{"id":1571,"date":"2020-09-22T15:32:29","date_gmt":"2020-09-22T15:32:29","guid":{"rendered":"https:\/\/courses.lumenlearning.com\/abnormalpsych\/?post_type=chapter&#038;p=1571"},"modified":"2022-07-26T20:06:56","modified_gmt":"2022-07-26T20:06:56","slug":"sexual-violence-crime-and-abuse","status":"publish","type":"chapter","link":"https:\/\/courses.lumenlearning.com\/wm-abnormalpsych\/chapter\/sexual-violence-crime-and-abuse\/","title":{"raw":"Sexual Violence, Crime, and Abuse","rendered":"Sexual Violence, Crime, and Abuse"},"content":{"raw":"<div class=\"textbox learning-objectives\">\r\n<h3>Learning Objectives<\/h3>\r\n<ul>\r\n \t<li style=\"font-weight: 400;\">Discuss problems and concerns related to the effects of rape and sexual abuse<\/li>\r\n<\/ul>\r\n<\/div>\r\nAs mentioned earlier, there is some controversy surrounding the diagnosis of a paraphilic disorder and what constitutes deviant sexual behavior. The definitions of these disorders can vary depending on time and culture, and the complication in diagnosing paraphilic disorders is compounded by the fact that several of the disorders could be associated with criminal behavior.[footnote]McManus, M. A., Hargreaves, P., Rainbow, L., &amp; Alison, L. J. (2013). Paraphilias: definition, diagnosis, and treatment. F1000prime reports, 5, 36. https:\/\/doi.org\/10.12703\/P5-36[\/footnote]\u00a0In this section, we will take a closer look at the criminal forms of sexual violence and abuse (that may or may not stem from a paraphilic disorder).\r\n\r\n<b style=\"font-size: 1rem; text-align: initial;\">Sexual assault<\/b><span style=\"font-size: 1rem; text-align: initial;\">\u00a0is an act in which a person intentionally sexually touches another person without that person's\u00a0consent or\u00a0coerces\u00a0or physically forces a person to engage in a\u00a0sexual act\u00a0against their will.\u00a0It is a form of\u00a0sexual violence, which includes\u00a0child sexual abuse,\u00a0groping,\u00a0<\/span><strong style=\"font-size: 1rem; text-align: initial;\">rape<\/strong><span style=\"font-size: 1rem; text-align: initial;\">\u00a0(forced\u00a0vaginal, anal, or oral penetration\u00a0or a\u00a0drug-facilitated sexual assault), or the\u00a0torture\u00a0of the person in a sexual manner.<\/span>\r\n\r\n[caption id=\"\" align=\"alignright\" width=\"417\"]<img src=\"https:\/\/upload.wikimedia.org\/wikipedia\/commons\/b\/bd\/BJS_Sexual_Assualt_Rates_1995-2013.png\" alt=\"Rate of rape or sexual assault for females from 1997-2013. Rates are declining, but cases spiked again between 2008 and 20011.\" width=\"417\" height=\"357\" \/> <strong>Figure<\/strong> 1. Reported rates of sexual assault in the United States (BJS)[\/caption]\r\n<h2>Victims of Sexual Assault<\/h2>\r\n<h3><b>Age<\/b><\/h3>\r\n<ul>\r\n \t<li>15% are under the age of 12<\/li>\r\n \t<li>29% are age 12\u201317<\/li>\r\n \t<li>44% are under age 18<\/li>\r\n \t<li>80% are under age 30<\/li>\r\n \t<li>12\u201334 are the highest risk years<\/li>\r\n \t<li>Girls ages 16\u201319 are four times more likely than the general population to be victims of rape, attempted rape, or sexual assault.<\/li>\r\n<\/ul>\r\n<h3><b>By Gender<\/b><\/h3>\r\nA study from 1998 found that\r\n<ul>\r\n \t<li>88.7% of rape victims are women, the other 11.3% are men.<\/li>\r\n \t<li>17.6% of women have been victims of attempted (2.8%) or completed (14.8%) rape during their lifetime.<\/li>\r\n \t<li>3% of men have been victims of attempted or completed rape during their lifetime.<\/li>\r\n \t<li>17.7 million women have been victims of attempted or completed rape during their lifetime.<\/li>\r\n \t<li>2.78 million men have been victims of attempted or completed rape during their lifetime.<sup id=\"cite_ref-rainn.org_72-1\" class=\"reference\"><\/sup><\/li>\r\n<\/ul>\r\nLargely because of\u00a0child\u00a0and\u00a0prison rape, approximately 10% of reported rape victims are male.\r\n\r\nThe National Crime Victimization Survey conducted by the U.S. Justice Department (Bureau of Justice Statistics) found that from 1995 to 2013, men represented 17% of victims of sexual assault and rape on college campuses, and 4% of non-campus sexual assaults and rapes.\r\n<h2><span id=\"Child_sexual_abuse\" class=\"mw-headline\">Child Sexual Abuse<\/span><\/h2>\r\nApproximately 15\u201325% of women and five to 15% of men were sexually abused when they were children.\u00a0The\u00a0median age for sexual abuse is eight or nine years for both boys and girls (Finkelhor et. al. 1990).\u00a0Most boys and girls are sexually abused by a male.\u00a0<strong>Childhood\u00a0sexual abuse<\/strong>\u00a0is defined as any sexual contact between a child and an adult or a much older child.\u00a0<strong>Incest<\/strong>\u00a0refers to sexual contact between a child and family members.\u00a0In each of these cases, the child is exploited by an older person without regard for the child\u2019s developmental immaturity and inability to understand the sexual behavior (Steele, 1986).\r\n\r\nSexual abuse can create feelings of self-blame, betrayal, and feelings of shame and guilt (Valente, 2005). The effects of child sexual abuse include\u00a0depression,\u00a0post-traumatic stress disorder,\u00a0anxiety,\u00a0propensity to\u00a0re-victimization\u00a0in adulthood,\u00a0physical injury to the child, and increased risk for future interpersonal violence perpetration among males, among other problems.<sup id=\"cite_ref-15\" class=\"reference\"><\/sup>\u00a0Additionally, victims of sexual abuse may suffer from problems with intimacy and suicide (Valente, 2005). Studies suggest that children who have been sexually abused have an increased risk of eating disorders and sleep disturbances.\r\n\r\n<span style=\"font-size: 1em;\">Sexual abuse is particularly damaging when the perpetrator is someone the child trusts. As stated above, s<\/span>exual abuse by a family member is a form of\u00a0incest. It is more common than other forms of sexual assault on a child and can result in more serious and long-term\u00a0psychological trauma, especially in the case of parental incest.\u00a0Most sexual abuse offenders are acquainted with their victims. Approximately 30% of the perpetrators are relatives of the child\u2014most often brothers, fathers, mothers, sisters, and uncles or cousins. Around 60% are other acquaintances such as friends of the family, babysitters, or neighbors. Strangers are the offenders in approximately 10% of child sexual abuse cases.\u00a0<span style=\"font-size: 1em; text-align: initial;\">Many states have criminalized sexual contact between teachers or school administrators and students, even if the student is over the age of consent.<\/span>\r\n\r\nOften, sexual assault on a child is not reported by the child for several of the following reasons:\r\n<ul>\r\n \t<li>children are too young to recognize their victimization or put it into words<\/li>\r\n \t<li>they were threatened or bribed by the abuser<\/li>\r\n \t<li>they feel confused by fearing the abuser<\/li>\r\n \t<li>they are afraid no one will believe them<\/li>\r\n \t<li>they blame themselves or believe the abuse is a punishment<\/li>\r\n \t<li>they feel guilty for consequences to the perpetrator<\/li>\r\n<\/ul>\r\nAlthough rates of sexual abuse are higher for girls than for boys, boys may be less likely to report abuse because of the cultural expectation that boys should be able to take care of themselves and because of the stigma attached to homosexual encounters (Finkelhor et. al. 1990).\u00a0Girls are more likely to be victims of incest and boys are more likely to be abused by someone outside the family.