Three distinct components to the abuse were identified and found to interact with one another: incest, neighborhood juvenile perpetration, and organized adult ritual sex rings. Among juvenile perpetrators were many who were considered conscientious; religious leaders and women were also involved. Lack of understanding led to oversimplification of the problem, inaccurate investigative work, and attempts to discredit victims and therapists. The majority of children showed little symptomology at first, but made significant increases during the disclosure process. Ritual abuse in neighborhood settings appears secretive, coercive, and complex. Table, figure, and 14 references (Author abstract modified)