First Motor Case

Global Perspectives on Accounting Education Volume 5, 2008, 17-25 FIRST MOTORS CORPORATION: A CLASSROOM CASE ON IMPAIRMENTS Tim Krumwiede College of Business Bryant University Smithfield, Rhode Island USA Emily Giannini Graduate Student, College of Business Bryant University Smithfield, Rhode Island USA ABSTRACT This case requires a detailed analysis of impairments of both long-lived assets and goodwill for First Motors Corporation, a fictitious automobile company. By integrating multiple issues into this case, students are presented with some of the complexities and interrelationships that are seen in practice.To properly prepare solutions to this case, students must successfully read, interpret, and apply both accounting standards and concept statements. The use of judgment in choosing a discount rate for present value computations is an important component of this case. In fact, an earnings management issue and resulting conflict between First Motors Management and the companyâ₠¬â„¢s auditor revolves around the discount rate choice. Additionally, the suggested questions provided with the case require that students address components of the conceptual framework in the context of the impairment standards.This case can be used in upper division financial reporting classes at either the undergraduate or graduate level. Key words: Impairment, goodwill, long-lived assets, discount rate BACKGROUND t is currently 2013 and you are a member of the engagement team assigned to audit First Motors Corporation for the year ending 12/31/2012. First Motors Corporation is a car manufacturing company focused on moving from the production of gasoline-based cars to the production of cars I 17 18 Krumwiede and Giannini based on alternative fuel sources.It was one of the first car companies to successfully produce hybrid-based vehicles in the United States. First Motors has successfully maintained car sales and retained valuable employees while creating modern, efficient cars. B y 2008, First Motors was manufacturing two vehicles, both of which are still being manufactured today. One model is a hybrid-powered vehicle that can be customized in style and features for any purchaser around the globe. This model, called the Passaic, is manufactured in Detroit, Michigan, close to the company’s corporate headquarters.First Motors also manufactures a gasoline-powered model, the Mendoza, at its plant in Lorain, Ohio. In 2008, to take advantage of its alternative fuel source expertise, First Motors purchased a large competitor, Macinaw Motors Corporation, which had made significant progress with hydrogen-powered cars. As the United States is moving toward alternative energy sources, hydrogen is increasingly being used as a fuel source to replace gasoline. To achieve such progress, several processes can be used to make hydrogen. According to the National Hydrogen Association (2006), hydrogen can be made from water, biomass, coal, and natural gas.Much of the hyd rogen produced today comes from steam reforming natural gas. Alternatively, an electrolyzer can be used to separate water into its components, oxygen and hydrogen. The hydrogen can then be cooled down to form liquid hydrogen which can be stored at hydrogen fuel stations. Macinaw Motors had experimented with several hydrogen technologies but eventually settled on the use of liquid hydrogen in an internal combustion engine as the most effective way to make substantial progress with hydrogen as an alternative fuel.Due to Macinaw Motors’ valuable research and development program, operating efficiencies, and exceptional reputation, part of the purchase price was allocated to goodwill. The amount recorded as goodwill was $1. 3 billion, or the difference between the $5 billion purchase price (fair value) of Macinaw Motors as a whole and the $3. 7 billion fair value of its identifiable net assets. When First Motors purchased Macinaw Motors, the combined company retained the name Firs t Motors Corporation.Although First Motors and Macinaw Motors merged, the former First Motors is operated as the First Motors Division and the former Macinaw Motors is operated as the Macinaw Motors Division. Each division acts as a component of the enterprise that earns revenues and incurs expenses from engaging in its own business activity. Additionally, each division is reviewed by the enterprise’s chief operating decision maker to assess its performance and each division has its own discrete set of financial information. At the time of the purchase, Macinaw Motors had three manufacturing plants, all of which are still operating today.Each plant is used to produce one car model. Plant 1 is located in Irvine, California, where the hydrogen-powered Mankato is produced. Plant 2 is located in Mishawaka, Indiana, where the hydrogen-powered Sheboygan is produced. Plant 3 is located in Braselton, Georgia, where the gasoline-powered Spokane is produced. When Macinaw Motors was pur chased in 2008, executives at First Motors believed that consumers were still purchasing gasoline-powered vehicles because their purchase price was still less than that of similarly equipped hybrid-based or hydrogen-based vehicles.Management of First Motors plans to convert Plant 3 to manufacture a hydrogen-based vehicle at some point in the future. However, for the next several years, First Motors wants to capitalize on the market for gasolinepowered vehicles and Plant 3 will continue to be used in the production of gasoline-powered cars. In late 2008, management began retooling Plant 3 of the Macinaw Division to create a new, efficient, and highly desirable gasoline-powered model of the Spokane. To retool Plant 3, the First Motors Corporation: A Classroom Case on Impairments 19 ivision incurred substantial equipment costs including the costs of body assembly jigs, welding equipment, conveyors, robots, and a new platform. Management decided to retool the plant and continue with a n ew model Spokane under the assumption that there was going to be a significant increase in oil supply from expected oil reserves in the Arctic National Wildlife Refuge of Alaska (ANWR). It was believed that these oil reserves would help keep the price of gasoline down which, in turn, would continue to stimulate demand for gasoline-powered cars. The retooling process was completed during 2009.THE CASE In 2012, First Motors management was surprised to learn that oil reserve estimates were inaccurate for the ANWR. After debate over this controversial drilling location, legislation was finally passed in 2010 that included approval for ANWR oil drilling. Some citizens of Alaska and other states were angered by the new law and protested the approval of oil drilling. Nevertheless, in 2012, drilling proceeded in one small select and authorized area. Results of the initial drilling revealed that the expected oil reserves in that location were not nearly as large as projected.Due to the ANWR finding and turmoil in the Middle East, there was a spike in gasoline prices during 2012 and the sales of the Spokane model did not meet expectations. Closure of Plant 3 was considered; however, for four reasons, management decided to keep Plant 3 open. First, management believed the spike in gasoline prices was not permanent and that other oil reserves would help to moderate future oil prices. Second, significant expenditures had already been made on the plant, and it would not require large amounts of additional capital in the near future.Third, consumers were still purchasing gasoline-powered vehicles because of the continued price differential between these vehicles and vehicles using alternative energy sources. Finally, because of union contracts, any assembly line workers laid off would be paid wages by the Macinaw Division at 75 percent of straight-time pay. Thus, management determined that it was not the appropriate time to convert Plant 3 to a hydrogen-based plant. Impairme nt Despite these reasons to keep Plant 3 open, its long-lived assets will not generate the net cash flows originally anticipated when the plant was retooled.In fact, as the result of very deep discounting of the Spokane’s retail price during the year, it is possible that the final numbers for 2012 may show negative operating cash flows related to Plant 3. Accordingly, management determined that an impairment test must be performed for the Plant 3 long-lived assets. To determine if the assets are impaired, management compares the future undiscounted cash flows of Plant 3 to the book value of the plant’s long-lived assets. As of 12/31/2012, the net book value of Plant 3’s property, plant, and equipment is $1. 4 billion, before any write-down from impairment is recorded.Additional relevant information is as follows: †¢ †¢ †¢ †¢ The estimated remaining life of the assembly line equipment is 11 years. Yearly anticipated net cash flows for each of the next 11 years is $62,504,377. It is assumed that the land, buildings, and equipment for Plant 3 can be sold for $30 million at the end of this 11-year period. The total estimated undiscounted net cash flows related to Plant 3 over the next 11 years are $717,548,147 (($62,504,377 x 11) + $30,000,000). 20 Krumwiede and Giannini The assembly-line and related equipment are considered the primary assets of Plant 3.In measuring the impairment loss for Plant 3, management considers various valuation methods for this equipment. It is determined that most of the equipment has no alternative use and that a sales value is not readily available. Accordingly, following the guidance of Statement of Financial Accounting Standards (SFAS) No. 157 (FASB, 2006), management determines that the fair value of the Plant 3 long-lived assets is best measured by the present value of its future net cash flows. The company’s management measures the present value of future cash flows using a riskfree discount rate of 3 percent.Because expected net cash flows are not adjusted for inflation, management does not incorporate an inflation factor into the discount rate. Using the 3 percent rate, the present value of the net cash flows is $600 million, resulting in an impairment loss of $800 million (book value of long-lived assets of $1. 