\r\n\r\n[caption id=\"attachment_4180\" align=\"alignleft\" width=\"204\"]<img class=\"wp-image-4180\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/5351\/2020\/09\/06002410\/mirror-4758692_1280-300x285.png\" alt=\"A graphic of a woman looking at her reflection in a mirror\" width=\"204\" height=\"194\" \/> <strong>Figure 2.<\/strong> Abuse can lead to low self-esteem in girls.[\/caption]\r\n\r\nBeing sexually abused as a child can have a powerful impact on self-concept.\u00a0The concept of\u00a0<strong>false self-training\u00a0<\/strong>(Davis, 1999) refers to holding a child to adult standards while denying the child\u2019s developmental needs.\u00a0Sexual abuse is just one example of false self-training.\u00a0Children are held to adult standards of desirableness and sexuality while their level of cognitive, psychological, and emotional immaturity is ignored.\u00a0Consider how confusing it might be for a nine-year-old girl who has physically matured early to be thought of as a potential sex partner.\u00a0Her cognitive,\u00a0psychological, and emotional state do not equip her to make decisions about sexuality or, perhaps, to know that she can say no to sexual advances.\u00a0She may feel like a nine-year-old in all ways and be embarrassed and ashamed of her physical development.\u00a0Girls who mature early have problems with low self-esteem because of the failure of others (family members, teachers, ministers, peers, advertisers, and others) to recognize and respect their developmental needs.\u00a0Overall, youth are more likely to be victimized because they do not have control over their contact with offenders (parents, babysitters, etc.) and have no means of escape (Finkelhor and Dzuiba-Leatherman, in Davis, 1999).\r\n\r\n<b>Child grooming<\/b>\u00a0is befriending and establishing an emotional connection with a child, and sometimes the family, to lower the child's inhibitions with the objective of\u00a0sexual abuse. To establish a good relationship with a child and the child's family, child groomers might do several things: They might try to gain the child's or parents' trust by befriending them, with the goal of easy access to the child.\u00a0Sexual grooming of children also occurs on the internet. Some abusers will pose as children online and make arrangements to meet with them in person. Online grooming of children is most prevalent within the 13\u201317 age group (99% of cases), and particularly 13\u201314 (48%). The majority of targeted children are girls, and most victimization occurs with mobile-phone support. Children and teenagers with behavioral issues such as \"high attention seeking\" have a much higher risk than others. Contact-driven pedophiles and predators\u00a0<sup id=\"cite_ref-25\" class=\"reference\"><\/sup><sup id=\"cite_ref-autogenerated17_26-0\" class=\"reference\"><\/sup><sup id=\"cite_ref-autogenerated1_27-0\" class=\"reference\"><\/sup>use online grooming to carry out\u00a0cybersex trafficking\u00a0crimes. The internet provides adults and children with a medium for professional and personal communication throughout the world. As widespread communication in cyberspace grows exponentially, the potential for internet-related crimes, such as cyberstalking, has accelerated. Children are particularly vulnerable to sexual predators, such as pedophiles, on the internet.\r\n<div class=\"textbox exercises\">\r\n<h3>Sexual Abuse in the Church<\/h3>\r\n<b>Catholic Church sexual abuse cases<\/b>\u00a0are cases of\u00a0child sexual abuse\u00a0by\u00a0Catholic priests,\u00a0nuns, and members of\u00a0religious orders. In the 20th and 21st centuries, the cases have involved many allegations, investigations, trials, convictions, and revelations about decades of attempts by Church officials to cover up reported incidents.\u00a0The abused include mostly boys but also girls, some as young as three years old, with the majority between the ages of 11 and 14.\u00a0Many of these cases allege decades of abuse, frequently made by adults or older youths years after the abuse occurred. Cases have also been brought against members of the\u00a0Catholic hierarchy\u00a0who covered up sex abuse allegations and moved abusive priests to other\u00a0parishes, where abuse continued.\u00a0By the 1990s, the cases began to receive significant media and public attention in countries including Canada, the United States, Chile,\u00a0Australia, Ireland, and much of Europe.\u00a0From 2001 to 2010, the\u00a0Holy See\u00a0examined sex abuse cases involving about 3,000 priests, some of which dated back fifty years.\u00a0Members of the Church's hierarchy have argued that media coverage was excessive and disproportionate and that such abuse also takes place in other\u00a0religions\u00a0and institutions, a stance that dismayed critics who saw it as a device to avoid resolving the abuse problem within the Church.\u00a0<span style=\"font-size: 1rem; text-align: initial;\">Hofstra University researcher Charol Shakeshaft, the author of a report on sexual offenses in schools, said sexual violence is much more prevalent in schools than in the Church.\u00a0<\/span><span style=\"font-size: 1rem; text-align: initial;\">According to the report, up to 422,000 students from California will be victims of sexual violence in the future.<\/span>\r\n\r\n<\/div>\r\nIn\u00a0<i>Sexual Addiction and<\/i> <em>Compulsivity<\/em>:<i> The Journal of Treatment and Prevention<\/i>, Cimbolic &amp; Cartor (2006) noted that because of the large share of post-pubescent\u00a0male minors among cleric victims, there is need to further study the differential variables related to\u00a0<strong>ephebophilia<\/strong>\u00a0(sexual interest in mid-to-late\u00a0adolescents, generally ages 15 to 19)<sup id=\"cite_ref-autogenerated2_280-0\" class=\"reference\"><\/sup>\u00a0versus\u00a0pedophilia\u00a0(sexual interest in\u00a0prepubescent\u00a0children, generally those 13 years of age or younger) offenders.\u00a0Cartor, Cimbolic &amp; Tallon (2008) found that 6% of the cleric offenders in the\u00a0<em>John Jay Report\u00a0<\/em>are pedophiles, 32% ephebophiles, 15% attracted to 11- and 12-year-olds only (both male and female), 20% indiscriminate, and 27% mildly indiscriminate.\r\n\r\nIn the United States, following\u00a0<i><strong>Kansas v. Hendricks<\/strong><\/i><strong>,<\/strong> sex offenders who have certain mental disorders, including pedophilia, can be subject to indefinite\u00a0civil commitment\u00a0under various state laws\u00a0(generically called\u00a0SVP laws or Sexually Violent Predator laws) and the federal\u00a0Adam Walsh Child Protection and Safety Act\u00a0of 2006.\u00a0Similar legislation exists in Canada.\u00a0Generally speaking, <em><strong>SVP laws<\/strong> <\/em>have three elements:\u00a0(1) that the person has been convicted of a sexually violent offense; (2) that the person suffers from a mental abnormality and\/or personality disorder, which causes them serious difficulty controlling their sexually violent behavior; and (3) that this mental abnormality and\/or personality disorder makes the person likely to engage in predatory acts of sexual violence if not confined in a secure facility.\r\n\r\nThe\u00a0<b>Adam Walsh Child Protection and Safety Act<\/b>\u00a0is a federal statute that was signed into law by\u00a0U.S. President\u00a0George W. Bush\u00a0on July 27, 2006. The Walsh Act organizes\u00a0sex offenders\u00a0into three tiers according to the crime committed, and mandates that Tier 3 offenders (the most serious tier) update their whereabouts every three months with lifetime registration requirements. Tier 2 offenders must update their whereabouts every six months with 25 years of registration, and Tier 1 offenders must update their whereabouts every year with 15 years of registration. Failure to register and update information is a\u00a0felony\u00a0under the law. States are required to publicly disclose information of Tier 2 and Tier 3 offenders, at minimum. As stated above, it also contains\u00a0civil commitment\u00a0provisions for\u00a0sexually dangerous people.