey LM, Ganzel BL, Matthews JA (May 1999). "Memories of childhood abuse: dissociation, amnesia, and corroboration". The American Journal of Psychiatry. 156 (5): 749–55. doi:10.1176/ajp.156.5.749 (inactive 31 May 2021). PMID 10327909.CS1 maint: DOI inactive as of May 2021 (link)
- Draijer N, Langeland W (March 1999). "Childhood trauma and perceived parental dysfunction in the etiology of dissociative symptoms in psychiatric inpatients". The American Journal of Psychiatry. 156 (3): 379–85. doi:10.1016/j.biopsych.2003.08.018. PMID 10080552. S2CID 14670794.
- McLean, CP; Rosenbach, SB; Capaldi, S; Foa, EB (2013). "Social and academic functioning in adolescents with child sexual abuse-related PTSD". Child Abuse & Neglect. 37 (9): 675–678. doi:10.1016/j.chiabu.2013.03.010. PMC 3740087. PMID 23623621.
- Schiff, M; Nacasch, N; Levit, S; Katz, N; Foa, EB (2015). "Prolonged exposure for treating PTSD among female methadone patients who were survivors of sexual abuse in Israel". Social Work & Health Care. 54 (8): 687–707. doi:10.1080/00981389.2015.1058311. PMID 26399489. S2CID 9288531.
- Hornor, G. (2010). "Child sexual abuse: Consequences and implications". Journal of Pediatric Health Care. 24 (6): 358–364. doi:10.1016/j.pedhc.2009.07.003. PMID 20971410.
- Mullen PE, Martin JL, Anderson JC, Romans SE, Herbison GP (January 1996). "The long-term impact of the physical, emotional, and sexual abuse of children: a community study". Child Abuse & Neglect. 20 (1): 7–21. doi:10.1016/0145-2134(95)00112-3. PMID 8640429.
- Pope, Harrison G.; Hudson, James I. (Fall 1995). "Does childhood sexual abuse cause adult psychiatric disorders? Essentials of methodology". Journal of Psychiatry & Law. 23 (3): 363–81. doi:10.1177/009318539502300303. S2CID 81434466.
- Levitt EE, Pinnell CM (April 1995). "Some additional light on the childhood sexual abuse-psychopathology axis". The International Journal of Clinical and Experimental Hypnosis. 43 (2): 145–62. doi:10.1080/00207149508409958. PMID 7737760.
- Fleming J, Mullen PE, Sibthorpe B, Bammer G (February 1999). "The long-term impact of childhood sexual abuse in Australian women". Child Abuse & Neglect. 23 (2): 145–59. doi:10.1016/S0145-2134(98)00118-5. PMID 10075184.
- Rind, Bruce; Tromovitch, Philip (1997). "A meta-analytic review of findings from national samples on psychological correlates of child sexual abuse". Journal of Sex Research. 34 (3): 237–255. doi:10.1080/00224499709551891.
- Dallam SJ, Gleaves DH, Cepeda-Benito A, Silberg JL, Kraemer HC, Spiegel D (November 2001). "The effects of child sexual abuse: Comment on Rind, Tromovitch, and Bauserman (1998)". Psychological Bulletin. 127 (6): 715–33. doi:10.1037/0033-2909.127.6.715. PMID 11726068.
- Oltmanns, Thomas F.; Emery, Robert E. (2001). Abnormal Psychology. Upper Saddle River, NJ: Prentice Hall. ISBN 978-0-13-187521-0.[page needed]
- US Congress (1999). "Whereas no segment of our society is more critical to the future of human survival than our children" (PDF). 106th Congress, Resolution 107.
- Anderson, James; Mangels, Nancie; Langsam, Adam (2004). "Child Sexual Abuse: A Public Health Issue". The Justice Professional. 17: 107–126. doi:10.1080/08884310420001679386. S2CID 144058326.
- De Jong AR (1985). "Vaginitis due to Gardnerella vaginalis and to Candida albicans in sexual abuse". Child Abuse & Neglect. 9 (1): 27–9. doi:10.1016/0145-2134(85)90088-2. PMID 3872154.
- Developing Mind, Daniel Siegel, Guilford Press, 1999[page needed]
- Maia Szalavitz; Perry, Bruce (2006). The boy who was raised as a dog: and other stories from a child psychiatrist's notebook: what traumatized children can teach us about loss, love and healing. New York: Basic Books. ISBN 978-0-465-05652-1.[page needed]
- Ito Y, Teicher MH, Glod CA, Ackerman E (1998). "Preliminary evidence for aberrant cortical development in abused children: a quantitative EEG study". The Journal of Neuropsychiatry and Clinical Neurosciences. 10 (3): 298–307. doi:10.1176/jnp.10.3.298. PMID 9706537.
- Teicher MH, Glod CA, Surrey J, Swett C (1993). "Early childhood abuse and limbic system ratings in adult psychiatric outpatients". The Journal of Neuropsychiatry and Clinical Neurosciences. 5 (3): 301–6. doi:10.1176/jnp.5.3.301. PMID 8369640.
- Anderson CM, Teicher MH, Polcari A, Renshaw PF (2002). "Abnormal T2 relaxation time in the cerebellar vermis of adults sexually abused in childhood: potential role of the vermis in stress-enhanced risk for drug abuse". Psychoneuroendocrinology. 27 (1–2): 231–44. doi:10.1016/S0306-4530(01)00047-6. PMID 11750781. S2CID 38238017.
