News Taylor Bright, D. Jeff Daniel, Lies, Damned Lies. And Truth? Louis Post-Dispatch Missouri , May 4, Alan P. Department of Defense supporting the validity and reliability of polygraph testing. American Polygraph Association. The professional association dedicated to furthering the use of polygraph testing. A comprehensive site dedicated to criticizing polygraph testing and providing information on how to "beat" the test.
DoD Polygraph Institute. The Department of Defense's educational institution offering courses for polygraph examiners. Brad V. Federation of American Scientists' Polygraph Policy.
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A non-profit organization advocating a scientific approach to public policy. Commercial site offering contact information for polygraph examiners. April 25, Larry D. Cases United States v. Scheffer , U. The United States Supreme Court examined the admissibility of polygraph results in court, stating: The contentions of respondent and the dissent not withstanding, there is simply no consensus that polygraph evidence is reliable. To this day, the scientific community remains extremely polarized about the reliability of polygraph techniques.
Some studies have concluded that polygraph tests overall are accurate and reliable. See, e. Read the Full Report Subscription Required.
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All Rights Reserved. Sex Offenders. Sexual Abuse and the Clergy. Punishing Sex Offenders. Control of Sex Offenses. Considering the impact that all these different layers of influence have on cutting down the number of CSA cases that are known to and substantiated by the authorities, victims identified in official-report inquiries are therefore believed to represent only a small fraction of the true occurrence. For all these reasons, relying on official-reports to determine the magnitude of CSA is a method that carries a constant error of underestimation. In other words, children that are identified are only those that were able to disclose, were believed, reported to, and followed up by proper authorities, and those cases that presented enough evidence to be substantiated as CSA.
In terms of risk factors, being female is considered a major risk factor for CSA as girls are about two times more likely to be victims than males [ 16 , 17 ]. Several authors do, however, point out that there is a strong likelihood that boys are more frequently abused than the ratio of reported cases would suggest given their probable reluctance to report the abuse [ 27 ]. With respect to age, children who are most vulnerable to CSA are in the school-aged and adolescent stages of development, though about a quarter of CSA survivors report they were first abused before the age of 6 [ 3 ].
The presence of disability is also considered a risk factor for CSA and other forms of maltreatment as the impairments may heighten the vulnerability of the child [ 29 ]. Aside, the absence of one or both parents or the presence of a stepfather, parental conflicts, family adversity, substance abuse and social isolation have also been linked to a higher risk for CSA [ 30 ].
In terms of the presupposed impact of socioeconomic status and ethnic background, the existing literature has many weaknesses and obvious contradictions.
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Overall, while low family or neighborhood socioeconomic status is a great risk factor for physical abuse and neglect [ 31 , 32 ], its impact on CSA is not as proven. On one hand, CSA could appear to occur more frequently among underprivileged families because of the disproportionate number of CSA cases reported to child protective services that come from lower socioeconomic classes [ 3 ].
In that vein, some populations of children have been overrepresented in research that focuses on vulnerable populations, such as Black American children from low socioeconomic status families, which may create an erroneous belief that race and ethnicity are risk factors for CSA [ 33 ]. On the other hand, some recent population-based studies are showing that, amongst other factors, living in poverty is a predictive factor for children to be subjected to both physical and sexual abusive experiences [ 34 , 35 ].
Frequently Asked Questions
Several models have been developed in an attempt to explain the adverse negative impact of CSA [ 36 ]. This model underscores the issues of trust and intimacy that are particularly pronounced among victims of CSA. The unique nature of CSA as a form of maltreatment is highlighted by the four trauma-causing factors that victims may experience, which are traumatic sexualization, betrayal, powerlessness, and stigmatization. Traumatic sexualization refers to the sexuality of the victims that is shaped and distorted by the sexual abuse. Betrayal is the loss of trust in the perpetrator who shattered the relationship and in other adults who are perceived as not having protected the child from being abused in the first place, or having not supported her upon disclosure.
Powerlessness is experienced through power issues at play in CSA, where victims are unable to alter the situation despite feeling the threat of harm and the violation of their personal space. Several reviews and meta-analyses published in the 90s and early years of suggested that a wide range of psychological and behavioral disturbances were associated with the experience of CSA, which led experts in the field to conclude that CSA was a substantial risk factor in the development of a host of negative consequences in both childhood, adolescence and adulthood [ 38 — 41 ]. More recently, systematic reviews have confirmed that, given the vast array of etiological factors that interact in predicting mental health outcomes, CSA is considered a significant, though general and nonspecific, risk factor for psychopathology in children and adolescents [ 42 — 44 ].
Among the wealth of psychopathologies that have been studied among CSA victims, post-traumatic stress and dissociation symptoms have received great attention. Overall, victims have been shown to present significantly more of these symptoms than non-abused children, or than victims of other forms of trauma. In one of our studies that compared 67 sexually abused school-aged girls with a matched group, CSA was found to significantly increase the odds of presenting with a clinical level of dissociation and PTSD symptoms, respectively, by eightfold and fourfold [ 45 ].
These results have echoed previous research conducted among cohorts of sexually abused school-aged children and teenagers where about a third to a half of all victims showed clinical levels of post-traumatic stress symptoms [ 46 — 50 ].
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Only a few studies have been conducted with younger cohorts of children, yet high levels of dissociation were documented among sexually abused preschoolers [ 51 , 52 ]. In that vein, results from one of our recent inquiries revealed higher frequencies of dissociative symptoms among a group of 76 sexually abused children aged 4 to 6 than children of the comparison group [ 53 ].
