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	Misconceptions Abound in Child Sexual Abuse By Nancy McVicar South Florida Sun-Sentinel October 15, 2006 http://www.sun-sentinel.com/features/health/sfl-rxsexabuse15oct15,0,5536451.story?coll=sfla-news-health The outrage over former U.S. Rep. Mark Foley's actions involving teenage pages in the House of Representatives has focused attention on children's vulnerability to adults who may prey on their trust and inexperience. But experts say the high-profile case involving a gay man and teenage boys may give people the impression that gay men are more likely to be child molesters than other people, which is not the case. That misconception is one of many that health experts say are frequently reinforced by sex scandals that receive widespread media attention. The Catholic priest scandals may have given impression that boys are more frequently targets of sexual predators than girls. Widely publicized cases such as the abductions, rapes and killings of two young Florida girls, Jessica Lunsford and Carlie Brucia, may suggest that abusers who prey on children are almost always men. And Dateline NBC's latest series, "To Catch a Predator" -- centering on men who abuse children after making contact online -- reinforced the notion that strangers are to be most feared. But research and child-safety experts indicate these and other headline-grabbing cases are not typical and may reinforce stereotypes that are not supported by the realities of child and adolescent abuse. A long-term study by researchers at the federal Centers for Disease Control and Prevention showed, for instance, that 40 percent of childhood sexual abuse against boys is committed by women. Heterosexual men were responsible for 94 percent of the abuse committed against girls, with 6 percent by women. The study did not determine how many of the men who abused boys were homosexual or heterosexual. And, more often, the perpetrators -- particularly abuse involving girls -- were not strangers but family members or trusted friends. "There's a misconception out there, but female children are more likely to be abused than boys, which shows right off the bat that most predators are not homosexuals," said Steven N. Gold, chairman of the American Psychological Association's trauma division and a psychology professor at Nova Southeastern University. "Yet the stereotypical perpetrator in most people's minds is a homosexual male, so there's a real disconnect there." Gold, director of the Trauma Resolution and Integration Program, or TRIP, at NSU, treats adult victims of child abuse and said those who seek treatment tend to have had much more serious abuse, and more problems as a result. "But the sort of things we've found are that many of the characteristics of the abuse are remarkably similar between boys and girls," he said. "One of the differences is that girls are much more likely to be abused by a family member, and boys by someone outside the family." Perhaps the biggest misconception is that child sexual abuse is not common. In fact, the CDC study, which involved more than 17,000 adults, found that 1 in 4 girls and 1 in 6 boys have been victims of abuse by the time they reach the age of consent, and that the effects are long-standing. Adults who were sexually abused as children are more likely to have long-term health and social problems including alcohol and substance abuse, depression, problems maintaining relationships, and a higher risk of attempted suicide, researchers found. "All children are vulnerable to this form of abuse, and the burden is similar for both men and women later in life," said Shanta Dube, lead author of the study published in the May 2005 issue of the American Journal of Preventive Medicine. Other studies have shown that the trauma and stress of being the victim of childhood sexual abuse can cause physical changes in the brains of victims "Trauma and stress affects the biology of developing children, and it can't be seen right away, but it's happening," Dube said. Dr. J. Douglas Bremner, professor of psychiatry at Emory University and a staff physician at the Atlanta VA hospital, found that the hippocampus, an area of the brain associated with learning and memory, was 19 percent smaller in women who had suffered abuse severe enough to cause post-traumatic stress disorder, or PTSD, than in women who had not suffered abuse. PTSD is a psychiatric anxiety disorder that can occur as a result of a traumatic event such as violent personal assault, military combat or natural or man-made disasters. A study published in the American Journal of Psychiatry in 1999 found that about 38 percent of victims of childhood sexual abuse develop PTSD. Bremner said the brain changes were more likely to occur in patients who were victims of repeated abuse. "There's not really any evidence that a single trauma would do that," he said. Bremner said the damage to the hippocampus does not have to be permanent. When patients were put on antidepressant medication for nine months to a year, the hippocampal volume increased, he said. Dr. Jon Shaw, professor and director of child and adolescent psychiatry at the University of Miami Miller School of Medicine, said childhood sexual abuse, especially in boys, can lead to confusion and later sexual difficulties. "If at the time you're being assaulted, you experience sexual arousal, aggression and sexuality become intermingled," he said. "Their bodies betray them, and it complicates the picture." Shaw, who has worked with adolescent boys who have committed sex acts upon younger children, said about 60 percent had been abused themselves. "Sexual offenders will often commit sexual crimes against children the same age as they were when they were abused, and they identify with both the abuser and the victim," Shaw said. Nancy McVicar can be reached at nmcvicar@sun-sentinel.com or 954-356-4593.
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