A nurse in a family practice clinic is collecting data from a school-age child. Which of the following behavioral findings should the nurse identify as a possible indication of sexual abuse?

A. Withdrawal can be a sign of trauma or distress, including sexual abuse. B. While destructive behavior can be a reaction to various stressors, it is less specific to sexual abuse. C. Perfectionistic behavior may be seen in children dealing with various pressures but is not specifically indicative of sexual abuse. D. Manipulative behavior can be a response to different environmental factors and is not specifically indicative of sexual abuse.