- Teicher MH (March 2002). "Scars that won't heal: the neurobiology of child abuse". Scientific American. 286 (3): 68–75. Bibcode:2002SciAm.286c..68T. doi:10.1038/scientificamerican0302-68. PMID 11857902.
- Ito Y, Teicher MH, Glod CA, Harper D, Magnus E, Gelbard HA (1993). "Increased prevalence of electrophysiological abnormalities in children with psychological, physical, and sexual abuse". The Journal of Neuropsychiatry and Clinical Neurosciences. 5 (4): 401–8. doi:10.1176/jnp.5.4.401. PMID 8286938.
- Arehart-Treichel, Joan (March 2001). "Psychological Abuse May Cause Changes in Brain". Psychiatric News. 36 (5): 36. doi:10.1176/pn.36.5.0036. Archived from the original on 2011-03-20.
- Trusiani, Jessica. "Working with Survivors of Child Incestuous Abuse". Rutgers University. Archived from the original on 2014-11-01. Retrieved 2014-04-04.
- Barabara E. Bogorad. "Sexual Abuse:Surviving the Pain". Sexual Abuse Recovery Program Unit South Oaks Hospital, New York. The American Academy of Experts in Traumatic Stress, Inc.
- Fridell, L. A. (1990). "Decision-Making Of The District Attorney: Diverting Or Prosecuting Intrafamilial Child Sexual Abuse Offenders". Criminal Justice Policy Review. 4 (3): 249–267. doi:10.1177/088740349000400304. S2CID 145654768.
- Turner, Jeffrey S. (1996). Encyclopedia of relationships across the lifespan. Westport, Conn: Greenwood Press. p. 92. ISBN 978-0-313-29576-8.
- "Williamapercy.com" (PDF). williamapercy.com.
- Calestro, Kenneth; Arnold, L. Eugene; Dixon, Katharine N. (1978). "Father-Son Incest: Underreported Psychiatric Problem?". The American Journal of Psychiatry. 135 (7): 835–8. doi:10.1176/ajp.135.7.835. hdl:1811/51174. PMID 665796.
- Meyer, Isabel Denholm; Dorais, Michel (2002). Don't tell: the sexual abuse of boys. Montreal: McGill-Queen's University Press. p. 24. ISBN 978-0-7735-2261-9.
- Courtois, Christine A. (1988). Healing the incest wound: adult survivors in therapy. New York: Norton. ISBN 978-0-393-31356-7.[page needed]
- Goldman JD, Padayachi UK (May 1997). "The prevalence and nature of child sexual abuse in Queensland, Australia". Child Abuse & Neglect. 21 (5): 489–98. doi:10.1016/S0145-2134(97)00008-2. PMID 9158908.
- Finkelhor, D. (1979). Sexually victimised children. New York: Free Press
- Cawson, Pat; Wattam, Corinne; Brooker, Sue (2000). Child Maltreatment in the United Kingdom: A Study of the Prevalence of Child Abuse and Neglect. London: National Society for the Prevention of Cruelty to Children. ISBN 978-1-84228-006-5.[page needed]
- Finkelhor, David; Ormrod, Richard (May 2001). "Child Abuse Reported to the Police" (PDF). Juvenile Justice Bulletin. U.S. Office of Juvenile Justice and Delinquency Prevention.
- Definitions of Child Abuse and Neglect, Summary of State Laws, Archived 2007-10-25 at the Wayback Machine National Clearinghouse on Child Abuse and Neglect Information, U.S. Department of Health and Human Services.
- Finkelhor, David; Ormrod, Richard (June 2004). "Prostitution of Juveniles: Patterns From NIBRS". Juvenile Justice Bulletin. U.S. Office of Juvenile Justice and Delinquency Prevention.
- "Philippines child slavery survivors fight to heal scars of abuse". Reuters. April 8, 2020.
- Child Sexual Exploitation: Improving Investigations and Protecting Victims, Massachusetts Child Exploitation Network, U.S. Office of Juvenile Justice and Delinquency Prevention, January 1995.
- "Technology News, Analysis, Comments and Product Reviews for IT Professionals". ZDNet.
- "UNICEF" (PDF). unicef.org.
- "Unescap.org" (PDF). Archived from the original (PDF) on February 22, 2014.
- "UNICEF" (PDF). unicef.org.
- "What we do – Commercial sexual exploitation of children". unicef.org. Retrieved 23 March 2015.
- DFE (February 2017). "Child sexual exploitation Definition and a guide for practitioners, local leaders and decision makers working to protect children from child sexual exploitation". Cite journal requires
- Phoenix, Jo (2012). Out of place: The policing and criminalisation of sexually exploited girls and young women (PDF). London: The Howard League for Penal Reform.
- Hallet, Sophie (2017). Making sense of child sexual exploitation: exchange, abuse and children and young people. Bristol: Policy Press.
- DCSF (2009). "Safeguarding Children and Young People from Sexual Exploitation" (PDF). Retrieved 29 March 2019. Cite journal requires
- Beckett, Helen; Walker, Joanna (2018). "Words Matter". In Beckett, Helen; Pearce, Jenny (eds.). Understanding and Responding to Child Sexual Exploitation. London: Routledge. pp. 9–23.
