Risk Factors for Child Sexual Abuse Annotated Bibliography The following annotated bibliography features articles on risk factors and characteristics associated with child sexual abuse perpetration. The bibliography provides research on child sexual abuse (CSA) perpetrators as a general population, as well as special perpetrator populations such as females, juveniles, pedophiles, and sexually reactive children. GENERAL Becker, J. V. (1994). Offenders: Characteristics and treatment. The Future of Children, 4, 177-197. doi:10.2307/1602530 Becker reviews research on child sexual abuse perpetrators, highlighting the role of deviant sexual interests and behaviors in perpetration. Becker discusses characteristics of child sexual abuse perpetrators, problems in determining recidivism rates, and the efficacy of sexual offender treatment measures. CSA perpetrators are a diverse group in terms of both background and perpetration acts, but many share traits in common, such as paraphilias (socially unacceptable sexual practices), a history of physical and/or sexual abuse, and early onset of deviant sexual interests. Research suggests that multiple variables, rather than a single variable, increase risk of child sexual abuse perpetration. Center for Sex Offender Management. (2000). Myths and facts about sex offenders [Fact sheet]. Retrieved from http://www.csom.org/pubs/mythsfacts.html This fact sheet confronts common myths about sex offenders, including but not limited to child sexual abuse perpetrators. The document addresses misconceptions about sex offender recidivism, sex offense rates, motivations for sexual offenses, sex offender demographics, and the role of childhood sexual abuse as a risk factor for perpetration. Cortoni, F., & Marshall, W. L. (2001). Sex as a coping strategy and its relationship to juvenile sexual history and intimacy in sexual offenders. Sexual Abuse: A Journal of Research and Treatment, 13, 27-43. doi:10.1177/107906320101300104 Cortoni and Marshall analyzed data from the Coping Using Sex Inventory (CUSI) to find correlations between sex-related coping strategies and sexual offending. The authors found that rapists and child sexual abuse perpetrators were significantly more likely to demonstrate sexual preoccupation during adolescence, which motivated the use of sex as a coping strategy later in life. Research data also suggested that intimacy deficits and loneliness contributed to greater use of sexual activity as a coping mechanism. Finkelhor, D., Turner, H., Ormrod, R., Hamby, S., & Kracke, K. (2009). Children’s exposure to violence: A comprehensive national survey (NCJ 227744). Washington, DC: Office of Juvenile Justice and Delinquency Prevention. Retrieved from http://www.ncjrs.gov/pdffiles1/ ojjdp/227744.pdf This document discusses results from the National Survey of Children’s Exposure to Violence (NatSCEV), conducted between January and May 2008. Drawing upon a study of 4,549 minors age 17 and younger, the authors found that 6.1 percent of children surveyed had been sexually victimized in the past year and 9.8 percent over their lifetimes. Finkelhor et al. also measured rates of physical assault, bullying, child maltreatment, and exposure to violence against others. Marshall, W. L., & Marshall, L. E. (2000). The origins of sexual offending. Trauma, Violence, & Abuse, 1, 250-263. doi:10.1177/1524838000001003003 The authors hypothesize that sexual offending is rooted in an offender’s poor childhood attachments to his/her parents. A poor child- parent relationship increases the child’s risk of being sexually abused, which increases the likelihood of the child using masturbation and sex as a coping strategy later in life. The use of sex as a coping strategy has been correlated with adult sexual aggression, and when coupled with conditioning processes that reinforce sexual deviancy, makes sexual offending more likely. Stirpe, T. S., & Stermac, L. W. (2003). An exploration of childhood victimization and family- of-origin characteristics of sexual offenders against children. International Journal of Offender Therapy and Comparative Criminology, 47, 542- 555. doi:10.1177/0306624X03253316 Stirpe and Stermac compared the childhood victimization experiences reported by 33 sexual offenders against children, 66 violent non- sexual offenders, and 25 non-violent non-sexual offenders. Sexual offenders against children reported significantly more childhood sexual abuse, sexual propositioning, and exposure to sex than subjects in the other two groups. Sexual offenders against children were also more likely to report physical discipline as the primary type of discipline in their childhood