Child Sexual Abuse: A Review Of The Literature

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Child Sexual Abuse:A Review of the LiteratureTHE JOHN JAY COLLEGE RESEARCH TEAMKAREN J. TERRY, Ph.D.PRINCIPAL INVESTIGATORJENNIFER TALLONPRIMARY RESEARCHER

PART I – LITERATURE REVIEWThis literature review provides the reader withan overview of major academic worksconcerning child sexual abuse in the generalpopulation. This is a comprehensive review ofthe available literature, though it is not a metaanalysis (a synthesis of research results usingvarious statistical methods to retrieve, select,and combine results from previous studies).During the course of the past thirty years, thefield of sex offender research has expanded andbecome increasingly inter-disciplinary. It wouldbe nearly impossible to review every piece ofinformation relating to the topic of child sexualabuse. Instead, this is a compilation ofinformation pertaining to theories, typologiesand treatments that have attained generalacceptance within the scientific community.In reviewing the literature concerningsexual abuse within the Catholic Church, theamount of empirical research was limited, andmanyofthestudiessufferedfrommethodological flaws. Additionally, much of theliterature consisted of either anecdotalinformationorimpassionedargumentsemployed by various researchers whencharacterizing the responses of the church tothis incendiary issue. In providing the readerwith a comprehensive review, it was necessaryto summarize every point of view no matter howcontroversial. Any of the ideas expressed in thisreview should not be considered indicative ofthe point of view of either the researchers atJohn Jay College of Criminal Justice, or theCatholic Church.One aim of this literature review is toput into perspective the problem of child sexualabuse in the Catholic Church as compared to itsoccurrenceinotherinstitutionsandorganizations. However, there is little or noempirical data pertaining to the true prevalenceof sexual abuse within most other organizations.For this reason, the sexual abuse of children inthe Catholic Church is difficult to contextualizebecause there is no basis for comparison in anygroup, including the general population. Somejournalists have conducted research on sexualabuse in particular organizations, such as theBoy Scouts. Though this work is an importantstep in studying the problem, it is notcomprehensive in nature and more empiricalwork should be conducted on institutions thatcater to children. Though not empirical innature, this literature review does contain anoverview of published newspaper articles onchild sexual abuse in specific organizations.

TABLE OF CONTENTSEstimates of Child Sexual Abuse.3Overview.3Criminal Justice and Social Service Data.3Research Estimates .5Reporting Child Sexual Abuse.6Victim’s Relationship to the Perpetrator.7Severity of Sexual Abuse .8Developmental and Cognitive Variables.8Fear of Negative Consequences.8Gender Differences .8Child Sexual Abuse within Specific Organizations .8Boy Scouts .8Big Brother .9Young Men’s Christian Association (YMCA) .10Athletic Organizations.10Child Caregivers .10The Catholic Church .11Theories and Etiology of Child Sexual Abuse .13Biological Theory .13Psychodynamic Theory .14Behavioral Theory .14Attachment Theory .15Cognitive-Behavioral Theory .15Integrated Theory.17Theories of Offending by Catholic Priests .19The Offense Cycle.21Grooming .22Typologies of Child Sexual Abusers .24The Fixated/Regressed Typology.24The FBI Typology .26The MTC:CM3 Typology.27Other Typologies .29Characteristics of Child Sexual Abusers in the Catholic Church .30Evaluation of Sex Offenders.32Models of Treatment for Sexual Offenders who Abuse Children .35Overview.351

Cognitive-Behavioral Treatment and Relapse Prevention .35Deviant Sexual Behavior and Interests .35Social Skills Deficits .36Cognitive Distortions .36The Relapse Prevention Process .37Treatment Efficacy Studies .38Pharmacological Treatments .38Sex Offender Treatment for Priests.39Victims of Child Sexual Abuse by Priests .40Bibliography .41CHARTS, FIGURES AND TABLESFigure1: Child sexual abuse rates 1992-2001 .3Figure 2: Percent of child abuse victims 1992-2001 .3Figure 3: The fixated/regressed typology continuum.25TableTableTableTable1:2:3:4:Summary of theories on child sexual abuse.20Characteristics of fixated and regressed child sexual abusers.26FBI typologies of child sexual abusers.27The MTC: CM3 classification of child sexual abusers.282

