Child Sexual Abuse (CSA) is a pressing human right issue and public health concern. We conducted a systematic review of quantitative and qualitative studies published in the past decade on CSA in India to examine the distribution of the prevalence estimates for both genders, to improve understanding of the determinants and consequences of CSA and identify gaps in the current state of research.

Given the fact that child abuse and intimate partner violence often co-occur, intra-household bargaining models provide a useful framework to investigate the relationship between macro-economic factors and child sexual abuse (CSA). Non-cooperative bargaining models predict that labor market opportunities that benefit women improve their bargaining power and lead to lower levels of intimate partner violence against them. We posit that this protective effect extends to children as well, and exploit exogenous variation in macro-economic factors to examine the impact of gender specific wages and employment on police reported CSA in South Carolina, Tennessee, and Virginia from 2006 to 2019. The empirical analysis provides evidence that narrowing the gender wage gap leads to a decline in police reported CSA incidents perpetrated by mothers' intimate partners, whereas improvements in relative employment opportunities do not yield any such effects. Consistent with previous literature, our results show that wages, not employment, determine bargaining power. The findings also underscore important spillover benefits of policy solutions directed towards narrowing the gender wage gap.

Vaginal foreign bodies are a complaint occasionally encountered in pediatric clinics and emergency departments, and when pediatric patients present with a vaginal foreign body sexual abuse may not be considered. We describe two children with vaginal foreign bodies who were found to have been sexually abused. Each child had a discharge positive for a sexually transmitted infection despite no disclosure or allegation of abuse. We recommend that all pre-pubertal girls who present with a vaginal foreign body should be considered as possible victims of sexual abuse and should receive a sexual abuse history and testing for sexually transmitted infections.

Experts in clinical evaluations of child sexual abuse were studied using a paradigm that requested them to estimate the likelihood of a 3-year-old child having been sexually molested by her father, as alleged by her mother, when she was two years old. All of the experts claimed special qualifications and experience in the field of diagnosing and treating child sexual abuse victims. Expert-respondents provided two estimates of the likelihood that the child had been molested, the first following a detailed presentation of the clinical case by the actual evaluator of the child (the presentation included opportunities to ask questions ad libitum beyond the presentation material), the second following an extensive discussion of the clinical material with other child experts present. The range of estimated likelihoods that the child had been molested was extreme among the expert respondents. The clinical conference format that was used seemed to provide the experts with no apparent means for eliminating or reducing differences in their clinical opinions. Recommendations concerning how the supervising court should regulate further child-father contacts were similarly varied. The implications of these findings for judicial acceptance of expert testimony in cases of alleged child sexual abuse are discussed.

Background: Existing efforts to understand school-based child sexual abuse (CSA) prevention programs mainly focus on the effectiveness of these programs in increasing participants' CSA knowledge and self-protective skills. There are currently no reviews addressing the underpinning pathways leading to these outcomes. In order to increase our understanding about the underpinning causal and contextual factors and inform the further development of school-based CSA prevention programs, a realist review was conducted to synthesize existing evidence from a broad range of data. Methods: An iterative search of electronic databases and grey literature was conducted, supplemented with citation tracking to locate relevant literature. For quantitative evidence, we considered evaluation studies that focused on students aged 5-18 years, who were enrolled in primary or secondary schools; for other types/formats of studies/documents, no population restrictions were applied. We included school-based CSA prevention programs that focused on improving knowledge of CSA or self-protective skills. Outcomes of interest included knowledge of CSA or self-protective skills. We did not apply methodological filters in terms of the types of studies to be included. Thematic content analysis was conducted to synthesize data. Results: Sixty-two studies were included. Five themes and five overarching Context-Strategy-Mechanism-Outcome configurations (CSMOs) that contributed to the success of school-based CSA interventions were identified, including tailoring programs to participants' cognitive developmental levels, repeated exposure of key concepts and skills, utilization of interactive delivery methods and positive feedback, delivery of positive information and application of the 'train-the-trainer' model. Implications: Findings from this realist review provide insights into the underlying program theory of school-based CSA prevention programs, which can aid in the development and implementation of these programs in the future.

