Home Truths about Child Sexual Abuse: Influencing Policy and Practice - A Reader

Susan Bailey

This chapter is based on the author's work as Consultant Adolescent Forensic Psychiatrist with children and adolescents who have committed 'the grave offence' of murder. She has become a specialist and an expert of international standing for her work with these children. This chapter includes new material commissioned for the purposes of this book. It also incorporates material which has been previously published as follows: 'Sadistic and Violent Acts in the Young' (Child Psychology and Psychiatry Review September 1997 (2.3) Cambridge University Press); 'Adolescents Who Murder' (Journal of Adolescence 1996 19:19-39); 'Fast Forward to Violence' (Criminal Justice Matters 1993 2:6-7); 'Violent Children and the Media' (Psychiatric Bulletin 1997 21:371-2).

In a brief clinical note entitled 'Violence Breeds Violence - Perhaps?', Curtis (1963) expressed concern that abused and neglected children would 'become tomorrow's murderers and perpetrators of other crimes of violence, if they survive'. The idea is appealing, making intuitive sense and allowing society to attribute blame and absolve itself of guilt, accountability or responsibility (Garbarino and Gilliam 1980). However, the theoretical work of the 1960s and 1970s provided a framework for understanding the multi-determined nature of abuse and neglect. Ecological models in which social, cultural interactional, individual and situational factors were positioned to interact and converge to bring about family violence, led in turn to the emergence of a more focused interest in clinical assessment and treatment. The 1980s saw the arrival of more sophisticated and ambitious epidemiological research, which documented the widespread prevalence of child abuse and neglect, spouse battering, elder mistreatment and psychological abuse, fuelling the development and evaluation of intervention for both victims and perpetrators.

Evidence continues to accrue establishing a causal link between maltreatment and short and long term psychopathology in victims. In children, physically abused and neglected infants typically have insecure attachments Contributing and causal factors

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