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Anogenital injuries in childhood sexual abuse victims treated in a pediatric Forensic Nurse Examiner (FNE) program

Campbell, Rebecca PhD1; Patterson, Debra PhD2; Dworkin, Emily BA3; Diegel, Renae RN4

doi: 10.1111/j.1939-3938.2010.01084.x
Original Articles: ORIGINAL ARTICLE

Medical forensic exams for victims of childhood sexual abuse (CSA) can be a helpful resource for addressing patients’ complex medical, psychological, and legal needs. These exams can be performed by physicians or forensic nurses to identify and treat injuries, evaluate the risk for sexually transmitted infections and pregnancy, and collect evidence. In this study, we examined CSA cases treated in a midwestern, community-based forensic nurse examiner (FNE) program to document rates of anogenital injury and identify what factors predict the presence of such injuries (N= 203). Overall, 39% of the cases had anogenital injury. Victims who were examined for suspected vaginal and/or anal assault were significantly more likely to have anogenital injuries, and patients examined within 24 hours of an assault were also significantly more likely to have documented injuries. Patients who were seen for vaginal and/or anal assaults and who had bathed since the assault were significantly less likely to have injury. Nurses who had less experience with pediatric medical forensic exams were somewhat more likely to document anogenital injuries. Findings suggest that clinical pediatric practice would benefit from additional practitioner training in injury detection to avoid false positives.

1Department of Psychology, Michigan State University, Michigan

2School of Social Work, Wayne State University, Michigan

3Department of Psychology, University of Illinois, Urbana-Champaign, Illinois

4Turning Point Forensic Nurse Examiner Program, Mt. Clemens, Michigan

Correspondence Rebecca Campbell, PhD, Department of Psychology, Michigan State University, Michigan. Tel: 517–353–5015; E-mail:

Received: August 12, 2009; accepted: January 7, 2010

© 2010 Lippincott Williams & Wilkins, Inc.
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