Table of Contents

Background -
The Project

Introduction - 
The Topic


Selected Resources for Researchers, Educators and Consumers

Monographs
Journal Articles
Dissertation
Newspaper Articles

Sources Of Additional Information
Author Index
Reviewers


 

 

Title: Selected Resources on Sibling Abuse
Entry Date: 10/94
Author: Billie H. Frazier, Ph.D.
Organization: University of Maryland, CES
Document Type: Annotated Bibliography
Document Size: 8K or 36 Pages


Selected Resources on Sibling Abuse:
An Annotated Bibliography For
Researchers, Educators and Consumers

SRB 94 - 08
Special Reference Briefs

Billie H. Frazier, Ph.D., CFLE
Associate Professor
Human Development Specialist
Cooperative Extension Service
University of Maryland

Kathleen C. Hayes, M.S., C.H.E.
Coordinator
Technology Transfer Information Center
National Agricultural Library
U.S. Department of Agriculture

The inclusion of a publication in this Special Reference Brief does not necessarily reflect U.S. Department of Agriculture (USDA) policy, nor does it imply any form of endorsement by USDA. USDA does not ensure accuracy of the information in this publication.

Background - The Project

The National Agricultural Library and the Maryland Cooperative Extension Service have been cooperating annually since 1989 to produce bibliographies related to family topics. The earlier bibliography topics addressed various issues of aging, while some of the more recent topics have identified literature related to areas of human development, such as "adult children living at home" and "emotional abuse."

This bibliography, begun in July 1993, is a compilation of selected materials on Sibling Abuse, a type of family violence which receives little attention. Although the topic is relatively obscure, the literature review revealed that sibling abuse, or violence between siblings, is quite common. In fact, it has been shown to be even more common than child abuse (by parents) or spouse abuse. Because of the potential lasting harmful effects on children that often extend into adulthood, the authors felt it was essential to compile what information is known about prevention, intervention and remediation.

The authors hope this annotated bibliography will stimulate further empirical research into the causes, dynamics, and effects of sibling abuse. The additional research will constitute a basis for developing more effective prevention, intervention, treatment, and educational programs. The authors also hope this information will make parents and educators aware of the contributions they can make in their nurturing, supportive, and advocacy roles for children.


Introduction - The Topic

Sibling abuse is defined as physical, emotional or sexual abuse of one sibling by another. It ranges from relatively mild forms of aggression occurring between siblings, such as pushing and shoving, to extremely violent behavior such as the use of a gun or knife by one sibling against another.

Excluding acts such as slaps, pushes, kicks, bites, and punches, it has been estimated (Gelles and Strauss, 1988) that three children in 100 are dangerously violent toward a brother or sister. When all types of mild aggression and extreme violence toward a sibling are considered, the estimate soars to more than 36 million individual acts of sibling aggression each year. It appears that sibling abuse is the most common and the most overlooked form of family violence.

Our understanding of the dynamics and causes of how sibling abuse is learned is greatly hindered by lack of research. Typically, fights and other physical forms of aggression among siblings are expected. Because of this, sibling abuse often is unidentified as a problem until serious injuries occur, or until the child hurts someone outside the family.

There are some factors that appear to contribute to the occurrence of sibling abuse. In our society, parents accept sibling rivalry as part of family life. It is not unusual for siblings to use violence as a means of control. Parents often excuse sibling abuse as simple sibling rivalry or "boys will be boys." However, when parents fail to intervene, they give permission for the sibling abuse to continue. Children also tend to learn about violent behavior from several other sources. They observe violence in the media, and sometimes in their family, among their peers, and in their neighborhoods. Children who witness or experience violence tend to use it against their siblings. One author stated that if you grow up and see violence between everyone else in the household, you not only learn the behavior, but also the justification and the morality of it, as well. It becomes acceptable for big people to control and punish little people.

Childhood is a time of strong competition. Parents can inadvertently exacerbate a potential sibling problem by making comparisons between the children or by labeling children. Sometimes parental favoritism is the real cause of a child's hostility toward a brother or sister. Having "favorites" in a family can be just as devastating as overt abuse. It can affect the favored child, as well as the non-favored child.

Within the last few years, researchers have been investigating lasting deleterious effects of early experiences with sisters and brothers. We now are beginning to understand the strong, sometimes long lasting effects siblings have on one another's emotional development as adults. Studies have shown that women who recall painful physical or emotional abuse by a sibling during childhood are much more likely than men to suffer from depression, anxiety, and low self-esteem as adults. Men who recall abuse by a sibling are more likely to suffer from low self esteem. Adults who suffered from sibling abuse as children, are often less trusting and less likely to feel that the world is a predictable place. Inability to trust; relationship difficulties; and alcohol, drug and eating disorders also have been linked to sibling abuse in childhood.

Even less extreme sibling rivalry during childhood can create insecurity and poor self-images in adulthood. Sibling conflict does not have to be physically violent to take a long lasting emotional toll. Emotional abuse, which includes teasing, name calling, and isolation can be just as detrimental.

All siblings fight, and all siblings call each other names, and some play doctor. But there is a difference between typical behaviors and abuse. There are a few guidelines to help parents make this distinction. One of the most important questions parents can ask themselves is, "Is one child constantly a victim of a sibling?" If the answer is "Yes," parents need to intervene, identify the source of the problem, and carefully monitor interactive behaviors between the children in the future.

Siblings are agents of development in the cognitive, social, and affective domains. Siblings teach one another cooperation and competition skills. For instance, college students with a history of positive sibling relationships have the easiest time getting along with roommates. They have a good sense of boundaries, show respect for others, and expect to be treated fairly in return. Experts agree that healthy sibling relationships can be tremendously beneficial not only during college but also throughout life.

References

Family Violence: An Overview. Office of Human Development Services, National Center on Child Abuse and Neglect. Washington, DC: U.S. Department of Health and Human Services, January 1991.

Wiehe, Vernon. Sibling Abuse: Hidden Physical, Emotional and Sexual Abuse (2nd ed). Thousand Oaks: Sage Publications, 1997.


Selected Resources For Researchers, Educators and Consumers

Monographs

Characteristics of Male Adolescent Sibling Incest Offenders. Preliminary Findings. O'Brien, Michael J. Orwell, VT: The Safer Society Program, 1989.

The author investigated demographic, sexual, individual, and family variables to determine unique characteristics of 170 male adolescent sibling incest offenders who were referred for evaluation to an outpatient mental health clinic. The sample was subdivided into three groups: sibling offenders, child molesters, and nonchild offenders. Data from a confidential questionnaire, intake data form, and demographic report were analyzed, comparing sibling incest offenders with the other offender types. Family environment, socialization and sexual victimization were etiological factors investigated.

