Incest

Sexual abuse accounts for 12% of the 1 million substantiated cases of child abuse and neglect annually. Approximately 20% of adult women and 5% to 10% of men were sexually abused as children. The peak age of vulnerability to sexual abuse is between 7 and 13 years of age. Girls are approximately three times more likely to be sexually abused than boys.

Incest is a subtype of child sexual abuse, referring to sexual abuse that occurs within the family. Research estimates that for girls, 33% to 50% of perpetrators are family members, whereas for boys, only 10% to 20% are. The most common perpetrators of intrafamilial abuse of girls are fathers, stepfathers, uncles, cousins, brothers, and grandfathers. The vast majority of perpetrators are male, but mothers and other female relatives can also abuse. Fathers' involvement in early caretak-ing may make them less likely to sexually abuse their daughters.

Unique legal issues occur when a child is abused within the family. The nonabusing parent may have to choose between the child and the abuser. A separation or divorce may ensue, including a custody dispute. False allegations of abuse in custody cases appear to be fairly rare. In one study of 9,000 divorces, only 2% (N = 180) had allegations of sexual abuse. Of those 180 cases, less than 1% of the total number were determined to be false reports. Further, professionals who regularly evaluate children report that preschoolers make the smallest percentage of false allegations.

Many factors contribute to severity of the abuse experience. Abuse by a nonblood relative is not automatically less severe than abuse by a blood relative, especially if the victim is emotionally close to the perpetrator. For example, a girl might be seriously affected by a stepfather's abuse, even though he is not related to her by blood. Other factors that make the experience severe include sexual penetration (oral, vaginal, or anal), use of force, long duration and frequent contact, [Page 351]and lack of support from a nonabusive parent. Many of these factors relate to each other, and are related to whether the abuse occurs within or outside of the family. For example, abuse that occurs within the family may start earlier, go on for a longer time, and include increasingly more serious sexual acts.

There is a range of symptoms that occur among sexually abused children and adults. Severity of the experience is often, but not always, related to the severity of the symptoms. Symptoms of abuse that occur among preschoolers include anxiety, nightmares, and inappropriate sexual behavior. Among school-age children, symptoms include fear, mental illness, aggression, nightmares, school problems, hyperactivity, and regressive behavior. For adolescents, symptoms include depression; withdrawn, suicidal, or self-injurious behaviors; physical complaints; illegal acts; running away; and substance abuse.