Skip to main content
NCBI home page
CMAJ : Canadian Medical Association Journal logoLink to CMAJ : Canadian Medical Association Journal
. 1987 Feb 1;136(3):245–252.

Sexual abuse of children: an update.

K C Finkel
PMCID: PMC1491576  PMID: 3801988

Abstract

An increasing number of studies in the past decade have shown that sexual abuse of children is disturbingly common. The author reviews some of the more recent knowledge about the problem, with particular reference to medical implications. The incidence and distribution of the problem and the relative importance of the medical examination are reviewed, and the diagnostic significance of clinical presentations such as vulvovaginitis, recurrent urinary tract infection and masturbation is evaluated. The agents responsible for sexually transmitted diseases in abused children are reviewed. Many crucial psychosocial issues are raised in the evaluation and management of sexual abuse. The author discusses some aspects of abuse that are hard to confront, such as the possible pleasure of the child and the nonoffending role of the mother in cases of incest. Information from sources other than the medical literature on the characteristics of abusers, therapy and prevention is reviewed. The medical implications of the Badgley Report are also discussed.

Full text

PDF
245

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Altchek A. Vulvovaginitis, vulvar skin disease, and pelvic inflammatory disease. Pediatr Clin North Am. 1981 May;28(2):397–432. doi: 10.1016/s0031-3955(16)34005-6. [DOI] [PubMed] [Google Scholar]
  2. Araji S., Finkelhor D. Explanations of pedophilia: review of empirical research. Bull Am Acad Psychiatry Law. 1985;13(1):17–37. [PubMed] [Google Scholar]
  3. Bagley C. Child sexual abuse and juvenile prostitution: a commentary on the Badgley Report on sexual offences against children and youth. Can J Public Health. 1985 Jan-Feb;76(1):65–66. [PubMed] [Google Scholar]
  4. Brant R. S., Tisza V. B. The sexually misused child. Am J Orthopsychiatry. 1977 Jan;47(1):80–90. doi: 10.1111/j.1939-0025.1977.tb03247.x. [DOI] [PubMed] [Google Scholar]
  5. Cantwell H. B. Vaginal inspection as it relates to child sexual abuse in girls under thirteen. Child Abuse Negl. 1983;7(2):171–176. doi: 10.1016/0145-2134(83)90069-8. [DOI] [PubMed] [Google Scholar]
  6. Cowell C. A. The gynecologic examination of infants, children, and young adolescents. Pediatr Clin North Am. 1981 May;28(2):247–266. doi: 10.1016/s0031-3955(16)33995-5. [DOI] [PubMed] [Google Scholar]
  7. Cramolini G. M., Litt I. F. The pharynx as the only positive culture site in an adolescent with disseminated gonorrhea. J Pediatr. 1982 Apr;100(4):644–646. doi: 10.1016/s0022-3476(82)80777-4. [DOI] [PubMed] [Google Scholar]
  8. De Jong A. R. The medical evaluation of sexual abuse in children. Hosp Community Psychiatry. 1985 May;36(5):509–512. doi: 10.1176/ps.36.5.509. [DOI] [PubMed] [Google Scholar]
  9. De Jong A. R. Vaginitis due to Gardnerella vaginalis and to Candida albicans in sexual abuse. Child Abuse Negl. 1985;9(1):27–29. doi: 10.1016/0145-2134(85)90088-2. [DOI] [PubMed] [Google Scholar]
  10. Felman Y. M., Nikitas J. A. Sexually transmitted diseases and child sexual abuse. Part II. N Y State J Med. 1983 Apr;83(5):714–716. [PubMed] [Google Scholar]
  11. Figueroa-Colón R., Grunow J. E., Torres-Pinedo R., Rettig P. J. Group A streptococcal proctitis and vulvovaginitis in a prepubertal girl. Pediatr Infect Dis. 1984 Sep-Oct;3(5):439–442. doi: 10.1097/00006454-198409000-00011. [DOI] [PubMed] [Google Scholar]
  12. Finkel K. C. Sexual abuse of children in Canada. Can Med Assoc J. 1984 Feb 15;130(4):345–348. [PMC free article] [PubMed] [Google Scholar]
  13. Gardner M., Jones J. G. Genital herpes acquired by sexual abuse of children. J Pediatr. 1984 Feb;104(2):243–244. doi: 10.1016/s0022-3476(84)81002-1. [DOI] [PubMed] [Google Scholar]
  14. Ghent W. R., Da Sylva N. P., Farren M. E. Family violence: guidelines for recognition and management. Can Med Assoc J. 1985 Mar 1;132(5):541–553. [PMC free article] [PubMed] [Google Scholar]
