Le processus de révélation dans les agressions sexuelles intrafamiliales et extrafamiliales sur mineurs

RésuméObjectifsUne étude prospective a été menée de juin 2008 à décembre 2010 pour analyser les différences dans le processus de révélation d’agression sexuelle sur les mineurs selon les liens entre les victimes et leur(s) agresseur(s).MéthodeLes victimes présumées d’agression sexuelle à Paris sont reçues sur réquisition à l’Unité médico-judiciaire de l’Hôtel-Dieu. Un questionnaire comportant des items sur la révélation a été rempli par les pédopsychiatres du service.RésultatsDeux cent vingt mineurs victimes ont été rencontrés. Les dévoilements chez les enfants et les adolescents se réalisent de manière beaucoup plus complexe, douloureuse et tardive lorsqu’il s’agit d’agressions sexuelles perpétrées par des agresseurs intrafamiliaux ; il s’agirait alors d’un réel processus. À l’inverse, les révélations dans le cadre extrafamilial se déroulent de manière plus spontanée et rapide, se caractérisant comme un événement psychique plus ponctuel. La révélation serait un facteur primordial dans l’apparition ou non de troubles psychologiques ultérieurs.ConclusionLa clarification des facteurs facilitant la révélation, notamment selon le type de liens unissant la victime à son (ses) agresseur(s), devrait permettre la mise en place d’actions de prévention pour lutter contre les graves conséquences d’un dévoilement tardif et douloureux.

ObjectivesA forward-looking study was led from June 2008 till December 2010 to clarify the child disclosure's factors of sexual abuse according to the type of relations between the aggressor and the victim at the time of the facts, specially whether these relations are intrafamilial or extrafamilial.MethodThe Medical-Judicial Units (UMJ) supply determining somatic and psychic elements for the conduct of the judicial procedures. The minors for whom a legal action was started in Paris for sexual abuse's suspicion are examined in the UMJ of the Hôtel-Dieu hospital, on requisition. A questionnaire containing disclosure's items was filled by the child's psychiatrics of the service.ResultsTwo hundred and twenty minor victims were met; 78.2% are female; 48.2% of sexual abuses took place within the family and 51.2% outside of the family context. Only 10% of the aggressors are totally unknown by the victims before the facts. The child and adolescent disclosures were realized in a much more complex, painful and latest way when it concerns sexual abuses committed by intrafamily aggressor: 60% of the victims reveal the facts several years after, to persons outside of the family (78.6% of the disclosures done at school), 6% stay in an abuse's situation in spite of the information in the circle of acquaintances and 85% of immediate commitments in reception centers or host families are pronounced by minors Public prosecutor's department in case of intrafamily abuse. On the contrary, the extrafamilial disclosure takes place in a more spontaneous and fastest way: 80% of the victims reveal the facts a few days after, to their mother or friends, only 15% of the disclosure know a complex story full of silences, unspoken or no-disclosure and very few immediate judicial measures are taken by minor Public prosecutor's department.DiscussionThe disclosure of intrafamily sexual abuse is for the victims a long, complex and painful process, full of pitfalls. More than an event, it is indeed a real process. On the contrary, the disclosure of extrafamilial sexual abuse seems less complex and faster, with a spontaneous character, much less influenced by internal and external factors. These disclosures are characterized by psychic event more restricted than a process. The disclosure would be an essential factor in the appearance or not of later psychological disorders. The victims of extrafamily sexual abuses quickly reveal and can then benefit a fast judicial and therapeutic care. Young child intrafamily sexual abuses disclosure seems to collide with numerous difficulties where the isolation prevails, partially linked up to the families failure to support the disclosure.ConclusionThe factors clarification easing the disclosure, in particular according to the type of relations between the victim and the aggressor, should allow the implementation of prevention initiatives to fight the grave consequences of a late and painful disclosure.