Livestreaming of child sexual abuse (LSCSA) is an established form of online child sexual exploitation and abuse (OCSEA). However, only a limited body of research has examined this issue. The Covid-19 pandemic has accelerated internet use and user knowledge of livestreaming services emphasizing the importance of understanding this crime. In this scoping review, existing literature was brought together through an iterative search of eight databases containing peer-reviewed journal articles, as well as grey literature. Records were eligible for inclusion if the primary focus was on livestream technology and OCSEA, the child being defined as eighteen years or younger. Fourteen of the 2,218 records were selected. The data were charted and divided into four categories: victims, offenders, legislation, and technology. Limited research, differences in terminology, study design, and population inclusion criteria present a challenge to drawing general conclusions on the current state of LSCSA. The records show that victims are predominantly female. The average livestream offender was found to be older than the average online child sexual abuse offender. Therefore, it is unclear whether the findings are representative of the global population of livestream offenders. Furthermore, there appears to be a gap in what the records show on platforms and payment services used and current digital trends. The lack of a legal definition and privacy considerations pose a challenge to investigation, detection, and prosecution. The available data allow some insights into a potentially much larger issue.

We intended to analyze the credibility judgment in written forensic psychiatric reports of child sexual abuse registered in Southern Taiwan.

Child Sexual Abuse (CSA) is a worldwide persisting public health problem which has generated interesting discussions within child protection scholarship. Globally as well as in Botswana, CSA estimates prove challenging to establish. This study sought to establish the extent of CSA in Botswana by use of existing data as well as narratives from key informants.

The aim of the study was to investigate peoples' views of characteristics associated with child sexual abuse (CSA) and place them in order of severity for subsequent trauma. Clinically relevant characteristics of CSA were presented in the form of a questionnaire to a sample of professionals working with CSA, a sample of student nonprofessionals and a sample of patients with eating disorders including a high proportion of CSA victims. A significant consensus existed across the three samples in the ranked order of characteristics from most to least severe for perceived adverse long-term outcome. Respondent sex, social class, or past sexual abuse experience had no significant effect on this concordance. The findings of this study have shown that professional, nonprofessional, and psychiatric patients opinions on CSA severity are consistent and coincide with clinical observations and empirical evidence. It is argued that a shared consensus on traumatic effects of CSA characteristics is important for the therapeutic process and may prove useful as a guideline for the assessment of severity in CSA cases.

The consequences of child sexual abuse (CSA) can be significant and can affect short-term and long-term mental, sexual and physical health. In order to offer timely and appropriate care for the child, early recognition of CSA is necessary. The lack of specific physical and psychological signs and barriers to abuse disclosure that these young victims face makes it difficult for medical and psychological professionals to recognise and confirm CSA signs. We aimed to validate the Sexual Knowledge Picture Instrument (SKPI) as a diagnostic instrument for CSA.

The significance of affective changes in psychosis is increasingly acknowledged, as is the role of early traumatic events. In a previous paper, using data from the English Adult Psychiatric Morbidity Survey 2007 (APMS2007), strong associations between child sexual abuse (CSA) and psychosis were demonstrated, with some evidence of mediation by affect. In the current paper, we subjected the same dataset to formal tests of mediation. For CSA involving sexual intercourse, 38.5% of the link was mediated, 30.0% by depression and 8.5% by anxiety. For all forms of contact abuse, 38.2% was mediated, 29.1% by depression and 9.1% by anxiety.

Child sexual abuse among adolescents is an often overlooked issue in pediatrics, yet it is a major cause of low self esteem and stigmatization in adolescents. The objective of this study was to determine the socioeconomic determinant and pattern of child sexual abuse among adolescent attending secondary schools in South East Nigeria.

Childhood sexual abuse (CSA) is associated with long-lasting and pervasive impacts on survivors' sexual health, particularly on their sexual satisfaction. Dispositional mindfulness has been found to be associated with greater sexual satisfaction among adult CSA survivors. However, the mechanisms involved in this association remain understudied. The present study examined the role of sexual self-concept (i.e., sexual esteem, sexual preoccupation, and sexual depression) in the relationship between dispositional mindfulness and sexual satisfaction among CSA survivors. A total of 176 adult CSA survivors (60.6% women, 39.4% men) completed an online survey assessing dispositional mindfulness, sexual self-concept, and sexual satisfaction. Path analyses revealed that dispositional mindfulness was positively related to sexual satisfaction through a significant indirect effect of higher sexual esteem and lower sexual depression. The integrative model explained 66.5% of the variance in sexual satisfaction. These findings highlight the key roles that dispositional mindfulness and sexual self-concept play in CSA survivors' sexual satisfaction. Implications for interventions based on trauma-sensitive mindfulness targeting the sexual self-concept are discussed, as they may promote sexual satisfaction in adult CSA survivors.

