Psychopathological Correlates of Child Sexual… Alemayehu H 32

ORIGINAL ARTICLE

PSYCHOPATHOLOGICAL CORRELATES OF CHILD SEXUAL

ABUSE: THE CASE OF FEMALE STUDENTS IN JIMMA ZONE,
SOUTH WEST ETHIOPIA
Alemayehu Haileye
ABSTRACT

BACKGROUND: Arguably, the sexual abuse of children raises a number of important questions for
researchers at different times. Thus, the present study was aimed to examine psychopathological
correlates of child sexual abuse.
METHODS: This cross-sectional survey study compared the degree of vulnerability to
psychopathological variables among respondents with a history of sexual abuse and their unabused
counter parts in Jimma Zone. To this end, 400 female students were selected from five high schools as
the sample population using multi-stage sampling procedure. Data were gathered using Reynold’s
Adolescent Depression Scale (RADS), Adolescent Panic Anxiety Scale, and Posttraumatic stress disorder
test. The collected data via self-administered questionnaire were analyzed through the two sample t-test
statistical procedure.
RESULTS: The study revealed a result of t=3.83 for depression, t=2.46 for panic episode, and t=4.23 for
PTSD score, whereas, the critical value of all the three psychopathological variables showed t (52)
=1.676 at P=0.05. Results illustrate the presence of statistically significant differences in the mean scores
of the above mentioned psychopathologies between females with history of sexual abuse and females who
were not victims of this sexual attack at df =52 and P=0.05.
CONCLUSION: The findings of the present study indicate that history of childhood sexual abuse has
adverse consequences on the future psychological wellbeing of females. Specifically, females with
experience of sexual abuse were found to be more susceptible to develop depression, panic anxiety, and
post-traumatic stress disorders than unabused females. Thus, parents, and teachers should give the
necessary care and protection to female children. Primary bio-psychosocial care services need to be
established in the school system, and both the Ministry of Health and the Ministry of Education should
work together against sexual exploitation of female children.
KEY WORDS: Child Sexual Abuse (CSA), Psychopathologies, Correlates

INTRODUCTION 40-50% of their population, major advances in

studying sexual abuse against children have not
While sexual use of children by adults has existed been observed. It is obviously true that such kind
throughout history, due to the presence of of problem is considered as very minor and
widespread socially tolerated cultural practices secondary in the third world countries, where
such as abduction and early marriage, presumed other numerous socio-economic crises are
popular misconceptions, and the absence of clear- conspicuous. Nevertheless, in order to address
cut meaning to child sexual abuse (CSA), the child sexual abuse and exploitation through
problem has been underreported and overlooked primary health care system, information is needed
for centuries in most parts of the world (1). on the frequency, type, and maladaptive
Especially, in most developing countries, despite psychosocial consequences of child abuse
the fact that children under 15 years old constitute prevailing in a given locality.
1
Department of psychology, College Social Science and Law, Jimma University
33 Ethiop J Health Sci. Vol. 23, No. 1 March 2013