\r\n\r\nThe Act also creates a <strong>national\u00a0sex offender registry<\/strong>\u00a0and instructs each state and territory to apply identical criteria for posting offender data on the internet (i.e., offender's name, address, date of birth, place of employment, photograph, etc.).\u00a0The Act was named after\u00a0Adam Walsh, an American boy who was abducted from a Florida\u00a0shopping mall\u00a0and later found murdered.\r\n\r\nIn\u00a0<i>Kansas v. Hendricks<\/i>, the\u00a0U.S. Supreme Court\u00a0upheld as constitutional a Kansas law, the\u00a0<strong>Sexually Violent Predator Act,<\/strong> under which Hendricks, a pedophile, was found to have a \"mental abnormality\" defined as a \"congenital or acquired condition affecting the emotional or volitional capacity that predisposes the person to commit sexually violent offenses to the degree that such person is a menace to the health and safety of others,\" which allowed the State to confine Hendricks indefinitely irrespective of whether the State provided any treatment to him.<sup id=\"cite_ref-guilford_127-0\" class=\"reference\"><\/sup><sup id=\"cite_ref-128\" class=\"reference\"><\/sup>\u00a0In\u00a0<i>United States v. Comstock<\/i>, this type of indefinite confinement was upheld for someone previously convicted on child pornography charges; this time a federal law was involved\u2014the Adam Walsh Child Protection and Safety Act.<sup id=\"cite_ref-apabc_126-1\" class=\"reference\"><\/sup>\u00a0The Walsh Act does not require a conviction on a sex offense charge, but only that the person be a\u00a0federal prisoner, and one who \"has engaged or attempted to engage in sexually violent conduct or child molestation and who is sexually dangerous to others,\" and who \"would have serious difficulty in refraining from sexually violent conduct or child molestation if released.\"\r\n\r\nIn the United States, offenders with pedophilia are more likely to be recommended for civil commitment than non-pedophilic offenders. About half of committed offenders have a diagnosis of pedophilia.\u00a0Psychiatrist\u00a0Michael First (2008), in\u00a0<em>\"Use of DSM Paraphilia Diagnoses in Sexually Violent Predator Commitment Cases\"<\/em>\u00a0writes that, since not all people with a paraphilia have difficulty controlling their behavior, the evaluating clinician must present additional evidence of volitional impairment instead of recommending commitment based on pedophilia alone.\r\n<h2><span id=\"Deviant_sexual_preferences\" class=\"mw-headline\">Deviant Sexual Preferences<\/span><\/h2>\r\nResearch focusing on the deviant sexual preferences propensity model suggests that people who perpetrate acts of sexual violence are sexually aroused by non-consensual sexual interactions more than consensual sexual interactions. The research that seeks to support this model (penile plethysmography) has not been able to reliably find differences in the two different groups of males (those who have committed acts of sexual aggression and those who have not).\u00a0Instead, the studies are providing more evidence for the cognitive, attitudinal, neuropsychological, and lifestyle differences that impact sexual arousal in certain situations, rather than a deviant sexual preference leading to a higher propensity for sexual violence.\r\n\r\nThe antisocial personality lens stems from a study done by Hall and Hirschman (1991)\u00a0and emphasizes the subsequent consequences of experiencing adversities\/abuses in childhood, which can lead to the development of antisocial personality traits in adulthood. The antisocial personality traits combine with contextual, emotional (rage\/anger), cognitive (irrational thoughts that influence emotions), and physiological (deviant sexual arousal) factors that increase the probability of committing sexual violence.\r\n<h2><span id=\"Domestic_violence\" class=\"mw-headline\">Domestic Violence<\/span><\/h2>\r\nDomestic violence is violence or other abuse by one person against another in a domestic setting, such as in marriage or cohabitation. It is strongly correlated with sexual assault. Not only can domestic abuse be emotional, physical, psychological, and financial, it can also be sexual. Some of the signs of sexual abuse are similar to those of domestic violence.\u00a0Domestic sexual violence includes all forms of unwanted sexual activity. It is considered abuse even if the victim may have previously engaged in consensual sexual activities with the perpetrator. Men and women can both fall victim to this type of abuse.\u00a0A 2006\u00a0WHO\u00a0study on physical and sexual domestic violence against women conducted across ten countries, found that the prevalence of sexual domestic violence ranges on average between 10 and 50%. Domestic sexual violence is also considerably less common than other forms of domestic violence.\r\n<h2><span id=\"Rape\" class=\"mw-headline\">Rape<\/span><\/h2>\r\nOutside of law, the term\u00a0<i>rape<\/i>\u00a0(sexual intercourse\u00a0or other forms of\u00a0sexual penetration\u00a0carried out against a person without that person's consent) is often used interchangeably with sexual assault.\u00a0Although closely related, the two terms are technically distinct in most jurisdictions. Sexual assault typically includes rape and other forms of non-consensual sexual activity.<sup id=\"cite_ref-RAINN_4-1\" class=\"reference\"><\/sup>\r\n\r\nAbbey\u00a0<i>et al.<\/i>\u00a0state that female victims are much more likely to be assaulted by an acquaintance, such as a friend or co-worker, a dating partner, an ex-boyfriend, or a husband or other intimate partner than by a complete stranger.\u00a0In a study of hospital emergency room treatments for rape, Kaufman\u00a0<i>et al.<\/i>\u00a0stated that the male victims as a group sustained more physical trauma and were more likely to have been a victim of multiple assaults from multiple assailants. It was also stated that male victims were more likely to have been held captive longer.\r\n\r\nIn the U.S., rape is a crime committed primarily against youth. A national telephone survey on violence against women conducted by the\u00a0National Institute of Justice\u00a0and the\u00a0Centers for Disease Control and Prevention\u00a0found that 18% of women surveyed had experienced a completed or attempted rape at some time in their lives. Of these, 22% were younger than 12 years and 32% were between 12 and 17 years old when they were first raped.<sup id=\"cite_ref-33\" class=\"reference\"><\/sup>\r\n\r\nIn the United States, several studies since 1987 have indicated that one in four college women have experienced rape or attempted rape at some point in their lifetime. These studies are based on anonymous surveys of college women, not reports to the police, and the results are disputed.<sup id=\"cite_ref-leaderu1_79-0\" class=\"reference\"><\/sup>\r\n\r\nThe removal of a condom during intercourse without the consent of the sex partner, known as\u00a0<strong>stealthing,<\/strong> may be treated as a sexual assault or rape.<sup id=\"cite_ref-35\" class=\"reference\"><\/sup>\r\n\r\n[caption id=\"attachment_4178\" align=\"alignright\" width=\"300\"]<img class=\"wp-image-4178 size-medium\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/5351\/2020\/09\/06000456\/artsy-solomon-nappy--300x200.jpeg\" alt=\"A woman sitting on an overlook during sunset and looking down. \" width=\"300\" height=\"200\" \/> <strong>Figure 3.<\/strong> For many victims, emotional trauma lasts for years after the assault takes place.