household. Terry, K. J., & Tallon, J. (2007). Child sexual abuse: A review of the literature. New York, NY: John Jay College of Criminal Justice. Retrieved from http://www.usccb.org/nrb/johnjaystudy/litreview.pdf This literature review provides an overview of the body of academic works on child sexual abuse. The authors explore estimates of child sexual abuse, theories and etiology of child sexual abuse, typologies of perpetrators, sex offender evaluation and treatment, and child sexual abuse within specific organizations (i.e., Boy Scouts, Catholic Church, athletic organizations, etc.). Whitaker, D. J., Le, B., Hanson, R. K., Baker, C. K., McMahon, P. M., Ryan, G., Klein, A., & Rice, D. D. (2008). Risk factors for the perpetration of child sexual abuse: A review and meta- analysis. Child Abuse & Neglect, 32, 529-548. doi:10.1016/j.chiabu.2007.08.005 Whitaker et al. reviewed 89 studies published between 1990 and 2003 on CSA perpetration risk. The authors examined six categories of risk factors: family risk factors, externalizing behaviors, internalizing behaviors, social deficits, sexual problems, and cognitions tolerant of sexual violence. The authors found that sexual offenders who targeted children demonstrated substantial differences from non-offenders in all six categories. Also, sexual offenders who targeted children did not differ significantly from sexual offenders who targeted adults, except that the former showed lower rates of externalizing behaviors (i.e., aggression/violence, substance abuse, non-violent criminality, etc.). Young, M. H., Justice, J. V., & Edberg, P. (2008). Sexual offenders in prison psychiatric treatment: A biopsychosocial description. International Journal of Offender Therapy and Comparative Criminology, 52, 1-21. doi:10.1177/0306624X08322373 Young, Justice, and Edberg evaluated 120 males (60 sexual offenders and 60 non-sexual offenders) in prison psychiatric treatment using psychological, neuropsychological, and sociological/demographic measures. The authors found that sexual offenders displayed significantly more neuropsychological impairment, disordered attachment, distorted self- perception, and impulsive emotionality than non- sexual offenders. FEMALE SEXUAL OFFENDERS Center for Sex Offender Management. (2007). Female Sex Offenders. Retrieved from http://www. csom.org/pubs/female_sex_offenders_brief.pdf This article discusses issues surrounding female sexual offenders. The document presents statistics on female sexual offending, arrests, and representation in sex offender treatment programs. Additionally, it explores sociocultural and systematic factors underlying the under- recognition of female sexual predation. It details characteristics, risk factors, and typologies for adult and adolescent female sexual offenders, contrasting these to male sexual offenders. Grayston, A. D., & De Luca, R. V. (1999). Female perpetrators of child sexual abuse: A review of the clinical and empirical literature. Aggression and Violent Behavior, 4, 93-106. doi:10.1016/S1359-1789(98)00014-7 Grayston and De Luca review the body of clinical and empirical literature on female perpetrators of child sexual abuse, exploring areas such as prevalence, characteristics of victims, and common characteristics of perpetrators. Oliver, B. E. (2007). Preventing female- perpetrated sexual abuse. Trauma, Violence, & Abuse, 8, 19-32. doi:10.1177/1524838006296747 Oliver provides an overview of female sexual offenders and reviews the body of literature on female-perpetrated sexual abuse. The author explores possible reasons why female sexual offending is under-recognized in society and how sexual stereotypes contribute to this under- recognition. This article observes that female sexual offenders usually target child or adolescent victims and provides characteristics and risk factors for adult and juvenile female offenders. Peter, T. (2009). Exploring taboos: Comparing male- and female-perpetrated child sexual abuse. Journal of Interpersonal Violence, 24, 1111-1128. doi:10.1177/0886260508322194 This article compared male- and female- perpetrated child sexual abuse in terms of type of abuse, victim characteristics, perpetrator characteristics, and family structure. In a study of 308 male and 37 female abusers drawn from the 1998 Canadian Incidence Study of Reported Child Abuse and Neglect, Peter found (1) a 10.7 percent prevalence rate for female-perpetrated child sexual abuse, (2) that girls were more likely to be victimized by both male and female perpetrators, (3) female perpetrators tended to abuse younger children, (4) the majority of victims came from families with lower socioeconomic status, and (5) referrals to child welfare agencies were more likely to be submitted by non-professionals when female perpetrators were involved. Roe-Sepowitz, D., & Krysik, J. (2008). Examining the sexual offenses of female juveniles: The relevance of childhood maltreatment. American Journal of Orthopsychiatry, 78, 405-412. doi:10.1037/a0014310 This study draws data from the case histories of 118 female juvenile sex offenders, the majority of whom perpetrated against children or juveniles. Female juvenile sex offenders who had a history of maltreatment (i.e., physical abuse, sexual abuse, exposure to violence in the home or community) were more likely to exhibit mental health problems, as well as clinical levels of anger/irritability, depression, and anxiety. The authors found correlations between histories of sexual abuse among female juvenile sex offenders and the degree to which they used coercion against their victims. Strickland, S. M. (2008). Female sex offenders: Exploring issues of personality, trauma, and cognitive distortions. Journal of Interpersonal Violence, 23, 474-489. doi:10.1177/0886260507312944 Strickland explores differences between female sexual offenders and female non-sexual offenders in the areas of personality disorders, chemical dependency, childhood trauma, sexual victimization, emotional neediness, cognitive distortions, and social competence. In a sample of 130 incarcerated women (60 sex offenders and 70 non-sexual offenders), Strickland found significant differences between the two groups in the areas of total childhood trauma, severity of sexual victimization, and social competence. Vandiver, D. M., & Kercher, G. (2004). Offender and victim characteristics of registered female sexual offenders in Texas: A proposed typology of female sexual offenders. Sexual Abuse: A Journal of Research and Treatment, 16, 121-137. doi:1079-0632/04/0400-0121/0 Drawing upon a sample of 471 adult female sexual offenders from the Texas Department of Public Safety’s sex offender registry, Vandiver and Kercher looked at characteristics of female sex offenders and their victims. Over three quarters of offenses involved child victims, with roughly equal percentages of male and female victims. The authors discuss female offender demographics and cluster female offenders into six typologies. JUVENILE SEXUAL OFFENDERS Burton, D. L. (2000). Were adolescent sexual offenders children with sexual behavior problems? Sexual Abuse: A Journal of Research and Treatment, 12, 37-48. doi:10.1177/107906320001200105 Burton conducted a study of 263 adolescent male offenders who had either been (a) adjudicated for sexual offenses, or (b) adjudicated for non- sexual crimes but also admitted to committing prior sexual offenses. Almost half of the subjects admitted to engaging in sexual offenses before age 12, and 47 percent admitted to having sexual behavior problems as children. The author also found a significant correlation between sexual victimization and sexual offense perpetration among the subjects. Center for the Study and Prevention of Violence. (2008). Juvenile sexual aggression [Fact sheet]. Boulder, CO: University of Colorado, Institute of Behavioral Science. Retrieved from http://www.colorado.edu/cspv/publications/ factsheets/cspv/FS-002.pdf This fact sheet lists findings from the current body of research on juvenile sexual aggression. The document highlights the fact that most juvenile sexual offenders exclusively target children, and discusses risk factors, demographics, and offense characteristics. Daversa, M. T., & Knight, R. A. (2007). A structural examination of the predictors of sexual coercion against children in adolescent sexual offenders. Criminal Justice and Behavior, 34, 1313-1333. doi:10.1177/0093854807302411 Daversa and Knight evaluated a sample of 329 juvenile sexual offenders to determine if childhood maltreatment fostered the development of personality traits predictive of sexual abuse of children. Study results indicated that childhood emotional abuse, physical abuse, and sexual abuse gave rise to psychopathologies (i.e., sexual inadequacy, sexual fantasies involving children) that later contributed to sexual abuse of children. Finkelhor, D., Ormrod, R., & Chaffin, M. (2009). Juveniles who commit sex offenses against minors (NCJ 227763). Washington, DC: Office of Juvenile Justice and Delinquency Prevention. Retrieved from http://www.ncjrs. gov/pdffiles1/ojjdp/227763.pdf This bulletin draws on data from the FBI’s National Incident-Based Reporting System to provide epidemiological information on juvenile sex offending. The authors found that juveniles account for more than one third of known sex