This paper reviews the literature on the nature and incidence of child sexual abuse, explores the link between child sexual abuse and later sexual exploitation, and reviews the literature on prevention strategies and effective interventions in child sexual abuse services. Our understanding of the international epidemiology of child sexual abuse is considerably greater than it was just 10 years ago, and studies from around the world are examined. Childhood sexual abuse can involve a wide number of psychological sequelae, including low self-esteem, anxiety, and depression. Numerous studies have noted that child sexual abuse victims are vulnerable to later sexual revictimization, as well as the link between child sexual abuse and later engagement in high-risk sexual behaviour. Survivors of child sexual abuse are more likely to have multiple sex partners, become pregnant as teenagers, and experience sexual assault as adults. Various models which attempt to account for this inter-relationship are presented; most invoke mediating variables such as low self-esteem, drug/alcohol use, PTSD and distorted sexual development. Prevention strategies for child sexual abuse are examined including media campaigns, school-based prevention programmes, and therapy with abusers. The results of a number of meta-analyses are examined. However, researchers have identified significant methodological limitations in the extant research literature that impede the making of recommendations for implementing existing therapeutic programmes unreservedly.
Studies report that women use as much or more physical intimate partner violence (IPV) as men. Most of these studies measure IPV by counting the number of IPV acts over a specified time period, but counting acts captures only one aspect of this complex phenomenon. To inform interventions, women’s motivations for using IPV must be understood. A systematic review, therefore, was conducted to summarize evidence regarding women’s motivations for the use of physical IPV in heterosexual relationships. Four published literature databases were searched, and articles that met inclusion criteria were abstracted. This was supplemented with a bibliography search and expert consultation. Eligible studies included English-language publications that directly investigated heterosexual women’s motivations for perpetrating nonlethal, physical IPV. Of the 144 potentially eligible articles, 23 met inclusion criteria. Over two thirds of studies enrolled participants from IPV shelters, courts, or batterers’ treatment programs. Women’s motivations were primarily assessed through interviews or administration of an author-created questionnaire. Anger and not being able to get a partner’s attention were pervasive themes. Self-defense and retaliation also were commonly cited motivations, but distinguishing the two was difficult in some studies. Control was mentioned but not listed as a primary motivation. IPV prevention and treatment programs should explore ways to effectively address women’s relationship concerns and ability to manage anger and should recognize that women commonly use IPV in response to their partner’s violence.
Domestic violence (DV) against women during pregnancy affects many women and unborn infants worldwide. Pregnancy presents a window of opportunity for health care providers to identify DV and provide appropriate intervention. The aim of this systematic review was to appraise the effectiveness of DV screening and interventions for women identified for DV through screening in pregnancy. The Cochrane Library, EMBASE, MEDLINE, and PsycINFO were searched from January 1995 to November 2009 to identify potentially relevant studies. Studies using any comparative methodology from both national and international arenas were included but had to be in the English language. Nine studies (13 references) met the inclusion criteria, five for screening and four for interventions. Of the five screening studies, the identification of DV was significantly higher compared to studies that used a nonstandardized screen or no screen at all. There was also evidence that recurrent screening throughout the pregnancy further increased identification rates. There was some evidence that interventions for pregnant women who had experienced DV reduced the amount of violence experienced by these women, but the evidence is very limited by the small number of randomized studies with small participant numbers. Further research is required to establish the most effective interventions for women who are identified at risk of DV during pregnancy.