- Gries, L.; Goh, D.; Andrews, M.; Gilbert, J.; Praver, F.; Stelzer, D. (2000). "Positive reaction to disclosure and recovery from child sexual abuse". Journal of Child Sexual Abuse. 9 (1): 29–51. doi:10.1300/J070v09n01_03. S2CID 144064563.
- Kogan, S. (2005). "The Role of Disclosing Child Sexual Abuse on Adolescent Adjustment and Revictimization". Journal of Child Sexual Abuse. 14 (2): 25–47. doi:10.1300/J070v14n02_02. PMID 15914409. S2CID 1507507.
- Arata, C. (1998). To tell or not to tell: Current functioning of child sexual abuse survivors who disclosed their victimization. Child Maltreatment, 3(1), 63.71.
- Palmer, S.; Brown, R.; Rae-Grant, N.; Loughlin, J. M. (1999). "Responding to children's disclosure of familial abuse: what survivors tell us". Child Welfare. 2 (78): 259–282.
- Ullman, S.E. (2003). "Social reactions to child abuse disclosure: A critical review". Journal of Child Sexual Abuse. 12 (1): 89–121. doi:10.1300/J070v12n01_05. PMID 16221661. S2CID 2926312.
- Roesler, T.A. (1994). "Reactions to disclosure of childhood sexual abuse: the effect on adult symptoms". Journal of Nervous and Mental Disease. 182 (11): 618–624. doi:10.1097/00005053-199411000-00004. PMID 7964669. S2CID 31403154.
- Schechter, DS; Brunelli, SA; Cunningham, N; Brown, J; Baca, P (2002). "Mother-daughter relationships and child sexual abuse: A pilot study of 35 dyads". Bulletin of the Menninger Clinic. 66 (1): 39–60. doi:10.1521/bumc.18.104.22.16874. PMID 11999103.
- "Responding To Child Sexual Abuse". www.aacap.org.
- Brown, Asa Don, "The effects of childhood trauma on adult perception and worldview". (Dissertation) Capella University, 2008, 152 pages. AAT 3297512. ISBN 978-0-549-47057-1; Publication #3297512.[page needed]
- Daniel L. Segal, Michel Hersen (2009). Diagnostic Interviewing. Springer Science & Business Media. p. 455. ISBN 978-1441913203. Retrieved November 23, 2017.CS1 maint: uses authors parameter (link)
- Wilson, S.F.W, Giddens, J.F.G. (2009) Health Assessment for Nursing Practice. St. Louis: Mosby Elsevier, page 506.
- Cynthia Winn; Anthony J. Urquiza (2004). Treatment For Abused And Neglected Children: Infancy To Age 18 – User Manual Series. Diane Pub Co. ISBN 978-0-7881-1661-2.[page needed]
- G, Macdonald; Jp, Higgins; P, Ramchandani; Jc, Valentine; Lp, Bronger; P, Klein; R, O'Daniel; M, Pickering; B, Rademaker (2012-05-16). "Cognitive-behavioural Interventions for Children Who Have Been Sexually Abused". Cochrane Database of Systematic Reviews (5): CD001930. doi:10.1002/14651858.CD001930.pub3. PMC 7061273. PMID 22592679.
- Summit, Roland C. (January 1983). "The child sexual abuse accommodation syndrome". Child Abuse & Neglect. 7 (22): 177–93. doi:10.1016/0145-2134(83)90070-4. PMID 6605796.
- Swaby, AN.; Morgan, KA. (2009). "The relationship between childhood sexual abuse and sexual dysfunction in Jamaican adults". J Child Sex Abuse. 18 (3): 247–66. doi:10.1080/10538710902902679. PMID 19856732. S2CID 33062149.
- Edmond, T.; Rubin, A. (2004). "Assessing the long-term effects of EMDR: results from an 18-month follow-up study with adult female survivors of CSA". J Child Sex Abuse. 13 (1): 69–86. doi:10.1300/J070v13n01_04. PMID 15353377. S2CID 28012364.
- Seto MC (2009). "Pedophilia". Annual Review of Clinical Psychology. 5: 391–407. doi:10.1146/annurev.clinpsy.032408.153618. PMID 19327034.
- Seto, Michael (2008). Pedophilia and Sexual Offending Against Children. Washington, DC: American Psychological Association. p. 171.
- Dennis JA, Khan O, Ferriter M, Huband N, Powney MJ, Duggan C (2012). "Psychological interventions for adults who have sexually offended or are at risk of offending". Cochrane Database of Systematic Reviews. 12 (12): CD007507. doi:10.1002/14651858.CD007507.pub2. PMID 23235646.
- Lösel F, Schmucker M (2005). "The effectiveness of treatment for sexual offenders: a comprehensive meta-analysis". Journal of Experimental Criminology. 1 (1): 117–46. doi:10.1007/s11292-004-6466-7. S2CID 145253074.
- Hanson RK, Gordon A, Harris AJ, Marques JK, Murphy W, et al. (2002). "First report of the collaborative outcome data project on the effectiveness of treatment for sex offenders". Sexual Abuse. 14 (2): 169–94. doi:10.1177/107906320201400207. PMID 11961890. S2CID 34192852.
