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Child Sexual Abuse - A Psychologist's Responsibilities

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-Child Sexual Abuse- A Psychologist's Responsibilities Name: Penny Hayden Student i.d: 2133799 Tutor: Colleen Respondek Tutorial: Tuesday 6pm Subject: Psyc 347 Abstract The pervasiveness of child sexual abuse in our society is becoming increasingly clear through an academic climate that no longer views this abuse as taboo. However, society at large seems reluctant to acknowledge let alone deal adequately with the issue. Psychologists, primarily because of the nature of their role, are continually faced with harrowing tales of child sexual abuse. As a group, psychologists cannot avoid the issue (Read, Kirsty, Argyle & Aderhold, 2003). Increasingly, research suggests that childhood sexual abuse places a person at a greater risk of a vast array of psychological problems. As a form of prevention psychologists play an important role in educating the public and providing current research (Paolucci, Genius & Vialato, 2001). Child sexual abuse is one of the most pervasive social problems faced by our society (Edwards, George, Holden, Felitti, Anda, 2003). Its impact is profound not only because of the frequency with which it occurs, but also because of the substantial trauma brought to the lives of victims. Historically, the sexual abuse of children was addressed reluctantly due to it being viewed as a disturbing taboo topic. In recent years the mental health profession has developed an understanding of the frequency and magnitude of concern necessary when dealing with child sexual abuse. This perspective is unavoidable as clinicians repeatedly see the manifestation of sexual abuse in the lives of their clients.


Schizophrenia is also believed to be heavily influenced by CSA. Read et al. (2003) cited that among inpatients diagnosed with schizophrenia 60% females and 48% males had suffered from CSA. Read et al. (2003) found that among women at a psychiatric emergency room, 53% of those who had suffered CSA had schizophrenia compared with 25% of those not exposed to CSA. Similar, statistics have been found with those diagnosed with borderline personality disorder (BDP). Zanarini, (2000) states that there is considerable consensus across studies regarding the prevalence of CSA in BDP patients, with rates ranging from 20% to 80%. Zanarnini (2000) cites a study of the psychosocial status of women prison inmates conducted by Jordan (1999). The analyses of early traumatic experiences for inmates with a diagnosis of BDP showed that 32% had been sexually assaulted before the age of 11. Herman and van der Kolk (1987) reported that BDP is related to posttraumatic stress disorder (PTSD) due to the early childhood trauma, including sexual abuse. The identification of increased psychophysiological reactivity and other neurobiological sequelae in adults with combat - related PTSD stimulated the search for similar effects in maltreated adults and children. In a series a studies with a prospective, longitudinal sample of sexually abused and non abused girls followed by Putnam and Trickett (1997), investigators have identified deleterious effects on the hypothalamic-pituary-adrenal axis (HPA), the sympathetic nervous system, and possibly the immune system. Additional studies cited by Lysaker, Meyer, Evans and Marks (2001)


There is a need for further research in order to establish the most appropriate age group to target with CSA education. In addition to this, future research involving males needs to be conducted. Many studies conducted have only included women, completely ignoring male CSA victims. This underrepresentation also happens in studies involving males, especially older boys who may be reluctant to disclose information due to social pressures (Putnam, 2003). The studies have shown that sexual abuse is prevalent and has extremely damaging effects. Compared with other psychiatric patients, those who experienced physical CSA not only are more likely to commit suicide, but also have earlier first admissions and longer and more frequent hospitalizations, spend more time in seclusion and exhibit higher symptom severity (Levitan et al., 1998). The significant impact of childhood abuse is unquestionable. This impact, however, speaks not only to the individual child victim of the crime, but also to the mental health community. Despite the magnitude of the child abuse problem in general, and its contribution to serious public health issues such as major depression, schizophrenia and borderline personality disorder, research support is still lacking. If education and awareness programs are put into place, this would promote support and thus create funding. Psychologists are responsible to the public to instigate the overcoming of disbelief with understanding, indifference and indignance, and reluctance to intervene with an intolerance of the victimisation of children. Tragic as it is, child abuse has a great deal to teach us about etiology, outcome, and intervention for psychiatric disorders, neurobiological dysregulation and dysfunctional behaviours.

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