Results challenge the previously held assumption that sibling incest is a benign phenomenon. A distinction needs to be drawn between peer-age siblings who engage in mutually consenting exploratory sexual behaviors, and children who sexually exploit their brothers or sisters over whom they have power, whether implied by age or status, or expressed through intimidation or force. The latter group represents serious sex offenders in need of intervention and treatment.

Generally, the sibling incest offenders came from the most dysfunctional families-- those having high rates of physical, sexual, and drug/alcohol abuse. There was some evidence to suggest a multigenerational transmission of incestuous dynamics. Also, when compared to the other two groups, the sibling incest offenders were most likely to have been sexually victimized prior to initiating their sexual offending behaviors. Of the sexually victimized sibling incest offenders, two of three were abused by family members or relatives.

Data show a significant association between choice of victim by gender and the adolescent's own experience as a victim of sexual abuse. An adolescent who was victimized by a male was more likely to choose a male victim, or both male and female victims. An adolescent victimized by a female or never sexually victimized was most likely to choose a female victim. The sibling incest offenders had significant deficits in socialization skills. They were more conduct-disordered than the child molesters or nonchild offenders, and more likely to have been involved in previous therapy.

The Common Secret: Sexual Abuse of Children and Adolescents. Kempe, R.S., and C.H. Kempe. New York, N.Y.: W.H. Freeman & Co., 1984.

The authors present information on why incest seems to be increasing, how to distinguish between various types of family affection, and signs of incestuous family relations. Types of incest are studied at the preschool years, early school years, and early and later adolescence. Specific topics addressed include mother-son incest, homosexual incest, and sibling incest.

The authors distinguish between normal and abnormal sexual activity between siblings, and they state that if the incestuous relationship is carried on through later adolescence and into adulthood, the consequences can be serious, particularly on the potential for successful marriages. Sibling incest may be true sexual abuse when it is forced with threats of bodily harm on a younger child by an older sibling.

Family Violence: An Overview. U.S. Department of Health and Human Services, Office of Human Development Services, National Center on Child Abuse and Neglect. Washington, DC: U.S. Department of Health and Human Services, January 1991.

This monograph is one of the resources used to develop the introduction to this bibliography. It provides a comprehensive outline of print materials related to family violence. Topics discussed include: Spouse Abuse/Domestic Violence; Elder Abuse and Neglect; Child Abuse and Neglect; Other Types of Family Violence; Effects of Family Violence; Federal Response to Family Violence; State and Local Responses to Family Violence.

Family Violence in American Families: Risk Factors and Adaptations to Violence in 8,145 Families. Strauss, Murray A. and Richard J. Gelles, eds. New Brunswick, NY: Transaction Publishers, 1990.

The editors present an in-depth overview of violence in contemporary families in the United States. They draw on data from two landmark investigations. The book is written for the scholarly community.

The section on violence by children (ages 3 through 17), states that children are the most violent people of all in American families. The rates are extremely high for violence against a sibling--eight hundred out of one thousand had hit a brother or sister, and more than half had engaged in one of the acts considered to be severely violent. The finding was a surprise, although it could have been an obvious prediction because of the well-known tendency for children to imitate and exaggerate the behavioral patterns of parents and because there are implicit norms that permit violence between siblings, exemplified by phrases such as "kids will fight." It was shown that two-thirds of American teens, ages 15-17, assault a sibling at least once during a year, and in over a third of these cases, the assault involved an act with a relatively high probability of causing injury (kicking, punching, biting, choking, or attacking with a knife or gun).

In the section on "Assaultive Families and Violence by Children in the Family," the authors ask the questions: "Are children who experience physical assault from parents and who witness assaults between their parents, or both more likely than other children to engage in violence toward family and nonfamily members?" Data indicate that the rate of sibling violence is higher among children in families in which child assault and/or spouse assault are present, and highest of all when both child assault and spouse assault are present. However, the analysis shows that sibling violence is more strongly associated with child assault than with spouse assault. Although the relationships between sibling violence and violence in other family relationships for both boys and girls is similar, boys display more assaultive behavior toward siblings than girls.

Data were presented to suggest that perhaps minor violence and violence that is severe enough to be classified as a criminal assault, are learned family behaviors. There were no significant differences in rates of sibling violence for children from blue or white collar families. Child assault victimization is significantly related to sibling violence for both socioeconomic groups. The highest rates of sibling violence occur among children from multiassaultive families, regardless of social class.

Intimate Violence in Families. Family Studies Text Series, Volume 2, 2nd ed. Gelles, R.J. and C.P. Cornell. Newbury Park, CA: Sage Publications, Inc., 1990.

Chapter 5, "Hidden Victims: Siblings, Adolescents, Parents, and the Elderly", examines family relations that have been largely overlooked. It focuses on sibling violence, not sibling abuse.

Violence between siblings is so common that people rarely think of these events as family violence. The author states that sibling violence is the most common form of family violence.

Sociologists have found that parents feel it is important for their children to learn how to handle themselves in violent situations. Parents do not actively discourage their children from becoming involved in disputes with their siblings. In fact, parents may try to ignore aggressive interactions, and only become involved when minor situations are perceived as escalating into major confrontations. Sibling rivalry is considered a "normal" part of sibling relations, and many believe that such rivalry provides a good training ground for successful management of aggressive behavior in the real world. Parents generally feel that some exposure to aggression is a positive experience that should occur early in life. Parents view frequent and violent confrontations between siblings as inevitable. The author describes sex, age, and other factors related to sibling violence.

Some researchers have postulated that sibling violence is a learned response. Some sociologists believe that siblings learn from their parents that physical punishment is an appropriate technique for resolving conflicts. In comparison, children who are raised in a nonviolent environment learn that there are a variety of nonviolent techniques available for resolving conflicts with brothers and sisters, and later with their spouses and children.

"The Role of Siblings and Peers." McHale, S.M., and W.C. Gamble. In Special Children-Special Risks. Eds. J. Garbarino, P.E. Brookhouser, and K.J. Authier. Hawthorne, NY: Aldine de Gruyter, 1987.

This chapter discusses the normalization movement of disabled children from institutions back into family and community settings. The authors stress the importance of preparing peers, siblings, and adults to face the challenges presented by special children as they re-enter family and community settings. However, the review of the literature suggests many potential positive consequences for disabled children who spend their time with nonhandicapped siblings and peers. It is the responsibility of parents and concerned professionals to establish optimal conditions for promoting positive relationships between children. The preventive approach is key to the overall strategy to create and maintain safe environments for disabled children.

Parents and professionals may fail to regard "sibling abuse" as pathological because (1) they consider such aggression as normative, or children are "just going through a stage"; (2) they think children are not strong enough to inflict severe harm; (3) they believe they ultimately can control such bouts of aggression by using physical force themselves; and (4) most importantly, they believe these aggressive exchanges occur between equals.