  15. Giarretto H. A comprehensive child sexual abuse treatment program. Child Abuse Negl. 1982;6(3):263–278. doi: 10.1016/0145-2134(82)90029-1. [DOI] [PubMed] [Google Scholar]
  16. Groothuis J. R., Bischoff M. C., Jauregui L. E. Pharyngeal gonorrhea in young children. Pediatr Infect Dis. 1983 Mar-Apr;2(2):99–101. doi: 10.1097/00006454-198303000-00005. [DOI] [PubMed] [Google Scholar]
  17. Hammerschlag M. R., Alpert S., Rosner I., Thurston P., Semine D., McComb D., McCormack W. M. Microbiology of the vagina in children: normal and potentially pathogenic organisms. Pediatrics. 1978 Jul;62(1):57–62. [PubMed] [Google Scholar]
  18. Hammerschlag M. R., Doraiswamy B., Alexander E. R., Cox P., Price W., Gleyzer A. Are rectogenital chlamydial infections a marker of sexual abuse in children? Pediatr Infect Dis. 1984 Mar-Apr;3(2):100–104. doi: 10.1097/00006454-198403000-00003. [DOI] [PubMed] [Google Scholar]
  19. James J., Meyerding J. Early sexual experience and prostitution. Am J Psychiatry. 1977 Dec;134(12):1381–1385. doi: 10.1176/ajp.134.12.1381. [DOI] [PubMed] [Google Scholar]
  20. Jones J. G., Yamauchi T., Lambert B. Trichomonas vaginalis infestation in sexually abused girls. Am J Dis Child. 1985 Aug;139(8):846–847. doi: 10.1001/archpedi.1985.02140100108046. [DOI] [PubMed] [Google Scholar]
  21. McCormack W. M., Braun P., Lee Y. H., Klein J. O., Kass E. H. The genital mycoplasmas. N Engl J Med. 1973 Jan 11;288(2):78–89. doi: 10.1056/NEJM197301112880206. [DOI] [PubMed] [Google Scholar]
  22. McCoy C. R., Applebaum H., Besser A. S. Condyloma acuminata: an unusual presentation of child abuse. J Pediatr Surg. 1982 Oct;17(5):505–507. doi: 10.1016/s0022-3468(82)80098-5. [DOI] [PubMed] [Google Scholar]
  23. Nahmias A. J., Dowdle W. R., Naib Z. M., Josey W. E., Luce C. F. Genital infection with Herpesvirus hominis types 1 and 2 in children. Pediatrics. 1968 Oct;42(4):659–666. [PubMed] [Google Scholar]
  24. Palmer W. M. Streptococcal vaginitis and sexual abuse. Pediatr Infect Dis. 1982 Sep-Oct;1(5):374–375. [PubMed] [Google Scholar]
  25. Paradise J. E., Willis E. D. Probability of vaginal foreign body in girls with genital complaints. Am J Dis Child. 1985 May;139(5):472–476. doi: 10.1001/archpedi.1985.02140070046031. [DOI] [PubMed] [Google Scholar]
  26. Pascoe D. J. Management of sexually abused children. Pediatr Ann. 1979 May;8(5):309–316. [PubMed] [Google Scholar]
  27. Rettig P. J., Nelson J. D. Genital tract infection with Chlamydia trachomatis in prepubertal children. J Pediatr. 1981 Aug;99(2):206–210. doi: 10.1016/s0022-3476(81)80451-9. [DOI] [PubMed] [Google Scholar]
  28. Rettig P. J. Pediatric genital infection with Chlamydia trachomatis: statistically nonsignificant, but clinically important. Pediatr Infect Dis. 1984 Mar-Apr;3(2):95–96. doi: 10.1097/00006454-198403000-00001. [DOI] [PubMed] [Google Scholar]
  29. Sharp F. R., Ryan A. F., Goodwin P., Woolf N. K. Increasing intensities of wide band noise increase [14C]2-deoxyglucose uptake in gerbil central auditory structures. Brain Res. 1981 Dec 28;230(1-2):87–96. doi: 10.1016/0006-8993(81)90393-0. [DOI] [PubMed] [Google Scholar]
  30. Singleton A. F. Vaginal discharge in children and adolescents. Evolution and management: a review. Clin Pediatr (Phila) 1980 Dec;19(12):799–804. doi: 10.1177/000992288001901204. [DOI] [PubMed] [Google Scholar]
  31. Summit R., Kryso J. Sexual abuse of children: a clinical spectrum. Am J Orthopsychiatry. 1978 Apr;48(2):237–251. doi: 10.1111/j.1939-0025.1978.tb01312.x. [DOI] [PubMed] [Google Scholar]
  32. White S. T., Loda F. A., Ingram D. L., Pearson A. Sexually transmitted diseases in sexually abused children. Pediatrics. 1983 Jul;72(1):16–21. [PubMed] [Google Scholar]
  33. Will D. Approaching the incestuous and sexually abusive family. J Adolesc. 1983 Sep;6(3):229–246. doi: 10.1016/s0140-1971(83)80037-2. [DOI] [PubMed] [Google Scholar]
  34. Woodling B. A., Heger A. The use of the colposcope in the diagnosis of sexual abuse in the pediatric age group. Child Abuse Negl. 1986;10(1):111–114. doi: 10.1016/0145-2134(86)90039-6. [DOI] [PubMed] [Google Scholar]

Articles from CMAJ: Canadian Medical Association Journal are provided here courtesy of Canadian Medical Association

RESOURCES