Rounds in the General Hospital December 16, 2021

Identifying and Reporting Child Sexual Abuse in Health Care Settings

Heather Burke, MD; Shixie Jiang, MD; Theodore A. Stern, MD

Prim Care Companion CNS Disord 2021;23(6):21f02978

LESSONS LEARNED AT THE INTERFACE OF MEDICINE AND PSYCHIATRY

The Psychiatric Consultation Service at Massachusetts General Hospital sees medical and surgical inpatients with comorbid psychiatric symptoms and conditions. During their twice-weekly rounds, Dr Stern and other members of the Consultation Service discuss diagnosis and management of hospitalized patients with complex medical or surgical problems who also demonstrate psychiatric symptoms or conditions. These discussions have given rise to rounds reports that will prove useful for clinicians practicing at the interface of medicine and psychiatry.

Continue Reading...

Did you know members enjoy unlimited free PDF downloads as part of their subscription? Subscribe today for instant access to this article and our entire library in your preferred format. Alternatively, you can purchase the PDF of this article individually.

Subscribe Now

Already a member? Login

Purchase PDF for $40

Members enjoy free PDF downloads on all articles. Join today

  1. Leeb RT, Paulozzi LJ, Melanson C, et al. Child Maltreatment Surveillance: Uniform Definitions for Public Health and Recommended Data Elements. Version 1.0. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. January 2008. Accessed November 3, 2021. https://www.cdc.gov/violenceprevention/pdf/cm_surveillance-a.pdf
  2. Murray LK, Nguyen A, Cohen JA. Child sexual abuse. Child Adolesc Psychiatr Clin N Am. 2014;23(2):321–337. PubMed CrossRef
  3. Vrolijk-Bosschaart TF, Brilleslijper-Kater SN, Benninga MA, et al. Clinical practice: recognizing child sexual abuse-what makes it so difficult? Eur J Pediatr. 2018;177(9):1343–1350. PubMed CrossRef
  4. Krug E, Dahlberg L, Mercy J, et al. World Report on Violence and Health. World Health Organization; 2002.
  5. Child Welfare Information Gateway. Mandatory Reporters of Child Abuse and Neglect. US Department of Health and Human Services, Children’s Bureau; 2019.
  6. Taskforce APSAC. Psychosocial Evaluation of Suspected Sexual Abuse in Children. 2nd ed. The American Professional Society on the Abuse of Children; 1997.
  7. Guidelines for the Clinical Evaluation for Child and Adolescent Sexual Abuse. American Academy of Child and Adolescent Psychiatry website. Modified December 1990. Accessed November 3, 2021. https://www.aacap.org/aacap/Policy_Statements/1990/Guidelines_for_the_Clinical_Evaluation_for_Child_and_Adolescent_Sexual_Abuse.aspx
  8. Jenny C, Crawford-Jakubiak JE; Committee on Child Abuse and Neglect; American Academy of Pediatrics. The evaluation of children in the primary care setting when sexual abuse is suspected. Pediatrics. 2013;132(2):e558–e567. PubMed CrossRef
  9. American Academy of Pediatrics. Committee on Hospital Care and Committee on Child Abuse and Neglect. Medical necessity for the hospitalization of the abused and neglected child. Pediatrics. 1998;101(4 Pt 1):715–716. PubMed
  10. Johnson CF. Child sexual abuse. Lancet. 2004;364(9432):462–470. PubMed CrossRef
  11. Hymel KP, Jenny C. Child sexual abuse. Pediatr Rev. 1996;17(7):236–249, quiz 249–250. PubMed CrossRef
  12. Kendall-Tackett KA, Williams LM, Finkelhor D. Impact of sexual abuse on children: a review and synthesis of recent empirical studies. Psychol Bull. 1993;113(1):164–180. PubMed CrossRef
  13. Hanson RF, Adams CS. Childhood sexual abuse: identification, screening, and treatment recommendations in primary care settings. Prim Care. 2016;43(2):313–326. PubMed CrossRef
  14. Hanson RF, Wallis E. Treating victims of child sexual abuse. Am J Psychiatry. 2018;175(11):1064–1070. PubMed CrossRef
  15. Louwers EC, Korfage IJ, Affourtit MJ, et al. Effects of systematic screening and detection of child abuse in emergency departments. Pediatrics. 2012;130(3):457–464. PubMed CrossRef
  16. Salvagni EP, Wagner MB. Development of a questionnaire for the assessment of sexual abuse in children and estimation of its discriminant validity: a case-control study. J Pediatr (Rio J). 2006;82(6):431–436. PubMed CrossRef
  17. Rogstad K, Johnston G. Spotting the Signs: A National Proforma for Identifying Risk of Child Sexual Exploitation in Sexual Health Services. BASHH/Brook, April 2014. Accessed November 3, 2021. https://www.bashh.org/documents/Spotting-the-signs-CSE-%20a%20national%20proforma%20April%202014%20online.pdf
  18. Shakil A, Day PG, Chu J, et al. PedHITSS: a screening tool to detect childhood abuse in clinical settings. Fam Med. 2018;50(10):763–769. PubMed CrossRef
  19. Gallion HR, Milam LJ, Littrell LL. Genital findings in cases of child sexual abuse: genital vs vaginal penetration. J Pediatr Adolesc Gynecol. 2016;29(6):604–611. PubMed CrossRef
  20. Workowski KA, Bolan GA; Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2015. MMWR Recomm Rep. 2015;64(RR-03):1–137. PubMed
  21. Chaffin M, Friedrich B. Evidence-based treatments in child abuse and neglect. Child Youth Serv Rev. 2004;26(11):1097–1113. CrossRef
  22. Silverman WK, Ortiz CD, Viswesvaran C, et al. Evidence-based psychosocial treatments for children and adolescents exposed to traumatic events. J Clin Child Adolesc Psychol. 2008;37(1):156–183. PubMed CrossRef
  23. Deblinger E, Mannarino AP, Cohen JA, et al. Trauma-focused cognitive behavioral therapy for children: impact of the trauma narrative and treatment length. Depress Anxiety. 2011;28(1):67–75. PubMed CrossRef
  24. Gilboa-Schechtman E, Foa EB, Shafran N, et al. Prolonged exposure versus dynamic therapy for adolescent PTSD: a pilot randomized controlled trial. J Am Acad Child Adolesc Psychiatry. 2010;49(10):1034–1042. PubMed CrossRef
  25. de Arellano MA, Lyman DR, Jobe-Shields L, et al. Trauma-focused cognitive-behavioral therapy for children and adolescents: assessing the evidence. Psychiatr Serv. 2014;65(5):591–602. PubMed CrossRef
  26. Cohen JA, Bukstein O, Walter H, et al; AACAP Work Group on Quality Issues. Practice parameter for the assessment and treatment of children and adolescents with posttraumatic stress disorder. J Am Acad Child Adolesc Psychiatry. 2010;49(4):414–430. PubMed
  27. Cutajar MC, Mullen PE, Ogloff JR, et al. Psychopathology in a large cohort of sexually abused children followed up to 43 years. Child Abuse Negl. 2010;34(11):813–822. PubMed CrossRef