The precipitants of sibling aggression are unknown. It has been suggested that poor parenting leading to emotional disturbance may be one basis of pathological levels of aggression exhibited by one sibling toward another. One authority sees sibling rivalry as a natural consequence of children's competition for a limited amount of parental attention and finite family resources.

Children will work to minimize competition by finding their own niche in the family. Thus, one child may become the family "scholar", and another the family "artist." When parents' rewards are distributed only to children who assume certain roles, and when the competition for those rewards is extreme, a child may assume the role of the "black sheep" and seek only negative kinds of attention. To avoid this problem, parents are told to "put all children in the same boat" rather than taking sides in a controversy, to spend time alone with each child, and to attend to and reward the unique abilities and achievements of each child.

Wiehe, Vernon. Sibling Abuse: Hidden Physical, Emotional and Sexual Abuse (2nd ed). Thousand Oaks: Sage Publications, 1997.

This book of landmark proportions is written for both therapists and parents. The author sheds light on the physical, emotional, or sexual abuse of one sibling by another. Testimonies of victims describe the abuse they received at the hands of a sibling, the devastating impact it had on their lives, and what their parents could have done to prevent it.

The book addresses normal sibling interactions versus abusive behaviors; psychological effects of sibling abuse on victims; parents' reactions to sibling abuse; and the role of parents in preventing abuse.

Dr. Wiehe identifies criteria for evaluating sibling interactions and provides practical guidelines for preventing abusive or potentially abusive behaviors.

Special Issues in Child Sexual Abuse. Green, A.H. In Child Sexual Abuse: A Handbook for Health Care and Legal Professionals. Eds. D.H. Schetky and A.H. Green. New York, NY: Brunner-Mazel, Inc., 1988.

The author states that although sexual contact between daughters and their fathers or step-fathers is the most frequently reported incestuous activity, incest between siblings probably occurs more frequently. The author cites a survey of New England students that revealed that while only 1 percent of the girls were victims of incest with their fathers or stepfathers, 15 percent had sexual contact with a sibling. Eighty percent of these girls were sexually involved with their brothers, while 20 percent had homosexual contact with their sisters. None of the boys reported parental incest, while 10 percent participated in sibling incest which was equally divided into brother and sister incest. Ninety percent of the girls and 80 percent of the boys were 12 or under at the time. The girls reported that 30 percent of the sibling incest took place under the threat of force.

Green identified the factors which might contribute to the development of sibling incest as parental and family psychopathology, and sibling psychopathology. The traumatic impact of sibling incest depends on the type of molestation; frequency, duration, and extent of the sexual contact; the degree of coercion and physical force applied; the discrepancy of age between the siblings; and the nature of the sibling relationship. Long term sibling incest involving coercion and physical threats or violence with a significant difference in age between the perpetrator and victim is likely to be more damaging than a mutually consensual exploratory sexual contact between siblings close in age. Some researchers have presented evidence that homosexual incest may be more pathogenic than heterosexual incest because the former involves the breaching of an additional taboo, homosexuality.


JOURNAL ARTICLES

"Abused and Non-Abused Children's Perceptions of Their Mothers, Fathers and Siblings: Implications for a Comprehensive Family Treatment Plan." Halperin, Sandra L. Family Relations. Jan. 1981; 30(1): 89-96.

In this study, the author reported two basic differential patterns that arise when children from abusive families are compared with those from nonabusive families. First, both abused and nonabused children from abusive families seem to have more negative feelings and perceptions and fewer positive ones toward their parents and siblings than children from nonabusive families. Second, the children from abusive families also have more feelings of ambivalence toward their parents than do children from nonabusive homes.

It is argued that the entire family system must be assessed and treated. The author proposes a comprehensive treatment model for abusive families.

"Adolescents May Experience Home, School Abuse; Their Future Draws Researchers' Concern." Randall, T. Journal of the American Medical Association. June 1992; 267(23): 3127-3128, 3131.

The author reviewed two studies and reported that sibling abuse is perhaps the most common form of violence within families. Of the students surveyed who had siblings living at home at age 12 years, almost half were victims or aggressors of "violent acts of kicking and punching". Ten percent said their siblings beat them up, and 4 percent said their siblings threatened them with a knife or gun, or had used a knife or gun against them.

In a survey of middle and senior high school student attitudes, 74 percent of the students approved of hitting one's sibling if one is reacting to being hit first. Forty-three percent approved of hitting if the sibling breaks one's stereo; 38.5 percent approved if the sibling makes fun of the student in front of friends; and 24.8 percent approved if there is an argument, and the other sibling does not listen to reason.

The author states that violence between children is so commonplace that it is perceived as "normal" childhood behavior. Parents take it for granted that "kids will be kids", and tend to ignore sibling violence. Yet, it can have long-lasting effects.

The researcher found that parents often "hotly defended" the aggressive child and were either unaware or refused to believe that their children behaved violently toward one another, especially when weapons were involved. It was found that families with sonsonly consistently have more sibling violence than families with daughters-only. This difference increases as the children mature, until it is twofold by ages 15 and 17 years.

"Child Abuse By Siblings." Green, Arthur S. Child Abuse and Neglect. 1984; 8: 311-317.

The case studies of five children who inflicted serious injuries on their young siblings are described in detail. The children shared the following experiences. They had been physically abused themselves; their families were undergoing crises, which accentuated their maternal deprivation and rejection; they were burdened with excessive caretaking for the target sibling, who was perceived as the favorite; and they also had experienced the recent loss of their father or paternal caretaker.

The psychodynamics associated with sibling abuse represented an intensification of "normal" sibling rivalry due to the abuser's own maltreatment and deprivation. Pent-up rage toward the mother was displaced onto the sibling rival. The sibling attacks were adaptive for the abusers in the following ways: (a) they afforded them a measure of revenge against the more highly regarded sibling rival; (b) they served as an outlet for rage directed toward the mother; (c) they were used as an attention getting device; (d) they provided a sense of mastery over the trauma of their own abuse; and (e) they were used to "educate" the abusing parent.

The author states that sibling abuse occurs in families torn by violence where patterns of maltreatment are passed from generation to generation. Since an abusing child usually has been abused, deprived, exploited, and rejected, one cannot help the child without intervening with the family unit. These families require a multidisciplinary treatment approach including crisis intervention, outreach, and the establishment of a supportive therapeutic relationship with the parent. The distorted parental perception and scapegoating of the abusing child should be explored and eliminated. The poor self-esteem of these children must also be a focus. Without intervention, children who abuse their siblings will be at risk for perpetuating their cruel and violent behavior in their relationships with peers, spouses, and with their own children.