4 billion less $600 million fair value as determined by discounted future cash flows). Once the impairment loss is determined, management is not sure how to allocate it and decides to wait for its auditors to assist in the allocation.The property, plant, and equipment of Plant 3 can be divided into four primary categories: land; buildings; robots and related equipment; and all other equipment. In anticipation of the audit, the following information is compiled regarding these Plant 3 assets: TABLE 1 Plant 3: Property, Plant, and Equipment Land Buildings Robots and Related Equipment Other Equipment Total Net Book Value $500,000 20,000,000 140,000,000 1,239,500,000 $1,400,000,000 Fair Value $1,000,000* 20,000,000* Not Available Not Available $21,000,000 Without undue costs, the fair value of the land and buildings are obtained from an outside appraisal. The 2012 Audit In early 2013, you go with your audit team to the First Motors headquarters in Detroit, Michigan for the audit, for the year ending December 31, 2012. Your team gets a quick tour of the factory, and you learn about various changes in the car industry, including the lack of oil reserves in the ANWR. You know that an impairment loss was recorded for the Plant 3 assets, and you are impressed with management’s initiative in measuring, recording, and disclosing the loss.However, you wonder if an impairment loss should have been recorded for the Mendoza, the other gasolinepowered car produced by First Motors. Fortunately, First Motors maintains cash flow and sales information on a plant by plant basis and you quickly learn that during 2012, sales of the Mendoza rem ained strong because of its compact size and excellent gas mileage. After reviewing the documentation supporting the impairment charge, you note that future cash flows are discounted at a risk-free rate of 3 percent and that this rate does not incorporate an First Motors Corporation: A Classroom Case on Impairments 1 inflation factor because the cash flow estimates were not adjusted for inflation. You vaguely recall from a college class that a discount rate should incorporate a risk premium and although you are relatively new to auditing, you know that 3 percent is a rather low discount rate. You approach management questioning this low discount rate and they become very defensive in explaining that 3 percent is the rate for all the Plant 3 assets and that no other rate would be appropriate. Upon inquiry about risk being considered in such a rate, management stubbornly states that the 3 percent rate is fine.When asked for justification, management reasons that they reached this conc lusion due to the fact that a risk premium could not be adequately measured. Additionally, they refer to Statement of Financial Accounting Concepts No. 7 (FASB 2000), which suggests that in such a situation a risk-free rate can be used. In re-evaluating the net cash flows, and after discussions with management, you agree that the cash flows are in fact the single, most-likely amount in a range of possible estimated amounts or the best estimate for the next 11 years (the expected life of the primary assets of Plant 3).However, you believe risk is not factored into these cash flow estimates. You suggest adding a risk premium to the discount rate, to incorporate fully the risk inherent in the cash flows. After consultation with the firm’s valuation experts, you are told that a risk premium is appropriate. Also, based on their experience in the auto industry and review of First Motors and Plant 3, the valuation experts suggest that an appropriate risk premium is 6 percent. From t heir advice, you conclude that 9 percent (3 percent risk-free rate + 6 percent risk premium) is a much more reasonable rate to use in discounting the cash flows.You are very proud of your findings and hope to make a good impression on your audit manager, Mr. Bother. Although you had briefly discussed with him the magnitude of the impairment loss and the discount rate used, he left the calculations and details up to you. When you approach him, however, he appears extremely frustrated and explains that First Motors never even complied with the yearly test for goodwill impairment, as specified in SFAS No. 142 (FASB 2001). You suggest that the goodwill impairment test may be unnecessary because an impairment loss for the plant assets has already been recorded by management.Mr. Bother shakes his head at you, grumbles, and tells you in a very stern manner that impairment of long-lived assets and goodwill often go hand in hand. He explains that upon acquisition of Macinaw Motors, $1. 3 bil lion was recorded as goodwill (the excess of the purchase price over the fair value of the identifiable net assets of Macinaw Motors). Mr. Bother explains to you that the fair value must be re-evaluated and compared to the book value. Furthermore, you heard some members of management grumbling about losing their bonuses if â€Å"these auditors keep coming up with more impairment charges. You realize management has significant bonuses tied to the 2012 target profits, and a large impairment loss will cause them to lose the expected bonuses. A quick review shows that the largest total impairment losses that can be recorded before the target profit will be missed and the management bonuses lost is $1. 75 billion. Your calculation is based on two facts: (a) 2012 unaudited net income before impairment charges is $2. 25 billion and (b) the management bonus arrangement states that bonuses will only be paid if 2012 net income exceeds $. 5 billion.You go home that evening and realize that yo u do not really understand what Mr. Bother said to you about goodwill impairment. For one thing, you do not know if Mr. Bother was referring to the fair value and book value of the entire company or just the Macinaw Division. You print out the firm’s training material on impairments and spend the rest of the evening reading about SFAS No. 142. 22 Krumwiede and Giannini The next day, you attend a meeting with management and Mr. Bother. During the meeting, you are first excited when you hear management indicate that they made an error in the recorded impairment charge for long-lived assets.You think that management finally realizes the necessity of incorporating a risk factor into the discount rate. However, your jubilation is quickly deflated when management indicates that the impairment testing for long-lived assets should have been done at a different level. In particular, management states that impairment testing of long-lived assets should have been for the company as a wh ole (Plant 1, Plant 2, and Plant 3 of the Macinaw Division, plus the two plants from the First Motors Division) and that the result is the impairment charge should not have been recorded.Management claims this result would hold because the decline in the value of the Plant 3 long-lived assets could be offset by the increase in the value of the longlived assets at the other plants. It is further explained that the individual who made the error is no longer with the company. Mr. Bother explains to management that the issue will be examined more closely. Before any further explanation can be provided, members of management are called away for another meeting.As you leave the meeting you realize that you do not know whether management is correct about combining long-lived assets for all plants of First Motors to perform the impairment test. Furthermore, you wonder if impairment testing is done for both plant assets and goodwill, if it can be a combined test, and if it needs to be done i n a specific order. After reviewing your notes and the company records, you also begin to wonder if a mistake was made in the original calculation of the impairment loss related to long-lived assets.In particular, for purposes of the present value calculations, you note that the land and buildings are assumed to be sold at the end of 11 years. However, you recall from discussions with management that manufacturing plants are used for many years and are retooled over and over. Accordingly, it does not seem appropriate to assume the sale of the land and buildings after 11 years. After all, according to the accounting records, the buildings have a remaining useful life of 25 years and the land has an unlimited useful life. A couple of days earlier, the valuation method for any possible goodwill impairment testing was discussed.It was determined that no fair value was readily available for First Motors or its divisions. Additionally, because the stock price of First Motors was so volati le over the past year, the market capitalization was not a good indicator of the fair value of First Motors. You, Mr. Bother, and management came to an agreement that discounted future cash flows was the appropriate valuation technique to use. However, the calculations provided by management incorporated a riskfree discount rate of 3 percent. You took the initiative to do your own calculations based on an 8 percent discount rate, which includes a 5 percent risk premium.The 5 percent risk premium was recommended by the same valuation experts from the firm who recommended a 6 percent risk premium for use in the Plant 3 long-lived asset impairment. Management calculations and your calculations are summarized below in Tables 2 and 3. The information in the first portion of Table 2 represents the total fair value of First Motors and its divisions based on discount rates of 3 percent and 8 percent, respectively. Presented in the second portion of Table 2 is the estimated fair value of ide ntifiable net assets based on discount rates of 3 percent and 8 percent, respectively.Finally, presented in Table 3 is a summary of the book value of identifiable net assets and the book value of net assets before recording any impairment for long-lived assets (the difference represents the book value of goodwill). First Motors Corporation: A Classroom Case on Impairments TABLE 2 Fair Value Information 3% Discount Rate Total Fair Value: First Motors Division Macinaw Division Total (First Motors) Fair Value of Identifiable Net Assets: First Motors Division Macinaw Division Total (First Motors) $2,600,000,000 3,200,000,000* $5,800,000,000 8% Discount Rate $2,045,000,000 2,550,000,000* $4,595,000,000 23 2,500,000,000 2,800,000,000 $5,300,000,000 $2,010,000,000 2,200,000,000 $4,210,000,000 * Please note that the total fair value for the Macinaw Division includes the combined net assets of Plants 1, 2, and 3. TABLE 3 Book Value First Motors Division Macinaw Division Total (First Motors) Identifiable Net Assets $2,000,000,000 3,000,000,000 $5,000,000,000 Goodwill $0 1,300,000,000 $1,300,000,000 Net Assets $2,000,000,000 4,300,000,000 $6,300,000,000 QUESTIONS (Assume that currently enacted GAAP is still applicable in the year 2012) Part 1 Please provide detailed explanations in answering each of the following questions.For questions 2a, 3a, 4a and 5, provide a citation to the appropriate accounting standard that supports your discussion. 1. Diagram the organizational structure of First Motors Corporation. 2. a. Under what circumstances is a company required to perform impairment testing for long-lived assets? b. Was impairment testing of long-lived assets required for First Motors? Why or why not? 3. a. At what level is impairment testing done for long-lived assets? b.Are the executives of First Motors correct in suggesting that the impairment of longlived assets at Plant 3 is not needed because the decline in the value of the Plant 3 assets can be offset by the incr ease in the fair value of long-lived assets at other plants? 4. a. At what level is impairment testing done for goodwill? 24 b. 5. Krumwiede and Giannini For First Motors, at what level should this testing be done (i. e. , should it be done for the company as a whole or just for the Macinaw Division)? If impairment testing of both goodwill and long-lived assets is required, in what order is it done?Part 2 Please provide detailed explanations in answering each of the following questions. Provide citations to the standards for each of the following: questions 6a, 7a, 8a, and 10a. Additionally, it is suggested that you provide citations to SFAC Number 2 (FASB 1980) when answering questions 10b, 11, and 12. 6. a. Prepare a schedule showing the computation of the long-lived asset impairment loss at both the 3 percent discount rate and the 9 percent discount rate. In the information provided in the case, it was assumed that the land and buildings for Plant 3 were sold at the end of 11 yea rs.Be sure to consider and discuss if the land and buildings’ â€Å"assumed sale† after 11 years is appropriate or if the â€Å"assumed sale† should be at the end of the buildings’ useful life. b. Do you think that management is correct in using the 3 percent rate, or are the auditors correct in suggesting the 9 percent rate, or can either interest rate be justified? Provide a detailed answer to this question including a discussion about a risk premium. Be sure to consider the type of cash flow information provided by management. 7. a. Once an impairment of long-lived assets is determined, how is the write-down allocated among multiple assets?Prepare a schedule showing this allocation for Plant 3 (use the impairment loss determined based on the discount rate you chose in question 6b). b. Refer to your answer for part a. After the allocation is completed, will each longlived asset (or asset category) that First Motors wrote down be stated at fair value? Wh y or why not? c. How will the impairment loss and the corresponding reduction of book value to the long-lived assets affect future depreciation expense to be recorded, (potential) future impairment charges and/or future gains or losses on the sale of the long-lived assets? 