Essay Sample on Identification and Prevention of Risk Behaviors in Sexually Abused Adolescents

Introduction

Sexual abuse refers to any sexual conduct or contact with a child by an adult or a significantly older child for sexual gratification or financial benefit to the perpetrator. It may include a contact for sexual purposes, molestation, statutory rape, prostitution, and exposure to pornography and incest among other sexually exploitative activities (Murat et al., 2015). Various studies have been conducted in the past that continue to find out whether childhood sexual abuse puts the children at risk of developing a myriad of medical, behavioral, psychological and sexual disorders that can persist as they develop into adulthood.

The general population has a probability of between 5% and 24% of developing Post-traumatic Stress Disorder (PTSD) after exposure to a traumatic event (McCarty et al., 2013). This may result in a severe life-disrupting disorder that may develop due to exposure to either a single or more traumatic events that may occur once or within a period of time. The disorder is characterized by a combination of re-experience of the event, avoidance of the symptoms that may be attributed to the event, hyperarousal and negative alterations in mood and cognition. It may also result in detrimental effects on one's quality of life and negatively affect their ability to sustain meaningful relationships.

Major depressive disorders (MDD) is among the most common mental illnesses with dramatically increasing rates from early to late adolescence while reaching an estimated lifetime prevalence of approximately 20-25% (Murat et al., 2015). This early onset of depression during adolescence is linked to various psychosocial problems during adulthood that may include poor performance in academices and increased chances of suicide and substance abuse. Erikson (1968) developed a theory of psychosocial development that emphasizes on the sociocultural determinants of development. With reference to the topic, Erikson suggests that the most vital developmental task for adolescents is to solve the identity versus role confusion crisis, establish their own unique sense of identity and find an environment where they can belong to and create meaningful relationships with other people. From the theory, failure to overcome crises and encounters that affect our psychosocial development at each stage may result in a significant negative impact on our psychosocial development.

Sexual abuse to children and adolescents is a vice that happens more than often and is perpetrated against children by their elders. The vice may negatively affect brain maturation, psychosocial and brain development (McCarty et al., 2013). The victims may succumb to Post-traumatic Stress Disorders and depression and develop behaviors such as substance abuse with the aim of establishing a strategy to cope up and alleviate the aftermath of the ordeal. It may also result in risky sexual behaviors that may include improper use of contraceptives due to the neurobiological dysregulation resulting in sexual abuse and its associated effects on cognitive and psychosocial development. The limited support and inadequate emotional treatment offered to the victims are among the major contributing factors to PTSD, incomplete psychological development and depression that provide future risky behaviors in adolescents.

Methods

The article focuses on various studies conducted by various researchers in relation to the subject matter to come up with a solution over the same. The inclusion criteria included studies that focused on an evaluation of the risk behaviors present in an adolescent who was diagnosed with Post-traumatic Stress Disorders, depression and any other behaviors that relate to PTSD and depression whose origin is specifically sexual abuse. These studies should provide an analysis of their research, the sources of data, methods used to analyze the data and the outcome of the study. Some of the studies used are highlighted below.

Homma et al. (2012) conducted a meta-analysis of the relationship between sexual abuse and risky sexual behavior among adolescent boys. The study focussed on computer-based literature searches via Medline, Web of Science and PsycINFO using relevant key terms including sexual offenses, sexual abuse, unsafe sex, pregnancy, contraceptive behavior, condoms, and sexual partners among others. The searches were limited to studies that were published between 1990 and 2011. The inclusion criteria included findings from reported for male samples; associations between the history of sexual abuse experienced during childhood or adolescence and either unprotected sexual intercourse, pregnancy resulting from the vice and multiple sexual partners. 33 articles that met the criteria focussed only on studies of adolescents in school since they were homogenous, cross-sectional school surveys and employed probability sampling methods. The studies were coded into variables that included the study design, sampling methods, age or grade range, methods of data collection and definition of sexual abuse involved.