"A Cross-Cultural Comparison of Sibling Violence." Steinmetz, S.J. International Journal of Family Psychiatry. 1981; 2(3/4): 337-351.

Sibling violence is probably not only the most prevalent and accepted form of family violence, but also the most potent form of violence. Sibling violence represents the child's first opportunity to engage in violence, acting out what has been witnessed and experienced. It is, therefore, a critical link for understanding and attempting to break the cycle of violence in the family. The practice of viewing sibling violence as a normal part of growing up, reinforces the acceptability of this method of resolving conflicts and provides an early opportunity for children to practice what they have observed and experienced.

In her review of the literature, the author mentions one study that revealed that 70 percent of young families used physical violence to resolve conflicts that usually centered around possessions. Sixty-eight percent of families with adolescents also engaged in physical violence in which conflicts tended to revolve around personal space boundaries--touching each other or "looking funny." Even among teenagers who fought over responsibilities and social obligations, 63 percent used high levels of physical violence. Data revealed that although male sibling pairs more often threw things, pushed, and hit than did female sibling pairs, the highest use of physical violence occurred between boy-girl sibling pairs, 68 percent of which engaged in high levels of violence.

The author conducted a cross-cultural comparison study using data from the United States, Canada, Finland, Puerto Rico and Israel to investigate methods used to resolve sibling conflicts. Preliminary analysis of data found no consistent conclusion about the relationship among siblings' use of discussion, verbal aggression, and physical aggression to resolve conflicts. Also, marital violence scores for a particular country did not predict the occurrence of sibling violence. However, more comprehensive analysis might reveal subtle relationships which are masked by group means.

Clear relationships are found when the data are analyzed by sex of the sibling pairs. Female sibling pairs had consistently higher discussion scores than did male pairs, and except in the Canadian sample in which brothers had higher verbal scores, the same trend was found for verbal aggression. Mixed-sex pairs had the lowest discussion and verbal scores in all countries but Canada, in which both scores were lower than either brother or sister sibling pairs. Consistent with other literature on aggression and violence, male sibling pairs were consistently more violent than female sibling pairs, although the lowest score tended to be among brother/sister sibling pairs.

Adjectives used to describe the paucity of research of sibling violence is illuminating. One author called sibling interaction the "neglected aspect in family life research," while another labeled the sibling relationship "the forgotten dimension."

"A Different Form of Abuse--Sibling Abuse." n.a. Child Abuse and Neglect. 1978; 2(3): 203-205.

The anonymous author of this article documents her personal experience as a victim of sibling abuse. She describes in great detail the hours of torture she experienced between the time she and her brother arrived home from school, and their mother arrived home from work. On her 18th birthday, she left home, never to return. As an adult, she became involved in therapy and worked in the field of child abuse. Through these, she was able to gain insight into some of her own behavior and to work through the after-effect of child abuse.

She wrote the paper because writing became a treasured refuge early in life, and it is highly therapeutic for her to organize and communicate her thoughts and feelings. She shared her experience so that readers may be aware that sibling abuse can occur, and that it can be a potentially serious problem.

"Effects of Older Brother-Younger Sister Incest: A Study of the Dynamics of 17 Cases." Laviola, M. Child Abuse and Neglect. 1992; 16(3): 409-421.

This author explored the effects of older brother-younger sister incest from the perspective of the women who experienced it. Seventeen women were interviewed with a semi-structured interview. Data were analyzed by organizing the women's perceptions and conceptualizations into common themes. All of the women's families of origin were described as dysfunctional. Typical effects reported included mistrust of men and women; chronic low or negative selfesteem; sexual response difficulties; and intrusive thoughts of the incest. To help them deal with the effects of the incest, the reporting women talked with supportive family members and friends, and validated themselves as victims at the time of the incest.

Half of the women reported that the age differential between them and their brothers was 5 years or less, and all of them perceived that they were either coerced or forced into the incest activity. They also reported negative long-lasting effects from the incest.

"Family Violence: Impact on Children." Kashani, J.H.; A.E. Daniel; A.C. Dandoy; and W.R. Holcomb. Journal of the American Academy of Child and Adolescent Psychiatry. March 1992; 31(2): 181-189.

Four types of family violence are discussed: violence toward children, siblings, women, and the elderly. The authors explore the development of violent family relationships from both biological and psychological perspectives. They examine risk factors for violence and the effects it has, as well as characteristics of the aggressor and the victim. Intervention strategies for various types of violent behavior are discussed.

The discussion on sibling abuse mentions that siblings do indeed play a shaping role in the development of aggressive behavior in both clinic and normal populations. It is suggested that coercive behavior by siblings makes a significant contribution to the development of coercive behavior that is independent of the contribution of parental behavior.

Effects on the child from sibling aggressiveness are still inconclusive. Parents are typically unaware of the abuse. However, the effects on the sibling from sexual abuse might mirror posttraumatic stress symptoms. In conclusion, the authors state that it is clear that the family is the first and most important source for the fostering of mentally healthy individuals. Their plea to people everywhere is to focus attention on this basic unit of socialization, and to develop policies and practices to support and protect the family.

"The Female Experience of Sibling Incest." Canavan, Margaret M., and Walter J. Meyer lll. Journal of Marital and Family Therapy. April 1992; 18(2): 129-142.

Four cases of females who experienced sibling incest illustrate problem areas or issues of enforced secrecy; interpersonal power differentials; influences on sexual development; individual aftereffects; disturbances in family dynamics; and gender-based difference in relationship styles.

Sibling incest is described as a significant interpersonal boundary violation with potentially devastating long-term effects. The experience creates an alternate path in sexual development for both partners who experience isolation, secrecy, shame, anger and poor communication.

The authors recommend that clinicians become familiar with signs that sibling sexual contact may be occurring in child clients, and be alert to the possibility that it is part of the history of their adult clients. It is important to sensitize parents, physicians and other caregivers of children to the problem so that prevention efforts can be implemented, and treatment can occur when needed.

"Forgotten Victims of Family Violence." Pfouts, J.H.; J.H. Schopler; and H.D. Henley, Jr. Social Work. July 1982; 27(4): 367- 368.

Family violence affects not only the children or women against whom it is directed, but also the children who must stand by helplessly. There has been almost no discussion on the plight of "uninvolved" children.

For this report, data on a sample of children who witnessed abuse within their families were gathered from case reports and interviews with either the social workers or supervisor responsible for each case.

Children who were witnesses to family violence coped better than those family members who were abused. Nevertheless, the uninvolved children were affected negatively by living in a violent milieu. Also, there were differences between children who saw their siblings abused and those who saw violence directed toward an adult family member. Children who stood by while their siblings were abused presented a picture of outward compliance, yet their incidence of anxiety, depression, and need for therapy gave evidence of internal stress.