8. . Determine the implied goodwill value and the goodwill impairment loss, if any, using both a 3 percent and an 8 percent discount rate. Which rate should be used and why? b. The valuation experts suggested that the risk premium (6 percent) in discounting the free cash flows from Plant 3, for purposes of the long-lived asset impairment, should exceed the risk premium (5 percent) in discounting the cash flows for the Macinaw Division. Why is this difference in a risk premium justified? 9. a. Will management still receive bonuses if the 3 percent discount rate is used in the calculations?If the 9 percent and 8 percent discount rates are used? b. What is earnings management? c. Discuss the relationship between earn ings management and the choice of discount rate to be used in discounting future cash flows for the long-lived asset impairment of Plant 3 and the goodwill impairment of the Macinaw Division. First Motors Corporation: A Classroom Case on Impairments 10. 25 11. 12. Once written down because of impairment, can long-lived asset write-downs or goodwill write-downs be recovered if predictions change (i. e. , the fair value subsequently increases)?Is there such a thing as a write-up for either long-lived assets or goodwill? a. Regarding reliability of financial information, comment on the verifiability and representational faithfulness characteristics of the conceptual framework as they relate to accounting for impairments. Be sure to incorporate First Motors into your discussion. b. Discuss the trade-off between the relevance and reliability of reporting long-lived assets and goodwill at fair value. How does the principle of conservatism apply to this trade-off? Consider the case of Firs t Motors in your discussion.Find a real-world company that has taken an impairment charge (either for goodwill or longlived assets) and discuss how the relevant information was disclosed in the notes to the financial statements and the affect the charge had on net income or net loss of the company. TEACHING NOTES Teaching notes are available from the editor. Send a request from the â€Å"For Contributors† page of the journal website, http://gpae. bryant. edu. REFERENCES Financial Accounting Standards Board. 1980. Qualitative Characteristics of Accounting Information. Concepts Statement No. . (Norwalk, CT: FASB). _______, 2000, Using Cash Flow Information and Present Value in Accounting Measurements, Concepts Statement No. 7. (Norwalk, CT: FASB). _______, 2001. Goodwill and Other Intangible Assets. Statement of Financial Accounting Standards No. 142. (Norwalk, CT: FASB). _______, 2006. Fair Value Measurements. Statement of Financial Accounting Standards No. 157. (Norwalk, CT: FASB). The National Hydrogen Association. Frequently Asked Questions. Retrieved July 12, 2006, from http://www. hydrogenassociation. org/general/faqs. asp.

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Adolescent Suicide Essay Example | Topics and Well Written Essays - 500 words

Adolescent Suicide - Essay Example First three things explain the 100% increase in suicides since 1960. However since 1997, despite the proliferation of guns, less parental attachment and more access to alcohol and drugs, the suicide rates are coming down. The anti-depressant medicine is considered responsible for this improvement (Berger). Similarly, a combination of medicine and cognitive-behavioral therapy has been found to be most effective for combating suicidal tendency (Berger). The availability of guns increases chances of fatal injuries/ completed suicides. This fact has been corroborated by the fact that about 52% of all suicides were with firearms (Jason, 2011). It should however be noted that guns may not be considered responsible for creating suicidal tendencies. Firearms are just instruments which are used for suicide. As long as there is the desire to commit suicide, more and more ways will become available. Despite the proliferation of guns over time, the suicide rates have been coming down since 1997 (McIntosh, 2011). The mix of suicidal ideation and availability of drugs is the most fatal combination as the suicidal ideation might lead to the use of drugs and the use of drugs might precipitate the suicidal tendencies. Malcolm Lowry (1909-1957), the British novelist and short-story writer was left by his parents at the mercy of â€Å"sadistic nannies or indifferent foster-parents† during his early childhood and later he developed emotional problems as a result of which he became alcoholic by age 13 (Day, 1973). A combination of factors precipitated his suicidal tendency resulting in his finally shooting himself (Shulman, 2011). The inappropriate or absence of parental supervision precipitates the desire to commit suicide. The fractured married life of the parents of John Berryman, the American poet, led to Berryman’s father shoot himself. While still a child, Berryman used to ask his mother as to why his father

The importance of volunteering in my community to make it a batter Essay

The importance of volunteering in my community to make it a batter place - Essay Example A volunteer helped him to the home. I immediately called for an ambulance and in no time, dad was taken to the hospital. It was all happening before my eyes, and the remembrance of that feel haunts me till this day. My father, who was both a parent and a spiritual guide to me, was struggling breath by breath for life. Any moment, anything could happen. Nonetheless, this saddest experience of my life taught me the importance of volunteering. In the few days I spent at the hospital to nurse my father as he was recovering, I used to see volunteers offering help to the needy and counseling them to raise their self esteem. I was totally impressed. After all, it was a volunteer that helped my father reach home when he was in trouble! That day, I took an oath to volunteer any way by which I could benefit my community. Few activities that I have made my habit and part of everyday routine in an attempt to benefit my community and making the environment better for them is picking up garbage fr om the streets and throwing it in dustbins, buying seeds and growing plants as many as I can, and providing people with due help in the way the need. I truly believe that volunteering is something much more sacred and noble than our possessions.

Nursing Research Paper - Leukemia Example | Topics and Well Written Essays - 1000 words

Nursing - Leukemia - Research Paper Example Introduction The word leukemia is derived from the Greek words leukos and aima, which stand for ‘white blood.’ Leukemia is a form of blood and bone marrow cancer and it points to an abnormal production and multiplication of white blood cells (leukocytes) in a person’s body. Blood cells are produced in the bone marrow and they divide to form new body cells according to the requirements of the body (there is the dying of old cells and new cells have to replace them). In a person suffering from leukemia, the DNA of immature white blood cells somehow becomes damaged and they grow and divide chaotically. The old cells do not die and there is rapid division of body cells – more and more cells are produced in the body taking up more and more space and cancer problem arises. Simply put, the bad cells in the blood crowd out the good cells (Nordqvist, 2009). History of Leukemia Ancient Greeks discovered leukemia way back in the 4th or 5th century BC. However, John Hu ghes Benett officially diagnosed it in Edinburgh in the year 1845. In the 19th century, some physicians from Europe further realized that a number of of their patients were suffering from peculiarly high white blood cells levels. They termed this condition 'weisses blut', meaning â€Å"white blood†. In the year 1913, leukemia was categorized into four types namely acute lymphocytic leukemia, chronic lymphocytic leukemia, acute myelogenous leukemia (Erythroleukemia) and chronic myelogenous leukemia. Further, in the year 1970, it was proven that there was cure for leukemia, and by 1980s and 1990s, roughly 70% of patients suffering from leukemia had been cured. This brought high hopes to all patients suffering from leukemia globally. For ages, people have been fighting with cancer, the only difference being that they were not aware of the details of what they were battling (Johnson, 2011). Treatment options Just like the information concerning leukemia has changed with time, the treatment options available for the patients have also changed. The earliest treatment option administered to leukemia patients was arsenic. Generally known in the West as a poison, arsenic has been used to treat leukemia and such conditions as psoriasis and syphilis in traditional Chinese medicine for almost two thousand years. It has been proven to have a considerable anti-cancer effect for leukemia although the mechanism for this effect has remained unknown till recently when scientists in China found out that it targets proteins which contribute to cancer cells’ growth (Edwards, 2010). Healthandnutritiontips.net (2011) records that arsenic is still used in the treatment of some types of leukemia and that it has proved very successful. In the early 20th century, radiation therapy replaced arsenic (Johnson, 2011). Scientists found out that exposure to radiation decreases the cancerous tumors on patients in size. Radiation is still a very common and a very effective treatme nt option for leukemia, as well as other cancer types. However, it has several side effects that a patient needs to take into consideration (Healthandnutritiontips.net, 2011). Other modern/recent treatment options for leukemia include biological therapy or immunotherapy, chemotherapy surgery and bone marrow transplants. Biological therapy/immunotherapy has to do with treatment

Neuroscience Article Example | Topics and Well Written Essays - 2000 words

Neuroscience - Article Example the center 4 tiles), the amount of time a rat spent in the center of the field (i.e. the center 4 tiles), and the number of tile crossings all indicated that rats treated with LiCl had indeed reduced risk taking, locomotor activity and exploratory behavior when undergoing the open-field test compared to sodium chloride (NaCl) treated control rats. Note, the tendency of the rat to cling and spend much time on the walls of the test apparatus indicates a high level of anxiety or fear. On the contrary, a less fearful rat portrays the tendency of greater exploration within the experiment apparatus. As such, the rats that had been injected with LiCl spent much time on the walls of the apparatus – a sign of increased fear and high level of anxiety. The results obtained in this test were in agreement with other studies previously conducted. Laboratory observations have suggested an interaction between lithium chloride (LiCl) and exploratory behavior of rats. Studies have confirmed that LiCl administration tends to suppress locomotor activity in rats (Johnson et al., 1972). An open field apparatus was used to observe the exploratory behavior and the movement of the rats one hour after the injection of LiCl. The purpose of the present study was to examine the effects of LiCl on risk taking, exploratory behavior, and locomotor activity of rats. The behavioral pharmacology test conducted was aimed at seeing the effectiveness of Lithium chloride on the various specimens used and their response. The experiment used Lithium Chloride as the main ingredient and sodium chloride as the control solution. The main objective of the experiment was an observation of the effects of taking against not taking Lithium chloride and on the other hand taking sodium chloride. We used an Open Field Apparatus from whence we could observe the behavior of the rat immediately after the injection with the drug.

