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There have been a growing number of researches that suggests a correlation between sexual abuse and Borderline Personality Disorder (BDP) (Westen, Ludolph, Misle, Ruffins, & Block, 1988). Borderline Personality Disorder is described as pervasive pattern of the instability of interpersonal relationships, self-image, mood, and marked impulsivity (APA, 2003). In a study conducted (1989) a sample of reliably of inpatient individuals diagnosed with BPD and major depressive found that 71% of borderline subjects reported a history of sexual abuse.
This abuse included physical contact and inappropriate sexual exposure compared with 22% of major depressive controls. The study also concluded that 53% of the sexually abused BPD population has been abused by more than one person (Ogata, Silk. , Goodnch, Lohr, Hill & Westen, 1990), whereas 62% were reported to have witnessed domestic violence. In more than 80% of women found to have BPD, a kind of childhood trauma is reported. There are also significant rates of adolescents who have been traumatized and been diagnosed with BPD or exhibiting the traits.
The risk of BPD and other personality disorders may be increased by childhood events such as physical or sexual abuse. A human’s sexual behavior articulates both the psychosexual makeup and the entire personality. Attributes such as cognitions, emotions, socialization, learned and acquired behaviors, traits and heredity factors are involved in sexuality. Patients who have BPD experience a dissatisfied and a diminutive sexuality (Trippany et al. 2006). In a study by Lehr et al. , (1995), the relationship of specific borderline personality disorder was compared to dimensions of severity of sexual experiences in childhood.
In this research, the continuing sexual abuse was a forecast of a para-suicidal behavior. The disordered interpersonal behavior and functioning observed in patients with borderline personality disorder could be determined through the ongoing sexual abuse. A repetition of a sexual abuse experiences in childhood could be as a result of the feelings that the BPDs hold, for instance the sensation that the world is an empty malicious place. Malevolence in patients with BPD can be evident in psychotherapy through regressive and isolation behavior
In a research on problematical sexuality in patients with BPD, the outcome of the study revealed two attributes of sexual dysfunction which include: promiscuous sexual behavior which is an outcome of impulsivity and homosexuality that results from identity problems that affect a majority of BPD patients. In addition, there are more significant relationship problems in BPD that pertain to sex, greater sexual boredom, sex avoidance, a greater preoccupation in sex, sexual depression and dissatisfaction. Thus, for the clinical course of BDP, sexual functioning may be relevant (Lehr et al.
, 1995). Sexual abuse actions are associated with promiscuity, substance abuse, and general impulsive accords. This study accentuates investigations in other studies that the history of physical and sexual abuse is related with many psychological disturbances especially BPD. The manifestation and the phenomenon of BPD in adolescent girls is the same even in adults. In a study by Martens, (2007), more than 50% of borderline patients who were sexually abused, it was both in childhood and adolescence and the frequency of the abuse was at least once a at a minimum of one year.
A feedback given by given in this report, states that at least on form of penetration and use of force was applied. Women who are diagnosed with personality disorder have a high likelihood of having been child sexual abuse victims, especially abuse by their fathers, as compared to women with other psychiatric disorders. Besides being abused their fathers, 70% of the women had also been abused by others. Additionally, they were neglected by their mothers. About a third of the rape victims develop a post traumatic stress disorder which is rape related.
In a case where the victim has gone through more than one kind of abuse, such as sex and physical abuse, the adult psychiatric problems that are associated with child abuse emerge to be very severe. The research indicated a there is a high likelihood of young adults who have gone through an incident of forced sex during childhood, engaging in high risk behaviors than non-abused young people. Also, they were four times likely to engage in sex with strangers, twice as much to have multiple sexual partners, and a likelihood of becoming pregnant while under the age of eighteen.
In adolescent girls, the physical and sexual dating violence is connected with increased risk of substance use sexual risk behavior, pregnancy, suicide and unhealthy weight controls behavior (Trippany et al. 2006). 2. 0 Mood Disorders Childhood sexual abuse can often cause feelings of guilt and shame. Victims can experience thoughts of self-blame for the abuse. These feelings and thoughts often lead to symptoms of depression. Research has shown that childhood sexual abuse is a major risk factor for depression.