Children who saw abuse directed toward their mothers appeared to suffer somewhat more emotional turmoil than those who observed abuse of their siblings. They also had a tendency to model the violent behavior of their parents.

This sketch of child witnesses within violent families is disturbing because the social workers who reported the information often understated the bystander's case. Although bystanders in violent families typically do not behave in ways that attract attention of the public or professionals, they should not be ignored. It is likely that these children (along with abused siblings) may be the abusing husbands and abused wives of the next generation.

The authors hope that this brief look into the effects that family violence has on its witnesses lends credence to the importance of conceptualizing child abuse and wife abuse as indicators of a dysfunction that affects every member of the family.

"Gender Dysphoria and Sexual Abuse: A Case Report." Zucker, Kenneth J., and Myra Kuksis. Child Abuse and Neglect: The International Journal. 1990; 14(2): 281-283.

The authors report a case of a gender identity disorder in an eleven year old boy who had been sexually coerced by his 16-yearold brother for the previous 2-3 years. The questions posed and discussed were: (1) Did the gender disturbance follow the onset of the sexual abuse and could it best be explained by this experience? (2) Did the child's prior development predispose him in any way to manifest this symptom? (3) What was the course of the gender disturbance following disclosure of the sibling sexual abuse?

The author states that the boy's desire to be a girl and to have his penis removed were shown to follow the initiation of sexual contact by the older brother. The boy had an earlier history of moderate femininity which may have made him vulnerable to gender identity conflict.

"Incestuous Victimization By Juvenile Sex Offenders." Pierce, L.H., and R.L. Pierce. Journal of Family Violence. Dec. 1987; 2(4): 251- 364.

Data are beginning to show that in a sizeable number of child sexual abuse cases, sexual encounters are being committed by juvenile offenders. Parents and professionals are beginning to see that what had previously been labeled "sexual experimentation" may be more serious. The authors used 37 cases from files of a local Child and Family Service Agency and reported on age difference between victim and offender; relationship between victim and offender; the act involved; the context in which the act occurred; and general demographic data about the offender's family.

Results indicate that the juvenile offenders almost always were victims of abuse themselves. It appeared that, especially for the young children in the study, sexual interactions with other children were the only way they may have known to be close. Juvenile offenders came from families that were confronted with numerous problems.

Many offenders came from broken homes, and many had parents who were seen as mentally ill.

The authors recommend that intervention should focus on the child and the child's victimization; and on helping the family become more functional and protective of the child. If this is not a possibility due to the extent of the family's problems, another permanent home should be established for the child.

The authors also suggest that new parents and foster or adoptive parents, should receive training so they can understand how prior abuse may affect a child's behavior. Also, parents should be made aware that sexual acting out cannot be set aside as exploration or nuisance offenses.

It is suggested that as we begin to become more aware of the juvenile offender's past, the frequency with which he or she has been a victim, and the effect that the victimization has on the offender's development, we will be better able to help offenders learn more appropriate behavior for responding to their needs and begin to break the intrafamilial cycle of sexual abuse.

"Long-Term Effects of Sibling Incest." Daie, Netzer; Eliezer Witztum; and Michael Eleff. Journal of Clinical Psychiatry. November 1989; 50(11): 428-431.

Although sexual abuse of children is recognized as a serious problem, sibling incest has received relatively little attention. A distinction was made between power-oriented sibling incest and nurturance-oriented incest. Relevant literature and four cases are presented. The cases illustrate the variety of sibling incest that exists, and they demonstrate long-term consequences for the perpetration. Difficulties in establishing and maintaining close sexual relationships is a major long term consequence. The authors emphasize exploitation and abuse as pathogenic aspects of sibling incest.

Factors contributing to long-standing damage in the four cases presented include: (1) considerable age difference between exploiter and victim; (2) length and character of the sexual relationship; (3) massive use of aggression and violence; (4) family constellation that does not encourage open communication either inside the family or with persons outside the family; (5) family communications that include a double message toward sexuality; and a (6) family constellation that encourages identity diffusion and problems with intergenerational boundaries.

The authors recognize that although many instances of benign sexual exploration between siblings occurs, there is a range of sibling incest that is exploitative and abusive.

"Maltreating Families: A Look At Siblings." Gilles, Jean Michelle, and Patricia M. Crittenden. Family Relations. 1990; 39: 323-329.

Beginning with the identification of the battered child syndrome in 1962, professionals have assumed that one child in a family is singled out as a scapegoat. However, a family systems perspective would suggest that dysfunction in one part of the family would be reflected in other parts and therefore negate the scapegoat hypothesis.

This study finds that reported abused children and their siblings are similar in stressful life experiences, quality of home environment, reported behavior problems, and the experience of maltreatment.

If, as this study suggests, siblings in reported families experience both maltreatment and developmental anomalies, investigators should view a report of maltreatment as indicative of a family in distress and, consequently, focus on all members of the family in order to provide appropriate assistance. Such investigations need to go beyond simply substantiating the report. They need to evaluate the functioning of family members both individually and within family relationships. Such an evaluation would provide information about strengths and resources as well as weaknesses and needs. Critical implications for social policy are discussed.

"The Self-Report of Personal Punitive Childhood Experiences and Those of Siblings." Rausch, K., and J.F. Knutson. Child Abuse and Neglect. 1991; 15(1-2): 29-36.

This study demonstrated that persons from severely punitive backgrounds are unlikely to classify their experiences as abusive, and are appreciably more likely to classify their siblings as having been abused. For persons whose punitive experiences or those of their siblings could be described as severely punitive, the classification of the experiences as abusive is, to some extent, a function of the degree to which the punitive experiences are perceived as deserved. "Deserved" punishment, even if severe, tends not to be perceived as abusive.

The authors suggest that assessments of specific experiences and perceptions of being deserving of punishment be included in studies of the long-term consequences of child physical abuse.

"Serious Sibling Abuse by Preschool Children." Rosenthal, P.A., and M.D. Doherty. Journal of the American Academy of Child Psychiatry. 1984; 23(2): 186-190.

Critical differences between sibling rivalry and pathological sibling abuse are identified in 10 cases. Three different psychodynamic formulations of sibling abuse were observed: (1) chronic parental abuse of the child; (2) unconscious, covert parental permission for the child's aggressive behavior; and (3) a child who identified with a dangerous, destructive person in the caretaker's life.

Most of the abusing children were the eldest, and most of the abusive interactions took place while parents were in close proximity. These abusive children had sad, helpless feelings, and experienced more sickness in their early years than did nonabusive children. They showed irregular sleep patterns, separation anxiety, and moodiness. Such children lacked empathy and a clear understanding of the consequences of their behavior. The authors state that the responsibility for modulating the child's behavior rests with parenting or other caretaking persons in the child's life.