- Rice ME, Harris GT (2012). "Treatment for adult sex offenders: may we reject the null hypothesis?". In Harrison K, Rainey B (eds.). Handbook of Legal & Ethical Aspects of Sex Offender Treatment & Management. London: Wiley-Blackwell.
- Babatsikos, Georgia (2010). "Parents' knowledge, attitudes and practices about preventing child sexual abuse: a literature review". Child Abuse Review. Wiley. 19 (2): 107–129. doi:10.1002/car.1102. ISSN 0952-9136.
- Hébert, Martine; Lavoie, Francine; Parent, Nathalie (2002-06-01). "An Assessment of Outcomes Following Parents' Participation in a Child Abuse Prevention Program". Violence and Victims. Springer Publishing Company. 17 (3): 355–372. doi:10.1891/vivi.17.3.355.33664. ISSN 0886-6708. PMID 12102058. S2CID 33445782.
- Wurtele, Sandy K.; Moreno, Tasha; Kenny, Maureen C. (2008). "Evaluation of a Sexual Abuse Prevention Workshop for Parents of Young Children". Journal of Child & Adolescent Trauma. Springer Nature. 1 (4): 331–340. doi:10.1080/19361520802505768. ISSN 1936-1521. S2CID 146651342.
- Wurtele, Sandy K.; Kenny, Maureen C. (2010). "Partnering with parents to prevent childhood sexual abuse". Child Abuse Review. Wiley. 19 (2): 130–152. doi:10.1002/car.1112. ISSN 0952-9136.
- Williams, Mike (2018). "Four Steps to the Prevention of Child Sexual Abuse in the Home" (PDF). NSPCC.
- Williams, Mike (2018). "Working with a community to prevent child sexual abuse in the home" (PDF). NSPCC. Retrieved 1 August 2018.
- Walsh, Kerryann; Zwi, Karen; Woolfenden, Susan; Shlonsky, Aron (2015-04-16). "School-based education programmes for the prevention of child sexual abuse". The Cochrane Database of Systematic Reviews (4): CD004380. doi:10.1002/14651858.CD004380.pub3. ISSN 1469-493X. PMID 25876919.
- Fergusson, DM; Lynskey, MT; Horwood, LJ (October 1996). "Childhood sexual abuse and psychiatric disorder in young adulthood: I. Prevalence of sexual abuse and factors associated with sexual abuse". J Am Acad Child Adolesc Psychiatry. 35 (10): 1355–1364. doi:10.1097/00004583-199610000-00023. hdl:10523/10282. PMID 8885590. S2CID 32786225.
- Joint Submission by The Office of the Governor C.L. Butch Otter, Governor and The Office of the Attorney General Lawrence Wasden, Attorney General (January 2008). "The Prosecution of Child Sexual Abuse in Idaho July 1, 2006 – June 30, 2007" (PDF). Archived from the original (PDF) on April 11, 2008. Retrieved January 28, 2008.CS1 maint: uses authors parameter (link)
- "KPVI article". kpvi.com. Archived from the original on 25 June 2009. Retrieved 23 March 2015.
- M. S., Denov (1 Aug 2003). "The myth of innocence: sexual scripts and the recognition of child sexual abuse by female perpetrators". The Journal of Sex Research. 40 (3): 303–314. doi:10.1080/00224490309552195. PMID 14533025. S2CID 41459407.
- "Educator Sexual Misconduct: A Synthesis of the Literature", U.S. Department of Education, 2004, p25, Shakeshaft, C." (PDF). ed.gov.
- Maletzky, Barry M. (1988). "Factors associated with success and failure in the behavioral and cognitive treatment of sexual offenders". Annals of Sex Research. 6 (4): 241–258. doi:10.1007/BF00856862. S2CID 198915624.
- Criminology, Australian Institute of (September 30, 2011). "Misperceptions about child sex offenders". Australian Institute of Criminology.
- Shakeshaft, C, "Educator Sexual Misconduct: A Synthesis of the Literature", U.S. Department of Education, 2004, p.24-25.
- "Ontucht voor de rechter" (PDF). Retrieved 2019-10-18.[dead link]
- "Seksueel misbruik minderjarigen vrijwel altijd door bekenden". nos.nl.
- Groth, A. Nicholas; Birnbaum, H. Jean (1978). "Adult sexual orientation and attraction to underage persons". Archives of Sexual Behavior. 7 (3): 175–81. doi:10.1007/BF01542377. PMID 666571. S2CID 11477434.
- Holmes, Ronald M.; Holmes, Stephen T. (2002-03-12). Profiling Violent Crimes: An Investigative Tool. Thousand Oaks, CA: Sage Publications, Inc. ISBN 978-0-7619-2593-4.[page needed]
- "Pedophilia". Psychology Today. Sussex Publishers, LLC. 7 September 2006. Archived from the original on 19 February 2008. Retrieved 9 January 2009.
- E L Rezmovic; D Sloane; D Alexander; B Seltser; T Jessor (1996). "Cycle of Sexual Abuse: Research Inconclusive About Whether Child Victims Become Adult Abusers" (PDF). US Government Accountability Office General Government Division United States. Archived from the original (PDF) on 2011-05-24. Retrieved 2009-01-09.
