Anxiety Symptom Burden at the Time of Forensic Evaluation in Child Victims of Sexual Assault: A Prospective Study Using the Beck Anxiety Inventory

Background/Objectives: Research on child sexual abuse has largely addressed long-term sequelae, whereas anxiety at the time of forensic evaluation has rarely been quantified. This prospective study measured anxiety symptoms in child victims of sexual assault at forensic evaluation and identified the associated sociodemographic and incident-related factors. Methods: Children aged 6 to 17 years referred on suspicion of sexual assault and undergoing genital examination at a university forensic medicine department (Adana, Türkiye; May 2024 to May 2025) were evaluated prospectively. The Beck Anxiety Inventory (BAI) was administered immediately before examination. A proportional-odds ordinal regression model was fitted, with sensitivity analyses restricted to adolescents (12 to 17 years) and robustness analyses (bootstrap resampling, outcome dichotomisation and Firth penalization). Results: Of 104 children (82.7% female), 35 (33.7%) had severe anxiety. After adjustment, age group (aOR 1.95, 95% CI 1.05 to 3.65), penetration (aOR 5.16, 2.02 to 13.22) and disclosure to a formal recipient (aOR 2.48, 1.09 to 5.67) remained associated with anxiety. When restricted to adolescents, penetration (aOR 5.60) and formal disclosure (aOR 2.50) persisted while age lost significance (aOR 2.08); both were confirmed in bootstrap, dichotomised and Firth-penalised models. Conclusions: One third of children carried a severe anxiety burden at forensic evaluation, associated most strongly with penetration and formal disclosure and less consistently with older age, which may be partly artefactual. Without a comparison group, these exploratory findings describe associations rather than causal relationships and support routine psychiatric assessment and psychological support at forensic evaluation.