[\/caption]\r\n<h2><span class=\"mw-headline\">Emotional Effects\u00a0<\/span><\/h2>\r\nAside from physical traumas, rape and other sexual assault often result in long-term emotional effects, particularly in child victims. These can include, but are not limited to denial,\u00a0learned helplessness,\u00a0genophobia,\u00a0anger,\u00a0self-blame,\u00a0anxiety,\u00a0shame,\u00a0nightmares,\u00a0fear,\u00a0depression,\u00a0flashbacks,\u00a0guilt,\u00a0rationalization,\u00a0mood swings,\u00a0numbness,\u00a0promiscuity,\u00a0loneliness,\u00a0social anxiety, difficulty trusting oneself or others, and difficulty concentrating. Being the victim of sexual assault may lead to the development of\u00a0post-traumatic stress disorder,\u00a0addiction,\u00a0major depressive disorder, or other\u00a0psychopathologies. Family and friends experience emotional scarring including a strong desire for\u00a0revenge, a desire to \"fix\" the problem and\/or move on, and a rationalization that \"it wasn't that bad.\"\r\n<h2><span id=\"Physical_effects\" class=\"mw-headline\">Physical Effects<\/span><\/h2>\r\nWhile sexual assault, including rape, can result in physical trauma, many people who experience sexual assault will not suffer any physical injury.\u00a0Rape myths\u00a0suggest that the stereotypical victim of sexual violence is a bruised and battered young woman. The central issue in many cases of rape or other sexual assault is whether or not both parties consented to the sexual activity or whether or not both parties had the capacity to do so. Thus, the physical force resulting in visible physical injury is not always seen. This stereotype can be damaging because people who have experienced sexual assault but have no physical trauma may be less inclined to report to the authorities or to seek health care.\u00a0However, women who experienced rape or physical violence by a partner were more likely than people who had not experienced this violence to report frequent headaches, chronic pain, difficulty sleeping, activity limitation, poor physical health, and poor mental health.\r\n<div class=\"textbox tryit\">\r\n<h3>Try It<\/h3>\r\nhttps:\/\/assess.lumenlearning.com\/practice\/f2f7bf8d-6c1c-4999-b445-22e5753c6f75\r\n\r\n<\/div>\r\n<div class=\"textbox learning-objectives\">\r\n<h3>Glossary<\/h3>\r\n<strong>Adam Walsh Child Protection and Safety Act:<\/strong>\u00a0a law that\u00a0does not require a conviction on a sex offense charge, but only that the person be a\u00a0federal prisoner, and one who \"has engaged or attempted to engage in sexually violent conduct or child molestation and who is sexually dangerous to others,\" and who \"would have serious difficulty in refraining from sexually violent conduct or child molestation if released\"\r\n\r\n<b>Catholic Church sexual abuse cases:<\/b>\u00a0cases of\u00a0child sexual abuse\u00a0by\u00a0Catholic priests,\u00a0nuns, and members of\u00a0religious orders\r\n\r\n<b style=\"font-size: 1rem; text-align: initial;\">child sexual abuse (<\/b><b style=\"font-size: 1rem; text-align: initial;\">child molestation):<\/b><span style=\"font-size: 1rem; text-align: initial;\">\u00a0a form of\u00a0child abuse\u00a0in which an adult or older adolescent uses a\u00a0child\u00a0for\u00a0sexual stimulation<\/span>\r\n\r\n<b>child grooming:\u00a0<\/b>befriending and establishing an emotional connection with a child, and sometimes the family, to lower the child's inhibitions with the objective of\u00a0sexual abuse\r\n\r\n<strong>childhood\u00a0sexual abuse:<\/strong>\u00a0defined as any sexual contact between a child and an adult or a much older child\r\n\r\n<strong>false self-training:<\/strong>\u00a0refers to holding a child to adult standards while denying the child\u2019s developmental needs\r\n\r\n<strong style=\"color: #800000;\"><span style=\"color: #333333;\">incest:\u00a0<\/span><\/strong>refers to sexual contact between a child and family members\r\n\r\n<strong>rape:<\/strong>\u00a0forced\u00a0vaginal, anal, or oral penetration\u00a0or a\u00a0drug-facilitated sexual assault\r\n\r\n<b>sexual assault:<\/b>\u00a0an act in which a person intentionally sexually touches another person without that person's\u00a0consent or\u00a0coerces\u00a0or physically forces a person to engage in a\u00a0sexual act\u00a0against their will\r\n\r\n<\/div>","rendered":"<div class=\"textbox learning-objectives\">\n<h3>Learning Objectives<\/h3>\n<ul>\n<li style=\"font-weight: 400;\">Discuss problems and concerns related to the effects of rape and sexual abuse<\/li>\n<\/ul>\n<\/div>\n<p>As mentioned earlier, there is some controversy surrounding the diagnosis of a paraphilic disorder and what constitutes deviant sexual behavior. The definitions of these disorders can vary depending on time and culture, and the complication in diagnosing paraphilic disorders is compounded by the fact that several of the disorders could be associated with criminal behavior.<a class=\"footnote\" title=\"McManus, M. A., Hargreaves, P., Rainbow, L., &amp; Alison, L. J. (2013). Paraphilias: definition, diagnosis, and treatment. F1000prime reports, 5, 36. https:\/\/doi.org\/10.12703\/P5-36\" id=\"return-footnote-1571-1\" href=\"#footnote-1571-1\" aria-label=\"Footnote 1\"><sup class=\"footnote\">[1]<\/sup><\/a>\u00a0In this section, we will take a closer look at the criminal forms of sexual violence and abuse (that may or may not stem from a paraphilic disorder).<\/p>\n<p><b style=\"font-size: 1rem; text-align: initial;\">Sexual assault<\/b><span style=\"font-size: 1rem; text-align: initial;\">\u00a0is an act in which a person intentionally sexually touches another person without that person&#8217;s\u00a0consent or\u00a0coerces\u00a0or physically forces a person to engage in a\u00a0sexual act\u00a0against their will.\u00a0It is a form of\u00a0sexual violence, which includes\u00a0child sexual abuse,\u00a0groping,\u00a0<\/span><strong style=\"font-size: 1rem; text-align: initial;\">rape<\/strong><span style=\"font-size: 1rem; text-align: initial;\">\u00a0(forced\u00a0vaginal, anal, or oral penetration\u00a0or a\u00a0drug-facilitated sexual assault), or the\u00a0torture\u00a0of the person in a sexual manner.<\/span><\/p>\n<div style=\"width: 427px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/upload.wikimedia.org\/wikipedia\/commons\/b\/bd\/BJS_Sexual_Assualt_Rates_1995-2013.png\" alt=\"Rate of rape or sexual assault for females from 1997-2013. Rates are declining, but cases spiked again between 2008 and 20011.\" width=\"417\" height=\"357\" \/><\/p>\n<p class=\"wp-caption-text\"><strong>Figure<\/strong> 1. Reported rates of sexual assault in the United States (BJS)<\/p>\n<\/div>\n<h2>Victims of Sexual Assault<\/h2>\n<h3><b>Age<\/b><\/h3>\n<ul>\n<li>15% are under the age of 12<\/li>\n<li>29% are age 12\u201317<\/li>\n<li>44% are under age 18<\/li>\n<li>80% are under age 30<\/li>\n<li>12\u201334 are the highest risk years<\/li>\n<li>Girls ages 16\u201319 are four times more likely than the general population to be victims of rape, attempted rape, or sexual assault.<\/li>\n<\/ul>\n<h3><b>By Gender<\/b><\/h3>\n<p>A study from 1998 found that<\/p>\n<ul>\n<li>88.7% of rape victims are women, the other 11.3% are men.<\/li>\n<li>17.6% of women have been victims of attempted (2.8%) or completed (14.8%) rape during their lifetime.<\/li>\n<li>3% of men have been victims of attempted or completed rape during their lifetime.<\/li>\n<li>17.7 million women have been victims of attempted or completed rape during their lifetime.<\/li>\n<li>2.78 million men have been victims of attempted or completed rape during their lifetime.<sup id=\"cite_ref-rainn.org_72-1\" class=\"reference\"><\/sup><\/li>\n<\/ul>\n<p>Largely because of\u00a0child\u00a0and\u00a0prison rape, approximately 10% of reported rape victims are male.