– Psychiatric Impact of Organized and Ritual Child Sexual Abuse: Cross-Sectional Findings from Individuals Who Report Being Victimized
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Psychiatric Impact of Organized and Ritual Child Sexual Abuse: Cross-Sectional Findings from Individuals Who Report Being Victimized
Johanna Schröder, Susanne Nick, Hertha Richter-Appelt and Peer Briken
Institute for Sex Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
Int. J. Environ. Res. Public Health 2018, 15(11), 2417; doi: 10.3390/ijerph15112417
Abstract: Organized and ritual child sexual abuse (ORA) is often rooted in the child’s own family. Empirical evidence on possible associations between ORA and trauma-related symptoms in those who report this kind of extreme and prolonged violence is rare. The aim of our study was to explore socio-demographic and clinical characteristics of the individuals reporting ORA experiences, and to investigate protective as well as promotive factors in the link between ORA and trauma-related symptom severity. Within the framework of a project of the Independent Inquiry into Child Sexual Abuse in Germany, we recruited 165 adults who identified themselves as ORA victims via abuse- and trauma-specific networks and mailing lists, and they completed an anonymous online survey. We used variance analyses to examine correlations between several variables in the ORA context and PTSD symptoms (PCL-5) as well as somatoform dissociation (SDQ-5). Results revealed a high psychic strain combined with an adverse health care situation in individuals who report experiences with ORA. Ideological strategies used by perpetrators as well as Dissociative Identity Disorders experienced by those affected are associated with more severe symptoms (η2p = 0.11; η2p = 0.15), while an exit out of the ORA structures is associated with milder symptoms (η2p = 0.11). Efforts are needed to improve health care services for individuals who experience severe and complex psychiatric disorders due to ORA in their childhood.
Child sexual abuse (CSA), once thought to be rare, is nowadays accepted as a frequent reality that occurs across a range of cultures and socioeconomic backgrounds worldwide and encompasses many types of sexually abusive acts towards children, including sexual assault, incest, the production and use of child pornography, as well as commercial sexual exploitation . Sexual child abuse involving a network of perpetrators acting repeatedly and jointly on multiple victims is defined as ‘organized abuse’ . Organized abuse that follows a (pseudo-) ideological strategy (e.g., symbols or group activities with religious, magical, or supernatural connotations) in order to frighten and intimidate the children or to force the victims to participate whilst simultaneously accomplishing the perpetrators’ exculpation is referred to as ‘ritual abuse’ [3,4]. Salter further describes ritual abuse as ideological framing in organized CSA contexts, functioning as strategical practices through which abusive groups indoctrinate the victims into a violently misogynistic worldview in order to control them . In other words, ritual abuse occurs when a religious, political, or spiritual authority uses its position of power and the sovereignty to interpret the respective belief system to manipulate and dominate its followers. Since the 1980s, evidence of organized and ritual abuse (ORA) has been consolidated due to studies documenting psychological harm amongst children and adults disclosing such experiences ….
ORA, defined as organized child sexual abuse where a (pseudo-)ideological (i.e., ritual) content serves as legitimization for violence, is a complex and polarizing issue in mental health care contexts as well as in research. At present, the uncovering and reprocessing of ORA is a problem that remains to be solved in Germany, as well as internationally. Given the paucity of research in this field, we believe that this study contributes to closing this evidence gap, as it presents empirical data on reported practices of ORA and its impact on trauma-related symptom severity in self-identified victims, in which reported ideological/ritual strategies by the perpetrators and an exit out of the ORA structures play a major role. A key policy priority should therefore be to intensify efforts on the understanding of ORA-related structures, as well as the complex clinical presentation of those affected. Services like information websites and exit programs should be developed by experts in the field in order to contribute to generating appropriate treatment services for this group of clients. Mental health professionals and centers specialized in the treatment of severely traumatized clients with CPTSD and dissociative disorders would contribute to a better support of clients who report such trauma histories. The therapeutic process of detachment from perpetrator networks is intense, and supporters of individuals who experience ORA face special difficulties, like, for example, dissociative personality states. Therefore, it is essential to ensure that constant professional supervision is provided to them by professionals who understand the spectrum of possibilities and pitfalls in the treatment….