In diagnosing incest, a high index of suspicion is of the greatest importance. Given the reluctance of professionals to consider this possibility and the unwillingness of the family to reveal its pathology, incest becomes doubly difficult to identify.In a pediatric setting the victim of incest may be the young girl who presents with a variety of physical or psychosomatic or behavioral complaints. Her family may appear to be stable and well functioning, or they may have many problems obvious to the community because of their acting-out. In either situation, family dynamics may reveal an inadequate sexual relationship between the parents, condoning of the incest by the mother, and denial of this behavior by all individual members who fear exposure and resultant family disintegration.Incest arises as a symptom of severely distorted family relationships and can inflict considerable psychological damage on the child involved in this pathological triangle. This is particularly true when the girl is an adolescent. For these reasons, professionals who deal with children need to have a heightened awareness of the possibility of incest so it can be identified and reported to the appropriate authorities, and intervention instituted.
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