Дети сексуализированы и без «педофилов»
The existing literature on PSB in children suggests that there may be risk factors associated with these behaviors. One common misperception is the assumption that all children displaying PSB have been sexually abused in the past. While sexual abuse has been shown to be a risk factor for displaying PSB, the prevalence of prior sexual abuse among PSB cases was found to be as low as 38% (2, 8, 9). Several other risk factors for PSB have been demonstrated to occur with significantly greater prevalence. For example, interpersonal violence was found in 68% of children presenting with PSB in the same study referenced above (9). A history of physical abuse was also identified in 47% of PSB cases (9). Other risk factors documented in the literature include high parental stress, neglect, and exposure to sexually explicit media (1, 8-13). A review by Elkovitch et al. (14) highlighted how the intersection of several risk factors plays a more impactful role in the development of PSB than any one risk factor (14). Research is needed to further characterize these risk factors and assess their impact on PSB.
Another misperception surrounding this topic is that PSB is comparable to sexual crimes committed by older adolescents and adults. Children who display PSB with other children are often labeled as "perpetrators, and viewed through the criminal lens, or considered victims of sexual abuse, although neither may be true (5, 12). The Survey on Youth with Problematic Sexual Behaviors also found that 67.8% of professionals in child-serving roles perceived children who displayed PSB to be similar to adult sexual offenders (15). Recent literature demonstrates that criminalizing the behavior and using punitive responses with children displaying PSB does a disservice to these children, who are in fact no more likely to perpetrate sexual abuse as adults when provided appropriate therapeutic intervention (16). These misinformed perceptions negatively impact the treatment of children affected by PSB and their ability to access care.
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Problematic Sexualized Behavior - Cognitive Behavioral Therapy (PSB-CBT) is one such intervention that has demonstrated success with this patient population, with evidence of a ten-year recidivism rate of 2% for children under 12 years of age (16, 17).
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The child's role was characterized as displayer, recipient, both or unknown. The role of "Displayer" was used to identify the child exhíbiting the problematic sexualized behavior, while the role of "Recipient" was used to identify the child on whom the behavior was performed. If a child both displayed and was the recipient of the behavior, their role in the behavior was designated as "Both": This included children who were the recipient of one behavior, who then displayed a different behavior at a different point in time. The designation of "Unknown" was assigned in cases where all children involved appeared to be participating in the problematic behaviors equally without a clear initiator (for example, in sexualized play).
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Only 22 (20%) of the 110 children referred to the CPP were the displayer of the behavior, compared to 76 (69%) the recipients of the behavior (see Table l). Of the recipient cases, the child displaying PSB was also referred to the CPP for medical evaluation 14.5% of the time.
Characteristics of children identified as having been affected by PSB are shown in Table 2. The mean age was 1.2 years older for children displaying PSB compared to the recipients of PSB. A presumed history of abuse was found in 45.5% of children identified as displaying PSB, compared to only 25% of children identified as the recipient of PSB.
There was no statistically significant association identified between history of abuse or developmental delay and having displayed PSB. Chi-square test for independence found the outcomes of displaying or being the recipient of PSB to be independent from history of abuse.
[DOI 14.10.3389/fpsyt.2023.1272789][THOMPSON, Kara & SVENDSEN, Sasha, «A descriptive analysis of children seeking medical attention for problematic sexualized behavior» (DOI 14.10.3389/fpsyt.2023.1272789) // FRONTIERS IN PSYCHIATRY. - 2023]
(pdf) a descriptive analysis of children seeking medical attention for problematic sexualized behavior
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