<\/p>\n<p>The National Crime Victimization Survey conducted by the U.S. Justice Department (Bureau of Justice Statistics) found that from 1995 to 2013, men represented 17% of victims of sexual assault and rape on college campuses, and 4% of non-campus sexual assaults and rapes.<\/p>\n<h2><span id=\"Child_sexual_abuse\" class=\"mw-headline\">Child Sexual Abuse<\/span><\/h2>\n<p>Approximately 15\u201325% of women and five to 15% of men were sexually abused when they were children.\u00a0The\u00a0median age for sexual abuse is eight or nine years for both boys and girls (Finkelhor et. al. 1990).\u00a0Most boys and girls are sexually abused by a male.\u00a0<strong>Childhood\u00a0sexual abuse<\/strong>\u00a0is defined as any sexual contact between a child and an adult or a much older child.\u00a0<strong>Incest<\/strong>\u00a0refers to sexual contact between a child and family members.\u00a0In each of these cases, the child is exploited by an older person without regard for the child\u2019s developmental immaturity and inability to understand the sexual behavior (Steele, 1986).<\/p>\n<p>Sexual abuse can create feelings of self-blame, betrayal, and feelings of shame and guilt (Valente, 2005). The effects of child sexual abuse include\u00a0depression,\u00a0post-traumatic stress disorder,\u00a0anxiety,\u00a0propensity to\u00a0re-victimization\u00a0in adulthood,\u00a0physical injury to the child, and increased risk for future interpersonal violence perpetration among males, among other problems.<sup id=\"cite_ref-15\" class=\"reference\"><\/sup>\u00a0Additionally, victims of sexual abuse may suffer from problems with intimacy and suicide (Valente, 2005). Studies suggest that children who have been sexually abused have an increased risk of eating disorders and sleep disturbances.<\/p>\n<p><span style=\"font-size: 1em;\">Sexual abuse is particularly damaging when the perpetrator is someone the child trusts. As stated above, s<\/span>exual abuse by a family member is a form of\u00a0incest. It is more common than other forms of sexual assault on a child and can result in more serious and long-term\u00a0psychological trauma, especially in the case of parental incest.\u00a0Most sexual abuse offenders are acquainted with their victims. Approximately 30% of the perpetrators are relatives of the child\u2014most often brothers, fathers, mothers, sisters, and uncles or cousins. Around 60% are other acquaintances such as friends of the family, babysitters, or neighbors. Strangers are the offenders in approximately 10% of child sexual abuse cases.\u00a0<span style=\"font-size: 1em; text-align: initial;\">Many states have criminalized sexual contact between teachers or school administrators and students, even if the student is over the age of consent.<\/span><\/p>\n<p>Often, sexual assault on a child is not reported by the child for several of the following reasons:<\/p>\n<ul>\n<li>children are too young to recognize their victimization or put it into words<\/li>\n<li>they were threatened or bribed by the abuser<\/li>\n<li>they feel confused by fearing the abuser<\/li>\n<li>they are afraid no one will believe them<\/li>\n<li>they blame themselves or believe the abuse is a punishment<\/li>\n<li>they feel guilty for consequences to the perpetrator<\/li>\n<\/ul>\n<p>Although rates of sexual abuse are higher for girls than for boys, boys may be less likely to report abuse because of the cultural expectation that boys should be able to take care of themselves and because of the stigma attached to homosexual encounters (Finkelhor et. al. 1990).\u00a0Girls are more likely to be victims of incest and boys are more likely to be abused by someone outside the family.<\/p>\n<div id=\"attachment_4180\" style=\"width: 214px\" class=\"wp-caption alignleft\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-4180\" class=\"wp-image-4180\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/5351\/2020\/09\/06002410\/mirror-4758692_1280-300x285.png\" alt=\"A graphic of a woman looking at her reflection in a mirror\" width=\"204\" height=\"194\" \/><\/p>\n<p id=\"caption-attachment-4180\" class=\"wp-caption-text\"><strong>Figure 2.<\/strong> Abuse can lead to low self-esteem in girls.<\/p>\n<\/div>\n<p>Being sexually abused as a child can have a powerful impact on self-concept.\u00a0The concept of\u00a0<strong>false self-training\u00a0<\/strong>(Davis, 1999) refers to holding a child to adult standards while denying the child\u2019s developmental needs.\u00a0Sexual abuse is just one example of false self-training.\u00a0Children are held to adult standards of desirableness and sexuality while their level of cognitive, psychological, and emotional immaturity is ignored.\u00a0Consider how confusing it might be for a nine-year-old girl who has physically matured early to be thought of as a potential sex partner.\u00a0Her cognitive,\u00a0psychological, and emotional state do not equip her to make decisions about sexuality or, perhaps, to know that she can say no to sexual advances.\u00a0She may feel like a nine-year-old in all ways and be embarrassed and ashamed of her physical development.\u00a0Girls who mature early have problems with low self-esteem because of the failure of others (family members, teachers, ministers, peers, advertisers, and others) to recognize and respect their developmental needs.\u00a0Overall, youth are more likely to be victimized because they do not have control over their contact with offenders (parents, babysitters, etc.) and have no means of escape (Finkelhor and Dzuiba-Leatherman, in Davis, 1999).<\/p>\n<p><b>Child grooming<\/b>\u00a0is befriending and establishing an emotional connection with a child, and sometimes the family, to lower the child&#8217;s inhibitions with the objective of\u00a0sexual abuse. To establish a good relationship with a child and the child&#8217;s family, child groomers might do several things: They might try to gain the child&#8217;s or parents&#8217; trust by befriending them, with the goal of easy access to the child.\u00a0Sexual grooming of children also occurs on the internet. Some abusers will pose as children online and make arrangements to meet with them in person. Online grooming of children is most prevalent within the 13\u201317 age group (99% of cases), and particularly 13\u201314 (48%). The majority of targeted children are girls, and most victimization occurs with mobile-phone support. Children and teenagers with behavioral issues such as &#8220;high attention seeking&#8221; have a much higher risk than others. Contact-driven pedophiles and predators\u00a0<sup id=\"cite_ref-25\" class=\"reference\"><\/sup><sup id=\"cite_ref-autogenerated17_26-0\" class=\"reference\"><\/sup><sup id=\"cite_ref-autogenerated1_27-0\" class=\"reference\"><\/sup>use online grooming to carry out\u00a0cybersex trafficking\u00a0crimes. The internet provides adults and children with a medium for professional and personal communication throughout the world. As widespread communication in cyberspace grows exponentially, the potential for internet-related crimes, such as cyberstalking, has accelerated. Children are particularly vulnerable to sexual predators, such as pedophiles, on the internet.<\/p>\n<div class=\"textbox exercises\">\n<h3>Sexual Abuse in the Church<\/h3>\n<p><b>Catholic Church sexual abuse cases<\/b>\u00a0are cases of\u00a0child sexual abuse\u00a0by\u00a0Catholic priests,\u00a0nuns, and members of\u00a0religious orders. In the 20th and 21st centuries, the cases have involved many allegations, investigations, trials, convictions, and revelations about decades of attempts by Church officials to cover up reported incidents.