Rarely is the abuser a stranger. Intrafamilial and incest sexual abuse is difficult to document and manage because the child just be protected from additional abuse and coercion to not reveal or deny the abuse, while attempts are made to preserve the family unit. Children themselves may also decide to recant thier recent accusations of abuse due to fear of retaliation by the perpetrator or other family members. They may also recant out of fear of loosing contact with the perpetrator who is commonly a family member or close friend tied to t he family by various social means. Violence is not common in sexual abuse, however, its incidence increases with the age and size of the victim and specific traits in the perpetrator.
Violence is more likely to occur in association with a single incident by a stranger.
In cases of vilent incest, the father has been described as sociopathic, with a sexual abuse extending outside the family circle. Clinical manifestations of sexual abuse 1. Vaginal, penile, or rectal pain, redness of area, or a discharge with or without bleeding. Chronic painful urination, constipation 3. Behaviors associated with sexual abuse 1. sexualized activity with peers, animals, or objects 2.