Gonzalez & Pereda (2017) focused on the systematic review of the prevalence of suicidal ideation and behaviors among minors that have been sexually abused. The study focused on an evaluation of a study sample of children and adolescents with the mean age of participants being less than 18 years or an upper limit of 25 years; a prevalence data on both childhood sexual abuse, suicidal behaviours and ideations, suicide planning and attempts and an evaluation of the risks of suicide resulting from an experience of childhood sexual abuse. The variables under consideration in the study included the authors and year of publication, the country, number of participants in the studies, sources of the sample and the type of victimization experienced. It also focused on the sex of the minors, age range of the participants (in years), the type of sexual abuse experienced and the prevalence of the sexual abuse.

The variables that were linked to the risks of suicidal behaviors and ideations were later recorded in terms of the prevalence of suicidal ideations; the prevalence of suicidal planning; prevalence attempted suicide among other variables that associate with sexual abuse and suicidal behavior. Most of the publications in the study dealt with samples from the US, China, Ethiopia, Brazil, Australia, Sweden, the Caribbean, and South Africa. 62.5% of the study used probabilistic methods of sample collection while 37.5% used conveniently available samples. The participants were recruited through surveys from schools, door-to-door surveys, and surveys in the waiting room and from home interviews. The sample sizes varied considerably from one study to another with a minimum containing 216 participants to a maximum of 81,247 participants.

Yuce et al. (2015), analyzed the psychiatric consequences of child and adolescent sexual abuse. The study involved a total of 590 children and adolescent [507 girls and 83 boys] who had strong evidence of sexual abuse as referred by the medico-legal units for psychiatric assessment at a child and adolescent psychiatry outpatient clinic within a period of two years (2010-2011). The cases were evaluated by the child and adolescent psychiatry and forensic medicine specialists. The comprehensive psychiatric assessments and diagnostic evaluations utilized the Wechsler Intelligence Scale for Children-Revised Form (WISC-R) and a schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Versions-Turkish Version (K-SADS-PL-T). They were applied to all the patients as well as their parents by physicians who were trained to use the structured interview techniques as stipulated by the K-SADS-PL. The tools were used alongside broad psychiatric clinical evaluations to investigate psychiatric comorbidities and disorders. The reports were then drafted and signed by a committee of forensic medicine and child and adolescent psychiatry specialists. Moreover, psychiatric diagnoses were based on DSM-IV-TR intelligence reports.

McLean et al. (2014), studied the trauma characteristics and Posttraumatic Stress Disorders among adolescent survivors of childhood sexual abuse. It helped to identify the factors that influence the impact of childhood sexual abuse on future mental health outcomes while focusing on abusive characteristics. The study included 83 female adolescents aged between 13 and 18 years who were seeking treatment for PTSD at Women Organized Against Rape (WOAR) (A community mental health clinic in Philadelphia that provides counseling to survivors of childhood sexual abuse and rape). The majority of the sample were African Americans (56.6%), followed by bi-racial (24.1%), Caucasian (14.5%), Spanish (3.6%) and Asian/Pacific Islander (1.2%). The adolescents who were eligible to participate include those with primary diagnostic chronic or subthreshold PTSD resulting from rape or attempted rape by same-age peers or sexual abuse by a perpetrator who was five or more years older. The various measures used include the Schedule for affective disorders and Schizophrenia for school-age children-epidemiological version (K-SADS-E; Orvaschel, 1995) Child PTSD Symptom Scale (CPSS; Foa, Johnson, Feeny & Treadwell, 2001), Trauma History Interview, Beck Depression Inventory (BDI), Suicidal Ideation Questionnaire-Junior (SIQ-JR; Reynolds, 1987) and Personal Experience Screening Questionnaire (PESQ; Winters, 1991). The type of trauma was recorded into rape, sexual assault, and sexual abuse. ANOVAS were used to examine the existing relationship between trauma characteristics and the severity of depression, PTSD, substance abuse and suicidality.

Results and Discussion

Homma et al. (2016), found that the individual effect sizes (ORs) for unprotected sexual intercourse ranged from 1.17 to 2.25. This indicates a significant association between the history of sexual abuse and unprotected sexual intercourse. Moreover, sexually abused boys had a likelihood of more than five times than non-abused ones to cause pregnancy. The overall results of the studies indicate that adolescent boys with a history of sexual abuse had a higher likelihood than non-abused boys to have engaged in unprotected sexual intercourse, have had multiple sexual partners or have even caused a p...