- Ward, Tony; Hudson, Stephen M.; Marshall, William L. (1995). "Cognitive Distortions and Affective Deficits in Sex Offenders: A Cognitive Deconstructionist Interpretation1". Sexual Abuse: A Journal of Research and Treatment. 7 (1): 67–83. doi:10.1177/107906329500700107. S2CID 145666322.
- World Health Organization, International Statistical Classification of Diseases and Related Health Problems 10. § F65.4
- American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders (fourth edition text revision), § 302.2
- "American Psychiatric Association Statement Diagnostic Criteria for Pedophilia" (PDF). American Psychiatric Association. June 17, 2003. Archived from the original (PDF) on June 29, 2007.
- Weinrott, M. R.; Saylor, M. (1991). "Self-Report of Crimes Committed by Sex Offenders". Journal of Interpersonal Violence. 6 (3): 286–300. doi:10.1177/088626091006003002. S2CID 143721956.
- Lanning, Kenneth V. (2010). Child Molesters: A Behavioral Analysis (PDF) (fifth ed.). National Center for Missing and Exploited Children. pp. 29–30. Archived from the original (PDF) on December 24, 2010. Retrieved June 9, 2010.
- Seto, Michael (2008). Pedophilia and Sexual Offending Against Children. Washington, DC: American Psychological Association. p. vii.
- Schauer, Cathrin (2003). Kinder auf dem Strich: Bericht von der deutsch-tschechischen Grenze (in German). Horleman Verlag. ISBN 978-3895021749.
- "Group of specialists on the impact of the use of new information technologies on trafficking in human beings for the purpose of sexual exploitation (EG-S-NT): Final Report". coe.int. Strasbourg, Alsace, France: Council of Europe. 16 September 2003. Retrieved 31 July 2015.
- Andrea Buskotte 2010: Sexuelle Ausbeutung von Kindern. In: Bernd-Dieter Meier (Hrsg.) Kinder im Unrecht, Junge Menschen als Täter und Opfer, Band 27 von Kriminalwissenschaftliche Schriften, LIT Verlag Münster, ISBN 3643105053 S. 63.
- Adolf Gallwitz, Manfred Paulus 2009: Pädokriminalität weltweit: sexueller Kindesmissbrauch, Kinderhandel, Kinderprostitution und Kinderpornographie. VDP, Verl. Dt. Polizeiliteratur, ISBN 3801105989.
- Amt für soziale Sicherheit ASO, Kanton Solothurn: Grundlagenbericht Dezember 2005/April 2006 (PDF; 220 kB). S. 12
- Niveau, G (2010). "Cyber-pedocriminality: characteristics of a sample of internet child pornography offenders". Child Abuse Negl. 34 (8): 570–5. doi:10.1016/j.chiabu.2010.01.011. PMID 20605633.
- "CSOM Publications". csom.org. Archived from the original on 1 April 2015. Retrieved 23 March 2015.
- Hanson RK, Steffy RA, Gauthier R (August 1993). "Long-term recidivism of child molesters". Journal of Consulting and Clinical Psychology. 61 (4): 646–52. doi:10.1037/0022-006X.61.4.646. PMID 8370860.
- Frisbie, Louise Viets (1965). "Treated Sex Offenders Who Reverted to Sexually Deviant Behavior". Federal Probation. 29: 52.
- "Chapter 5: Adult Sex Offender Recidivism | Sex Offender Management Assessment and Planning Initiative". www.smart.gov. Retrieved 2019-10-18.
- Shaw JA, Lewis JE, Loeb A, Rosado J, Rodriguez RA (December 2000). "Child on child sexual abuse: psychological perspectives". Child Abuse & Neglect. 24 (12): 1591–600. doi:10.1016/S0145-2134(00)00212-X. PMID 11197037.
- Caffaro, J; Conn-Caffaro, A (2005). "Treating sibling abuse families". Aggression and Violent Behavior. 10 (5): 604–623. doi:10.1016/j.avb.2004.12.001.
- Gray A, Pithers WD, Busconi A, Houchens P (June 1999). "Developmental and etiological characteristics of children with sexual behavior problems: treatment implications". Child Abuse & Neglect. 23 (6): 601–21. doi:10.1016/S0145-2134(99)00027-7. PMID 10391518.
- Gray, Alison; Busconi, Aida; Houchens, Paul; Pithers, William D. (1997). "Children with sexual behavior problems and their caregivers: Demographics, functioning, and clinical patterns". Sexual Abuse: A Journal of Research and Treatment. 9 (4): 267–290. doi:10.1007/BF02674853. S2CID 195274544.
- Bromberg, Daniel S.; Johnson, Blair T. (2001). "Sexual interest in children, child sexual abuse, and psychological sequelae for children". Psychology in the Schools. 38 (4): 343–355. doi:10.1002/pits.1023.
- Wieckowski, Edward; Hartsoe, Peggy; Mayer, Arthur; Shortz, Joianne (1998). "Sexual Abuse: A Journal of Research and Treatment". Sexual Abuse: A Journal of Research and Treatment. 10 (4): 293–303. doi:10.1023/A:1022194021593. S2CID 195292356.
- "Abuse of power". Foreignpolicy.com. 14 April 2014. Retrieved 20 April 2014.
- Stoltenborgh, M.; van IJzendoorn, M. H.; Euser, E. M. & Bakermans-Kranenburg, M. J. (2011). "A global perspective on child sexual abuse: meta-analysis of prevalence around the world". Child Maltreatment. 16 (2): 79–101. doi:10.1177/1077559511403920. PMID 21511741. S2CID 30813632.