Child sexual abuse (CSA) is an important public health problem with long-standing neurobiological, developmental, and psychiatric abnormalities. The present review analyzes the long-term effects of CSA from a developmental, psychiatric morbidity, neurochemical and neurobiological perspective and then tries to posit a developmental neurobiological trajectory from CSA to the genesis of psychopathology in later life. The role of various neurotransmitters such as serotonin and dopamine affected by CSA are discussed. Serotonin abnormalities have been reported in various studies among participants exposed to CSA. Structures such as the prefrontal cortex, superior temporal gyrus, corpus callosum, parietal lobes, hippocampus, and cerebellum all demonstrate volumetric and structural changes in response to the trauma of CSA. Neurocognitive studies demonstrate memory and spatial awareness as well as decrements in general cognitive performance and memory when compared to normal individuals. The hypothalamic-pituitary-adrenal axis has also been implicated in CSA, and there is an alteration in corticotropin-releasing hormone response due to the continuous cumulative trauma of CSA. This paper also reviews a section on the role of genetic and epigenetic factors in the development of psychiatric disorders as a result of exposure to episodes of CSA where studies have demonstrated changes in DNA methylation in response to CSA. This review tries to hypothesize a developmental trajectory framework which is individual for every case where exposure to CSA may lead to psychopathology and psychiatric morbidity later in life. Rapid and emerging fields such as developmental traumatology in relation to CSA are also discussed.

Child sexual abuse (CSA) is a public health problem of considerable magnitude. The prevailing primary prevention strategies are universal, school-based CSA prevention programs, some of which have been designated as evidence-based, such as Safe Touches. However, to reach their public health impact potential, effective universal school-based CSA prevention programs require effective and efficient dissemination and implementation strategies. The purpose of this study was to demonstrate the reach and effectiveness of a school-based CSA prevention curriculum, Safe Touches, when implemented on a wide scale. Using a longitudinal cohort design, children in second grade classrooms in public elementary schools in five counties received the Safe Touches workshop and completed surveys designed to assess gains in knowledge at four timepoints (one week prior, immediately post-workshop, 6- and 12-months post-workshop). In total, the Safe Touches workshop was delivered in 718 classrooms in 92% of school districts, reaching ~14,235 second graders. Multilevel models (n = 3,673) revealed that Safe Touches significantly increased CSA-related knowledge, and that these gains were maintained 12-months post-workshop (ps < .001). There were some small but significant time-varying effects among participants in schools with a greater percentage of low income and minority students, but these effects largely disappeared 12-months post workshop. This study demonstrates that a single-session, universal school-based CSA prevention program can effectively increase children's knowledge when implemented and disseminated on a wide scale and knowledge gains can be retained 12-months post intervention.

Child sexual abuse (CSA) poses a significant threat to the health and well-being of children in the USA and globally. Many states have introduced or implemented policies to address and prevent CSA, but little research has linked the effects of this legislation on the reduction of adult-perpetrated CSA. The objective of this scoping review is to identify US policies which aim to prevent CSA, explain the components of these types of legislation, review evidence of effectiveness, describe the populations included in the literature, and identify barriers and facilitators to the implementation of said policies.

