Child Sexual Abuse in Clinical and Forensic Psychiatry

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Child Sexual Abuse in Clinical and Forensic Psychiatry

Abstract and Introduction

Abstract


Purpose of Review: To review papers from the recent literature on child sexual abuse and to highlight the clinical and forensic issues raised and how these have been addressed. Also, to identify new demands and recommend future research.
Recent Findings: The validity of forensic evaluations depends on the quality of the protocols used and the training of the forensic mental health practitioners involved. Diagnosis of child sexual abuse still depends mainly on the child's allegation of abuse, while anogenital examination yields minimal medical evidence of sexual abuse. The relationship between child sexual abuse and victims' mental health is increasingly being proven, underlining the importance of correct clinical and forensic diagnosis of abuse to permit preventive, therapeutic and legal measures. Sexual offences via the internet have raised new demands.
Summary: Forensic child and adolescent practitioners need to be very highly trained. Evaluation of sexually abused children and adolescents must be accurate to ensure legal validity and be performed with diligence so that alleged victims do not experience recurrence. Practitioners' actions must be referenced against appropriate instruments and they must be prepared for the ethical and forensic dilemmas and new demands that arise in this field.

Introduction


Child sexual abuse (CSA) is acknowledged internationally as an important issue. Related dilemmas of forensic ethics- the subject of this review- figure prominently for practitioners of child and adolescent forensics in obtaining legally useful evidence while minimizing the risk to the child of recurrence. For over 20 years, special protocols and instruments have been proposed, and research has examined aspects of anogenital physical examination and the use of projective techniques. Certain empirically unfounded beliefs about CSA persist. The repercussions of CSA on victims' future mental health need to be studied better.

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