"Sexual Interactions Among Siblings and Cousins: Experimentation or Exploitation?" De Jong, A.R. Child Abuse and Neglect. 1989; 13(2): 271-279.

In comparison to sibling incest, incest by cousins has not been well researched. Writers have reported that this form of abuse is at least as common or perhaps twice as common as sibling incest, and as common or more common than father-daughter incest. This study describes features of incest by cousins and siblings at a sexual assault center and differentiates abusive behavior from normal sexual exploration.

Four criteria were considered indicative of abusive behavior: (1) age difference of 5 or more years between victim and perpetrator; (2) use of force, threat, or authority by abuser; (3) attempted penile penetration; and (4) documented injury in victim.

Of 831 sexually abused children under 14 years of age, 49 cases of cousin incest (5.9 percent) and 35 cases of sibling incest (4.2 percent) were identified. A total of 54 male cousins abused 8 boys and 41 girls. Brothers abused 3 boys and 32 girls. The victims' median age was 5 years for cousins and 7 years for siblings. The perpetrators' mean age was l6.2 years for cousins and 15.5 years for siblings with 16 (19 percent) of all perpetrators being 16 years or less. Of the perpetrators, 66 (79 percent) were 5 or more years older than their victims. All 18 victims with age differences of 5 years or more met one or more of the other abusive criteria listed above.

Appropriate case management requires understanding of normal sexual experimentation and recognition of the abusive nature of these cases. No universally accepted criteria are available for distinguishing between abusive sexual contact and normal sexual exploratory behavior. Some studies have based their definition of sexual abuse on age criteria, some on the unwanted nature of the contact, and others on both.

A broad definition emphasizing the unwanted and exploitative factors of the sexual contact that includes age or developmental level is most appropriate. It was suggested that abusive sexual contact occurs when a child is less than 13 years of age and the perpetrator is 5 or more years older than the victim, or when a child is 13-16 years of age and the perpetrator is 10 or more years older than the victim. the partner.

"Sibling Incest: A Consequence of Individual and Family Dysfunction". Ascherman, Lee I., and Ellen J. Safier. Bulletin of the Menninger Clinic. Summer 1990; 54(3): 311-322.

Sibling incest has seldom been researched and remains poorly understood. The authors presented a case study and demonstrated that the incestuous relationship can be best understood when adequate attention is given to assessing the overlapping individual and intrafamilial factors that merge to create the climate for incest. It was suggested that evaluators of incest cases note the kind of incest, its context, the ages of participants, the family dynamics, and the individual psychopathology of family members to be able to adequately understand the incest and effectively plan a treatment program.

Numerous authors have suggested that sibling incest is the most common form of incest, but the least reported and least documented. Many concepts useful for understanding the incest-prone family have emerged. Most of the ideas developed from analyses of (step)fatherdaughter incest, the most commonly reported form of incest. Incestuous families have been described as dysfunctional and disorganized, with their members lacking role definition. They also have been referred to as enmeshed, secretive families whose disorganization arises from social isolation. The intergenerational re-creation of family disturbance and incest has been observed.

Little has been written to address the dynamics of sibling incest. One researcher cited circumstances where sex between siblings could occur, including: sex play among siblings that goes too far; situational pressures; personality disorders; family dysfunctions; assumptions of inappropriate family roles; or the consequence of encouragement or force by a third party. He also noted that sibling incest may not always be a situation involving one victim and one aggressor. Both may engage willingly in the activity as an attempt to cope with unmet needs that may include a desire for affiliation and affection; a combatting of loneliness or depression; a sense of isolation; or a discharging of anxiety and tension due to stress.

More violent forms of sibling incest involve an aggressor who acts out sexually to gratify needs for retaliation, retribution, power, or control. One researcher noted that sibling incest often occurs in families with distant, nonaffectionate parents. Children may turn to each other for emotional warmth, while others in a dominant position may forcibly take from young siblings what is not being given to them voluntarily.

"Sibling Incest: A Study of the Dynamics of 25 Cases." Smith, Holly, and Edie Israel. Child Abuse and Neglect: The International Journal. 1987; 11(1): 101-108.

Sibling incest is described as one of the most underreported and misunderstood areas of sexual abuse. Believed to be the most widespread form of incest, sibling incest is a sexual interaction between individuals who have one or both parents in common. Statistics indicate that the number of reports of sibling abuse cases to appropriate agencies is increasing.

The purpose of this descriptive study was to explore the frequently observed dynamics distinctive to the sibling incest family system, and to evaluate how these dynamics might predispose the family system to act out its dysfunction through sibling sexual conduct. Data are based on 25 families reported to a sexual abuse team during a three year period. Many common dynamics were observed: (1) distant, inaccessible parents; (2) parental stimulation of sexual climate in the home; and (3) family secrets, especially with regard to extramarital affairs. Implications of the study suggest that the emerging patterns are making prognosis and therapeutic intervention more encouraging.

"Siblings of Oedipus: Brothers and Sisters of Incest Victims." de Young, Mary. Child Welfare. Sept-Oct 1981; 60(8): 561-68.

The author investigates the roles and problems of the siblings of incest victims by illustrating two clinical cases. In one of the cases, the incestuous family is described as a character-disordered family that typically includes a patriarchal structure with role reversals, collusion, and a secretive, enmeshed quality. The author states that these characteristics foster incest and have other negative effects on nonvictimized siblings. Most researchers agree that incest can have short-term and long-term negative effects on incest victims.

"Treating Sibling Violence". Reid, W.J., and T. Donovan. Family Therapy. 1990; 17(1): 49-59.

The authors suggest that sibling violence is a widespread problem that can be distressful in its own right and can cause other family disturbances. This paper presents a problem-solving, task-centered model for treating sibling violence. The model emphasizes helping parents and siblings create rules for controlling sibling conflict. Rules are developed through in-session problem solving that includes direct negotiation between siblings. Rules are then implemented in tasks carried out between sessions. The model is illustrated with a single case evaluation.

Specific goals for the father were to talk to the boys instead of hitting them. The mother's goal was to follow through on consequences with the boys. The parent's goal was to spend more time together. The goals for the boys included: ask before using others' things; avoid name calling; and "back off" before fighting. All family members were expected to reduce physical fighting.

"The Use of Force For Resolving Family Conflict: The Training Ground for Abuse." Steinmetz, Suzanne K. Family Coordinator. 1977; 26(1): 19-25.

Respondents in a small exploratory study reported on how intrafamilial conflict was resolved in their family. The author found that verbal aggression was used as a conflict resolution mode in nearly all families. Physical aggression to resolve parent-child and sibling conflict occurred in about 70 percent of the families. Physical aggression to resolve husband-wife conflict occurred in 30 percent of the families. Intra-generational patterns of conflict resolution were found. Four types of intra-familial patterns were reported: screaming sluggers; silent attackers; threateners; and pacifists.