When we see its current epidemiology, estimates problems such as anxiety, depression, and sexual
of the incidence of sexual abuse ranges from abuse are prevalent among females (the
15% to 22% for female children and 3% to 8% relationship of sexual abuse with anxiety and
for male children, or higher, depending on the depression needs to be further examined). Above
definition of abuse and the method of data all, this article describes the first prospective
collection (4, 5). In most Ethiopia cultures, the assessment of psychopathological correlates of
issue of sexuality is an emotion charging topic. CSA. Therefore, the study intended to fill the
Few available studies reported that around content, spatial, and methodological gaps that
11.4%-16% of females had a history of sexual have been critically observed on the available
abuse during their childhood (6, 7, and 8). studies conducted on issue of CSA by
Specially, children working as maidservants and examining the association of prevalent
children who are destined to street life have been psychopathologies (depression, panic anxiety,
exceedingly exposed to sexual violence (9). and PTSD) with the history of CSA among
Nevertheless, the continuing maladaptive females. To this end, the basic question “Is there
consequences of child sexual abuse on the a significant association between CSA and
victims were without being clearly seen yet. psychopathologies (depression, panic anxiety,
The debate over the effects of child sexual and PTSD)?” was raised.
abuse has long history starting from Sigmund
Freud; the issue has been taken up again in MATERIALS AND METHODS
several studies of sexuality since then (1, 4).
Even today, although research findings show a Cross-sectional survey design was employed to
considerable inconsistency across studies, most explore the association between major
research works have concluded that sexually psychopathologies with a history of CSA among
abused children are more prone to a range of high school female students. Since the main
mental and behavioral aberrations including purpose of the study was comparing females
somatoform disorders, sexual dysfunction, who had a history of sexual abuse with non-
sexually acting out behaviors, dissociation, abused counterparts in terms of their
physical injury, and relationship difficulties in vulnerability to psychopathologies, the
childhood, adolescence, and adulthood than researcher employed quantitative approach. The
children with no history of sexual violence (4, study was undertaken in one of the regional
10). However, a specific characteristic pattern of states of Ethiopia, i.e. Oromia Region, Jimma
symptoms has not been identified while there are Zone in the year 2010. Out of the total 27 high
several hypotheses on the causality of these schools of the study area, 5 (20%) high schools
associations. (i.e. Sokoru, Dedo, Saka, Agaro, and Seto) were
Generally, recent theories that explain the incorporated in the study using simple random
effects of childhood sexual abuse have sampling technique.
encouraged the studies on the associations Since ample studies have claimed that
between certain characteristics of abusive females are more vulnerable to sexual abuse
experiences and mental health conditions (11). than males, this study covered 1522 Grade Ten
However, in most cases, these associated female students as the study population. Of
consequences have been roughly mentioned these, 400 (i.e., 75 from Sekoru, 55 from Dedo,
using retrospective data and unstandardized 82 from Seka, 93 from Agaro, and the rest 95
tests/scales (13), specially, in Ethiopia. In from Seto) of them were taken as respondents of
addition, studies have indicated that females are the study using stratified random sampling
more vulnerable to anxiety and mood disorders technique. Grade Ten students were
than males (14). For instance, approximately purposefully selected because all the 3 adopted
one-third of the female population across the scales were developed for adolescents. Thus, the
world experience depression (15). Likewise, researcher believed that Grade Ten students
studies have also shown that the same proportion were in the most appropriate age group.
(one-third) of females have been sexually Instrument and Procedure: Relevant data were
abused before the age of 18 (16, 17). Thus, gathered using structured questionnaire. The
 Psychopathological Correlates of Child Sexual… Alemayehu H 34

Reynold’s Adolescent Depression Scale employed the two sample t-test so as to analyze
(RADS), containing 18 items was adopted and the relative association of psychopathologies
used for measuring depression symptoms. with the history of CSA for all the three scales
Similarly, Goldberg’s Adolescent Panic Anxiety were simultaneously administered to the same
Scale and PTSD Scale were adopted on the basis groups of respondents .
of DSM-IV and ICD-10 classification criteria
consisting of 19 and 14 items respectively. RESULTS
These scales were composed of items rated on a
6-point Likert-type format with scores ranging This section presents the findings of the study
from 1 (almost never) to 5 (most of the time). In beginning with the description of the prevalence
developing the questionnaire, all the necessary of CSA and moving on to psychopathological
steps were followed. Initially, items were correlates to CSA. Even though 400 females
prepared based on the purpose of the study. were participated in the study, only 379 filled
Then, all items were evaluated by three experts out the questionnaire properly. Among these, the
to check the content validity of the instrument. majority, 185 (49%), were Muslims and 136
As a result of this, a few items were discarded (35.7%) were Orthodox Christians while the
and some were modified. Before the remaining 58 (15.3%) were protestants.
questionnaire was disseminated to the larger Regarding their marital status, only 16 (4%)
sample population, a pilot test was administered were married, whereas the vast majority, i.e. 363
to 60 randomly selected female students. Based (96%) of them were single.
on the results of the pilot test, the reliability of
each scale was computed using Cronbach's alpha The prevalence of child sexual abuse:
and the following were found: r=0.91, r=0.82 Regarding the history of sexual abuse,
and r=0.85 respectively for the above indicated respondents were asked to rate experience of
scales. Ultimately, the questionnaire was sexual assault (verbal such as insulting children
administered. using taboo sexual words; visual-
Data Analysis: The analysis and interpretation displaying pornography, forcing one to show
of the data were carried out using both his/her sex organ or forcing you to see
descriptive and inferential statistical techniques somebody’s sex organ and physical, i.e.
through SPSS statistical package. First, some fondling, touching in a sexual manner, and
basic information and the prevalence of the raping).They were required to respond to this
problem among respondents were analyzed question by choosing ‘Yes’ or ‘No’ in the two
using descriptive statistics (percentage, mean items indicated in table 1.
and frequency distribution), but, the researcher

Table 1: Prevalence of child sexual abuse, Jimma Zone, March 25, 2010.