\u00a0The abused include mostly boys but also girls, some as young as three years old, with the majority between the ages of 11 and 14.\u00a0Many of these cases allege decades of abuse, frequently made by adults or older youths years after the abuse occurred. Cases have also been brought against members of the\u00a0Catholic hierarchy\u00a0who covered up sex abuse allegations and moved abusive priests to other\u00a0parishes, where abuse continued.\u00a0By the 1990s, the cases began to receive significant media and public attention in countries including Canada, the United States, Chile,\u00a0Australia, Ireland, and much of Europe.\u00a0From 2001 to 2010, the\u00a0Holy See\u00a0examined sex abuse cases involving about 3,000 priests, some of which dated back fifty years.\u00a0Members of the Church&#8217;s hierarchy have argued that media coverage was excessive and disproportionate and that such abuse also takes place in other\u00a0religions\u00a0and institutions, a stance that dismayed critics who saw it as a device to avoid resolving the abuse problem within the Church.\u00a0<span style=\"font-size: 1rem; text-align: initial;\">Hofstra University researcher Charol Shakeshaft, the author of a report on sexual offenses in schools, said sexual violence is much more prevalent in schools than in the Church.\u00a0<\/span><span style=\"font-size: 1rem; text-align: initial;\">According to the report, up to 422,000 students from California will be victims of sexual violence in the future.<\/span><\/p>\n<\/div>\n<p>In\u00a0<i>Sexual Addiction and<\/i> <em>Compulsivity<\/em>:<i> The Journal of Treatment and Prevention<\/i>, Cimbolic &amp; Cartor (2006) noted that because of the large share of post-pubescent\u00a0male minors among cleric victims, there is need to further study the differential variables related to\u00a0<strong>ephebophilia<\/strong>\u00a0(sexual interest in mid-to-late\u00a0adolescents, generally ages 15 to 19)<sup id=\"cite_ref-autogenerated2_280-0\" class=\"reference\"><\/sup>\u00a0versus\u00a0pedophilia\u00a0(sexual interest in\u00a0prepubescent\u00a0children, generally those 13 years of age or younger) offenders.\u00a0Cartor, Cimbolic &amp; Tallon (2008) found that 6% of the cleric offenders in the\u00a0<em>John Jay Report\u00a0<\/em>are pedophiles, 32% ephebophiles, 15% attracted to 11- and 12-year-olds only (both male and female), 20% indiscriminate, and 27% mildly indiscriminate.<\/p>\n<p>In the United States, following\u00a0<i><strong>Kansas v. Hendricks<\/strong><\/i><strong>,<\/strong> sex offenders who have certain mental disorders, including pedophilia, can be subject to indefinite\u00a0civil commitment\u00a0under various state laws\u00a0(generically called\u00a0SVP laws or Sexually Violent Predator laws) and the federal\u00a0Adam Walsh Child Protection and Safety Act\u00a0of 2006.\u00a0Similar legislation exists in Canada.\u00a0Generally speaking, <em><strong>SVP laws<\/strong> <\/em>have three elements:\u00a0(1) that the person has been convicted of a sexually violent offense; (2) that the person suffers from a mental abnormality and\/or personality disorder, which causes them serious difficulty controlling their sexually violent behavior; and (3) that this mental abnormality and\/or personality disorder makes the person likely to engage in predatory acts of sexual violence if not confined in a secure facility.<\/p>\n<p>The\u00a0<b>Adam Walsh Child Protection and Safety Act<\/b>\u00a0is a federal statute that was signed into law by\u00a0U.S. President\u00a0George W. Bush\u00a0on July 27, 2006. The Walsh Act organizes\u00a0sex offenders\u00a0into three tiers according to the crime committed, and mandates that Tier 3 offenders (the most serious tier) update their whereabouts every three months with lifetime registration requirements. Tier 2 offenders must update their whereabouts every six months with 25 years of registration, and Tier 1 offenders must update their whereabouts every year with 15 years of registration. Failure to register and update information is a\u00a0felony\u00a0under the law. States are required to publicly disclose information of Tier 2 and Tier 3 offenders, at minimum. As stated above, it also contains\u00a0civil commitment\u00a0provisions for\u00a0sexually dangerous people.<\/p>\n<p>The Act also creates a <strong>national\u00a0sex offender registry<\/strong>\u00a0and instructs each state and territory to apply identical criteria for posting offender data on the internet (i.e., offender&#8217;s name, address, date of birth, place of employment, photograph, etc.).\u00a0The Act was named after\u00a0Adam Walsh, an American boy who was abducted from a Florida\u00a0shopping mall\u00a0and later found murdered.<\/p>\n<p>In\u00a0<i>Kansas v. Hendricks<\/i>, the\u00a0U.S. Supreme Court\u00a0upheld as constitutional a Kansas law, the\u00a0<strong>Sexually Violent Predator Act,<\/strong> under which Hendricks, a pedophile, was found to have a &#8220;mental abnormality&#8221; defined as a &#8220;congenital or acquired condition affecting the emotional or volitional capacity that predisposes the person to commit sexually violent offenses to the degree that such person is a menace to the health and safety of others,&#8221; which allowed the State to confine Hendricks indefinitely irrespective of whether the State provided any treatment to him.<sup id=\"cite_ref-guilford_127-0\" class=\"reference\"><\/sup><sup id=\"cite_ref-128\" class=\"reference\"><\/sup>\u00a0In\u00a0<i>United States v. Comstock<\/i>, this type of indefinite confinement was upheld for someone previously convicted on child pornography charges; this time a federal law was involved\u2014the Adam Walsh Child Protection and Safety Act.<sup id=\"cite_ref-apabc_126-1\" class=\"reference\"><\/sup>\u00a0The Walsh Act does not require a conviction on a sex offense charge, but only that the person be a\u00a0federal prisoner, and one who &#8220;has engaged or attempted to engage in sexually violent conduct or child molestation and who is sexually dangerous to others,&#8221; and who &#8220;would have serious difficulty in refraining from sexually violent conduct or child molestation if released.&#8221;<\/p>\n<p>In the United States, offenders with pedophilia are more likely to be recommended for civil commitment than non-pedophilic offenders. About half of committed offenders have a diagnosis of pedophilia.\u00a0Psychiatrist\u00a0Michael First (2008), in\u00a0<em>&#8220;Use of DSM Paraphilia Diagnoses in Sexually Violent Predator Commitment Cases&#8221;<\/em>\u00a0writes that, since not all people with a paraphilia have difficulty controlling their behavior, the evaluating clinician must present additional evidence of volitional impairment instead of recommending commitment based on pedophilia alone.<\/p>\n<h2><span id=\"Deviant_sexual_preferences\" class=\"mw-headline\">Deviant Sexual Preferences<\/span><\/h2>\n<p>Research focusing on the deviant sexual preferences propensity model suggests that people who perpetrate acts of sexual violence are sexually aroused by non-consensual sexual interactions more than consensual sexual interactions. The research that seeks to support this model (penile plethysmography) has not been able to reliably find differences in the two different groups of males (those who have committed acts of sexual aggression and those who have not).\u00a0Instead, the studies are providing more evidence for the cognitive, attitudinal, neuropsychological, and lifestyle differences that impact sexual arousal in certain situations, rather than a deviant sexual preference leading to a higher propensity for sexual violence.