Substance Abuse and Abuse Q 40
Nurse Meredith is observing 8-year-old Anna during a community visit. Which of the following findings would lead the nurse to suspect that Anna is a victim of sexual abuse?
A. The child is fearful of the caregiver and other adults.
B. The child has a lack of peer relationships.
C. The child has self-injurious behavior.
D. The child has an interest in things of a sexual nature.
Correct Answer: D. The child has an interest in things of a sexual nature.
An 8-year-old child is in the latency phase of development; in this stage, the child’s interest in peers, activities, and school is the priority. Interest in sex and things of a sexual nature would occur appropriately during the age of puberty, not at this time. A child who is the victim of sexual abuse, however, may show an unusual interest in sex. The assessments in the other answer choices may indicate abuse, but not necessarily sexual abuse.
Option A: Another consequence of sexual abuse, according to Finkelhor and Browne (1985), is powerlessness, in which a child learns that his or her needs or requests are ignored by others; the child thus fails to develop self-efficacy to stop unwanted sexual advances. More severe sexual abuse, particularly sexual abuse involving force or penetration, may lead to greater feelings of powerlessness. Perhaps because they lack the interpersonal skills or the self-efficacy to stop unwanted sexual advances, these individuals may be less likely to refuse intercourse with aggressive partners, resulting in more sexual partners.
Option B: Powerlessness could help explain findings linking more severe sexual abuse to more adult sexual risk behavior (e.g., Cinq-Mars et al., 2003; Fergussion et al., 1997). In this regard, Kallstrom-Fuqua, Weston, and Marshall (2004) found that sexual abuse severity had an indirect effect on maladaptive relationships, mediated through powerlessness; thus, having many sexual partners could be a consequence of difficulty forming close relationships.
Option C: Patients with a history of childhood sexual abuse showed a marked clustering of four major risk factors for repeat Deliberate Self-Harm or DSH (unemployment, past deliberate self-poisoning, self-injury and psychiatric illness) and were significantly more likely to repeat DSH within the 6-month follow-up period.