In this paper we report on the findings from a preliminary study in the UK into the effects of crime on health. The aim of the study was to investigate what victims of crime report to be the effects of both actual crime and the fear of crime on their physical and psychological health (as well as social well-being) and what actions they take (if any) to deal with these effects. A survey method was adopted using a modified version of the 'Health, Quality of Life and Crime Questionnaire' with 866 undergraduate student respondents from three UK universities. University students were selected as the sample population because, as a group, they form a specific 'victim community'. Conclusions extrapolated from the respondents' replies were first, there are serious negative health effects (particularly on psychological health) of a considerable minority of those students who are victims of crime. Second, the vast majority of the victims did not initiate any health intervention. Third, a large minority of the victims did not report the crime to the police. Fourth, a majority of both victims and non-victims suffered psychological negative effects from the fear of crime. Fifth, there is a huge gender imbalance among those affected by crime with female students much more fearful of crime than men. Moreover, female students were much more likely to use specific strategies to lower the risk of crime. These conclusions suggest that there may be important policy implications for universities, the police, victim support organizations and mental health services, regarding the effects of crime on students. This study is intended as a preliminary stage for subsequent in-depth and larger projects.
BackgroundDespite differences in perceptions of what constitutes child sexual abuse there is a general consensus amongst clinicians and researchers that this is a substantial social problem which affects large numbers of children and young people worldwide. The effects of sexual abuse manifest themselves in a wide range of symptoms, including fear, anxiety, post‐traumatic stress disorder and behaviour problems such as externalising or internalising, or inappropriate sexual behaviours. Child sexual abuse is associated with increased risk of psychological problems in adulthood. Knowing what is most likely to benefit children already traumatised by these events is important.ObjectivesThe aim of this review was to assess the efficacy of cognitive‐behavioural approaches (CBT) in addressing the immediate and longer‐term sequelae on children who have been sexually abused.Search strategyThe Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 5, 2005), MEDLINE (1966 ‐ November 2005); EMBASE (1980 ‐ November 2005); CINAHL (1982 ‐ November 2005), PsycINFO (1897 ‐ November 2005); LILACS (1982 ‐ November 2005); SIGLE (1980 to November 2005) and the register of the Cochrane Developmental, Psychosocial and Learning Problems Group (November 2005) were searched.Selection criteriaIncluded studies were randomised or quasi‐randomised controlled trials investigating the efficacy of cognitive behavioural therapy on children and adolescents up to age 18 years who had experienced sexual abuse.Data collection and analysisTitles and abstracts identified in the search were independently assessed for eligibility by two reviewers (GM and PR). Data were extracted and entered into REVMAN (JH and GM), and synthesised and presented in both written and graphical form (forest plots).Main resultsTen trials, including 847 participants, were included in this review. Data suggest that CBT may have a positive impact on the sequelae of child sexual abuse, but most results were statistically non‐significant.Authors' conclusionsThe review confirms CBT's potential as a means of addressing the adverse consequences of child sexual abuse, but highlights the tenuousness of the evidence base and the need for more carefully conducted and better reported trials.Plain language summaryThe sexual abuse of children is a substantial social problem which affects large numbers of children and young people worldwide. For many children, but not all, it can result in a range of psychological and behavioural problems, some of which can continue into adulthood. Knowing what is most likely to benefit children already traumatised by these events is important. This review aimed to assess the efficacy of cognitive‐behavioural approaches (CBT) in addressing the immediate and longer‐term sequelae on children who have been sexually abused. Ten studies were identified that met the inclusion criteria for the review in which a total of 847 children participated. The evidence suggests that CBT may have a positive impact on the sequelae of child sexual abuse, but most results were statistically non‐significant. Implications for practice and further research are noted.
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Aims Child sexual abuse in Africa is common with increasing numbers seeking professional care. In well-resourced countries a one-s top centre (OSC), where different agencies (health, social services, counselling, police and justice) operate together in one building, is an ideal way to care for survivors. The suitability of the OSC model has not been evaluated in low-income settings. In 2013, we evaluated the services offered within a recently established OSC in Malawi to determine the: proportion of children that receive services in accord with national guidelines factors that encourage or discourage the use of the service perceptions of quality of child protection services amongst users and providers Methods In this prospective, exploratory study between August 2012 and June 2013, the experiences of consenting consecutive service users were evaluated 3 months after attending the OSC. Of 228 CSA survivors seen, 59 were lost to follow up and 62 did not consent leaving 107 participants who completed questionnaires. Semi-structured interviews (SSI) were held with 25 guardians of survivors and with 10 service providers representing all agencies involved. Interviews were transcribed and common themes identified. Results 82% of survivors received health services in accord with guidelines, 84% counselling, 54% police and 29% social welfare services. 18% received all services as they should. The majority of guardians (75.8%, n = 107) were satisfied with the services received. In SSI (n = 25), factors encouraging use of the service were fear of HIV (19 of 25), seeking justice (3/25), need for counselling (2/25), fear of pregnancy (1/25) and verification of rape (5/25). Discouraging factors were concerns about corruption (9 of 25), negligence by police (3/25), sentence too short (3/25) and when post-exposure prophylaxis was not provided (2/25). Lack of transport impaired social services delivery. Conclusion The OSC model is an appropriate means to deliver high quality care to CSA survivors in Malawi. Fear of HIV encourages use of the service. Perceptions of corruption and negligence amongst the police discourage clients; lack of transport reduces the effectiveness of the service.
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