Outline and illustrate two ways in which an action may be both self-interested and altruistic Essay Example for Free

Outline and illustrate two ways in which an action may be both self-interested and altruistic Essay Another way in which and action can be both altruistic and self interested is aided by the concept that altruism may lead others to think more highly of you, which is in beneficial for you and makes you feel better about yourself, so is therefore also in your self interest. An example of this is giving to charity. This may give you positive feelings as you enjoy helping others and seeing that your own actions can benefit people other than yourself. Therefore you’re being altruistic and still acting in your self interest. This then illustrates that being altruistic coincides with your self interest as you get positive outcomes by helping others. Another way in which and action can be both altruistic and self interested is aided by the concept that altruism may lead others to think more highly of you, which is in beneficial for you and makes you feel better about yourself, so is therefore also in your self interest. An example of this is giving to charity. This may give you positive feelings as you enjoy helping others and seeing that your own actions can benefit people other than yourself. Therefore you’re being altruistic and still acting in your self interest. This then illustrates that being altruistic coincides with your self interest as you get positive outcomes by helping others. Another way in which and action can be both altruistic and self interested is aided by the concept that altruism may lead others to think more highly of you, which is in beneficial for you and makes you feel better about yourself, so is therefore also in your self interest. An example of this is giving to charity. This may give you positive feelings as you enjoy helping others and seeing that your own actions can benefit people other than yourself. Therefore you’re being altruistic and still acting in your self interest. This then illustrates that being altruistic coincides with your self interest as you get positive outcomes by helping ot hers. Another way in which and action can be both altruistic and self interested is aided by the concept that altruism may lead others to think more highly of you, which is in beneficial for you and makes you feel better about yourself, so is therefore also in your self interest. An example of this is giving to charity. This may give you positive feelings as you enjoy helping others and seeing that your own actions can benefit people other than yourself. Therefore you’re being altruistic and still acting in your self interest. This then illustrates that being altruistic coincides with your self  interest as you get positive outcomes by helping others. Another way in which and action can be both altruistic and self interested is aided by the concept that altruism may lead others to think more highly of you, which is in beneficial for you and makes you feel better about yourself, so is therefore also in your self interest. An example of this is giving to charity. This may give you positive feelings as you enjoy helping others and seeing that your own actions can benefit people other than yourself. Therefore you’re being altruistic and still acting in your self interest. This then illustrates that being altruistic coincides with your self interest as you get positive outcomes by helping others. Another way in which and action can be both altruistic and self interested is aided by the concept that altruism may lead others to think more highly of you, which is in beneficial for you and makes you feel better about yourself, so is therefore also in your self interest. An example of this is giving to charity. This may give you positive feelings as you enjoy helping others and seeing that your own actions can benefit people other than yourself. Therefore you’re being altruistic and still acting in your self interest. This then illustrates that being altruistic coincides with your self interest as you get positive outcomes by helping others. Another way in which and action can be both altruistic and self interested is aided by the concept that altruism may lead others to think more highly of you, which is in beneficial for you and makes you feel better about yourself, so is therefore also in your self interest. An example of this is giving to charity. This may give you positive feelings as you enjoy helping others and seeing that your own actions can benefit people other than yourself. Therefore you’re being altruistic and still acting in your self interest. This then illustrates that being altruistic coincides with your self interest as you get positive outcomes by helping ot hers. Another way in which and action can be both altruistic and self interested is aided by the concept that altruism may lead others to think more highly of you, which is in beneficial for you and makes you feel better about yourself, so is therefore also in your self interest. An example of this is giving to charity. This may give you positive feelings as you enjoy helping others and seeing that your own actions can benefit people other than yourself. Therefore you’re being altruistic and still acting in your self interest. This then illustrates that being altruistic coincides with your self interest as you get positive outcomes by helping others.

The Long Term Effects of Child Sexual Abuse Essay Example for Free

The Long Term Effects of Child Sexual Abuse Essay Abstract Childhood sexual abuse is a serious concern that has been associated with long term effects amongst survivors. Using secondary data, this qualitative piece of research explores the long term effects of child sexual abuse in later adult life. The purpose for this study is to create awareness to professionals that sexual abuse effects continue long after the abuse stops thus, sufficient knowledge on the characteristics of the abuse. The long term effects focuses on three developmental domains; emotional social and behavioural. The emotional aspect looks at depression, feelings of guilt and anxiety. The social aspect focuses on relationships and intimacy, and the behavioural aspect will discuss issues self-destructive behaviours. Results from the research highlight that the long term effects are not consistent across the three domains. Thus, child sexual abuse is viewed as a risk factor, as opposed to an actual cause to the effects. Nevertheless, knowledge on the long term effects is imperative, to provide appropriate support and services. Research recommendations are discussed. Acknowledgments The writing of this dissertation has been one of my biggest challenges thus far; as emotional as it was, I am pleased that I decided to follow through with my chosen topic. I have learnt so much in the process, both academically and personally. This dissertation would not have been possible without the support and guidance of several individuals. First and foremost, I would like to give thanks to God for providing me with the strength and courage to undergo such a huge challenge. I would like to say a special thank you to my beloved family and friends who have given me their support and understanding over the past five months. I am really grateful to be blessed with such wonderful people, may God bless you all. I would like to express my deepest gratitude to my dissertation tutor, Tricia Ayre. Thank you for your invaluable assistance from the beginning to the end. Your support has meant a lot and kept me on the right tracks. Thanks. Thanks to my manager and colleagues at my final year placement who also showed me a generous amount of support. A great effort has been put into enabling children to disclose their abuse, interventions and laws to protect survivors from such abuse. However, how the abuse effects the survivors has received comparatively little attention, (Nelson and Hampson 2008). Research has documented that survivors are more prone to suffer from physical, social emotional, cognitive and behavioural problems than non survivors, (Piper 2008, Nelson and Hampson 2008, Sanderson 2002). This is vital knowledge; as such effects are likely to have an impact on the survivor’s well-being. The aim of the research is to explore the long term effects of CSA in three developmental domains; Social, Emotional and Behavioural. The three domains are associated with The Framework for the Assessment of Children in Need and their Families, (Department of Health 2012). Each domain plays a vital role in the developmental needs of a child, interruptions in one or more of the domains can lead to a child not meeting their full potential, (Department for Education and Skills 2004). The Framework for the Assessment of Children in Need and their Families, highlights the importance of these specific developmental domains in order for a child to achieve, it is for this reason why I have chosen to explore these areas. The emotional aspect will discuss depression, feelings of guilt and anxiety. The social aspect will focus on relationships and intimacy, and finally the behavioural aspect will discuss issues self-destructive behaviours. CSA can leave survivors with both short and long term effects. This view is supported by Ferguson (1997), ‘as well as the immediate effects of such abuse seen in childhood, findings from research have reported how the impact of CSA can affect the lives of adult survivors. ’ â€Å"Sexual abuse is a traumatic and damaging experience which can affect a child’s capacity for trust, intimacy, mental health and emotional development and ability to achieve both educationally and socially†,( London Child Protection Committee 2005). As a result of the damage caused, it is likely for survivors to come into contact with professionals and services to address issues they may be undergoing. However, not all victims will disclose that they are survivors of CSA due to shame and embarrassment. In some cases, the individuals may not be aware that their present issues are related to their past abuse therefore will not feel the need to make the professional aware. Only 27 per cent of abused women attending general practices disclosed childhood abuse to their doctors, (Mammen and Olsen 1996). Therefore, it is important for professionals to have sufficient knowledge of the long term effects of CSA, as unknowingly may well be working with survivors. Long term effects of CSA can interfere with survivor’s mental health and well being, for these reasons social workers are likely to work with such service users, empowering them to reach their full potential. Thus it is imperative that social workers are aware of and familiar with the symptoms and long term effects associated with childhood sexual abuse, to gain a better understanding of how to support such service users, (Hall and Hall 2011). I have taken an interest in this subject for a number, as whilst undergoing my social work placement in a women’s prison, I worked with offenders with drug and alcohol misuse. A number of women disclosed that as a child, they had experienced a form of sexual abuse as a child. Anecdotally, many of the women used substances to control their emotions or repress the painful memories from their childhood. Research findings from Nesse (1994) states that drugs artificially induces pleasure or blocks normal suffering and are routinely used to block defences; such as pain and anxiety. Substance misuse can lead the individual to experience issues in areas such as social, emotional, and behavioural, (National Institute on Drug Abuse 2004). Without the prisoner disclosing their past abuse, or the professional not being aware of the long term effects caused by CSA, the effects of the abuse can go unnoticed. Consequently issues surrounding their drug misuse are addressed however; the underlying problem of CSA still remains. As a newly qualified social worker, it is important that I am aware of both the short and long term effects of CSA, as there is a likelihood of meeting with survivors in my work