<\/p>\n<p>The antisocial personality lens stems from a study done by Hall and Hirschman (1991)\u00a0and emphasizes the subsequent consequences of experiencing adversities\/abuses in childhood, which can lead to the development of antisocial personality traits in adulthood. The antisocial personality traits combine with contextual, emotional (rage\/anger), cognitive (irrational thoughts that influence emotions), and physiological (deviant sexual arousal) factors that increase the probability of committing sexual violence.<\/p>\n<h2><span id=\"Domestic_violence\" class=\"mw-headline\">Domestic Violence<\/span><\/h2>\n<p>Domestic violence is violence or other abuse by one person against another in a domestic setting, such as in marriage or cohabitation. It is strongly correlated with sexual assault. Not only can domestic abuse be emotional, physical, psychological, and financial, it can also be sexual. Some of the signs of sexual abuse are similar to those of domestic violence.\u00a0Domestic sexual violence includes all forms of unwanted sexual activity. It is considered abuse even if the victim may have previously engaged in consensual sexual activities with the perpetrator. Men and women can both fall victim to this type of abuse.\u00a0A 2006\u00a0WHO\u00a0study on physical and sexual domestic violence against women conducted across ten countries, found that the prevalence of sexual domestic violence ranges on average between 10 and 50%. Domestic sexual violence is also considerably less common than other forms of domestic violence.<\/p>\n<h2><span id=\"Rape\" class=\"mw-headline\">Rape<\/span><\/h2>\n<p>Outside of law, the term\u00a0<i>rape<\/i>\u00a0(sexual intercourse\u00a0or other forms of\u00a0sexual penetration\u00a0carried out against a person without that person&#8217;s consent) is often used interchangeably with sexual assault.\u00a0Although closely related, the two terms are technically distinct in most jurisdictions. Sexual assault typically includes rape and other forms of non-consensual sexual activity.<sup id=\"cite_ref-RAINN_4-1\" class=\"reference\"><\/sup><\/p>\n<p>Abbey\u00a0<i>et al.<\/i>\u00a0state that female victims are much more likely to be assaulted by an acquaintance, such as a friend or co-worker, a dating partner, an ex-boyfriend, or a husband or other intimate partner than by a complete stranger.\u00a0In a study of hospital emergency room treatments for rape, Kaufman\u00a0<i>et al.<\/i>\u00a0stated that the male victims as a group sustained more physical trauma and were more likely to have been a victim of multiple assaults from multiple assailants. It was also stated that male victims were more likely to have been held captive longer.<\/p>\n<p>In the U.S., rape is a crime committed primarily against youth. A national telephone survey on violence against women conducted by the\u00a0National Institute of Justice\u00a0and the\u00a0Centers for Disease Control and Prevention\u00a0found that 18% of women surveyed had experienced a completed or attempted rape at some time in their lives. Of these, 22% were younger than 12 years and 32% were between 12 and 17 years old when they were first raped.<sup id=\"cite_ref-33\" class=\"reference\"><\/sup><\/p>\n<p>In the United States, several studies since 1987 have indicated that one in four college women have experienced rape or attempted rape at some point in their lifetime. These studies are based on anonymous surveys of college women, not reports to the police, and the results are disputed.<sup id=\"cite_ref-leaderu1_79-0\" class=\"reference\"><\/sup><\/p>\n<p>The removal of a condom during intercourse without the consent of the sex partner, known as\u00a0<strong>stealthing,<\/strong> may be treated as a sexual assault or rape.<sup id=\"cite_ref-35\" class=\"reference\"><\/sup><\/p>\n<div id=\"attachment_4178\" style=\"width: 310px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-4178\" class=\"wp-image-4178 size-medium\" src=\"https:\/\/s3-us-west-2.amazonaws.com\/courses-images\/wp-content\/uploads\/sites\/5351\/2020\/09\/06000456\/artsy-solomon-nappy--300x200.jpeg\" alt=\"A woman sitting on an overlook during sunset and looking down.\" width=\"300\" height=\"200\" \/><\/p>\n<p id=\"caption-attachment-4178\" class=\"wp-caption-text\"><strong>Figure 3.<\/strong> For many victims, emotional trauma lasts for years after the assault takes place.<\/p>\n<\/div>\n<h2><span class=\"mw-headline\">Emotional Effects\u00a0<\/span><\/h2>\n<p>Aside from physical traumas, rape and other sexual assault often result in long-term emotional effects, particularly in child victims. These can include, but are not limited to denial,\u00a0learned helplessness,\u00a0genophobia,\u00a0anger,\u00a0self-blame,\u00a0anxiety,\u00a0shame,\u00a0nightmares,\u00a0fear,\u00a0depression,\u00a0flashbacks,\u00a0guilt,\u00a0rationalization,\u00a0mood swings,\u00a0numbness,\u00a0promiscuity,\u00a0loneliness,\u00a0social anxiety, difficulty trusting oneself or others, and difficulty concentrating. Being the victim of sexual assault may lead to the development of\u00a0post-traumatic stress disorder,\u00a0addiction,\u00a0major depressive disorder, or other\u00a0psychopathologies. Family and friends experience emotional scarring including a strong desire for\u00a0revenge, a desire to &#8220;fix&#8221; the problem and\/or move on, and a rationalization that &#8220;it wasn&#8217;t that bad.&#8221;<\/p>\n<h2><span id=\"Physical_effects\" class=\"mw-headline\">Physical Effects<\/span><\/h2>\n<p>While sexual assault, including rape, can result in physical trauma, many people who experience sexual assault will not suffer any physical injury.\u00a0Rape myths\u00a0suggest that the stereotypical victim of sexual violence is a bruised and battered young woman. The central issue in many cases of rape or other sexual assault is whether or not both parties consented to the sexual activity or whether or not both parties had the capacity to do so. Thus, the physical force resulting in visible physical injury is not always seen. This stereotype can be damaging because people who have experienced sexual assault but have no physical trauma may be less inclined to report to the authorities or to seek health care.\u00a0However, women who experienced rape or physical violence by a partner were more likely than people who had not experienced this violence to report frequent headaches, chronic pain, difficulty sleeping, activity limitation, poor physical health, and poor mental health.<\/p>\n<div class=\"textbox tryit\">\n<h3>Try It<\/h3>\n<p>\t<iframe id=\"assessment_practice_f2f7bf8d-6c1c-4999-b445-22e5753c6f75\" class=\"resizable\" src=\"https:\/\/assess.lumenlearning.com\/practice\/f2f7bf8d-6c1c-4999-b445-22e5753c6f75?iframe_resize_id=assessment_practice_id_f2f7bf8d-6c1c-4999-b445-22e5753c6f75\" frameborder=\"0\" style=\"border:none;width:100%;height:100%;min-height:300px;\"><br \/>\n\t<\/iframe><\/p>\n<\/div>\n<div class=\"textbox learning-objectives\">\n<h3>Glossary<\/h3>\n<p><strong>Adam Walsh Child Protection and Safety Act:<\/strong>\u00a0a law that\u00a0does not require a conviction on a sex offense charge, but only that the person be a\u00a0federal prisoner, and one who &#8220;has engaged or attempted to engage in sexually violent conduct or child molestation and who is sexually dangerous to others,&#8221; and who &#8220;would have serious difficulty in refraining from sexually violent conduct or child molestation if released&#8221;<\/p>\n<p><b>Catholic Church sexual abuse cases:<\/b>\u00a0cases of\u00a0child sexual abuse\u00a0by\u00a0Catholic priests,\u00a0nuns, and members of\u00a0religious orders<\/p>\n<p><b style=\"font-size: 1rem; text-align: initial;\">child sexual abuse (<\/b><b style=\"font-size: 1rem; text-align: initial;\">child molestation):<\/b><span style=\"font-size: 1rem; text-align: