Child Sexual Abuse & Substance Abuse: Impacts and Consequences
Item 1. Domestic and Sexual Abuse
Outside the Family
It is important to differentiate between domestic and extra-familial sexual abuse due to several factors:
- Intervention and approach strategies vary significantly.
- The psychological profiles of offenders differ radically.
- There may be distinguishing features in the profiles of child victims.
- Family dynamics and responses to abuse vary greatly.
- The methods used to commit sexual abuse differ.
The Child’s Emotional State When Reporting Sexual Abuse
- A) Resistance to Disclosure:
- B) Embarrassment: (Common with younger children)
- C) Anger/Rage: (More common in boys)
- D) Anxiety: (More common with teenage girls)
- E) Disgust/Aversion: (More common when describing oral sex)
- F) Sexual Stimulation: (More common with emotionally disturbed children)
- G) Fear: (Common if threatened by the offender)
Emotional Aftermath of Sexual Abuse
Short-Term Consequences
80% of victims suffer negative psychological consequences. Girls tend to exhibit anxious-depressive reactions, while boys may experience school failure, difficulties with socialization, and aggressive sexual behavior.
Long-Term Consequences
Less frequent (30% of victims) and more diffuse, including alterations in the sexual sphere (sexual dysfunction and decreased ability to enjoy sex), depression, post-traumatic stress disorder, and inadequate anger management.
Item 2. Terminology
- Substance Abuse: Consumption of a psychoactive substance to an extent that seriously interferes with health or social/occupational functioning.
- Addiction: A pattern of drug consumption characterized by unsurpassed clinging to substance use, compulsive seeking behavior, and a high tendency to relapse after withdrawal.
- Dependence: A mental or physical state established by continued drug administration, characterized by a compulsion for periodic use.
- Tolerance: The need to increase the amount of a substance to achieve the desired effect, or diminished effects from regular doses.
- Craving: A strong desire for the acquisition and immediate use of a drug.
- Withdrawal: Symptoms that appear when substance intake is stopped or reduced after long-term, high-quantity consumption. The subject takes the substance to alleviate these symptoms.
- Dual Pathology: The co-occurrence of a psychiatric disorder and drug use.
Delictology
Drug use can lead to criminal behavior in several ways:
- Crimes related to drug production and distribution, committed by individuals who may not have substance abuse issues.
- Crimes committed under the influence of substances.
- Crimes committed to obtain money to maintain dependence.
Drug Imputability
A. Opiates
- Adverse reactions to drugs (ranging from decreased accountability to total insanity)
- Psychic disturbances accompanying somatic alterations during addiction (rarely affects attribution)
- Intoxication: Loss of ethics and conduct disorders, but basic psychological functions are preserved, so accountability is usually normal.
- Withdrawal Syndrome: Ranges from normal accountability (discrete symptoms) to significant decrease (clear symptoms) and potential non-accountability (severe syndromes).
B. Barbiturates and Alcohol
- Acute intoxication: Reduced or canceled accountability.
- Subacute toxicity: Significant reduction of accountability.
- Alcohol abuse is a source of violent and sexual aggression, both within and outside the family.
C. Hallucinogens
Abnormal conduct caused by fear, anxiety, paranoia, and hallucinations can lead to extreme actions (e.g., murder, sexual assault). Accountability can range from diminished to canceled due to impaired cognition and distorted reality perception.
D. Amphetamines
Thefts and robberies are common. Acute intravenous use can reduce accountability due to altered will and understanding. Psychotic symptoms can significantly decrease or cancel accountability.
E. Cocaine
Crimes like fraud, theft, trafficking, and prostitution are associated with cocaine use. Acute cocaine syndrome diminishes accountability, and hallucinations can render the accused unimpeachable.
Labor and Financial Situation
Factors to consider include education, profession, employment history, resources, pensions, and dependents.
Consumption of Alcohol and Drugs
Information on usage days, dosages, routes of administration, intoxication effects, treatment, withdrawal, and overdose is relevant.
Legal Status
Arrests, imprisonment, types of crimes, convictions, and probation should be documented.
Family History
Marital status, family stability, social relations, and friendships are important factors.
Psychopathology
Psychiatric symptoms, suicide attempts, treatment, and hospitalizations should be noted.