- Andersson, N.; Paredes-Solís, S.; Milne, D.; Omer, K.; Marokoane, N.; Laetsang, D.; Cockcroft, A. (2012). "Prevalence and risk factors for forced or coerced sex among school-going youth: National cross-sectional studies in 10 southern African countries in 2003 and 2007". BMJ Open. 2 (2): e000754. doi:10.1136/bmjopen-2011-000754. PMC 3293138. PMID 22389362.
- "Child rape survivors saves 'virgin myth' victims". cnn.com. 2009-06-04. Archived from the original on 2012-01-27. Retrieved 2012-04-05.
- Child Rape: A Taboo within the AIDS Taboo: More and more girls are being raped by men who believe this will 'cleanse' them of the disease, but people don't want to confront the issue Archived April 5, 2010, at the Wayback Machine, by Prega Govender, Sunday Times (South Africa), April 4, 1999.
- Thomson Reuters Foundation. "Thomson Reuters Foundation". alertnet.org. Retrieved 23 March 2015.
- "BBC NEWS – Africa – DR Congo child rape victim dies". bbc.co.uk. Retrieved 23 March 2015.
- "Oprah Scandal Rocks South Africa". Time. 5 November 2007. Archived from the original on August 18, 2009. Retrieved 23 March 2015.
- "South Africa's rape shock". bbc.co.uk. Retrieved 23 March 2015.
- South African Men Rape Babies as "Cure" for AIDS, Jane Flanagan, Daily Telegraph (UK), November 11, 2001.
- "Baby rape sparks outrage". abcnews.com. July 30, 2011. Retrieved 2011-07-12.
- "Child rape in South Africa". Medscape. Retrieved 2010-12-31.
- "Bacha bazi: the scandal of Afghanistan's abused boys". The Week. 29 January 2020. Retrieved 16 April 2020.
- Mondloch, Chris (Oct 28, 2013). "Bacha Bazi: An Afghan Tragedy". Foreign Policy. Retrieved 16 April 2020.
- "Bangladesh's teenage brothels hold dark steroid secret". reuters.com. 2012-03-19. Retrieved 2012-03-20.
- "A new danger for sex workers in Bangladesh". guardian.com. 2010-04-05. Retrieved 2012-03-20.
- "Bangladesh's dark brothel steroid secret". bbcnews.com. 2010-05-30. Retrieved 2012-03-20.
- "Study on Child Abuse: India 2007" (PDF). Published by the Government of India, (Ministry of Women and Child Development). Archived from the original (PDF) on 2010-03-26.
- "Parliament passes bill to protect children from sexual abuse". NDTV. May 22, 2012.
- Gannon, Kathy (22 November 2017). "Islamic schools in Pakistan plagued by sex abuse of children". AP News. Retrieved 14 April 2020.
- Ernest, J (26 October 2019). "Why are we silent about the sexual abuse at madrassas?". Pakistan Express Tribune. Retrieved 14 April 2020.
- "Kasur child pornography ring: Lawyer accuses police of protecting culprits". The Express Tribune. August 10, 2015.
- Shahab-ud-Din, Makhdoom (15 July 2019). "Child Pornography in Pakistan: Reality or myth?". Daily Times. Retrieved 16 April 2020.
- "Child pornography a business in Pakistan: FIA cyber-crime chief". Geo News. 13 February 2019. Retrieved 16 April 2020.
- Yen, Cheng-Fang; Yang, Mei-Sang; Yang, Ming-Jen; Su, Yi-Ching; Wang, Mei-Hua; Lan, Chu-Mei (2008). "Childhood physical and sexual abuse: Prevalence and correlates among adolescents living in rural Taiwan". Child Abuse & Neglect. 32 (3): 429–438. doi:10.1016/j.chiabu.2007.06.003. PMID 18308392.
- Dirty Diplomacy, Craig Murray, Scribner, 2007
- "UNICEF strives to help Papua New Guinea break cycle of violence". UNICEF. 18 August 2008. Retrieved 26 February 2014.
- Davidson, Helen (26 November 2013). "Papua New Guinea takes first steps to combat 'epidemic' of abuse". Guardian News and Media Limited. Retrieved 9 March 2014.
- Jewkes, Rachel; Emma Fulu; Tim Roselli; Claudia Garcia-Moreno (10 September 2013). "Prevalence of and factors associated with non-partner rape perpetration: findings from the UN Multi-country Cross-sectional Study on Men and Violence in Asia and the Pacific". The Lancet. 323 (4): e208-18. doi:10.1016/S2214-109X(13)70069-X. PMID 25104346.
- Kendall-Tackett KA, Williams LM, Finkelhor D (January 1993). "Impact of sexual abuse on children: a review and synthesis of recent empirical studies". Psychological Bulletin. 113 (1): 164–80. doi:10.1037/0033-2909.113.1.164. PMID 8426874. S2CID 2512368.
- Finkelhor D (1993). "Epidemiological factors in the clinical identification of child sexual abuse". Child Abuse & Neglect. 17 (1): 67–70. doi:10.1016/0145-2134(93)90009-T. PMID 8435788.