According to Roosa, Reinholtz, and Angelini (1999) depression was associated with child sexual abuse. The symptoms of depression tend to increase with the severity of the abuse (Feinauer, Callahan, & Hilton, 1996). According to Allers, Benjack, and Allers (1992) there is a higher incidence of depression and depressive episodes among women that had been sexually abused by physical contact. In addition they also concluded that these adult survivors tended to be more self-destructive and had high suicidal ideations or attempts.
Sad moods are a manifest of a reaction towards negative situations such as loss, failure, separation, family conduct and conflict, and do not necessarily signify depression. The word depression is commonly used to describe a depressive mood that may be temporary; or diagnosis of an ailment known as clinical depression. In children and adolescents, it can interfere with the normal development tasks, for instance: social and an economic skills mastering, academic skills and forming relationships (Cacioppo& Gardner 1999). Depression is a common symptom in people who have childhood sexual abuse.
At least 30% of rape victims have a higher probability of a major depressive state in their lives. At the same age, before adolescence, an equal number of boys and girls are depressed. However, there is a drastic change when at the age of 13, girls are depressed more than boys are (usually in the ratio of 2:1 respectively); a trend that persists to adulthood. It appears that depression could be having a genetic basis. In recent studies, a higher percentage of depression and other mental disorders has been found to occur frequently in a family line that has had a depression history.
On the basis of gender difference, it is stated that the observed disparity in depression between boys and girls is due to changes that occur in puberty; negative life events and a combination of the genetic factors (Bagwell, et al. 2006). Some studies indicate that a lower social status in females and the traditional way of bringing up girls cultivates traits which can increase the vulnerability of adolescent girls to depression. As the adolescents’ female bodies differentiate, sex roles take on new importance.
At the onset of adolescence, girls tend to compare themselves with the standard female stereotypes; this may lead to dissatisfaction in their bodies hence creating an increase in the depressed mood and low self esteem (Martens, 2007). Adolescents react differently to events in life that are stressful and this plays an important role in the development of depression. The increased depressed mood of adolescent girls is associated with the stressful life events. Childhood sexual abuse is becoming rampant whereas the rate of sexual abuse in girls increases gradually from puberty, however, between the ages of 10-14 abuse is greatest.
Compared to boys, girls are more sexually abused with the ratio of female to male victims being 12:1. Sexual abuse affects both the physiological and psychological functioning. Recent research advocates that heightened physiological responses in females, for instance, dysregulation of the hypothalamic-pituitary adrenal (HPA) axis similar to what is observed in patients who are depressed; is as a result of sexual abuse. Even though individual differences exist, sexual abuse has a major psychological impact on its fatalities. In addition, not all individuals are traumatized in the same way.
Sexual abuse effects are characterized by the following aspects: the type of abuse, whether the abuser was a member of the family or stranger, the duration of the abuse-either short or long term; and the age of the victim at the time of the abuse. Adolescent victims of sexual abuse often act out, with long term reactions occurring in two fifths of sexually abused girls whereas children may react immediately or delay. Young children become anxious as a result of sexual abuse. Long term psychological symptoms in victims of sexual abuse include: depression, substance abuse and sexual problems (http://www.
aboutourkids. org/articles/depression_in_adolescence_does_gender_matter). 3. 0 Training Needs Childhood Sexual Abuse has an influential role on the impact of mental health and the residential care facilities. It is imperative to consider the training needs of the staff that provide direct care this population. Research has shown a significant relationship between childhood abuse and the development of many mental health problems in adulthood such as, depression, anxiety disorders, post-traumatic stress disorder, eating disorders, dissociative disorders, sexual dysfunction, and substance abuse.
Research on the effectiveness of treatment modalities is still developing; counselors should have some awareness of the pervasiveness, dynamics, and approaches used with sexually traumatized adolescents. According to Kitzrow (2000) the complexity of the treatment issues and the ethical considerations of untrained counselors are two major arguments for graduate programs to adequately train counselors to work with victims of sexual abuse.