Yes No
Exposure to Sexual Abuse Frequency % Frequency %
Have you experienced sexually abusive advances 53 16.6 326 83.4
before in my life?
Have you ever come across other children who 374 98.4 4 1.6
had been sexually abused?
* Items measuring the history of CSA among respondents

The result depicted that despite the fact that In addition, results of the study illustrated in
almost all (N=374, i.e. 98.4%) of the Table 2 below reveal that more than half
respondents came across other children who had (N=194, i.e. 51.3%) of the respondents began
been sexually abused, only 53 (16.6%) of them sexual relationship. Of these, 48(12.7%) of them
reported that they personally experienced reported that they began sexual intercourse
sexually abusive advances before the age of 18. during an age when sexual consent cannot
35 Ethiop J Health Sci. Vol. 23, No. 1 March 2013

legally be given (i.e. before the age of 15). ranges from 0 (not at all) to 5 (all the times). The
However, rape (N=7, with x=1.80), making results show that verbal sexual abuse (N=53,
children look at somebody's genital organ, and with mean x=4.83) and fondling in a socially
touching around the genitals were among unacceptable manner (N=36, with x=4.61) were
infrequently occurring forms of CSA. the two most frequent forms of CSA among
respondents.
Table 2: The respondents’ ages, Jimma Zone, Correlates (i.e. depression, panic anxiety,
March 25, 2010. and PTSD) of CSA were examined by the two
sample t-test statistical package. The following
Age Responses tables display the mean difference, SD, and t-test
No % results.
< 15 years 48 12.7 As illustrated in Table 3, the sample mean of the
16-17 years 74 19.6 difference scores is 28, with a standard deviation
>18 years 72 19 of the differences given by 1.36. The calculated
Not yet experienced/ 181 48.7 t-statistics (with 52 df) is given by 3.83, which
started has a p-value of 0.018. At p=0.05 level, we
Total 379 100 reject H0 and conclude that the history of CSA
has an effect on depression. This explicates that
†Age distribution at which respondents began sexual respondents with childhood sexual abuse
intercourse demonstrated a significantly higher mean score
(X=61) on the depression scale than did those
Forms of child sexual abuse: Again, those 53 without the history of childhood sexual abuse
respondents with a history of CSA were asked to (X=33). Thus, this implies that victims of child
look back into the forms of sexual advances sexual abuse are more vulnerable to develop
performed by their perpetrators. At the same symptoms of depression than non-abused
time, they were also requested to rate the counter parts.
frequency of each form in a 6-point scale that

Table 3: The two sample t-test results for depression, Jimma Zone, March 25, 2010.

Psychopathological Unabused Abused Mean t Sig.

Variable Mean (X1) N1 Sd1 Mean(X2) N2 Sd2 Difference
Depression 33 325 5.3 61 53 3.96 28 3.83 0.018‡
‡ Statistically significant at p<0.05 level

Similarly, a paired t-test was computed to difference in the mean values of panic anxiety
ascertain the link between CSA and panic score (X=57) among females with the history of
episode. The result demonstrated that the sample CSA and those without it (X=26). This implies
mean of the difference is 31 with a SD of the that one of the associated factors with panic
differences =0.53, t=2.46 (with 52 df) at anxiety disorder, especially among females, is
p<0.013. That is, at p = 0.05 level, we can reject CSA.
H0 and conclude that there is a significant

Table 4: The two sample t-test result for panic anxiety, Jimma Zone, March 25, 2010.

Psychopathological Unabused Abused Mean t Sig.

Variable Mean(X1) N1 Sd1 Mean(X2) N2 Sd2 Difference
panic anxiety 26 325 4.70 57 53 5.23 31 2.46 0.013§
§ Statistically significant at p<0.05 level
 Psychopathological Correlates of Child Sexual… Alemayehu H 36

With the same trend, the degree of association presence of a substantial difference between the
between PTSD and history of child sexual abuse mean values of the two groups (X=42 and
was examined as illustrated in Table 5 above. X=18) of respondents in terms of their
The result of the t-test (t=4.23, df =52, mean susceptibility to PTSD.
difference of 24; p=0.015) indicates the

Table 5: The two sample t-test result for PTSD, Jimma Zone, March 25, 2010.