- Goldman, Juliette D. G.; Padayachi, Usha K. (November 2000). "Some methodological problems in estimating incidence and prevalence in child sexual abuse research". Journal of Sex Research. 37 (4): 305–14. doi:10.1080/00224490009552052. S2CID 143565708.
- Gorey, Kevin; Leslie, DR (April 1997). "The prevalence of child sexual abuse: Integrative review adjustment for potential response and measurement biases". Child Abuse & Neglect. 21 (4): 391–398. CiteSeerX 10.1.1.465.1057. doi:10.1016/S0145-2134(96)00180-9. PMID 9134267.
- Radford; Lorraine; Corral; Susana; Bradley; Christine; Fisher; Helen; Bassett; Claire; Howat; Nick; Collishaw; Stephan (2011). "Child abuse and neglect in the UK today" (PDF). NSPCC. p. 5.
- Baker, AW; Duncan, SP (1985). "Child sexual abuse: a study of prevalence in Great Britain". Child Abuse & Neglect. 9 (4): 457–67. doi:10.1016/0145-2134(85)90054-7. PMID 4084825.
- "NSPCC says child sex abuse has risen to 64 crimes a day" BBC News. 26 May 2011. Retrieved February 4, 2012.
- "60 sex offences against children a day – NSPCC" BBC News. 25 January 2010. Retrieved February 4, 2012.
- Malik, Zubeida (2014-08-27). "Barnardo's: Sexual exploitation of boys 'overlooked'". BBC News. Retrieved 23 March 2015.
- "Our cases - Child abuse group actions". Abuselaw.co.uk. Retrieved 15 September 2016.
- Rind, B; Tromovitch, P.; Bauserman, R. (1998). "A meta-analytic examination of assumed properties of child sexual abuse using college samples". Psychological Bulletin. 124 (1): 22–53. doi:10.1037/0033-2909.124.1.22. PMID 9670820.
- "ACF Questions and Answers Support". Administration on Children and Families. US Department of Health and Human Services. Retrieved December 26, 2007.[permanent dead link]
- "Child Maltreatment 2005". Administration on Children and Families. US Department of Health and Human Services. Archived from the original on January 3, 2008. Retrieved December 26, 2007.
- Children's Bureau (31 December 2010). "Child Maltreatment 2010 – Data Tables". Administration for Children and Families. Retrieved 29 January 2018.
- "Child Sexual Abuse". Facts for Families, No. 9. American Academy of Child and Adolescent Psychiatry. May 2008.
- Child Sexual Abuse Fact Sheet. (PDF). Emily M. Douglas and David Finkelhor.
- "Correlates of Adolescent Reports of Sexual Assault: Findings From the National Survey of Adolescents". (PDF). Child Maltreatment Volume:8 Issue:4 Dated:November 2003 Pages:261 to 272
- Herman, Judith (1981). Father-Daughter Incest. Cambridge, Massachusetts: Harvard University Press. p. 282. ISBN 978-0-674-29506-3.
- Sariola, Heikki; Uutela, Antti (1996). "The prevalence and context of incest abuse in Finland". Child Abuse & Neglect. 20 (9): 843–850. doi:10.1016/0145-2134(96)00072-5. PMID 8886468.
- Keuhnle, K., Assessing Allegations of Child Sexual Abuse, Professional Resources Press, Sarastota, FL, 1996[page needed]
- pg7., In. Keuhnle, K., Assessing Allegations of Child Sexual Abuse, Professional Resources Press, Sarastota, FL, 1996
- Tsui, Anjali (July 6, 2017). "Child Marriage in America By Number". apps.frontline.org. Retrieved 2019-10-10.
- Shakeshaft, C, "Educator Sexual Misconduct: A Synthesis of the Literature", U.S. Department of Education, 2004
- Shakeshaft, C, "Educator Sexual Misconduct: A Synthesis of the Literature", U.S. Department of Education, 2004, p26.
- Watkins, B.; Bentovim, A. (1992). "The sexual abuse of male children and adolescents: a review of current research". Journal of Clinical Psychology & Psychiatry. 33 (10): 197–248. doi:10.1111/j.1469-7610.1992.tb00862.x. PMID 1737828.
- Shakeshaft, C, "Educator Sexual Misconduct: A Synthesis of the Literature", U.S. Department of Education, 2004, p22.
- Denov, Myriam S. (2004) "Perspectives on Female Sex Offending: A Culture of Denial"
- Cathy Young (2002). "Double Standard". The Boston Globe. The article may currently be viewed for free on Reason.com.
- Estimated 20,000 British men interested in sexually abusing children The Guardian
- Levesque, Roger J. R. (1999). Sexual Abuse of Children: A Human Rights Perspective. Indiana University Press. pp. 1, 5–6, 176–180. ISBN 978-0-253-33471-8.
The world community recently has recognized every child's fundamental human right to protection from sexual maltreatment. This right has been expressed in recent declarations, conventions, and programs of action. Indeed, the right to protection from sexual maltreatment is now entrenched so strongly in international human rights law that no country can relinquish its obligation.
- "United Nations Convention on the Rights of the Child". Office of the United Nations High Commissioner for Human Rights. 1989. Archived from the original on 2010-06-11.
