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Psychosocial And Behavioral Measures Among Female Adolescent Victims Of Sexual Abuse: Differences Based On Perpetrator Identity

American Journal of Health Studies, Wntr, 2000 by Stephen Nagy

Abstract: Adolescent females in a rural southern state who were sexually active were compared with adolescent females who met inclusion criteria for sexual abuse on seven behavioral measures. Victimization comparisons utilized the classification categories based upon the identity of the perpetrator; immediate family member (N=316), boyfriend (N=237), external family member (N=60), and other or stranger (N=143). Risky profiles utilizing odds ratios showed that the victimized group where perpetrators were immediate family members only differed from the sexually active group on risk for pregnancy. The other perpetrator groups showed increased risk for most of the seven measures. Implications for developing intake criteria to review for sexual abuse history using the presence of risk factors is discussed.

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Due to the frequency of sexual abuse, its sequelae have been studied extensively. Studies have shown that a number of factors have been associated with the effects of sexual abuse in children and adolescents, including: truancy, depression, inappropriate sexual behavior, substance abuse, and pregnancy (Nagy, Adcock & Nagy 1994; Green, 1996; Finkelhor, 1994). Problematic in interpreting much of this research has been the methodologic limitations of sampling from clinical populations and the varing definition among researchers of sexual abuse terminology (Green 1996; Paradise, Rose, Sleeper & Nathanson, 1994). Methodological and sampling issues have provided an inconsistent framework from which clinical personnel can apply findings to medical, school and community settings. These issues make it difficult to clearly distinguish which factors may assist in the identification of youngsters who have been victims of sexual abuse. All victims of sexual abuse do not necessarily need psychotherapy however, it is generally agreed that victims would benefit from professional counseling to ensure appropriate coping from victimization.

Although research has supported a relationship between a history of sexual abuse abuse.

sexually abused samples have usually been compared with non-abused samples (Rind & Tromovitch, 1997). This presents methodological issues since sexually active adolescents display attributes that are frequently different from their non-experienced counterparts (Nagy, Adcock & Nagy, 1994; Nagy, DiClementi & Adcock, 1995). When comparing sexually abused, sexually active and sexually inactive groups, behaviors become progressively more deviant, with sexually inactive adolescents showing fewest deviant behaviors while sexually abused adolescents display significantly more deviant behaviors. The comparison of sexually abused groups with sexually active groups should assist in clarifying some of these methodological issues when examining possible sequelae of sexual abuse.

The present study was undertaken to clarify factors associated with sexually active non-abused adolescent females and sexually abused adolescent females. A sample of grade eight and grade ten students were surveyed using an anonymous self-administered questionnaire. The main objective was to learn whether a non-clinical sample of sexually abused females differed from non-abused sexually active females, and whether the perpetrator's identity modified the identified associations with sexual abuse.

METHODS

Data were collected using an instrument that retained a core of items from two previous surveys conducted in 1988 (Nagy & Adcock, 1990), and 1990 (Nagy & Adcock, 1992) and examined a variety of health behaviors and attitudes. Unique to the 1993 questionnaire, were items on Sexual abuse and forced sex experiences. Sexual abuse was broadly defined as "someone touching you in a place that you did not want to be touched, or did something to you sexually that you did not want." Previous experiences with similar samples (Nagy & Adcock, 1990; Nagy & Adcock 1992) demonstrated that students had difficulties in distinguishing between forced sex and sexual abuse. Subsequently, students were also asked if they had ever experienced forced sex by asking "has someone ever forced you to have intercourse (sex)?" Students also responded to two questions on the identity of the perpetrator, which allowed one selection from nine categories. Due to the age range of the students, school personnel did not allow additional questions addressing oral and anal sex and same gender experiences.

The questionnaire was reviewed by a panel of experts and pilot-tested with eighth and tenth grade students. A correlation of .80 was obtained (N=69) for the great majority of items when using a test re-test method with a four week interim. Most students completed the survey within a 50-minute class period.

Subjects were selected from schools utilized in previous surveys and consisted of two metropolitan school districts, four rural school districts and three districts in semi-urban settings. State Health Department data on adult mortality and morbidity rates and teenage pregnancy rates show these districts to be similar to surrounding counties. All students present on the day of testing were included. A week before the survey was administered, students were provided with letters to take home informing parents about the study. If parents elected not to involve their child in the study they were required to return a signed letter indicating their decision. Fewer than 1% of the students returned signed letters.

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Psychosocial And Behavioral Measures Among Female Adolescent Victims Of Sexual Abuse: Differences Based On Perpetrator Identity

American Journal of Health Studies, Wntr, 2000 by Stephen Nagy

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