To review papers from the recent literature on child sexual abuse and to highlight the clinical and forensic issues raised and how these have been addressed. Also, to identify new demands and recommend future research.
The validity of forensic evaluations depends on the quality of the protocols used and the training of the forensic mental health practitioners involved. Diagnosis of child sexual abuse still depends mainly on the child's allegation of abuse, while anogenital examination yields minimal medical evidence of sexual abuse. The relationship between child sexual abuse and victims' mental health is increasingly being proven, underlining the importance of correct clinical and forensic diagnosis of abuse to permit preventive, therapeutic and legal measures. Sexual offences via the internet have raised new demands.
Forensic child and adolescent practitioners need to be very highly trained. Evaluation of sexually abused children and adolescents must be accurate to ensure legal validity and be performed with diligence so that alleged victims do not experience recurrence. Practitioners' actions must be referenced against appropriate instruments and they must be prepared for the ethical and forensic dilemmas and new demands that arise in this field.
aMedical School, Fluminense Federal University (UFF), Forensic Psychiatry, Rio de Janeiro State Public Prosecutor's Office (MPRJ), Rio de Janeiro School of Judges (EMERJ), Rio de Janeiro, Brazil
bHeloisa Marinho Research Institute (IPHEM), Rio de Janeiro School of Judges (EMERJ), Child and Adolescent Mental Health, Euclides da Cunha Foundation (FEC), Niterói, Rio de Janeiro, Brazil
Correspondence to Jairo Werner, IPHEM– Instituto de Pesquisas Heloisa Marinho, Rua Ministro Otávio Kelly, 453– Térreo, Icaraí, Niterói, Rio de Janeiro, Brazil. Tel: +55 21 2714 4584; fax: +55 21 2710 2416; e-mail: firstname.lastname@example.org