INCEST IN TURKEY: THE EXAMPLE OF AN ADOLESCENCE CENTER

Öz

Background Child sexual abuse, especially incest may reveal more serious consequences in terms of young victims, the relationship’s context between abuser and victim, and the presence of the risk associated with sexual activity. In this context, the aim of this study was to provide awareness and perspective for healthcare professionals on the subject by publishing our experiences on incest, which is a difficult and sensitive subject. Methods This study was carried out retrospectively and descriptively based upon medico-legal records of girl children under the age of 18 evaluated in an Adolescence Center between the years of 2004-12. Results Intrafamilial abuse was 23 of 139 victims of child sexual abuse during this period of time. The gender of the victims female only, and the age of victims was between 2-18 ages, and 10 of 23 presented with various gynecological complaints. The abuse of 56.52 % of the cases was detected by gynecologists. Also, 34.7 % of them were pregnant. The long term consequences of incest were determined ASD, PTSD, social isolation, ADHD and substance abuse. Conclusion The decision as to whether the child is a victim of incest or not is difficult and has serious implications. In cases with delayed notification, changes or loss in evidence may lead to confusion in medico-legal evaluation, which makes social and legal management harder, thus causing a delay in the protection of victims from abuse. At this stage, early diagnosis of abuse becomes very important in line with the best interests of the child.

Anahtar Kelimeler

• Child sexual abuse
• incest
• early diagnosis
• prevention
• adolescence center

Kaynakça

1. ACOG, Committee Opinion No. 498. (2011). Adult manifestations of childhood sexual abuse. Obstetrics & Gynecology, 118(2Pt1), 392-395. http://dx.doi.org/10.1097/AOG.0b013e31822c994d.
2. ACOG, Committee Opinion No. 777 (2019). Sexual assault. Obstetrics & Gynecology, 133(4), e296-e302. http://dx.doi.org/10.1097/AOG.0000000000003178.
3. Al-Mahroos, F., & Al-Amer, E. (2011). Reported child sexual abuse in Bahrain: 2000-2009. Annals of Saudi Medicine, 31(4), 376-382. http://dx.doi.org/10.4103/0256-4947.83218.
4. Browne, A., & Finkelhor, D. (1986). Impact of child sexual abuse: A review of the research. Psychological Bulletin, 99(1), 66–77. https://doi.org/10.1037/0033-2909.99.1.66.
5. Carlstedt, A., Nilsson, T., Hofvander, B., Brimse, A., Innala, S., & Anckarsater, H. (2009). Does victim age differentiate between perpetrators of sexual child abuse? A study of mental health, psychosocial circumstances, and crimes. Sexual Abuse, 21(4), 442-454. https://doi.org/10.1177/1079063209346699.
6. Centers for Disease Control and Prevention (CDC). (2018). Sexual violence: additional resources. (Information can be found at https://www.cdc.gov/violenceprevention/sexualviolence/resources.html).
7. Csorba, R., Aranyosi, J., Borsos, A., Balla, L., Major, T., & Poka, R. (2005). Characteristics of female child sexual abuse in Hungary between 1986 and 2001: a longitudinal, prospective study. European Journal of Obstetrics & Gynecology Reproductive Biology, 120(2), 217-221. https://doi.org/10.1016/j.ejogrb.2004.08.018.
8. Engelmann, M. D., Vener, A. M., & Krupka, L. R. (1996). College students’ willingness to terminate a pregnancy. College Student Journal, 30(1), 29-36.

