The Child Sexual Abuse Experience and the Child Sexual Abuse Medical Examination: Knowing What Correlations Exist

• Published in: Journal of child sexual abuse Vol. 9; no. 1; pp. 15 - 27
• Main Authors: Gully, Kevin J., Hansen, Karen, Britton, Helen, Langley, Marcie, McBride, Karma K.
• Format: Journal Article
• Language: English
• Published: Binghamton Taylor & Francis Group 01.01.2000; Taylor & Francis Ltd
• Subjects: Allegations; and PTSD; anogenital; Child Abuse; Child abuse & neglect; Child Sexual Abuse; Children; Correlation; Emotional distress; Emotional Problems; Genital Examination Distress Scale; Health Care Services; medical examination; Medical examinations; Physical Examinations; Psychological Distress; sequelae; Sex crimes; Sexual Abuse; Stress; Stress Variables; Tests; trauma; Utah; Victimology
• ISSN: 1053-8712; 1547-0679
• DOI: 10.1300/J070v09n01_02

The purpose of this study was to assess what children experience when they are sexually abused and determine if these experiences correlate with emotional distress and anogenital findings identified during medical examinations for sexual abuse. There were 269 children examined medically for sexual abuse and for whom the adult bringing the child to the medical examination reported that the child had made a statement alleging sexual abuse. Differences in what these children reportedly had stated about their sexual abuse was quantified on a questionnaire by the adults who brought the children. After the examination, children rated how distressed they felt having their bodies examined. The physician or nurse practitioner evaluating the child provided the second measure of emotional distress using the Genital Examination Distress Scale (GEDS) to rate behaviors observed during the anogenital component of the medical examination. The anogenital findings were classified as negative, inconclusive, or positive for abnormal anogenital findings consistent with sexual abuse. More frequent abuse, more perpetrators, physical injury and more severe sexual acts reportedly described by the children prior to the medical examination were variables significantly correlated with increased emotional distress. Reported threats of physical harm during the sexual abuse and a belief by mothers that sexual abuse occurred both correlated significantly with anogenital abnormalities consistent with sexual abuse. These results indicate that if children are more emotionally distressed during the medical examination and have abnormal anogenital findings consistent with sexual abuse, then they possibly have experienced more extensive and aggravated events during the sexual abuse. These results may help determine which children need more preparation for a medical assessment and which children are more likely to have sexual abuse related anogenital findings.