environment. Being able to identify the effects, would allow me to develop a more effective way of addressing the service users immediate needs, making sure they are aware of the supportive services available in the community. Therefore conducting this piece of research would have a positive contribution towards my professional development, as I would be equipped with sufficient knowledge and understanding, prior going into practice. Conducting research into this field I believe will also have a positive impact on my personal development, as I am a survivor of CSA. Although it is important for professionals working with survivors to be aware of the effects, it is equally important for the survivors themselves to be aware that the effects can continue long after the abuse stops. Through considerable media attention public awareness on CSA has increased throughout the years, though CSA is not a recent phenomenon. CSA is a social problem that has been of concern during earlier historical periods, (Conte 1994). According to Jeffery (2006), prior to the 1960’s there was very little mention of CSA. CSA and incest was seen as a taboo, (La Fontaine 1988). As this taboo was often shared by the victim, family and professional the problem remained widely unrecognised, (Bentovim et al 2009). In 1908 the Incest Act was established and incest became illegal. However, this era was still seen as ‘The time of silence’, as it was literally impossible to think about disclosing or debating sexual abuse, such acts were not accepted and viewed as forbidden. (Carlsson 2009). The Children Act in 1948 introduced child care departments to be set up in local authorities. Under the 1948 Children Act, it became the duty of a local authority to receive the child into care in cases of abuse or neglect, (Spicker 2007). In the 1940’s there was an interest in CSA by social scientists; large scale studies of sexual practices were conducted, these were known as the Kinsey studies. Findings showed that a number of participants had a sexual experience as a child with an adult, (Jeffery 2006). Even in the light of these and other studies, there remained widespread public and professional denial that CSA took place, Jeffery (2006). However this could be explained, â€Å"Before the 1970’s the justice system was not receptive to CSA: children viewed as presumptively unreliable; hard to prove abuse; general climate of disbelief; little or no training for police or prosecutors on how to investigate, recognize, and prove child abuse†, (Bala 2006). The growth of the woman’s movement was a turning point for CSA; the role of women in society had shifted, women were now encouraged to speak out about their experiences, as supposed to being ashamed and having to suppress feelings. Sanderson (2002) argued that from this exchange of information and the sharing of experiences it became evident that CSA was a common rather than an isolated experience which many women had experienced. In the 1980’s there was an increase in awareness and concern about sexual abuse of children, this was displayed in the increase of reported incidents of child abuse. Professionals were now playing a more active role in protecting children from such abuse; however this was later criticised, as they were seen as acting too quickly in removing children from their parents. In 1987, over 100 children were removed from their families on emergency Place of Safety Orders on the basis of a diagnosis of sexual abuse made by two paediatricians at a hospital in Middlesbrough, (Munro 2007, p. 21). Following the media outcry these events led to a public inquiry, famously known as The Cleveland inquiry. The message from the inquiry was that professionals needed to take a more legalistic approach to collecting evidence, (Munro 2007, p. 21) Two years later, The Children’s Act 1989 was passed, although it was not implemented until 1990. The Children Act 1989 gave every child the right to protection from abuse and exploitation and the right to inquiries to safeguard their welfare, (Batty 2005). The introduction of the Children’s Act, allowed professionals to intervene in cases they suspected a child was likely to suffer from significant harm. From the 1990’s a number of laws and legislations were put in place to prevent and detect cases of CSA, and prosecute abusers. The Protection of Children’s Act was passed in 1999; it aimed to prevent paedophiles from working with Children, (Batty 2005). In 2003, The Sexual Offences Act was passed; it criminalises all sexual activity with a child under the age of 16, (The Crown Prosecution service 2012). In addition to the increase of laws introduced, CSA has triggered a major reaction in the media; as a result CSA has received increasing public attention, (Ferguson 1997). Jeffery (2006) suggested that the increase in reported incidents of CSA over the years is related to a better understanding of the signs and symptoms of abuse and better inter-agency working. Although there has been an increase in the number of reported incidents, CSA is still largely hidden and unreported, so it is difficult to get an accurate picture of the extent of different forms of abuse, (London Child Protection Committee 2005). Pereda et al (2009) reviewed 65 studies from 22 different countries and concluded that the global prevalence of CSA is estimated at 19. 7 per cent for females and 7. 9 per cent for men. The highest prevalence rate of CSA geographically was found in Africa with 34. 4 per cent. This was mainly due to the high rate of abuse in South Africa. South Africa has many migrant workers; due to lack of job opportunities in their vicinity parents left their children alone for weeks to months with relatives or minders, while they travelled to distant places. This exposed the children to all sorts of abuse, especially sexual abuse, (Madu and Peltzer 2000). On the other hand, Europe displayed the lowest prevalence rate with 9. 2 per cent. However, even the lowest prevalence rate includes a large number of victims who need to be taken into account, (Wihbey 2011). Chapter Two 2. 0Methodology This dissertation was conducted to explore and critically examine the current literature on the long term effects of CSA, focusing on three specific domains; social, emotional and behavioural. To begin with, I attended tutorials that primarily focused on how to write and structure a dissertation. With the knowledge gained I was able to compose my first stage proposal form, at this point I identified my dissertation topic, title, rationale and aim. I was then allocated a supervisor; through one to one meetings and emails, I sought advice and guidance on the best approach that suited my dissertation topic. Targets and deadlines were also agreed upon as time management was essential. To aid my literature search I also sought advice from the librarian at the University of West London. All Material used for this dissertation solely relied upon secondary data sources. Data was gathered from the University of West London and The British library. Search engines such as Google and Yahoo were used to search web resources. I initially began by using the phrase ‘Long term effects of CSA’; however the results produced were broad, I decided to narrow my results by searching for the three domains individually, e. g. ‘Behavioural effects of CSA in adulthood’. I then read through the results provided, those that were significant to my research I printed off. Reading the literature thoroughly, I highlighted relevant points, using different colour highlighters for each domain. Findings from this dissertation were presented using qualitative research. As CSA is a sensitive topic, it was important that the approach used suited the content of the dissertation. Qualitative research aims to describe and explain relationships, where quantitative research predicts casual relationships, (Family health international 2011). Presenting the data using qualitative research allowed me to explore the subject in great detail. Family health international (2011) states that qualitative research provides information about the ‘human’ side of an issue; giving the nature of the dissertation I believed this design was the most appropriate. When athering information for the literature review, I primarily focused on literature published in the United Kingdom. However, the research presented was insufficient; I therefore furthered my search to various countries. For this reason, this study will not be based solely in the United Kingdom. The dissertation aimed to reflect both females and males experience of CSA. However, a considerable amount of literature gathered had used female participants. As Jehu (1991 cited in Forensic Psychology Practice 1999) highlighted, in regards to research and treatment literature, male survivors have been neglected. Jehu (1991 cited in Forensic Psychology Practice 1999) further explained, ‘ from a cultural perspective, there appears to be some ‘societal reluctance’ to recognise boys as victims of abuse rather than willing participants in sexual encounters’. As mainly female participants were used, it could be argued that the research is not a representative sample of CSA survivors, this could possibly interfere with the study’s validity. Validity is used to determine whether research measures what it intended to measure and to approximate the truthfulness of the results, (Tariq 2009). It is also possible that the gender specific sample could generate significant bias. As I am a survivor of CSA, it is important to acknowledge that my past experiences are likely to affect how I interpret findings gathered from the research. This could cause possible issues surrounding bias, again affecting the validity of the dissertation. Although material used for this research was based on secondary data sources, if I was to conduct primary research on my chosen topic, a number of ethical issues would have to be taken into consideration, due to the complex and sensitive nature of the subject. Firstly, I would need to ensure that full consent is gained from all participants as this protects the individuals from harm and protects the researchers from having their project deemed invalid or unethical, ( Helping Psychology 2009). It is also important, that I inform participants that they have the right to withdraw from the study at any time. Confidentially is another ethical issue that needs to be implemented when carrying out primary research. ‘The assurance of confidentiality carries with it the implication that non-researchers cannot discover the respondents identity’, (Jamison 2007). In this circumstance, confidentially is necessary as it is possible survivors taking part have not disclosed their abuse. Holmes (2004, p. 120) stated; ensuring that transcripts do not include participant’s names was a way to protect participant’s confidentiality. According to Ghate and Spencer (1995, p. 79), the most important concern when undertaking such research is the after effects of the interview on the survivors, as it may trigger and painful memories. Thus it is essential that researchers carefully balance ethical principles, so that collection of data can occur without harm to participants. Ghate and Spencer (1995, p. 79) suggested that post interviewing would be useful for participants who might have found the interview stressful. Chapter Three 3. 0Literature Review According to Office of the United Nations High Commissioner for Human Rights, (2012) Article 1 the definition of a child is â€Å"every human being below the age of eighteen years unless, under the law applicable to the child, majority is attained earlier. † Sexual abuse can be defined as an umbrella term as existing definitions of childhood sexual abuse are diverse and cover a wide range of factors. Sexual abuse can occur in several forms, these include intercourse, attempted intercourse, oral genital contact, fondling of genitals directly or through clothing, exhibitionism or exposing children to adult sexual activity or pornography, (Putnam 2003). For the purpose of this research, the following definition will be used; ‘CSA is the involvement of a child in sexual activity that he or she does not fully comprehend, is unable to give informed consent or for which the child is not developmentally prepared and cannot give consent,’ (World Health Organisation 1999). . 