Estimates of Child Sexual AbuseOVERVIEWwho have been victims of child sexual abuse.Figure 1National Child Sexual Abuse Rate, 1992-2001The estimation of any form of deviance in thegeneral population is a very difficult task. It isimpossible to assess the extent of sexualoffending, either in general or with children astargets. Most estimates of the distribution ofsexual offenders in the general population arederived from forensic sources, that is, samplesof those who are arrested or convicted for sexoffenses. All researchers acknowledge that thosewho are arrested represent only a fraction of allsexual offenders. Sexual crimes have the lowestrates of reporting for all crimes. Not all potentialparticipants in such studies can be known orcontacted, not all would use the same languageto describe their experiences, and not all arewilling to share information. The sexual abuse ofchildren by Catholic priests and deacons is partof the larger problem of sexual abuse of childrenin the United States. This chapter is a summaryof the estimates of child sexual abuse in theCatholic Church as well as the generalpopulation.250Sexual Abuse Rate per 100,000 Child 001992CRIMINAL JUSTICE AND SOCIAL SERVICEESTIMATES OF CHILD SEXUAL ABUSE19931994199519961997199819992000Figure 2.Child Victims of Sexual Abuse as a % ofChild Population, 1992-2001Child sexual abuse data has been collectedannually since 1992 through the National ChildAbuse and Neglect Data System (NCANDS) ofthe Federal Department of Health and HumanServices. These data are based on incidentlevel reports gathered from state child protectiveservices and agencies and are published in anannual report. The publication ChildMaltreatment, which is released annually,reports incident-based allegations per statealong with census-based estimates of thepopulation of children younger than 18. Childsexual abuse is defined as “maltreatment thatinvolves the child in sexual activity to providesexual gratification or financial benefit to theperpetrator” (Child Maltreatment, 2001). Childmaltreatment reports show a decline in reportedincidents from 1992 to 2001 for all reportingstates. Figure 1 shows the incident dataexpressed as a rate per 100,000 children. Figure2 shows the percent of the total child population0.25%0.21%0.23%0.19%Child Victims in Hundredths of a 000It is important to note that social serviceagencies and criminal justice institutions eachonly capture part of the picture. Incidents orevents involving the sexual abuse of children320012001

