Child and adolescent sexual abuse (SA) is as old as human history.
SA includes traumatic experiences such as sexual intercourse, attempted sexual intercourse, oral-genital contact, stroking the genital area directly or through clothing, exhibitionism or exposure of the child to adult sexual activity or pornography, and use in prostitution or pornography. gets.
Types of sexual abuse:
a. Non-contact sexual abuse: Behaviors such as speaking with sexual content, showing off, voyeurism, showing pornographic materials to the child, witnessing sexual intercourse or masturbating next to the child.
b.Sexual touch: The abuser may touch the victim or force the victim to touch him.
c.Oral-genital sex
d. Interfemoral intercourse (Irza tasatti): It is a form of abuse where there is no penetration and friction.
e.Sexual penetration (Rape): It can be in the form of genital intercourse, anal intercourse, penetration with objects and finger penetration.
f. Sexual exploitation: Includes child pornography and child prostitution.
Incest relationship has been ignored for many years. Exploitation; If it is done by someone who is related to a child or adolescent or is responsible for taking care of them, this situation is called incest.
Although SA is a common condition that usually lasts for years, it is often hidden. The secrecy of SA and the absence of witnesses in general cause the abuser to frequently deny the abuse. Due to feelings such as shame and guilt caused by abuse, SA is often kept secret and it is difficult to reach real statistical data because it is kept secret.
Children of all ages can be exposed to SA. First-time exposure to abuse peaks between the ages of 8 and 12, on average. Studies evaluating the time taken to disclose the abuse report a delay of 3-18 years on average.
The main individual risk factors for SA are gender, age and disability. It is reported by various studies that girls are 2 to 5 times more at risk than boys. Being mentally disabled, having a mental disorder such as schizophrenia, bipolar disorder, impulse control disorder, Attention Deficit Hyperactivity Disorder (ADHD) increase the risk of sexual abuse. In such situations, children may not be able to assess the severity of the situation they are exposed to, or even if they do, it may be more difficult to protect themselves. SA is more common in children from families with family conflicts and economic problems, especially in mothers with chronic diseases, and in families with divorce, violence, alcohol and substance use. The presence of step-parents at home can also increase the risk.
Sexual abuse; It is a trauma that shakes the child’s emotional and sexual development, interpersonal relationships and self-confidence. There is not a single psychological symptom specific to SA. While the symptoms vary from child to child, they may also change over time with development in the same child. The clinical features of SA and its effects on the child; It varies depending on the child’s relationship with the abuser, the type and duration of abuse, the use of violence, the presence of physical harm, the child’s age and developmental stage, psychological characteristics and pre-traumatic psychological development, and the level of support of the family. The reaction of the family to the event also plays an important role in the clinical presentation.
in children aged 0-3; eating and sleeping disorders, fear of strangers, starting to cause problems while wearing and taking off, sexual play that is not appropriate for their age, restlessness, tantrums, sudden changes in behavior and reactions can be seen.
in children aged 3-6; regression (like baby talk, thumb sucking, more attachment to the mother), withdrawal, Enuresis Nocturna (EN) (incontinence), encopresis (poop incontinence), eating and sleep disorders, aggression, submissive behavior, constant sexual play and frequent masturbation behaviors.
in children aged 6-12; social withdrawal, truancy from home and/or school, eating and sleeping disorders, learning disabilities, obsessions and compulsions, e.g. washing hands or genital area constantly, asking sexual questions repetitively), auto-aggression, sexual abuse of minors, crying out of the blue, tenderness, stomachaches and headaches, restlessness can be seen.
between the ages of 13-18; addiction to addictive substances, auto-aggression, phobia, running away from home and/or school, abusing others, obsessions and compulsions, avoiding emotional and physical intimacy, eating disorder, irritability, promiscuous sexual intercourse, social withdrawal, psychosis, suicide attempts visible.