1Factors contributing to the impact of CSA CSA effects can vary from no apparent effects to very severe ones, such as depression and self-injurious behaviours. The impact CSA can have on an individual can differ according to a multiple of factors. Cited in Piper (2008, Ullman 2003) is in support of this view, he concluded that the degree of impact CSA has on a person varies, studies demonstrated the follow ing influencing factors; age of the child abuse, duration of the abuse, frequency of the abuse, relationship with the offender, severity of the ssault and reactions to disclosure. A number of researchers have established that the age at the onset of abuse is an important factor that can influence the impact of CSA; however researchers share contradicting views in regards to what age the abuse has the most impact on the survivor. Corby (1993 p. 123) supports the view that both the short and long term consequences of sexual abuse are less harmful in the younger children, because of the lack of awareness of the social stigma attached to sexual abuse. Gomes-Schwartz (1990 p. 07) found that their 7 to 13 years age group experienced more adverse reaction than did children in their 4 to 6 years. In contrast, Living Well (2010) suggested earlier onset is linked to greater impact. Baker and Duncan (1985) found that majority of women reporting most perceived ill-effects were abused before the age of 10. Cited in Corby (1993 p. 123, Beitchman et al 1991) raised an important argument; they suggested that age needs to be considered in conjunction with other variables. Studies have found a link between the duration of the abuse and the trauma of CSA. Barriere (2005 cited in Sanderson 2006) reported an ongoing sexual relationship with repeated contacts is generally more traumatic and usually produces more sexual abuse effects than a single contact. Browne and Finkelhor (1986 ) reviewed 11 studies and found that six confirmed the longer the duration of the abuse went on, the more traumatic was the effect on the victim. However, it must be addressed that there are many instances of one –off abuses that can have a traumatic effect on victims; this could be the case if the abuse is linked with violence, (Corby 1993, p. 24). If the abused knows their abuser, it is said that the impact of the abuse is much greater, than being abused by an unfamiliar person. Barriere (2005, cited in Sanderson 2006) supports this view as she states the closer the emotional relationship, the greater the emotional trauma. A reason for the increased trauma could possibly be due to betrayal of trust. CSA can occur in multiple forms, from asking or pres suring a child to engage in sexual activities to behaviour involving penetration. The type of sexual activity the victim is exposed to can influence the impact of the abuse. Groth (1982, p. 129-144. ) has differentiated between the child rapist, who uses force, power, and threats in the sexual abuse, and the abusers who takes the more slow approach and often with considerable affection. The effects on the child will be different. Nevertheless, it is important to stress the effects of any type of sexual abuse can cause considerable damage to the individual, (MacFarlane et al 1986, p. 10). When a child discloses their sexual abuse, it is important to remember the reaction can contribute to how the child will cope from their sexual abuse experience, (Allnock 2010). Conte and Schuerman (1987) found that a supportive response was an important factor in reducing the extent of long term problems following sexual abuse. 3. 2Reasons for limited research Over the past years CSA has received much public attention however, majority of research has focused on the victims as children; comparatively little work has been published on the long term consequences, (Cahill et al 1991). CSA researchers are faced with a number of challenges. The definition of CSA is a reason to why there is lack of research. As there is no universal definition researcher’s definitions can differ, and as a result depending on the definition used in the study findings can vary. The lack of research in the long term effects of CSA is also due to the difficulties in establishing casual connections between the abuse and the later affects years after the abuse. The greater the gap between the abuse event and the later behaviour the less chance there is of casually linking the two because of the existence of more intervening variables†, (Corby, 1993 p107). Effects found in survivors are not always exclusive to the childhood sexual abuse and may reflect other underlying issues, (Sanderson 2002, p. 54). Conducting studies in sensitive areas such as CSA has been proven to be difficult; therefore research in such fields may be limited. Willows (2009, p. 7) found â€Å"People who have experienced abuse in childhood may be understandably reluctant to share their experiences, especially in a research setting†. A study conducted on the ethical issues in research on sensitive topics noted that, participants who had experienced child abuse were more likely to report distress after participating in research, due to remembering the past. However, researchers also found that these participants were more likely to report that participation was helpful, (Decker et al 2011). According to Sanderson (2002, p. 5) another difficulty in assessing the long term effects of childhood sexual abuse, is that through the repression of the trauma, or dissociation, survivors of such abuse may possibly not consciously remember the abuse experience. Therefore findings gathered from research could be effected, interfering with the validly and reliability of the study. Despite the difficulties in undertaking research in the long term con sequences of CSA, a number of authors have made positive contributions to such a high profile topic, (Briere and Elliot 1994, Sanderson 2002, Hall and Hall 2011). Research has documented that CSA survivors are more prone to suffer from social, emotional and behavioural problems than non survivors; difficulties include, however are not limited to, anxiety depression, guilt, difficulty with interpersonal relationships, self-destructive behaviours and lowered self-esteem, (Piper 2008). It is important to be mindful that the effects and degree of such abuse varies from person to person. 3. 3Emotional There have been numerous studies examining the association between a history of CSA and emotional distress, (Sanderson 2002, Beitchman et al 1992, Mullen and Fleming 1999). Emotional effects most commonly experienced by survivors of CSA focus on depression, problems of guilt, low self-esteem and anxiety†, Sanderson (2002 p. 57). Amongst the category of emotional distress, depression has been found to be the most commonly reported symptom among survivors, and empirical findings support this view, (Cahill et al 1991). World Health Organisation (20 12) provides a definition of depression; â€Å"Depression is a common mental disorder that presents with depressed mood, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy, and poor concentration†. Hall and Hall (2011) documented that survivors may have difficulty in externalizing the abuse, thus thinking negatively about themselves. Ratican (1992) furthered this view by describing the symptoms of survivors’ depression to feeling down, having suicidal ideation, disturbed sleeping and eating patterns. The onset of depression has been associated with CSA in numerous studies, cited in Briere and Elliott (1994). Lanktree et al (1991) reported that adults with a history of CSA may have as much as four-time greater chance of developing depression than do individuals with no such abuse history. Beitchman et al (1992) agrees that depression is a significant issue to survivors of CSA. Reviewing eight studies they were able to identify six of the eight identified association between CSA and depression. Similarly, Briere and Runtz (1985, cited in Cahill et al 1991) found a positive correlation, in their survey of undergraduate women, those who had been sexually abused as a child reported experiencing more depressive symptoms in the preceding 12 months compared to non-abused participants. Although there is thorough research to support the correlation between CSA and depression, a small percentage of researchers failed to find a significant difference. Herman’s (1981 p. 56) found that the difference between participants from abused backgrounds and those from non-abused backgrounds proved to be statistically non-significant. His study demonstrated that 60 per cent of abused survivors reported depression, in relation to 55 per cent of the control group. In some cases, no connection was found; Fromuth (1986) undertook research and no relationship were found between depression and CSA survivors. However, her sample consisted of women with the average age of 19. 4 years, whereas majority of the other studies involved older participants. This could possibly indicate that the onset of depression is more likely to develop in later adult life. Having analysed my literature, low self-esteem was another long term effect commonly identified in CSA survivors. Robson (1988) defined self-esteem as â€Å"the sense of contentment and self-acceptance that stems from a person’s appraisal of his/her own worth, significance, attractiveness, competence and ability to satisfy aspirations†. Studies have implicated CSA in lowering self-esteem in adults, (Mullen and Fleming 1999, Herman and Hirchman 1981,). Bagley and Ramsay (1986) documented a low self-esteem rate of 19 per cent with participants from a sexual abuse background in comparison to 5 per cent among the control group. Herman and Hirchman (1981 cited in Cahill 1991) study, they found that 60 per cent of abused victims reported ‘predominantly negative self-image’ in relation to 10 per cent of their control group. Further evidence to support lowered self- esteem in sexually abused survivors is displayed in Jehu et al study (1985 cited in Sanderson 2002); using the Battle Self Esteem Questionnaire, they reported that 86 per cent of sexually abused women generated scores indicating low self-esteem. Roman’s et al (1996 cited in Mullen and Fleming 1999) agrees that low self- esteem is a significant issue to survivors of sexual abuse. The study showed a clear relationship between the two factors. From their findings, they noted that the impact of the abuse contributed to participant’s level of self- esteem. Those who reported the more intrusive forms of abuse, such as penetration, experienced lower levels of self-esteem. CSA is, by nature, threatening and disruptive, and may interfere with the survivor’s sense of security; therefore it is likely that victims of such maltreatment are prone to chronic feelings of anxiety, (Briere and Elliot1994). Sedney and Brook (1984) found from their college sample, 59 per cent of those participants who had history of sexual abuse suffered from anxiety and nervousness in contrast with 29 per cent of those who had no history of abuse. Briere and Elliot (1994) conducted further research and found that sexually abused adults became anxious in intimate or close relationships or frightened when interacting with authority figures, due to being exposed to sexual acts throu gh manipulation, coercion or power tactics upon a child who is not developmentally capable of understanding or consenting to such acts, (Walding 2002). It has been shown that survivors of CSA frequently take personal responsibility for the abuse; this often translates into feelings of guilt, (Hall and Hall 2011). MacMillan Dictionary (2012) defines guilt as â€Å"a feeling of being ashamed and sorry because you have done something wrong†. Hall and Hall (2011) went on to report that survivors often blame themselves and internalize negative messages about themselves. Tsai and Wanger (1978) reported the feeling of guilt could be accounted for by three important factors; due to sexual abuse being a secret act, the abused feels such acts is shameful therefore should not be disclosed to others. Secondly if during the abuse, if the abused experiences any physical or sexual pleasure, this causes them to feel guilty. The third factor is that the abused may feel guilty for not stopping the abuser by not disclosing the abuse and in some way ‘allowed’ it to continue. Jehu et al (1985) provides clinical evidence to reflect Tsai and Wanger (1978) theory. In their study 82 per cent of survivors blamed themselves for the abuse; this was mainly down to their feeling of guilt. 