may be reported directly to the police and/ormay come to the attention of the staff of socialservice agencies. It is important toacknowledge that many such incidents may notgenerate any official report at all.As a part of the work on the Study,state-level criminal justice data on theprevalence of child sexual abuse were soughtfrom all 50 states and the District of Columbia.The agencies were asked for: 1) the number ofoffenders arrested for sex crimes againstchildren for a series of years, 2) the number ofchild victims of sexual assault or abuse, 3)demographic information for both offenders andvictims, and 4) conviction rates of thoseoffenders arrested for child sexualabuse/assault. Of 49 states, only 13 hadcriminal justice system data available. Thosestates that have implemented the NationalIncident-Based Reporting System (NIBRS),which collects crime information at the incidentlevel and includes victim age, were able toprovide the requested data, if only for the mostrecent year. NIBRS collects data on thefollowing types of sex crimes: forcible rape,forcible sodomy, sexual assault with an object,forcible fondling, incest and statutory rape.In the summaries below, this criminaljustice data from NIBRS is compared to theNCANDS data. These comparisons generallyshow that state criminal justice systems arereporting considerably more incidents of sexualabuse than the social service agencies. Thedecline shown in the charts on the previouspage may therefore be a result of a change inthe patterns of response by victims' families,with more incidents now being reported to thepolice.It should be noted that somediscrepancies were found between the NCANDSdata and the data obtained from the state socialservice agency for the same year. Oneexplanation for this may be due to the fact thatNCANDS collects data from a calendar yearperiod and some state agencies collect datafrom a fiscal year period when publishing theirown reports. Additionally, some data – such asthat from California – are taken from theOffender Based Transaction Statistics Systemwhere only those offenders who have received a“final disposition” are included; therefore, thesenumbers may be substantially smaller than acount of arrests for child sexual abuse would be. 4ALABAMA There were 632 child rapesreported to the Alabama state criminaljustice agency in 2001, for a reported rateof 56 per 100,000 children. The NCANDSrate for all incidents of abuse is 174 per100,000 children.DELAWARE Delaware’s criminal justicedata reported 510 child victims of sexualassault crimes in 1995, for a rate of 285per 100,000 children. This data was takenfrom a report requested by the AttorneyGeneral’s Task Force on Child Victims andincludes all known incidents of sexualassault against children where an arrestoccurred. In contrast, the NCANDS reportfor 1995 shows only 200 incidents, for arate of 112 per 100,000 children.CALIFORNIA A total of 13,075 offenderswere convicted of sex crimes againstchildren in the state of California for theyear 2001, for a rate of 141 sexual abuseconvictions per 100,000 children. TheNCANDS rate for the same year is 112sexual abuse incidents per 100,000children.IDAHO NIBRS data shows that in 2001there were 1,363 victims of child sexualabuse known to the state criminal justicesystem, for a rate of 363 victims per100,000 children. The NCANDS rate ismuch smaller -- 295 known child victims,for a rate of 79 per 100,000 children.IOWA The NIBRS data set for Iowashows that in 2001 there were 1,454 childvictims of sex crimes, for a rate of 198victims per 100,000 children. TheNCANDS data reports 1,031 victims, or arate of 141 incidents per 100,000 children.MICHIGAN Michigan’s NIBRS data setindicates a total of 1,812 rape victims whowere infants or children up to age 14, andanother 1,269 rape victims who werechildren between 15 and 19 years old. Incontrast, the 2001 NCANDS data reported1,656 incidents of sexual abuse onchildren 19 and under.SOUTH CAROLINA South Carolina’sNIBRS data indicates that in 2000 therewere 2,438 child victims (infants tochildren 16 years old) of forcible sexcrimes. The NCANDS data reports 610incidents of child sexual abuse in 2002.SOUTH DAKOTA In South Dakota, theNIBRS data set shows 131 child victimsof crimes from rape to forcible fondling,