Kitzrow (2002) further explains that without adequate training counselors will not be prepared to understand the family dynamics of sexual abuse and most importantly how to identify victims of childhood sexual abuse. In a study conducted of 64 accredited and non- accredited graduate counseling programs to determine how many provided courses that specifically addressed child sexual abuse or sexual victimization, only 16 programs offered a specialized course in sexual abuse.
There were 27 programs which reported to offer a course that at least minimally mentioned the topic (Priest & Nishimura, 1995). This is an alarming find based on the prevalence rates of childhood sexual abuse. These findings suggest that there is a strong need for graduate programs to increase the awareness of childhood sexual abuse. In a research carried out by Goldman & Padayachi (2005), suspicions of child sexual abuse are under-reported by school counselors. There is a tendency of school counselors suspecting abuse, instead of reporting it to the correct authorities.
Moreover a good number of counselors in training institutions believe that they have less knowledge in identifying incidences of child sexual abuse; they can’t serve as resource persons due to lack of necessary training and knowledge. They also lack skills and procedures to enable them with sexually abused children. However there is an interest in the counselors to attend in-service education programs that focus on addressing knowledge, prevention, intervention, and treatment of child sexual abuse including other forms of abuse. School counselors are in a good strategic position to enhance the campaign against child abuse.
But as mentioned above, there are quite significant limitations in the counselors and this makes it hard for them to put efforts against sexual abuse in children. Therefore there is need to identify the type, nature and duration of support required by the school counselors in this area in this area, as well as emotional factors that will help in making the process a success. Two effective prevention programs in improving children’s ability to discriminate between appropriate and inappropriate touching were studied by Blumberg et al. (2004).
This study indicated that in a play group, children can be able recognize touch after training than before. Caregivers should understand child sexual abuse and their role in preventing it. The perspective of education at this stage is to explain healthy sexual development. Children sexual abuse is defined; appropriate and inappropriate behaviors outlined; challenging commonly held myths like offenders are strangers hence easily identifiable. Warning signs for sexuality and offending when utilized they, have an impact on a population.
Caregivers talk to their children about sexuality and child sexual abuse; the parents are educated as well before any suspicion of sexual abuse has been raised. Awareness is created on where one can seek for help incase of an incidence of child abuse. Policies put in organizations will take care of the people’s welfare and educate them on child sexual abuse. Many factors can help the youth get protected from getting sexually abused. Child sexual abuse education and training for the youth is developmental appropriate and offer the proper skill. Varied skills and knowledge can be applied to adolescents and young children.
The basic general information about sexuality abuse is explored including the virtues that make up sexual abuse. The youth are taught on how to interact with one another and to whom they should report in case of sexual abuse. Empowered youth can adopt a health strategy to safeguard themselves, for instance, informing the caregiver before proceeding to any place and always walking in the company of friends-not alone and identifying adults who can be trusted. Educated youth recognize appropriate behavior and an inappropriate behavior and they refrain from undesired kind of a behavior (Blumberg et al. 2004).
4. 0 Conclusion Normally, children fail to report because of the fear that whatever they speak out will make them victimized or worse consequences. Additionally, some disorders like BPD and the mental disorders create fear, isolation and a sense of insecurity in the patients. Thus prior to reporting an incidence, the victim fears the consequences of the family, feels guilty and may fear disciplinary actions from the perpetrator. As a result this has led to the sexual abuse. However through training and treatment, the problem can be managed appropriately.
In many countries, sexual child abuse has been incorporated into an aspect of health education. In all levels of education from pre-schools, primary and high schools, teachers are striving hard to educate children and the youth on sexuality. In some institutions, a policy on mandatory reporting of child sexual abuse to the principles then to the government authorities has been instituted. Also, there is added effort to ensure everyone is informed about child sexual abuse. As an example, multimedia CD-Rom on child sexuality abuse has been made to enhance knowledge and attitude in institutions in Australia (Torrisi-Steele & Goldman, 2004).
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