Characteristics and follow-up of adolescents victims of sexual abuse
Jean-Yves Frappier, MD, Reine Gagné, BSC. Nursing Section de Médecine de l’adolescence, Hôpital Ste-Justine, Montréal, Québec
Objectives
To describe:
- the characteristics of teenage girls consulting the emergency room (ER) of a Paediatric Hospital designated for victims of sexual abuse,
- the short term follow-up of these victims.
Methods
Medical records of 102 teenage girls seen consecutively in the ER and followed by a multidisciplinary team, were reviewed. Data were collected on standardized forms, so the information obtained was fairly complete.
Results
Characteristics of victims
- Mean age: 15 y.o.
- Live with two parents 58%
- Previously known to a social worker 34%
- Past history of sexual abuse 37%
- Previous socio-familial problem 38%
Circumstances
- Abused between 18:00 and 24:00hrs 43%
- Force used 60%
- Threats reported 51%
- Weapon used 17%
- One episode of abuse (vs repeated) 93%
- Forced intercourse 78%
- Police contacted 80%
- Parents informed immediately after the aggression 83%
Emergency Room Visit
- Seen in ER within 12 hours of the abuse 66%
- Accompanied by parents 46%
- Had physical complaints 41%
- Significant genital findings <5%
The aggressor
- A minor 21%
- A family relative 7%
- An acquaintance 41%
- Unknown 52%
First follow-up
92% showed up for first follow-up visit, an average of 26 days after the ER visit.
Accompanied by parents 57%
Reported:
- Fears of being killed at time of abuse 40%
- Nightmares 39%
- Aggressiveness 44%
- Sadness 53%
- Fears 74%
- Guilt 52%
- Missed school for few days 3%
- Angry feelings towards aggressor 79%
- Friends aware of sexual abuse 66%
- Reported negative reaction from their mother 14%
- Had discussed with parents about the abuse 66%
At time of abuse
- had a boyfriend 40%
- had already been sexually active 45%
at first follow-up visit, among sexually active, had resumed their sexual activities 22%
Problems most often identified by victims:
- fears 49%
- family conflicts 27%
- Reported to feel much improved 66%
- Denied any need for additional support 55%
- Had seen a professional elsewhere 22%
- Reported somatic complaints 78%
Other Follow-up
60% present for a second follow-up (an average of 114 days of ER visit)
- Altogether, had more than 2 visits (mostly 3 or 4) 54%
- At last visit, still experience difficulties 40%
- During follow-up, families considered as “problem family” 43%
Discussion
Two important time for follow-up (medically and psychosocially): 2-3 weeks and 3 months
The role of parents in the recovery process of these adolescents is important and supporting the family is crucial. However, compliance to follow-up visits is low.