This systematic review is the first to synthesize knowledge of parental involvement in child sexual abuse (CSA) prevention programs. Guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria, 24 intervention evaluations met the inclusion criteria of aiming to change parental knowledge, attitudes, behaviors, behavioral intentions, self-efficacy, response-efficacy, or capabilities for prevention of CSA. Included papers were identified via a combination of electronic database searches (PsycINFO, Web of Science, Scopus, Google Scholar, Cochrane Library, World Health Organization's International Clinical Trials Registry Platform, google.com.au, open.grey.eu, Global ETD, Open Access Theses & Dissertations, EThOS, and Trove) and direct communication with researchers. Improvement post intervention was found most commonly for parental behavioral intentions and response-efficacy, closely followed by parental behaviors, then capabilities, self-efficacy, knowledge, and lastly, parental attitudes. Improvements in behaviors, intentions, and response-efficacy occurred in 88 to 100% of the studies in which they were addressed, improvements in self-efficacy and capabilities occurred in 67 to 75%, and improvements in knowledge and attitudes occurred in only 50 to 56%. Many of the included evaluation studies suffered from methodological and reporting flaws, such as high participant attrition, lack of control group, lack of statistical tests, missed testing time points, and a lack of (or short) follow-up. Future parent-focused CSA prevention evaluations must address these concerns by conducting rigorous empirical research with sound methodologies and comprehensive reporting. Furthermore, study designs should consider measuring the real-world impact of increases in assessed parent variables, including their ability to prevent sexual victimization of children.

Child sexual abuse (CSA) occurs frequently in society to children aged between 2 and 17. It is significantly more common in girls than boys, with the peak age for CSA occurring when girls are aged 13-17. Many children experience multiple episodes of CSA, as well as having high rates of other victimizations (such as physical assaults). One of the problems for current research in CSA is different definitions of what this means, and no recent review has clearly differentiated more severe forms of CSA, and how commonly this is disclosed. In general we suggest there are four types of behavior that should be included as CSA, namely (1) non-contact, (2) genital touching, (3) attempted vaginal and anal penetrative acts, and (4) vaginal and anal penetrative acts. Evidence suggests that CSA involving types (2), (3), and (4) is more likely to have significant long-term outcomes, and thus can be considered has having higher-impact. From the research to date approximately 15% of girls aged 2-17 experience higher-impact CSA (with most studies suggesting that between 12 and 18% of girls experience higher-impact CSA). Approximately 6% of boys experience higher-impact CSA (with most studies suggesting that between 5 and 8% experience higher-impact CSA). The data also suggests that in over 95% of cases the CSA is never disclosed to authorities. Thus, CSA is frequent but often not identified, and occurs "below the surface" in the vast majority of higher-impact cases. Helping adults to understand "below the surface" CSA might help them to recognize it early, but there are very few indicators specific to CSA, making this a challenging goal to achieve. Nonetheless, given that CSA frequently occurs with other types of abuse, a training program that focuses on both CSA and other abuse may offer a method to allow both early recognition and prevention by adults in the general population.

This article examines the experiences of female partners and relatives of child sexual abuse material offenders and the (il)legibility of their experiences within prevailing theoretical frameworks and policy responses to violence against women. Drawing on survey and interview data with clients of a specialist support agency, we situate the lack of understanding and support available to these women within the systematic depoliticization of child sexual abuse. The article traces how women developed their own social critique of child sexual exploitation as a form of gendered violence and called for a feminist reengagement with the politics of child sexual abuse.

Child sexual abuse (CSA) is a global problem that affects children of all ages, and the evaluation of these victims by psychologic and gynecologic experts in pediatric emergency departments is an important issue. Few data are available on the characteristics of children admitted to pediatric emergency department with recurrent CSA and delayed reported CSA. The aim of the present study was to describe the clinical features of, and risk factors for, recurrent CSA and delayed reported CSA. The study retrospectively analyzed victims of CSA who were admitted to a pediatric emergency department. Chi-square tests and univariate analyses were performed to assess the risk factors of recurrent or delayed reported CSA. Of the 91 CSA cases, 32 (35.2%) were recurrent assaults. Of the 70 cases recorded the duration of the event, 22 (31.4%) were delayed report cases. Comparisons of the non-recurrent and recurrent CSA assault groups revealed a significant increase in comorbidities (odds ratio [OR]: 4.46, 95% confidence interval [CI]: 1.54-12.93), acute psychiatric problems (OR: 3.18, CI: 1.26-8.06), attempted suicide (OR: 4.23, CI: 1.28-13.99), and the need for treatment with antipsychotic medications (OR: 5.57, CI: 1.37-22.65). Compared with non-delayed reported cases, the delay reported cases of CSA were significantly more likely to have anxiety (P < .05). The CSA victims in the present study exhibited acute medical and/or psychosocial problems, which indicate that pediatric emergency professionals have a responsibility to look for and recognize particular characteristics in these victims.