Psychopathological Unabused Abused Mean t Sig.

Variable Mean(X1) N1 Sd1 Mean(X2) N2 Sd2 Difference
PTSD 18 325 7.84 42 53 5.72 24 .23 0.015

Statistically significant at p<0.05 level

DISCUSSION significant difference between sexually abused

females and unabused counterparts in their mean
Most previous studies on the issue of CSA scores of depression, panic, and PTSD test
estimated the incidence of child sexual abuse to scores. This shows the presence of a significant
be at least 6%–17% (4, 5). Likewise, the result difference between mean values of the two
in this study depicted that 53 (16.6%) of the groups in their depression, panic episode, and
respondents experienced sexually abusive PTSD test scores. In other words, respondents
advances that ranged from verbal harassment to with childhood sexual abuse experiences
rape before in their life, whereas a huge portion demonstrated a significantly higher mean score
(N=374, 98.4%) of the respondents came across of depression (X=61), panic episode (X=57),
other children who had been sexually abused. and PTSD (X=42) than did those without the
This implies that there might be unreported and history of childhood sexual abuse, who exhibited
overly-tolerated (due to some socio-cultural and mean scores of 33 for depression, 26 for panic
other unknown reasons) cases of sexual episode, and 18 for PTSD. Generally, females
molestations against female children. Moreover, who were sexually abused had higher mean of
more than half (N=194, i.e. 51.3%) of the self-report depression scores. They also
respondents began sexual relationship; among indicated more incidences of panic, and PTSD
these, 48(12.7%) of teens reported that their age syndromes than their counterparts.
of sexual onset was <15. In sum, the findings of this study revealed
Findings of earlier studies (1, 4, 6, 8) that a substantial proportion (16.6%) of the
reported that subjects with sexual abuse history respondents had history of sexual abuse
often encounter a range (in terms of both manifested through verbal, visual, and physical
severity and complexity) of psychopathologies sexual advances. There were also two additional
than unabused groups. Similarly, in this sets of evidence supporting the existence of the
particular study, a comparison was made problem. The first one was based on whether the
between sexually abused and unabused groups respondents had ever come across other children
of respondents in terms of their vulnerability to who had been sexually abused or not. And the
depression, panic anxiety, and PTSD. To this second type of evidence was their age of sexual
effect, as indicated in Table 3, Table 4 and Table onset. Accordingly, 98.4% of the respondents
5 above, a two-sample t-test was conducted for knew other females who had been sexually
each of the psychopathological variables and the abused; and 12.7% of them also reported that
results were t=3.83 for depression, t=2.46 for they began sexual intercourse during an age
panic episode, and t=4.23 for PTSD test scores when sexual consent cannot legally be given (i.e.
with df=52 at p<0.05 level. When we compare before the age of 15). Generally, all these
the t-test values with the critical value of t (52) premises, disclose the prevalence of child sexual
=1.676 at P=0.05, the data give evidence of a abuse among the study population.
37 Ethiop J Health Sci. Vol. 23, No. 1 March 2013

Principally, this particular study found out that ACKNOWLEDGEMENTS

that females with sexual abuse are more
susceptible to develop or be affected by I would like to express my deep gratitude to all
psychological aberrations, specifically, individuals who provided valuable comments
depression, panic anxiety and PTSD than and guidance in the process of the study.
unabused females. Likewise, the findings from Particularly, I extend my special thanks to Ato
this study showed that a history of childhood Teshome Belayneh who translated the
sexual abuse has an adverse consequence on the instrument into Oromo Language (i.e. the
future psychological wellbeing of females. mother tongue of most of the respondents). His
Specifically, they are more susceptible to friendly and professional supports were quite
develop or be affected by depression, panic useful for the success of the study. My sincere
anxiety, and PTSD than non-abused females. gratitude also goes to W/o Kidist G/Mariam who
However, the study is not without supported me in writing and editing the various
limitations. One of the drawbacks that might drafts of the study. Finally, grateful
adversely influence the results of the study was acknowledgement is due to Jimma Zone
recall bias which is the common phenomenon Education Bureau and administrators of the
among retrospective studies. Moreover, it is not target high schools for allowing me to collect all
clear whether the observed symptoms of the necessary information vital for the study.
psychological disorders preceded the abusive
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