The author found a relationship between the method of conflict resolution used by spouses to resolve marital conflict and that which they used to resolve parent/child conflict. Findings suggest that children are likely to use similar methods to resolve disagreements between one another.


Dissertation

"Sibling Interaction in Abusive & Neglectful Families." Heilbrunn, Debbie Joan. Dissertation Abstracts International. 1986; 47(11-B): 4673.

An observational study of sibling interaction in abusive, neglectful, and nonabusive two-parent families provided data to explore the impact of abuse on verbal and physical social behaviors between siblings.

The author summarized the following conclusions drawn from a literature search on sibling interaction and relationships: (a) siblings may be thought of as "first peers" who provide children with some of their earliest social experiences; (b) sibling relationships generally endure the tests of time and intrarelationship struggles; (c) siblings act as models for the acquisition and development of social skills; (d) siblings may protect one another from hostile intra- or extra-familial influences; and (e) siblings are agents of development in the cognitive, social, and affective domains. Researchers have begun to isolate trends regarding the influence of siblings relationships on peer relationships.

Results of the reported study indicate that sibling interaction was related to the occurrence of parental abuse and neglect. Specifically, results found that:

  • Neglected children directed more positive behavior to each other than to their parents;
  • Older children were involved more often with siblings than younger children. They directed as well as received more verbal, positive, and negative behavior than did their younger siblings. Older children were more involved with siblings than with parents as compared to younger children.
  • Greater age differences between siblings appear to enhance sibling relationships.
  • Children's ordinal position significantly affected sibling interaction. First-borns (1) received fewer behaviors from siblings than did later-born children; (2) directed and received less negative behavior than did middle-born or last-born children; and (3) engaged in less verbal behavior in sibling interaction than later-born children. It appeared that first-borns, also, were less involved in sibling interaction than middle- and last-born children. These findings corroborate the literature which suggests that first-borns tend to be more adult-oriented than their laterborn siblings. Also, they may be perceived by siblings as having greater status and power.
  • Family size was strongly related to a number of sibling interaction variables. In larger families, as compared to smaller families, children received more positive behavior from siblings as compared with parents. There was also more verbal and physical interaction per child as well as more negative behavior among children. Sibling exchanges were more negative in larger families than in smaller ones.
  • In general, the rate of children's negative interaction with siblings was four times greater than positive sibling interaction. Children averaged 48 verbal and 21 physical sibling interactions per hour. Of the 69 sibling interactions, 1.6 were positive and 6.4 were negative.

NEWSPAPER ARTICLES

"Brother Against Brother." Daily News of Los Angeles. 20 November 1991, Section:TV Book, L75.

A real life landmark court case was depicted in a television movie about sibling abuse, the nation's most common and most overlooked form of family violence. In the movie a brother kills a brother. His lawyer advises him to plead not guilty and prove he was provoked by years of beatings at the hands of his brother. The mother did not want to admit there was a problem. An important lesson for parents is to stop this family problem before it gets out of control.

"E-mail Message Unlocks Memory of Sibling Abuse." Montgomery Express [Montgomery County, MD], 20 April 1994, A6.

After receiving a message that was signed with an abusive label that was used by a sibling on him as a child, the author reflected on his personal experience of being the victim of sibling abuse. The experience is described in the article.

"Flesh and Blood Adult Sibling Rivalry Is Often A Carryover From Childhood. These Destructive Relationships Can Be Healed, However, If Brothers and Sisters Are Willing To Explore Their Own Behavior. Newsday. 12 September 1992, Section: Part II, 17.

In this cover story, the writer states that experts say the sibling bond is the longest and most complex family relationship. Parents die, friends drift away and marriages dissolve, but siblings remain forever connected by blood and history. Psychologists say that sibling ties have a profound impact on nearly every aspect of one's life. One author states that sibling relations help shape intimate relationships with lovers and spouses, attitudes toward co-workers, and behavior toward children. Another author suggests that a sibling who can never compete against an older brother may have such feelings of inadequacy that he or she may have a hard time getting a promotion at work. One author found that 84 percent of people in a survey said they felt their parents "played favorites" in the family.

A healthy sibling relationship is one where channels of communication remain open, where envy and jealousy are tempered by admiration and love. It is when you can talk about things that bother or disappoint you.

In answer to how can siblings resolve the rivalry between them, the writer provides several ways. (1) Evaluate the problem; siblings rarely identify themselves as the source of the rivalry. (2) Ask friends or your spouse for their opinion; try to look at the situation objectively. (3) Make the first move. (4) If you decide to get together for a discussion, meet on neutral ground away from spouses and children. (5) Clear up misconceptions. (6) Stop the comparisons; avoid comparing yourself with the sibling. Instead, compare yourself with goals you have set for yourself. (7) Look at old stereotypes; get rid of labels.

One authority states that prevention depends on clearly defined standards. A parent must be able to say "You must not hit your sister, no hairpulling, kicking or biting." Then the parents must enforce the rule.

The articles identifies current references available at most book stands.

"Growing Up Scared: Sibling Abuse Leaves Deep Scars." Zupin, Fran H. State [Columbia, SC] 24 September 1992, Sec. Metro/Region, 3B.

The reporter interviewed Dr. Vernon Wiehe, who advised that sibling abuse can occur in any family, not just those living in poverty or having substance abuse problems. He advocates after-school care programs and urges parents to talk with children individually after they go out for the evening. Dr. Wiehe also suggests other important measures of prevention: teach children to "own" their own bodies; teach them to say no to unwanted sexual touching; and create a family atmosphere where sexual issues and problems can be discussed.

When trying to decide if sibling interaction is normal or abusive, parents and other adults might want to ask some questions, including: How often and how long has the behavior been going on? Is there a victim? Is there a purpose to the behavior? What are circumstances surrounding the behavior? What preceded the behavior? How did the victim feel about what happened?

"How To Spot and Deal With Sibling Abuse." Mary Jo Kochakian. Palm Beach Post. 20 October 1992, Section: Accent, 3D.

The writer quoted Stephen Bank, psychologist and co-author of The Sibling Bond. The author differentiated by minor and major sibling abuse. For example, minor abuse is when one sibling turns off the TV, grabs the control, and the siblings fight about it; or when one sibling gets a larger portion of ice cream and steals the sibling's share. Major abuse is siding with a sibling's friend against a sibling; blackmail; sexual contact; or repeated use of painful physical force to get something to which the sibling is not entitled.

Bank describes enduring effects of sibling abuse. The experience of repeatedly being a victim at the hands of anyone, when the unfairness of that power cannot be revealed publicly, is humiliating and can produce deep feelings of inferiority. One study found that female college students who had been abused suffered from lower self-esteem and higher levels of depression. Girls are more likely than boys to be abused by siblings, especially girls with older brothers. Sibling abuse is more common in childhood than in the teen years.