3. 4Emotional Discussion Depression, anxiety, low self-esteem and guilt were identified as the emotional long term effects most commonly displayed in CSA survivors. The four effects highlighted are all issues of identity, confidence and self-worth. In addition to sexual abuse, it is likely the survivor may have undergone emotional abuse from the abuser. This can also contribute to the survivor’s lack of identity and confidence, (Campling 1993). Mollon (2005, cited in Sanderson 2006) states ‘an individual’s cohesive sense of self and core identity is like the individual’s ‘psychological clothes’, without which the individual is naked, exposed and vulnerable’. As impaired sense of self can lead to vulnerability, reoccurrence of abuse is possible thus the adult may come into contact with a social worker for example, rape or domestic violence. This would suggest that working with CSA survivors, social workers would not only need to have understanding of their signs and symptoms but the manner in which they are going to work with them. Social workers would need to carefully consider the most appropriate intervention when working with such service users as it is likely, survivors would be vulnerable. It is important for professionals not to impose their own views, but to empower survivors to define and build on their own sense of self, that is not dependent on external definitions, (Sanderson 2006). Depression and anxiety disorders are both mental health issues. This would need to be considered by the professional involved in the context of the intervention, as well as risk and safeguarding concerns. 3. 5Social The long-term effects of CSA may also extend beyond victims themselves to impact survivors’ interpersonal relations with significant individuals in their lives, (Dilillo 2001). Research and clinical observations have long suggested that CSA is associated with both initial and long term alterations in social functioning†, (Briere and Elliot 1994). Hall and Hall (2011) reported that symptoms correlated with childhood sexual abuse may hinder the development and growth of relationships therefore survivors may experience a variety of interpersonal effects. Mullen a nd Fleming (1999) state in circumstances when the survivors shared a close relationship with the abusers there impac t is likely to be more profound. Isolation is a social long term effect that survivors of CSA may suffer from. â€Å"It has been observed that sexually abused children tend to be less socially competent and more socially withdrawn than no abused children†, (Briere and Elliot 1994). This is echoed in Courtois (1979) study, findings showed that 73 per cent of sexually abused survivors expressed feelings of isolation and feelings of being different from others. Lew (1988 p. 54) reported that isolation in some cases was something that was learnt from the survivor’s hildhood experience. As a way of keeping the abuse a secret, isolation was often reinforced by the abuser. The lack of ability to trust in relationships has been identified in literature, and is considered a major and significant problem. Mullen and Fleming (1999) provided an explanation into why this might be the case, they stated fears of trust or establishing interpersonal boundaries could stem from the breach of trust and the exploration of vulnerability experienced in the abuse. From the findings gathered in her research, Alexander (1992) stated that the history of CSA was found to be related to insecure and disorganised attachments in adult life. Sanderson (2002, p63) applied the view that the experience of CSA created a fear of intimacy amongst survivors. As a direct response there is a constant search for numerous transient relationships, in preference to stable and constant relationships. Jehu et al (1985) research reflects the work of Sanderson, 77 per cent of their survivors reported that it was ‘dangerous to get close to anyone because they always betray, exploit or hurt you’. A small amount of research has demonstrated that adult survivors of childhood sexual abuse experience greater parental challenges than mothers with no history of abuse, (Dilillo 2001). Cohen (1995) conducted numerous investigations and found differences between abused and non-abused mothers in relation to their parenting skills. Women who had been abused performed less well on the all seven scales on the Parenting Skills Inventory, particularly in areas that assed role support, communication and role image. Van Scoyk et al (1991) provided an explanation into why previously abused parents lack particular parenting skills. They reported these individuals may possibly have inadequate opportunity to observe and learn from healthy, effective parenting models. However, Coleman and Widom (2004 cited in Brick 2005) disagreed with literature found and stated a history of CSA does not necessarily entail that one will have interpersonal dysfunction. In their study, they found amongst those who were abused about 40 per cent of females and 60 per cent of males were in long term relationships. In addition 90 per cent of participants did not commit infidelity with multiple partners. 3. 6Social Discussion Social workers must strive to establish and maintain the trust and confidence of service users, (General Social Care Council, 2012). Research into the long term social effects has shown that, survivors of CSA could possibly have difficulties in building relationships. Therefore, this could have an impact on the working relationship between the survivor and social worker. Trust is an essential factor in building an effective rapport with service users, (Crowther and Cowen 2011). Given the nature of the trauma, disruptions may arise in the survivor’s sense of safety and ability to trust. For that reason, it is important that social workers are equipped with an understanding of how to build and maintain the trust of survivors, as this may differ from working with service users with no history of abuse. Effective training in this area could possibly avoid issues that may sabotage the working relationship between the social worker and survivor. Therefore, more specialist knowledge would be advantageous. Furthermore, the power dynamics of the relationship may well have an impact on the rapport between the survivor and social worker. Fear of authority could influence the survivor’s perception of social workers. As abusers of CSA are often authority figures who exert their power, survivors may learn to fear authoritative figures, (Croft 2008). The inability to grow and develop healthy relationships for some survivors could possibly raise safeguarding concerns. For example, such effect could perhaps interfere with the attachment between a parent and child, resulting to issues effecting parenting capacity. Dr John Bowlby, founder of the attachment theory believed the earliest bonds between a child and care-giver have a great impact on the child that continues throughout their life, (Cherry 2012). However, due to early experiences in their own childhood, parents may become over-protective in order to protect their child from experiencing the same traumas. Conversely in some cases, this could promote the opposite behaviour and the parent become under-protective as it is difficult to display affection and closeness. In either circumstance the child may experience difficulty in achieving and meeting their full potential, due to impaired or inadequate relationships with the parent. Social workers along with other working professionals have the statutory duty to protect children who are at risk. This is in accordance to section 47 of the Children’s Act 1989, (Northamptonshire Local Safeguarding Children Board 2012). Parenting capacity is one of the three domains for The Framework for assessment of children and families and is essential in securing the best outcomes for the child, (Parker and Bradley 2003, p. 19). Disruptive attachment can cause issues with the child’s emotional warmth, stimulation, guidance, boundaries and stability. 3. 7Behavioural According to Thompson (2012) it is possible that repressed or forgotten abuse may manifest itself in adult life by out-of-control behaviours which can lead to the abuse of self and/or others. According to research evidence, early sexual experiences often have an influence on later sexual behaviour, (Herman 1981, Randolph and Mosack 2006, Wooden 2010). Randolph and Mosack (2006) quoted â€Å"When early sexual experience is abusive, it can exert specific effects on subsequent sexual behaviours†. Findings from their research found that, survivors of CSA engaged in risky sexual behaviour at higher rates than individuals who had not experienced such abuse, (Randolph and Mosack 2006). A number of studies furthered Randolph and Mosack findings and reported that risky sexual behaviour in adults previously abused was exhibited in many forms; having many sexual partners, failing to use condoms during intercourse increasing the risk of sexually transmitted infections and having anal sex, (Batten et al, 2001, Wingood and DiClemente, 1997). Herman (1981, p. 84) research echoed these findings, within her sample of sexually abused survivors 35 per cent of the women had a ‘ repertoire of sexually styled behaviour’, it was found they behaved in such manner for attention and1 affection. Wooden, (2010) provided an explanation as to why some adults with a history of CSA may participate in risky sexual behaviour. He stated that sexual abuse could result in the abused to disregard their own humanity therefore, perform sexual acts in a more promiscuous way. Rape and Sexual abuse centre (2011) provided their account of why survivors take part in such behaviours; they stated that due to survivor’s childhood experience it was possible that they were incapable to separating sex from affection, which then leads to promiscuity or impaired arousal. Thompson (2012) also made a contribution and stated that sexual promiscuity was a way of the survivors taking control of their feelings. In contrast to the above findings, Fromuth (1983) found no significant difference between promiscuous behaviour and the previously abused women who participated in the research. Riley (2011, p. 127) stated that in some cases victims could take the opposite direction and avoid sex entirely. She stated that the abused may often refuse to take part in sexual activity to remain in control of their own body, unlike when they were abused against their will as a child. Krahe et al (1999) found that female survivors of CSA were at risk of suffering from abuse in later life. Moore and Long (2002) suggested that abuse could occur in the form of adult sexual assault, physical abuse or psychological maltreatment. They also stated that a number of factors could increase a woman’s vulnerability towards abuse; learned manipulative behaviour, beliefs and attitudes, low self-esteem and learned helplessness. Survivors of childhood sexual abuse may compulsively attach themselves to unsuitable partners, who frequently resemble their abuser, Sanderson (2002, p62). Russell (1986, p. 2) found that 65 per cent of participants from sexual abuse backgrounds were victims of subsequent or attempted rape, in comparison to 36 per cent of non-abused participants. In addition, her findings also displayed that an average of 43 per cent of