9. Finkelhor, D. (1994). Current information on the scope and nature of child sexual abuse. The Future of Children, 4(2), 31-53. https://doi.org/10.2307/1602522.
10. Finkel, K. C. (1994). Sexual abuse and incest. What can you do? Canadian Family Physician, 40, 935-944.
11. Kardam, F. & Bademci, E. (2013). Mothers in cases of incest in Turkey: Views and experiences of professionals. Journal of Family Violence, 28, 253-263. https://dx.doi.org/ 10.1007/s10896-013-9495-z.
12. Kellogg, N. (2005). The evaluation of sexual abuse in children. Pediatrics, 116(2), 506-512. https://doi.org/10.1542/peds.2005-1336.
13. Kempe, C. H. (1978). Sexual abuse, another hidden pediatric problem: the 1977 C. Anderson Aldrich lecture. Pediatrics, 62(3), 382-389.
14. Leander, L. (2010). Police interviews with child sexual abuse victims: Patterns of reporting, avoidance and denial. Child Abuse & Neglect, 34(3), 192-205. http://dx.doi.org/10.1016/j.chiabu.2009.09.011.
15. Lorentzen, E., Nilsen, H., & Traeen, B. (2008). Will it never end? the narratives of incest victims on the termination of sexual abuse. The Journal of Sex Research, 45(2), 164-174. http://dx.doi.org/10.1080/00224490801987473.
16. Magalhaes, T., Taveira, F., Jardim, P., Santos, L., Matos, E., & Santos, A. (2009). Sexual abuse of children. A comparative study of intra and extra-familial cases. Journal of Forensic and Legal Medicine, 16(8), 455-459. http://dx.doi.org/10.1016/j.jflm.2009.05.007.
17. Mahkorn, S. (1999). Report of Sandra Mahkorn. Issues in Law & Medicine, 14(4), 433-441.
18. Mollamahmutoglu, L., Uzunlar, O., Kahyaoglu, I., Ozyer, S., Besli, M., & Karaca, M. (2014). Assessment of the sexually abused female children admitted to a tertiary care hospital: Eight year experience. Pakistan Journal of Medicine Sciences, 30(5), 1104-1107. http://dx.doi.org/10.12669/pjms.305.5274.
19. Muram, D. (1993). Child sexual abuse. Current Opinion in Obstetrics & Gynecology, 5(6), 784-790.
20. National Center on Child Abuse and Neglect (NCCAN). (1978). Child Sexual Abuse: Incest, Assault and Exploitation. A Special Report from the National Center on Child Abuse and Neglect 1978. (Information can be found at https://www.ojp.gov/pdffiles1/Digitization/57111NCJRS.pdf.
21. Pickering, L. K. (2003). Sexually transmitted diseases in adolescents and children. In L. K. Pickering (Ed.), American Academy of Pediatrics Report of the Committee on Infectious Diseases, 157-166. Red Book, 26th Ed., Elk Grove Village, IL. (Information can be found at https://redbook.solutions.aap.org/DocumentLibrary/RB2003.pdf).
22. Polat, O. (2006). All Aspects of Child Abuse. Ankara: Seckin Publisher.
23. Raboei, E. H. (2009). Surgical aspects of child sexual abuse. European Journal of Pediatric Surgery, 19(1), 10-13. http://dx.doi.org/10.1055/s-2008-1038763.
24. Sapp, M. V., & Vandeven, A. M. (2005). Update on chilhood sexual abuse. Current Opinion Pediatrics, 17(2), 258-264. http://dx.doi.org/10.1097/01.mop.0000158731.64293.c7.
25. Stechna, S. B. (2011). Childhood pregnancy as a result of incest: A case report and literature review with suggested management strategies. Journal of Pediatric & Adolescent Gynecology, 24(3), e83-e86. http://dx.doi.org/10.1016/j.jpag.2010.11.010.
26. The Report of the Turkey Demographic and Health Surveys (TNSA) (2008). (Information can be found at http://www.hips.hacettepe.edu.tr/tnsa2008/data/TNSA-2008_ana_Rapor-tr.pdf).
27. The Turkish Criminal Code (TCC) 2005. (Information can be found at https://www.legislationline.org/download/id/6453/file/Turkey_CC_2004_am2016_en.pdf).
28. Ullman, S. E., & Filipas, H. H. (2005). Gender differences in social reactions to abuse disclosures, post-abuse coping, and PTSD of child sexual abuse survivors. Child Abuse & Neglect, 29(7), 767-782. http://dx.doi.org/ 10.1016/j.chiabu.2005.01.005.
29. UNICEF (2001). Country profiles: Effective parenting in Turkey 2001, 39-53. In World Report on Children at Risk. (Information can be found at https://www.unicef.org/media/84781/file/SOWC-2001.pdf).
30. Yuksel, B., Kilic, S., Su, F. A., Tasdemir, N., Uzunlar, Ö., & Mollamahmutoglu, L. (2008). What should the management of incest pregnancies be? An ethical view presented via three cases. Reproductive Biomedicine Online, 17(3), 52-54. https://doi.org/10.1016/S1472-6483(10)60331-8.