Sibling abuse is more likely to occur in families without clear standards of behavior. Parental over-involvement and neglect can also be problems.

"Mother May Have Missed Key Signs of Sexual Sibling Abuse." Daily News of Los Angeles. 5 May 1992, Section: LA Life, L4.

A 60 year old mother wrote to Ann Landers and described how her world fell apart when her youngest son of 17 committed suicide; her husband committed suicide two years later; the older son started to drink and ruined his life; and the daughter was diagnosed with a multiple personality disorder caused by being sexually abused and tortured by her older brother. The mother's advice to parents everywhere is parents must watch out for sadistic and abusive behaviors, many times acted out in secrecy. She added that when older children are given too much authority over younger ones, they can become skillful at hiding the truth from their parents.

Ann Landers said that perhaps the younger children were not taken seriously when they asked for protection against their cruel, older brother. She advised the mother to seek counseling and to talk about her grief with a professional.

"Recounting Abuse At Hands of a Sibling." Los Angeles Times. 23 May 1985, V. 104, Sec. V, p. 26, col. 1.

This news article is a personal account of abuse suffered by a sibling. Vivid descriptions are provided about behaviors that occurred between two children.

"Sad Facts About Sibling Violence." Foreman, Judy. Boston Globe. 20 January 1982, First Edition, Living Section, p. 53.

This article asserts that the bottom line is that when kids see their parents being violent against each other, they learn that people who love each other have a right to be violent. Researchers have distinguished between petty violence and abusive violence, and they believe that 29 million of the nation's 36 million children, ages 3 to 17, have engaged in petty violence. As children grow up, boys remain much more violent than girls.

One author states that people hit family members because there are no physical, social, or emotional costs to the abuser, and the least costly form of all family violence is hitting a sibling. A violent society teaches sibling violence. It is more a social issue than a psychodynamic one. The average child between 5 and 15 years of age witnesses the killing of 12,000 persons on television.

The causes of sibling violence include violence between parents; violence from parents toward children; major psychiatric problems in the child's development; living in a violent milieu, such as a violent housing project or with street violence; poverty; and social isolation.

An author's answer to the problem of sibling abuse is to put an end to all family violence by making the costs of abuse higher to the abuser.

"Severe Sibling Abuse Can Leave Long-term Harm, Study Finds." The Sacramento Bee Final. 15 August 1992.

The article cited two studies that linked childhood sibling abuse to greater anxiety, lower self-esteem, and a more depressed mood in college. The first study focuses on long term physical conflict and the psychological health of 202 students who were victimized by a high level of conflict with a sibling; initiated such conflict; started fights and were also attacked; and experienced normal levels of conflict. Conflict was more prevalent at ages 6 to 12 than at ages 13 to 18. Tests showed that for female victims, the higher the level of violence, the greater the anxiety and depression experienced.

The second study found that some kids are literally terrorized by their siblings.


Sources Of Additional Information

Hotlines

For immediate assistance in situations of abuse, call:

Local departments of Social Services. Telephone numbers are listed in the phone books under county government.

Childhelp National Child Abuse Hotline
(800) 422-4453 or
(800) 4-A-Child

This number provides crisis counseling, child abuse reporting information, and information and referrals for every county in the United States. Referrals include national, state, and local agencies. The hotline is staffed 24 hours a day, 7 days a week by mental health professionals.

For general information on family violence and abuse, contact:

C. Henry Kempe National Center for the Prevention & Treatment of Child Abuse and Neglect 1205 Oneida Street
Denver CO 90220

Clearinghouse on Child Abuse and Neglect and Family Violence Information
National Center on Child Abuse and Neglect P.O. Box 1182
Washington, DC 20013
(703) 821-2086

International Society for Prevention of Child Abuse and Neglect 1205 Oneida St.
Denver, CO 80220
(303) 321-3963

National Committee for Prevention of Child Abuse 332 S. Michigan Ave., Suite 950
Chicago, IL 60604
(312) 663-3520

National Council on Family Relations
3989 Central Avenue, NE
Suite 550
Minneapolis, MN 55421
(612) 633-6933

National Resource Center on Child Sexual Abuse (NRCCSA) 106 Lincoln Street
Huntsville, AL 35801

For information on local groups that can provide specific referrals to qualified therapists and support groups, contact:

American Psychiatric Association
1400 K. St. N.W.
Washington, D.C. 20005
(202) 682-6220

The American Psychological Association 1200 17th Street., N.W.
Washington, D.C. 20036 (202) 336-5700


Author Index

Ascherman, Lee I. 20
Authier, K.J. 8
Brookhouser, P.E. 8
Canavan, Margaret M. 15
Cornell, C.P. 7
Crittenden, Patricia M. 18
Daie, Netzer 17
Dandoy, A.C. 14
Daniel, A.E. 14
De Jong, A.R. 19
de Young, Mary 21
Doherty, M.D. 16
Donovan, T. 21
Eleff, Michael 17
Foreman, Judy 27
Gamble, W.C. 8
Garbarino, J. 8
Gelles, R.J. 7
Gelles, Richard J. 6
Gilles, Jean Michelle 18
Green, A.H. 9
Green, Arthur S. 12
Halperin, Sandra L. 11
Heilbrunn, Debbie Joan 23
Henley, H.D. Jr. 15
Holcomb, W.R. 14
Israel, Edie 21
Kashani, J.H. 14
Kempe, C.H. 6
Kempe, R.S. 6
Kochakian, Mary Jo 26
Knutson, J.F. 18
Kuksis, Myra 16
Laviola, M. 14
McHale, S.M. 8
Meyer, Walter J. III 15
O'Brien, Michael J. 5
Pierce, L.H. 16
Pierce, R.L. 16
Pfouts, J.H. 15
Randall, T. 11
Rausch, K. 18
Reid, W.J. 21
Rosenthal, P.A. 16
Safier, Ellen J. 20
Schetky, D.H. 9
Schopler, J.H. 15
Smith, Holly 21
Steinmetz, S.K. 12
Steinmetz, Suzanne K. 22
Strauss, Murray A. 6
U.S. Department of Health and Human Services 3, 6
Wiehe, Vernon R. 3, 9
Witztum, Eliezer 17
Zucker, Kenneth J. 16
Zupin, Fran H. 26


Reviewers

Cindy W. Christian, M.D.
Assistant Professor of Pediatrics
University of Pennsylvania School of Medicine
Medical Director, Child Abuse Services
Children's Hospital of Philadelphia
Philadelphia, PA

Margaret Feldman, Ph.D.
Washington Representative
National Council on Family Relations
Washington, D.C.

Bibliography Produced by:

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