offenders who have victimized minors. Juveniles who commit sex offenses against other children are more likely than adult sex offenders to offend in groups, to offend at school, and to victimize male victims. The majority of juvenile sex offenders (93 percent) are male and between the ages of 12 and 14. Jurisdictions vary in their concentration of reported juvenile sex offenders, far more so than in their concentration of adult sex offenders. Grabell, A. S., & Knight, R. A. (2009). Examining childhood abuse patterns and sensitive periods in juvenile sexual offenders. Sexual Abuse: A Journal of Research and Treatment, 21, 208- 222. doi:10.1177/1079063209333133 In this study, Grabell and Knight draw upon a sample of 193 juvenile sexual offenders to determine the relationship between childhood sexual abuse and deviant sexual interests in juvenile offenders. The authors found a correlation between sexual abuse at 3-7 years of age and the presence of sexual compulsivity, sexual preoccupation, and hypersexuality. Righthand, S., & Welch, C. (2001). Juveniles who have sexually offended: A review of the professional literature (NCJ 184739). Washington, DC: U.S. Department of Justice, Office of Juvenile Justice and Delinquency Prevention. Retrieved from http://www.ncjrs.gov/pdffiles1/ojjdp/184739.pdf While juvenile offenders are a diverse group, their developmental issues and treatment needs are distinct from those of adult offenders. The authors discuss juvenile sexual offender traits, assessment approaches, treatment approaches, and treatment efficacy. Statistically, several variables are correlated with juvenile sexual offending, such as childhood sexual abuse, physical abuse, neglect, perpetration of non-sexual crimes, social deficits, deviant sexual arousal, and various psychopathologies. Zakireh, B., Ronis, S. T., & Knight, R. A. (2008). Individual beliefs, attitudes, and victimization histories of male juvenile sexual offenders. Sexual Abuse: A Journal of Research and Treatment, 20, 323-351. doi:10.1177/1079063208322424 This study looks at the attitudes, beliefs, and victimization histories of 100 male juveniles divided into four groups: (1) sexual offenders in residential placement, (2) non-sexual offenders in residential placement, (3) sexual offenders in outpatient treatment, and (4) non-sexual offenders in outpatient treatment. Juvenile sexual offender samples included subjects who offended against children, same-age victims, and adults. The authors found that residential sex offenders exhibited more paraphilias, sadism, anger/aggression, and offense planning than the three other groups, and demonstrated higher scores on child abuse scales. SEXUALLY REACTIVE CHILDREN Merrick, M. T., Litrownik, A. J., Everson, M. D., & Cox, C. E. (2008). Beyond sexual abuse: The impact of other maltreatment experiences on sexualized behaviors. Child Maltreatment, 13, 122-132. doi:10.1177/1077559507306715 This study investigated whether or not a correlation exists between non-sexual childhood maltreatment experiences and sexually reactive behaviors in children (i.e., sexual intrusiveness, exhibitionism, boundary problems). The authors found that physical and emotional abuse at various stages of childhood significantly predicted a range of sexually reactive behaviors in children. National Clearinghouse on Family Violence. (2008). When children act out sexually: A guide for parents and teachers. Ottawa, ON: Public Health Agency of Canada. Retrieved from http://www.phac-aspc.gc.ca/ncfv-cnivf/pdfs/ nfntsx-visac-nfntsact_e.pdf This guide book discusses sexually reactive behaviors in children and how adults can intervene. The guide distinguishes normal sexual development from sexually reactive behaviors, listing risk factors for disrupted child sexual development (including but not limited to sexual abuse). SPECIAL POPULATIONS Elliott, I. A., Beech, A. R., Mandeville-Norden, R., & Hayes, E. (2009). Psychological profiles of internet sexual offenders: Comparisons with contact sexual offenders. Sexual Abuse: A Journal of Research and Treatment, 21, 76-92. doi:10.1177/1079063208326929 Elliott, Beech, Mandeville-Norden and Hayes collected data from a sample of 1,031 adult male sexual offenders: 505 offenders with one or more offenses related to accessing, downloading, trading; and/or making indecent images of minors under 18 years old, and 526 offenders with one of more offenses related to direct contact sexual assault of minors under 16. The authors found that offenders who had contact with victims had significantly more victim empathy distortions and cognitive distortions than Internet offenders. High scores on scales of