These symptoms were found to persist over a period of a year following disclosure [ 54 ]. In contrast to children who have experienced other forms of trauma, it was also found that CSA victims are more likely to present post-traumatic stress symptoms [ 55 ]. Using a prospective method in which sexually abused children were followed over 36 months, Maikovich, Koenen, and Jaffe [ 25 ] demonstrated that boys were as likely as girls to exhibit post-traumatic stress symptoms.
Aside from post-traumatic stress and dissociation symptoms, a significant number of other mental health and behavioral disturbances have been linked to CSA. High levels of mood disorders, such as major depressive episodes, are found in cohorts of children and teenagers who have been sexually abused [ 56 , 57 ].
Sexually abused children are more likely than their non-abused counterparts to present behavior problems, such as inappropriate sexualized behaviors [ 58 ]. In the teenage years, they are found to more often exhibit conduct problems [ 59 ] and engage in at-risk sexual behaviors [ 60 , 61 ]. Victims are more prone to abusing substances, to engaging in self-harm behaviors, and to attempting or committing suicide [ 62 — 65 ]. Adolescents sexually abused in childhood are five times more likely to report non-clinical psychotic experiences such as delusions and hallucinations than their non-abused counterparts [ 66 ].
The mental health outcomes of CSA victims are likely to continue into adulthood as the link of CSA to lifetime psychopathology has been demonstrated [ 67 — 72 ]. Even more worrisome is the fact that CSA victims are more at risk than non-CSA youth to experience violence in their early romantic relationships [ 73 , 74 ] and that they are 2—5 times more at risk of being sexually revictimized in adulthood than women not sexually abused in childhood [ 75 — 77 ]. In adulthood, CSA survivors are more likely to experience difficulties in their psychosexual functioning [ 78 , 79 ].
A year longitudinal study of the impact of intrafamilial sexual abuse on female development confirmed the deleterious impact of CSA across stages of life, including all of the mental health issues mentioned above, but also hypothalamic—pituitary—adrenal attenuation in victims, as well as asymmetrical stress responses, high rates of obesity, and healthcare utilization [ 80 ]. The impact of CSA as a predictor of major illnesses is garnering increasing attention, including gastrointestinal disorders, gynecologic or reproductive health problems, pain, cardiopulmonary symptoms, and diabetes [ 81 — 83 ].
In all cases, early assessment and intervention to offset the exacerbation and continuation of negative outcomes is highlighted, according to several studies [ 84 ], as symptoms can develop at a later age [ 3 ] or may not be apparent at first [ 85 ]. Indeed, despite overwhelming evidence of deleterious outcomes of CSA, it is commonly agreed that the impact of CSA is highly variable and that a significant portion of victims do not exhibit clinical levels of symptoms [ 86 ].
Some authors have suggested that about a third of victims may not manifest any clinical symptoms at the time the abuse is disclosed [ 87 ]. This can be explained, in part, by the extremely diverse characteristics of CSA which lead to a wide range of potential outcomes [ 86 ]. Related to this latter explanation, among an array of variables potentially influencing the resilience capacities of CSA victims, children who receive support from their non-offending parents [ 89 ] and those who have not experienced prior abuse [ 90 ] seem to fare better in spite of the sexual abuse adversity.
Among other personal and relational factors that promote resilience in victims are: less reliance on avoidant coping strategies to deal with the traumatic event [ 91 — 93 ], higher emotional self-control [ 94 ], interpersonal trust and feelings of empowerment [ 85 ], less personal attributions of blame and of stigmatization [ 95 , 96 ], and high family functioning and secure attachment relationships [ 97 , 98 ].
This scholarship points to the importance of using a broad ecological framework when researching and intervening on the factors that promote resilience in victims of CSA [ 88 ]. Three promising lines of research have recently emerged that shed new light on the relationships between CSA and psychopathology. This suggests that measuring the impact of all forms of victimization alongside CSA is warranted in order to fully capture the influence of violence and abuse on the development of children and youth mental health outcomes.
Second, recognizing the great diversity of symptom presentations in sexually abused cohorts, several scholars have attempted to identify the different profiles or sub-categories of victims. For example, Trickett and colleagues [ ] found distinct profiles in their sample of girls sexually abused by family members, including victims of multiple perpetrators, characterized by significantly higher levels of dissociation, and victims of father-daughter incest who presented higher levels of disturbances across domains, including internalized e. As a whole, these studies call for a better tailoring of the services offered to sexually abused children, so that services can well match the mental health needs of victims [ ].
Third, drawing from epigenetics [ ], cutting-edge inquiries are developing in CSA research on the interaction of CSA with other environmental factors and with genetic factors to predict mental health and behavioral outcomes, for example, violent behavior [ ], or suicidal gesture [ ]. These inquiries confirm the relevance of studying the psychobiology of child maltreatment [ ] as a promising route to better our understanding of the unique contribution of CSA to mental health disturbances, relative to other factors, as well as of the complex nature of the interactions at play.
This knowledge could eventually benefit the elaboration of effective intervention programs. In light of the high prevalence of CSA and the wealth of deleterious outcomes associated with this abusive experience, it stands to reason that research attention must turn toward preventing CSA. Offender management is the approach that aims to control known offenders, for example, registries, background employment checks, longer prison sentences and various intervention programs. It is a tertiary prevention initiative that acts mostly in the individual sphere and, as such, presents certain inherent limitations in regards to preventing CSA from happening in the first place [ ].
The second most frequent approach, primary prevention, involves universal educational programs generally delivered in schools and aimed at potential victims. In the majority of cases, these universal programs also intervene in the individual preventive sphere and more infrequently in the family or societal sphere. The second of those two meta-analyses further demonstrated that programs are more effective if they are longer in duration four sessions or more , if they repeat important concepts, if they provide children with multiple opportunities to actively practice the taught notions and skills, and if they are based on concrete concepts what is forbidden rather than abstract notions rights or feelings.