Elsevier

Child Abuse & Neglect

Volume 22, Issue 6, June 1998, Pages 573-579
Child Abuse & Neglect

Original Articles
Emotional Impact of the Medical Examination for Child Sexual Abuse

https://doi.org/10.1016/S0145-2134(98)00029-5Get rights and content

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Importance of the Problem

Performing an anogenital examination as part of the medical assessment for suspected child sexual abuse has been an accepted standard of care by the health care profession. The goals of this examination have included not only the diagnosis and treatment of genital trauma and infection, but the recognition of emotional trauma and the initiation of social healing. Since less than 25% of children have definitive physical findings on the examination (Adams et al 1994), emphasis is often placed on

State of Current Research

Research regarding the emotional impact of the genital examination in evaluating child sexual abuse is limited in scope, focusing mainly on external factors that may mediate a child’s response. In a study of 99 children evaluated for sexual abuse, Lazebnik found that fear of the examination was most highly related to past negative medical experiences (Lazebnik et al 1994). In a study by Steward, 43 mother and daughter pairs were evaluated pre- and post-sexual abuse assessment. The children

Unanswered Questions

Unanswered questions regarding the emotional impact of the examination fall into four general categories. These include: (1) identification of pre-existing factors that influence a child’s response to the medical examination; (2) evaluation of possible variables in the medical setting that may influence a child’s response; (3) recognition of both positive and negative consequences of the medical examination with emphasis on facilitating the positive and reducing the negative; (4) obtaining a

Suggested Research Agendas

Research agendas may be organized using the same categories as those listed in the previous section on “unanswered questions,“ thus focusing on the evaluation of: (1) pre-existing factors that influence emotional impact; (2) variables within the medical setting that may effect outcome; (3) well defined positive and negative mental health outcomes and the factors correlated with these outcomes; and (4) the emotional/behavioral response of the child to the medical examination as a diagnostic and

Barriers to Research

One of the largest and most consistent barriers to the purposed research is lack of adequate funding to obtain necessary resources. The accurate and inclusive collection of background variables, collaboration of multiple professional disciplines, efforts to standardize procedures among multiple groups of care providers, and statistical guidance in study design and data analysis are all needed in order to successfully implement such research agendas. Other obstacles include soliciting and

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References (6)

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    Given this goal, efforts to extend services to a wider range of suspected victims may be beneficial. However, considering that some children, especially those without a clear explanation about the exam or those with a previous negative medical experience, report a negative experience during exams (Allard-Dansereau, Hebert, Tremblay, & Bernard-Bonnin, 2001; Britton, 1998; Davies & Seymour, 2001; Lazebnik et al., 1994; Prior, 2001), more research is needed on optimal referral criteria. About half of exams were conducted the same day as the report of abuse.

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