fantasy, under-assertiveness, and motor impulsivity were correlated with Internet offenders. High scores on scales of over-assertiveness, victim empathy distortions, cognitive distortions, and cognitive impulsivity were correlated with contact offenders. John Jay College of Criminal Justice. (2004). The nature and scope of the problem of sexual abuse of minors by priests and deacons in the United States. Washington, DC: United States Conference of Catholic Bishops. Retrieved from http://www.jjay.cuny.edu/churchstudy/main.asp This study examines the number and nature of allegations of sexual abuse of minors by Catholic clergy between 1950 and 2002. After collecting data from 195 diocese and 140 religious communities in the U.S., researchers found that 4.3 percent of diocesan priests and 2.5 percent of religious priests had been accused of sexual abuse. Moulden, H. M., Firestone, P., & Wexler, A. F. (2007). Child care providers who commit sexual offences: A description of offender, offence, and victim characteristics. International Journal of Offender Therapy and Comparative Criminology, 51, 384-406. doi:10.1177/0306624X06298465 Moulden, Firestone and Wexler review literature on child sexual abuse and explore the dynamics of child sexual abuse perpetration by care providers. In a study of 305 sexual offenders against children who acted as care providers, the authors look at the common traits, pathologies, and acts of male and female offenders, as well as adult and juvenile offenders. Terry, K., & Smith, M. L. (2006). The nature and scope of sexual abuse of minors by Catholic priests and deacons in the United States: Supplementary data analysis. Washington, DC: U.S. Conference of Catholic Bishops. Retrieved from http://www.usccb.org/ocyp/ JohnJayReport.pdf This report, commissioned by the United States Conference of Catholic Bishops, discusses the scope of sexual abuse of minors by Catholic clergy. Terry and Smith discuss patterns of offending among clergy and comparative characteristics of clergy offenders. PEDOPHILIA Fagan, P. J., Wise, T. N., Schmidt, C. W., Jr., & Berlin, F. S. (2002). Pedophilia. Journal of the American Medical Association, 288, 2458-2465. doi:10.1001/jama.288.19.2458 This article defines and establishes typologies for pedophilia, discusses the scope of child sexual abuse, and elaborates on the responsibilities of physicians to assist possible sexual abuse victims. The authors reviewed 584 articles on pedophilia from 1965 to 2002, noting developmental, psychological, and organic factors that have been correlated with pedophilia. Lee, J. K. P., Jackson, H. J., Pattison, P., & Ward, T. (2002). Developmental risk factors for sexual offending. Child Abuse & Neglect, 26, 73-92. doi:10.1016/S0145-2134(01)00304-0 This study was designed to identify risk factors associated with pedophilia, exhibitionism, rape, and multiple paraphilias. In a study of 97 offenders (64 sexual offenders and 33 non- sexual, non-violent offenders), Lee et al. found that childhood emotional abuse, childhood sexual abuse, childhood behavioral problems, and family dysfunction were general risk factors for paraphilias. Specifically, the authors found that childhood sexual abuse was a specific developmental risk factor for pedophilia. Lee, J. K. P., Pattison, P., Jackson, H. J., and Ward, T. (2001). The general, common, and specific features of psychopathology for different types of paraphilias. Criminal Justice and Behavior, 28, 227-256. doi:10.1177/0093854801028002005 Lee, Pattison, Jackson, and Ward studied a sample of 64 sex offenders who exhibited one of four paraphilias (pedophilia, exhibitionism, rape, or multiple paraphilias) against 33 non-sexual, non-violent offenders. The authors found that high levels of anger/hostility, as well as sexual maladjustment and poor hetero-social skills, were correlated with a paraphilic diagnosis. Specifically, sexual maladjustment and poor hetero-social skills were associated with pedophilia, and high levels of anger/hostility were associated with multiple paraphilias as opposed to single paraphilias. This annotated bibliography was compiled by Emily Dworkin, with contributions from Hallie Martyniuk, and is part of a Child Sexual Abuse Prevention Information Packet. Contact the National Sexual Violence Resource Center for more information: http://www.nsvrc.org or 877-739-3895. NSVRC • 123 North Enola Drive, Enola, PA 17025 • Toll free: 877-739-3895 • www.nsvrc.org • resources@nsvrc.org This project was supported by Cooperative Agreement #5VF1CE001751-02 from the Centers for Disease Control and Prevention. © National Sexual Violence Resource Center 2011. All rights reserved.