Uncovering symptoms of child abuse and sexual violence: a medico-legal and psychosocial perspective.
Date
2021
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Abstract
Child abuse is a pervasive problem in South Africa, with many cases neither disclosed nor
reported. Identifying symptoms of sexual and physical abuse in children can be difficult. This
study, therefore, sought to uncover symptoms of sexual violence and child abuse from a
medical, legal and psychosocial perspective. The primary objectives were, firstly, to establish
presenting symptoms of sexual violence and child abuse; secondly, to highlight the
associated risk factors; thirdly, to ascertain factors that influence the impact of sexual
violence and abuse on the child; and, lastly, to gather knowledge that will assist in
developing an evidence-based screening tool for sexual violence and child abuse. The study
adopted a qualitative and interpretive approach, drawing mainly on betrayal trauma theory
in the discussion of findings. Data were collected through interviews with six participants,
namely a medical doctor, a criminologist, two psychologists, and two social workers. Data
were then analysed using thematic analysis, in which themes and subthemes were
identified in relation to the research questions. The findings suggested that indicators of
child abuse are linked to a range of notable physical symptoms as well as sudden
behavioural, emotional and psychological changes. Participants noted parent intrinsic
characteristics that put children at risk of abuse included the detached parent with avoidant
attachment style, and the inconsistent parent with anxious attachment style. Risk factors
identified included family and environmental factors such as family discord, parental stress,
and parents or caregivers with unresolved trauma. Furthermore, protective factors, which
influence the impact of sexual violence and abuse on the child, were identified as family and
environmental support, where the family listens to and believes the child, and takes the
necessary steps to protect them; access to services such as medical, legal and psychosocial
support for the child; and the child’s own resilience. From these results, a diagram was
developed to help parents and practitioners to screen for symptoms of child abuse. This
diagram could assist other sectors to take suspicions or reports of child abuse more
seriously, which could encourage more timely interventions.
Description
Masters Degree. University of KwaZulu-Natal, Pietermaritzburg.