women had been subjected to physical violence by husbands or partners compared with 18 per cent of the control group. Bauserman an d Davis (1996 cited in Randolph and Mosack 2006), concluded that the relationship between CSA and adult sexual behaviour may depend on whether the individuals viewed the early sexual experience in a positive or negative way. Research has highlighted another effect of childhood sexual abuse; self-destructive behavior. Van der Kolk et al (1991) quoted â€Å"childhood trauma such as sexual abuse contributes heavily to the initiation of self-destructive behaviour’†. Erdmans and Black (2008) noted the different forms of self-destructive behaviour; self-mutilation, alcohol abuse, eating disorders and in some cases suicide. Wonderlich et al (2001) believed that this behaviour is presented as a result to reduce emotional distress associated with their abuse. Hiebert-Murphy and Woytkiw, (2000) added self-destructive behaviour was a maladaptive coping strategy for managing negative- self direct feelings. The experience of being abused as a child may increase a person’s risk for alcohol-related problems as an adult, (Windom 1993). Scher ;amp; Twaite, (1999, cited in Lee et al 2008) explained survivors may turn to alcohol as a means to block out psychological pain as they dissociate from their traumatic memories. Evidence to support this view can be seen in Langeland and Hartgers (1998) study; they found a significantly higher prevalence of issues surrounding alcohol in abused women than in the non- abused women. A positive correlation was also identified in Peters (1984, cited in Sanderson 2006, P. 126) research, 17 per cent of participants subjected to sexual abuse during their childhood had symptoms of alcohol abuse, compared to 4 per cent of the control group. However, Fleming et al (1998) study displayed conflicting results. There was no relationship found between alcohol intake and a history of CSA. Fleming et al (1998) argued that, the relationship between childhood sexual abuse and the development of adult alcohol problems needed to be researched further, as there is a sufficient amount of evidence to suggest that CSA alone is not a causative factor in the development of alcohol abuse. Eating disorders is another form of self-destructive behaviour. Research indicates a possible relationship between sexual abuse and the development of an eating disorder, (Myers 2005). Nelson and Hampson (2008) suggested a significant number of survivors have issues with food for a variety of reasons; determination to exercise control over their lives, self-hatred, reactions to oral assault, self -comfort in compulsive eating and in extreme cases sometimes the eating disorder is adopted as a wish to die. Johnson et al (2002 cited in Sanci et al 2008), conducted a longitudinal study among 782 participants and found that CSA was a risk factor for eating disorders in early adulthood. Oppenheimer et al (1986) found that women with anorexia and bulimia also reported a high incidence of childhood sexual abuse. Sanci et al (2008) reported discrepant findings, as some studies found that CSA was no more prevalent in females that were not subjected to such abuse. Another form of self-destructive behaviour that could possibly manifest into adulthood as a result of CSA is self injurious behaviour (Briere and Elliot, 1994 and Mundy, 2010) Klonsky and Moyer (2008) defined self injurious behaviour as ‘the causing of intentional, direct damage to one’s body tissue without suicidal intent’. Self injurious behaviour can be displayed in many forms such as cutting, burning or bruising, (Mundy 2010). Briere and Elliot, (1994) reported in their research, that self injurious behaviour is aimed to reduce the psychic tension associated with extremely negative guilt, intense depersonalization and feelings of helplessness. Similar to CSA, self injurious behaviour is often a source of humiliation and shame and grows in secrecy, (Mundy 2010). The pleasure gained from self injurious is not so much the inflicting of physical pain, but the cessation of emotional pain, Mundy 2010). Findings to support the view that individuals from a sexually abused background are likely to conduct self injurious behaviour can found in Gibson and Crenshaw (2010) research, a sample of individuals with self injurious behaviour took part in study and it was found that, 93 per cent of participants reported a history of childhood sexual abuse. The study also identified the more severe, the longer the durati on of the abuse or the more frequent the abuse took place the greater the risk of engaging in self injurious behaviour during their adult life. Briere (1984) also provides findings to support this view; it was found during his community study that 31 per cent of survivors expressed a desire to harm themselves, in comparison to 19 per cent of the non-survivors. 3. 8Behavioural Discussion The long term behavioural effects of CSA can raise safeguarding issues as such behaviours can cause significant harm to the survivor as well as the risk of others. Social work is a profession that works with a wide range of individuals in a number of different situations and settings. Alcohol and Drugs are related to a number of issues involving social services. Goodman (2009, p. ) quoted ‘clients will bring with them multiplicity of concerns; relationship issues, financial problems, housing, risk of offending, health (physical and mental) and behaviour problems. For this reason, it is imperative that CSA knowledge is not limited to social workers in the child protection field. However, it should be extended across the board, as the lon g term effects of CSA can present themselves in different situations. Chapter Four 4. 0Discussion The primary aim of the dissertation was to gain an understanding of the long term effects of CSA in three different domains; social, emotional and behavioural. A review of research suggest that although, there is existing evidence to indicate that survivors of CSA are likely to experience lasting effects in adulthood, findings are inconsistent and further research is required. The inconsistency within the results across all domains, has led me to conclude that CSA is in fact a risk factor, rather than a sole cause of the long term effects. When reviewing the literature, a number of CSA authors were in disagreement of the association between CSA and the long term effects in the different domains. Sharland et al (1996, p. 5) states that evidence supporting the effects of child sexual abuse can not be viewed as reliable as most of the evidence has been anecdotal, or based on unrepresentative or small samples. For this reason, it is not always clear to what extent a given study has identified the unique effects of CSA, (Briere and Elliot 1994). According to Ferguson (1997) ‘a well designed and controlled study following the child victims of CSA into adulthood, would enable the effects of such abuse to be monitored and allow data on possible confounding variables to be collected’. Unfortunately not only will this be expensive but also time consuming, thus as previously discussed in the literature review it is important to note that undertaking research in sensitive topics such as CSA can be difficult, and as a result is likely to be restricted. With respect to the literature, patterns emerged in relation to the period the research was published. Majority of the CSA research was carried out in the late 1980’s and 1990’s. Although up-to-date statistics on the prevalence of CSA were referred to, current studies relating to the effects of CSA were limited. The sudden rise in research can be linked with the increased awareness and concern of CSA at the time. â€Å"†¦ it was not until the 1980’s that the existence of CSA, in particular, fully entered the public consciousness†, (Pence and Wilson 1994). The lack of recent research may lead me to believe that society still views CSA as a taboo and unpalatable. It is also possible to propose that other types of sexual abuse have diverted the attention away from CSA. For example, sexual exploitation has recently received a great deal of public attention. In a recent report Barnardos (2012) stated that, child sexual exploitation has become a major child protection issue for communities across the UK. As a result of the increase of interest in the other forms of sexual abuse, CSA has been overlooked. The leading writers in the subject appear to be John Briere and David Finkelhor. Both authors published their research between the period of 1980 and 1990. I found that whilst gathering literature for my review I commonly came across both authors, also many other authors commonly referred to their work. Briere’s focused his work on all forms of child abuse and how the abuse affects the survivor’s psychosocial functioning as an adult, (Goldstien 1992). Finkelhor is best known for his conceptual and empirical research on child sexual abuse this is reflected in his publications, (Durham 2006). The most common long term effect highlighted in the literature was depression. Research illustrates, of all the long term effects depression is the most frequently reported symptom amongst CSA survivors, (Briere and Elliot 1994, Sanderson 2002, Lanktree et al 1991). A plausible explanation to why depression is reported as the most frequent effect, can be due to the fact survivors are more likely to seek medical help for this effect in comparison to effects such as guilt or self-injurious behaviour. A number of survivors of CSA who visit their doctors are acutely distressed and depressed, (Mammen and Oisen 1996). Chapter Five 5. 0Conclusion/Recommendations The study demonstrates that the relationship between long term effects in the three domains; emotional, social, behavioural and the history of CSA abuse is inclusive. Therefore, the inconsistency of findings suggests that CSA can be viewed as a risk factor as opposed to a cause for the wide range of long term effects amongst survivors of CSA. Despite the increase in research, further research is required to enable a more in-depth understanding of the long term effects with a more representative sample of survivors. As literature gathered mainly focused on female survivors, results cannot be generalised. With the purpose of improving the quality of professional’s intervention as well as relevant strategies being developed to support survivors. Having undertaken secondary research on the long term effects of CSA, I would recommend that social workers and related practitioners not just in the child protection field but across all sectors have more adequate training in identifying survivors of CSA to ensure they can provide the appropriate care, treatment, support, and also more awareness on effectively handling disclosures. The outcome of this could possibly increase the numbers of disclosures made and may also prevent survivors of CSA suffering in silence. Personally and professionally, I have successfully gained a better understanding on the journey a number of individuals may experience as a survivor of CSA. Although as a survivor of such abuse, prior to conducting the research I was conscious of some of the effects present however, was not fully aware of the severity and the significant implications such abuse had on not only the life of the survivor, but also on other significant individuals in their lives. I believe having such knowledge will have a positive impact on both my personal and professional development as a social worker. Before undertaking the research, I was always reluctant to speak about my experience of CSA; I tended to repress my memories as a way of coping with the abuse. However, increasing my awareness on the topic I believe, has given me the confidence to feel comfortable within myself to openly disclose my past. The research has allowed me to understand that in fact, sexual abuse effects continue long after the abuse stops. I am now able to identify that many of my current issues stem from my history of abuse; as a result a sense of self-blame has been removed.