initial;\">\u00a0a form of\u00a0child abuse\u00a0in which an adult or older adolescent uses a\u00a0child\u00a0for\u00a0sexual stimulation<\/span><\/p>\n<p><b>child grooming:\u00a0<\/b>befriending and establishing an emotional connection with a child, and sometimes the family, to lower the child&#8217;s inhibitions with the objective of\u00a0sexual abuse<\/p>\n<p><strong>childhood\u00a0sexual abuse:<\/strong>\u00a0defined as any sexual contact between a child and an adult or a much older child<\/p>\n<p><strong>false self-training:<\/strong>\u00a0refers to holding a child to adult standards while denying the child\u2019s developmental needs<\/p>\n<p><strong style=\"color: #800000;\"><span style=\"color: #333333;\">incest:\u00a0<\/span><\/strong>refers to sexual contact between a child and family members<\/p>\n<p><strong>rape:<\/strong>\u00a0forced\u00a0vaginal, anal, or oral penetration\u00a0or a\u00a0drug-facilitated sexual assault<\/p>\n<p><b>sexual assault:<\/b>\u00a0an act in which a person intentionally sexually touches another person without that person&#8217;s\u00a0consent or\u00a0coerces\u00a0or physically forces a person to engage in a\u00a0sexual act\u00a0against their will<\/p>\n<\/div>\n\n\t\t\t <section class=\"citations-section\" role=\"contentinfo\">\n\t\t\t <h3>Candela Citations<\/h3>\n\t\t\t\t\t <div>\n\t\t\t\t\t\t <div id=\"citation-list-1571\">\n\t\t\t\t\t\t\t <div class=\"licensing\"><div class=\"license-attribution-dropdown-subheading\">CC licensed content, Original<\/div><ul class=\"citation-list\"><li>Modification, adaptation, and original content. <strong>Authored by<\/strong>: Sonja Ann Miller for Lumen Learning. <strong>Provided by<\/strong>: Lumen Learning. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><\/ul><div class=\"license-attribution-dropdown-subheading\">CC licensed content, Shared previously<\/div><ul class=\"citation-list\"><li>Mirror. <strong>Authored by<\/strong>: mohamed Hassan. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/pixabay.com\/vectors\/mirror-woman-silhouette-looking-4758692\/\">https:\/\/pixabay.com\/vectors\/mirror-woman-silhouette-looking-4758692\/<\/a>. <strong>License<\/strong>: <em>Other<\/em>. <strong>License Terms<\/strong>: Pixabay License<\/li><li>Sunset. <strong>Authored by<\/strong>: Artsy Solomon. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/www.nappy.co\/\">https:\/\/www.nappy.co\/<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/about\/cc0\">CC0: No Rights Reserved<\/a><\/em><\/li><li>Stressors in Middle Childhood. <strong>Provided by<\/strong>: Lumen Learning. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/courses.lumenlearning.com\/wm-lifespandevelopment\/chapter\/stressors-in-middle-childhood\/\">https:\/\/courses.lumenlearning.com\/wm-lifespandevelopment\/chapter\/stressors-in-middle-childhood\/<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\">CC BY: Attribution<\/a><\/em><\/li><li>Causes of Sexual Violence. <strong>Provided by<\/strong>: Wikipedia. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/Causes_of_sexual_violence\">https:\/\/en.wikipedia.org\/wiki\/Causes_of_sexual_violence<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><li>Sexual Abuse. <strong>Provided by<\/strong>: Wikipedia. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/Sexual_abuse\">https:\/\/en.wikipedia.org\/wiki\/Sexual_abuse<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><li>Sexual Assault. <strong>Provided by<\/strong>: Wikipedia. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/Sexual_assault\">https:\/\/en.wikipedia.org\/wiki\/Sexual_assault<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><li>Child grooming. <strong>Provided by<\/strong>: Wikipedia. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/Child_grooming\">https:\/\/en.wikipedia.org\/wiki\/Child_grooming<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><li>Child sexual abuse. <strong>Provided by<\/strong>: Wikipedia. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/Child_sexual_abuse\">https:\/\/en.wikipedia.org\/wiki\/Child_sexual_abuse<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><li>Catholic Church Sexual Abuse. <strong>Provided by<\/strong>: Wikipedia. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/Catholic_Church_sexual_abuse_cases#Comparisons_with_other_environments\">https:\/\/en.wikipedia.org\/wiki\/Catholic_Church_sexual_abuse_cases#Comparisons_with_other_environments<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by\/4.0\/\">CC BY: Attribution<\/a><\/em><\/li><li>Situational offender. <strong>Provided by<\/strong>: Wikipedia. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/Situational_offender\">https:\/\/en.wikipedia.org\/wiki\/Situational_offender<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><li>Adam Walsh Child Protection Act. <strong>Provided by<\/strong>: Wikipedia. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/Adam_Walsh_Child_Protection_and_Safety_Act\">https:\/\/en.wikipedia.org\/wiki\/Adam_Walsh_Child_Protection_and_Safety_Act<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><li>Sexually violent predator laws. <strong>Provided by<\/strong>: Wikipedia. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/Sexually_violent_predator_laws\">https:\/\/en.wikipedia.org\/wiki\/Sexually_violent_predator_laws<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><li>Causes of sexual violence. <strong>Provided by<\/strong>: Wikipedia. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/Causes_of_sexual_violence\">https:\/\/en.wikipedia.org\/wiki\/Causes_of_sexual_violence<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/licenses\/by-sa\/4.0\/\">CC BY-SA: Attribution-ShareAlike<\/a><\/em><\/li><li>Sexual violence. <strong>Provided by<\/strong>: Wikipedia. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/Sexual_violence\">https:\/\/en.wikipedia.org\/wiki\/Sexual_violence<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/about\/pdm\">Public Domain: No Known Copyright<\/a><\/em><\/li><li>Sexual assault reported cases. <strong>Provided by<\/strong>: BJS. <strong>Located at<\/strong>: <a target=\"_blank\" href=\"https:\/\/en.wikipedia.org\/wiki\/Sexual_assault#\/media\/File:BJS_Sexual_Assualt_Rates_1995-2013.png\">https:\/\/en.wikipedia.org\/wiki\/Sexual_assault#\/media\/File:BJS_Sexual_Assualt_Rates_1995-2013.png<\/a>. <strong>License<\/strong>: <em><a target=\"_blank\" rel=\"license\" href=\"https:\/\/creativecommons.org\/about\/pdm\">Public Domain: No Known Copyright<\/a><\/em><\/li><\/ul><\/div>\n\t\t\t\t\t\t <\/div>\n\t\t\t\t\t <\/div>\n\t\t\t <\/section><hr class=\"before-footnotes clear\" \/><div class=\"footnotes\"><ol><li id=\"footnote-1571-1\">McManus, M. A., Hargreaves, P., Rainbow, L., &amp; Alison, L. J. (2013). Paraphilias: definition, diagnosis, and treatment. F1000prime reports, 5, 36. https:\/\/doi.org\/10.12703\/P5-36 <a href=\"#return-footnote-1571-1\" class=\"return-footnote\" aria-label=\"Return to footnote 1\">&crarr;<\/a><\/li><\/ol><\/div>","protected":false},"author":29,"menu_order":13,"template":"","meta":{"_candela_citation":"[{\"type\":\"cc\",\"description\":\"Mirror\",\"author\":\"mohamed Hassan\",\"organization\":\"\",\"url\":\"https:\/\/pixabay.com\/vectors\/mirror-woman-silhouette-looking-4758692\/\",\"project\":\"\",\"license\":\"other\",\"license_terms\":\"Pixabay License\"},{\"type\":\"cc\",\"description\":\"Sunset\",\"author\":\"Artsy Solomon\",\"organization\":\"\",\"url\":\"https:\/\/www.nappy.co\/\",\"project\":\"\",\"license\":\"cc0\",\"license_terms\":\"\"},{\"type\":\"cc\",\"description\":\"Stressors in Middle Childhood\",\"author\":\"\",\"organization\":\"Lumen 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