Rape Awareness Week (2-8th May)

During Rape Awareness Week it is important to acknowledge the estimated 1 in 3-5 girls and 1 in 6-10 boys who are likely to be sexually abused or raped before the age of 16 in this country [1-3]. One NZ study found that 1 in 4 girls experienced sexual abuse such as genital contact, attempted intercourse or actual intercourse before the age of 16 [1]. Of these, 16% were under 12 years old. The greatest age of risk of sexual abuse was eight to twelve years old. Only 7.5% of cases of sexual abuse were ever officially reported. One overseas study found only a 1% conviction rate for child sexual abuse crimes [4].

While some children will escape serious effects on their lives, many will be set off on a path of self-destruction. Common long-term effects of childhood sexual abuse (CSA) in women include: depression; substance abuse; self-harming behaviours including suicidality; symptoms of post traumatic stress; increased anxiety; interpersonal difficulties including difficulties relating to peers and later parenting difficulties; teen pregnancy; an increased chance of experiencing some form of revictimization such as adult rape and partner violence; as well as an increased risk of a range of health effects such as eating disorders, obesity, smoking, gastrointestinal complaints, chronic pain, somatic complaints, unnecessary surgical procedures, sexually transmitted infections, infertility and childbirth difficulties [5-7] [8].

Given the wide-ranging effects on a person’s life, it should not be surprising that a 2001 study of the costs of CSA in NZ estimated that when health, mental health, and legal costs were combined with losses in earnings and the loss of potential to a person’s life, the overall costs of CSA to the country was estimated to be $2.4 billion per year [9].

Not all of those who experience CSA will seek help to deal with these effects. In one NZ study only 16.6% of women who had experienced CSA sought professional help [10]. Problematic relationships or depression were the reasons given most often for help-seeking.

Those who seek therapy for the effects of CSA often have not disclosed the CSA until they are adults. A NZ study of 191 women with histories of CSA who sought therapy help found that they took 16 years on average before they told anyone about the CSA [11]. The range of time was from telling immediately to 57 years. Only 3.8% disclosed the abuse immediately.

The majority of disclosures (76%) were first made to family, friends and partners. Only 15% of first disclosures of CSA were made to therapists and less than 4% to doctors and other health professionals. This finding seems to suggest that we need to resource family, friends and partners in the general community how to respond to disclosures of CSA. We also need to train health and mental health professionals to know how to ask about the possibility of a history of CSA and to know how to respond to any such disclosures.

In the same study, of the 450 offenders, 94.9% were male. Over half (52.2%) of the total group of offenders were males related to the child. Under half (42.7%) were non-related males such as parents friends, neighbours, brother’ s friends, borders, teachers, priests, and bus drivers.

Of those who sought therapy help, 85.6%, overall, found therapy to be either very or somewhat helpful. Overall, only 6.4% rated therapy somewhat or very unhelpful.

In summary, it seems that CSA is a common occurrence that is under-reported, it can have profound negative effects on a person’s life, it is costly to society as a whole but when help is sought it can be very helpful.

ENDS

1. Anderson, J., et al., The prevalence of childhood sexual abuse experiences in a community sample of women. Journal of the American Academy of Child and Adolescent Psychiatry, 1993. 32(5): p. 911-919.

2. Watkins, B. and A. Bentovim, The sexual abuse of male children and adolescents: A review of current research. Journal of Child Psychology and Psychiatry, 1992. 33(1): p. 197-248.

3. Adolescent Health Research Group, New Zealand Youth: A profile of their health and well being - Early findings of Youth 2000: A national secondary school youth health survey. 2003, University of Auckland.

4. Russell, D.E.H., The Secret Trauma: Incest in the lives of girls and women. 1986, New York: Basic Books.

5. Shand, C., et al., eds. The Medical Management of Sexual Abuse. 2002, Doctors for Sexual Abuse Care. 1-416.

6. Seng, J.S. and J.A. Hassinger, Relationship strategies and interdisciplinary collaboration: improving maternity care with survivors of childhood sexual abuse. Journal of Nurse-Midwifery, 1998. 43(4): p. 287-295.

7. Seng, J.S. and B.A. Petersen, Incorporating routine screening for history of childhood sexual abuse into well-woman and maternity care. Journal of Nurse-Midwifery, 1995. 40(1): p. 26-30.

8. Springs, F.E. and W.N. Friedrich, Health risk behaviours and medical sequelae of childhood sexual abuse. Mayo Clinic Proceedings, 1992. 57: p. 527-532.

9. Julich, S.J., Breaking the silence: Restorative justice and child sexual abuse. 2001: Massey University.

10. Morris, E., J. Martin, and S. Romans, Professional help sought for emotional problems: Coping with child sexual abuse in a Dunedin community sample of women. New Zealand Medical Journal, 1998. 111(1063): p. 123-136.

11. McGregor, K., Therapy - It's a two-way thing: women survivors of child sexual abuse describe their therapy experiences, in Psychology. 2003, University of Auckland: Auckland. p. 1-265.

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