Forensic medical evaluation of child sexual abuse: Factors influencing children's coping and distress.

摘要

There are numerous interpersonal and intrapersonal factors that may affect children's coping and the level of distress experienced during forensic medical evaluations for alleged child sexual abuse. Children's temperament, previous experiences with medical procedures, parental presence during the examination, and parental psychopathology are factors that have been found to influence children's coping and their distress during general medical procedures. However, although much empirical attention has been given to children's adjustment to general medical procedures, there appears to be a dearth of research addressing adjustment to forensic medical evaluations. Thus, the purpose of this study was to identify factors predictive of children's coping and distress during these evaluations. Fifty-two 6- to 10-year-old children, their maternal caregivers, and agency staff completed standardized measures. Children were administered coping measures and rated their level of distress. Maternal caregivers completed measures assessing child temperament, parental psychopathology, and state anxiety. Agency staff completed distress ratings based on their behavioral observations of the children. As expected, temperament, parental psychopathology, and state anxiety were related to children's coping and distress, but only during the medical examination. Previous medical experiences were related to children's distress, but not coping. Finally, contrary to hypotheses, coping did not mediate the relationship between temperament and distress. Overall, these findings suggest that children's adjustment to forensic medical evaluations are influenced by many different interpersonal and intrapersonal factors. Understanding these influential factors is important in promoting change and exploring different approaches during these sensitive examinations.