while the NCANDS data shows 169incidents of child sexual abuse.TENNESSEE The NIBRS system forTennessee reports 3,488 child victims ofcrimes of sexual abuse for the year2001, a rate of 248 crimes per 100,000children. The NCANDS data reports2,333 incidents in 2001, for a rate of166 per 100,000 children. RESEARCH ESTIMATES Prevalence refers to the proportion of apopulation that has experienced a particularevent or behavior. Since it is not known howmany people in the United States experience aform of sexual abuse as children, someresearchers select groups, or samples, ofindividuals to study and direct questions tothem. If the selection of the group to besurveyed is not biased, the results of the studyprovide estimates of the prevalence of sexualabuse in the population from which the group isselected. In order to avoid bias in a sample,every person in the part of the population to beused as a framework for selecting the samplemust have an equal chance of being asked toparticipate. Researchers use the data gatheredfrom those who participate to estimate theproportion of the United States population whoare sexually abused during childhood.Studies of the incidence, as opposed tothe prevalence, of sexual abuse of childrenconcentrate on estimating the number of newcases occurring over a particular period of timeand on whether the number of events orincidents is increasing or decreasing. Scholarlystudies of both the incidence and the prevalenceof sexual abuse of children in the United Statesbegan emerging in the 1960s and gainedgreater urgency after the cluster of day carecenter child abuse cases in the 1980s made theissue one of acute public interest. A look atvictimization studies that focus on the sexualabuse of minor children suggests that the scopeof this problem is extensive.Although we do not have data reflectingthe prevalence of abusers, there are data fromseveral studies reporting the prevalence ofvictimization. The prevalence rates reported inthese studies vary somewhat. 27% of the females and 16% of themales disclosed a history of childhoodsexual abuse; 42% of the males werelikely to never have disclosed theexperience to anyone whereas 33% ofthe females never disclosed (Finkelhoret al., 1990).12.8% of the females and 4.3% of themales reported a history of sexual abuseduring childhood (MacMillan et al.,1997).15.3% of the females and 5.9% of themales experienced some form of sexualassault (Moore, Nord, & Peterson,1989).Only 5.7% of the incidents werereported to the police; 26% of theincidents were not disclosed to anyoneprior to the study (Boney-McCoy &Finkelhor, 1995).In summary, when compared with theirmale counterparts, females were morelikely to have been sexually abusedduring childhood. Furthermore, femaleswere more likely than the males todisclose such information; however,disclosure rates are quite low regardlessof the victim’s gender.Finkelhor and Jones (2004) have useddata from NCANDS to make a national estimateof the number of sexual abuse casessubstantiated by child protective service (CPS)for the period from 1992 to 2000. Using datafrom more than forty states they report that thenumber of substantiated sexual abuse casespeaked at approximately 149,800 in 1992,followed by annual declines of 2 to 11 percentper year through 2000-when the number ofcases reached a low of approximately 89,355.Professional opinion is divided aboutwhy this drop occurred and how much of thedrop is real as opposed to a reflection of factorssuch as changes in definitions, reporting andinvestigation by the states (Jones and Finkelhor,2001; Jones, Finkelhor, and Kopiec, 2001).Finkelhor and Jones (2004) examined otherindicia of sex abuse rates and conclude that,taken together, they suggest that at least partof the drop in cases has resulted from a declinein sexual abuse of children. The National CrimeVictimization Survey (NCVS) - which asks aboutrape and sexual assault for victims ages 12 and5

older (including acts counted within the broaderdefinition of child sexual abuse) shows that sexoffenses against children ages 12-17 declined 56percent between 1993 and 2000. Virtually all thedecline occurred in offenses committed byknown perpetrators (family and acquaintances),72 percent. Finkelhor and Jones observe thatcases involving known perpetrators are the onesmost likely to be categorized as sexual abuse.Another source of self-report data onsexual abuse is the Minnesota Student Surveywhich has been administered to 6th, 9th, and12th grade students in Minnesota in 1989, 1992,1995, 1998, and 2001. Between 90 and 99percent of Minnesota's school districts and morethan 100,000 students have participated in thesurvey each year. The survey includes twoquestions about sexual abuse. Results indicatethat sexual abuse by family and nonfamilyperpetrators showed a slight rise between 1989and 1992 followed by a 22-percent drop from1992 to 2001.At the same time reports of sexualabuse have declined, there has been asignificant drop in crime rates and measures offamily problems, such as violence among adultintimates, and a drop in of out-of-wedlockteenage pregnancies and live births to teenagemothers (some of which are attributable to childsexual abuse) – all of these suggest a generalimprovement in the well-being of children.Additionally, Finkelhor and Jonessuggest that rates of sexual abuse have perhapsbeen reduced as a result of increasedincarceration for sexual abuse offenders. Theyreport that surveys of state correctional facilitiesindicate that between 1991 and 1997, thenumber of individuals incarcerated in statecorrectional facilities for sex crimes againstchildren rose 39 percent, from 43,500 to 60,700(Finkelhor and Ormrod, 2001), having alreadymore than doubled from 19,900 in 1986. Theyfurther note that these totals do not includelarge numbers of sexual abusers who receivesanctions that do not involve incarceration for ayear or more.Statistics from recent United StatesJustice Department studies of the prevalence ofyouth victimization confirm what other surveyshave found: a startling proportion of y

PART I – LITERATURE REVIEW This literature review provides the reader with an overview of major academic works concerning child sexual abuse in the general population. This is a comprehensive review of the available literature, though it is not a meta-analysis (a synthesis of research results using various statistical methods to retrieve, select,