Parties shall take all appropriate legislative, administrative, social and educational measures to protect the child from all forms of physical or mental violence, injury or abuse, neglect or negligent treatment, maltreatment or exploitation, including sexual abuse ... States Parties undertake to protect the child from all forms of sexual exploitation and sexual abuse. For these purposes, States Parties shall in particular take all appropriate national, bilateral and multilateral measures to prevent: (a) The inducement or coercion of a child to engage in any unlawful sexual activity; (b) The exploitative use of children in prostitution or other unlawful sexual practices; (c) The exploitative use of children in pornographic performances and materials.
- Black's Law Dictionary 8th Edition. child, "at common law, a person who has not reached the age of 14." See also definition under rape "carnal knowledge of a child is frequently declared to be rape by statute."
- "unhchr.ch". www.unhchr.ch.
- United Nations Treaty Collection. Convention on the Rights of the Child Archived 2015-01-22 at the Wayback Machine. Retrieved on 26 November 2008.
- United Nations Treaty Collection. Convention on the Rights of the Child Archived 2014-02-11 at the Wayback Machine. Retrieved 21 May 2009.
- "Government of Somalia ratifies UN Convention on the Rights of the Child". UNICEF. Retrieved 20 January 2015.
- DIRECTIVE 2011/92/EU OF THE EUROPEAN PARLIAMENT AND OF THE COUNCIL of 13 December 2011 on combating the sexual abuse and sexual exploitation of children and child pornography, and replacing Council Framework Decision 2004/68/JHA Eur-lex.europa.eu
- Mintz, Steven (2012-07-13). "Placing childhood sexual abuse in historical perspective – The Immanent Frame". tif.ssrc.org. Retrieved 2018-01-29.
- Conte, Jon (1994). "Child Sexual Abuse: Awareness and Backlash" (PDF). The Future of Children. 4 (2): 224–225. doi:10.2307/1602532. JSTOR 1602532. PMID 7804765. Archived from the original (PDF) on 2017-08-15. Retrieved 2018-01-29.
- Masson, Jeffrey Moussaieff (1984). Assault on the Truth. New York: Farrar Straus. pp. 15–25. ISBN 978-0-374-10642-3.
- Reavey, Paula; Warner, Sam (June 29, 2003). New Feminist Stories of Child Sexual Abuse: Sexual Scripts and Dangerous Dialogues. Routledge. ISBN 9780415259446 – via Google Books.
- Turner, Francis J. (March 15, 2011). Social Work Treatment: Interlocking Theoretical Approaches. Oxford University Press. ISBN 978-0-19-983196-8 – via Google Books.
- "Conversation with History; Dr. Judith Lewis Herman". Conversations with History: Institute of International Studies. UC Berkeley. Retrieved December 22, 2007.
- Herman, JL (1997). Trauma and recovery: The aftermath of violence from domestic abuse to political terror. Basic Books. pp. 119–121.
- Wright, Ph.D Richard G. (2014). Sex offender laws : failed policies, new directions (Second ed.). Springer Publishing Co Inc. pp. 50–65. ISBN 9780826196712.
- From Generation to Generation: Understanding Sexual Attraction to Children, p.15
- B.J. Cling (2004). Sexualized Violence Against Women and Children: A Psychology and Law Perspective. Guilford Press. p. 177. ISBN 978-1-59385-061-6.
- Legislatures, National Conference of State. "State Civil Statutes of Limitations in Child Sexual Abuse Cases". www.ncsl.org. Retrieved 2017-10-18.
- "The Church Child Sex Abuse Scandal Widens and Deepens". dailykos.com. Retrieved 23 March 2015.
- Cifarelli, T.A.,Shielding Minors, Los Angeles Daily Journal, (October 10, 2001).
- "When A Girl Student Stands Up and Wins", Women News Network – WNN, August 11, 2008
- World Health Organization Report on Sexual Violence, 2002
- Lew, Mike (2004). Victims No Longer: The Classic Guide for Men Recovering from Sexual Child Abuse (2nd ed.). Perennial Currents. ISBN 978-0-06-053026-6.
- Cynthia Crosson-Tower (2008). Understanding child abuse and neglect. Boston: Pearson/Allyn & Bacon. ISBN 978-0-205-50326-1.
- Asa Don Brown (2009). "Posttraumatic stress disorder in childhood". New Orleans: Family and Marriage Counseling, FMC. Cite journal requires
- Lascaratos, J; Ascaratos J; Poulakou-Rebelakou, E (2000). "Child Sexual abuse: Historical cases in the Byzantine Empire (324–1453 A.D.)". Child Abuse & Neglect. 24 (8): 1085–1090. doi:10.1016/S0145-2134(00)00156-3. PMID 10983818.
- Durkin, KF; Clifton DB (1999). "Propagandizing pederasty: A thematic analysis of the on-line exculpatory accounts of unrepentant pedophiles". Deviant Behavior. 20 (2): 103–127. doi:10.1080/016396299266524.
- Zimring, Franklin E. (2009). An American Travesty: Legal Responses to Adolescent Sexual Offending. University of Chicago Press. ISBN 978-0-226-98358-5.
- Media related to Child sexual abuse at Wikimedia Commons
- American Academy of Child and Adolescent Psychiatry Facts for Families: Child Sexual Abuse
- Men who molest their sexually immature daughters: Is a special explanation required?
- Child Abuse: Sexual Abuse at Curlie
- 2017 child sexual abuse statistics from Darkness to Light