The international epidemiology of child sexual abuse: A continuation of Finkelhor (1994)☆
Introduction
The widespread prevalence of child sexual abuse has been reported in several countries, thus highlighting the social importance of understanding the nature and scope of this problem. In this regard, epidemiological studies conducted over the last two decades have made important contributions to understanding this problem (Leventhal, 1998). The prevalence of child sexual abuse has been defined as the proportion of a population who have suffered sexual abuse during childhood (generally before the age of 18) and it is based on retrospective accounts. In contrast, incidence studies estimate the number of new child sexual abuse cases occurring during a specified period of time, typically a year (Runyan, 1998). Although results vary considerably, and cannot be compared directly due to substantive methodological differences, they all suggest that child sexual abuse is clearly an international problem. Finkelhor (1994) reviewed the prevalence studies on child sexual abuse from the 1970s to the 1990s. Although the literature included in his review is extremely variable in its scope and quality, he concluded that sexual abuse was reported in all of the studies; specifically, he confirmed a history of sexual abuse in at least 7% of females and at least 3% of males, with a range of up to 36% of women in Austria and 29% of men in South Africa. As stated by Finkelhor (1994) and by Wynkoop, Capps, and Priest (1995) differences in research methodology (e.g., child abuse definitions, data gathering techniques, populations sampled, the use of broad or more behaviorally specific questions) are thought to account for most of the variance in prevalence rates between studies.
Sexual abuse researchers have used different definitions of what constitutes childhood sexual abuse (e.g., the age difference between the perpetrator and the victim, the age used to define childhood or the type of sexual abuse). Whereas some researchers have set the age of the victim at 18 (e.g., Bendixen et al., 1994, Briere and Elliott, 2003, Collings, 1997), others have used a cut-off both below and above this age (Arreola et al., 2005, Chen et al., 2004, Jumaian, 2001). Obviously, such variability influences the estimates of child sexual abuse prevalence in any given sample (Wynkoop et al., 1995).
Much of the variability in child sexual abuse prevalence is presumed to be due to methodological differences between studies, especially as regards the methods of data collection (Leventhal, 1998, Wyatt and Peters, 1986). Peters, Wyatt, and Finkelhor (1986) concluded that face-to-face interviews result in higher reporting rates for prevalence. Other authors, however, have established that self-administered questionnaires probably cause less embarrassment among respondents and produce better response rates than do face-to-face interviews in some societies (Tang, 2002). However, the use of self-administered questionnaires to identify personal experiences such as sexual abuse increases the risk of false negatives and affects the estimation of prevalence (Berliner and Conte, 1995, Oates et al., 2000, Wolfe and Birt, 1997). The number of false negatives is always higher than the number of victims who report false allegations of sexual abuse (Brown et al., 2001, Fergusson et al., 2000).
Reviews have also found that the use of broad questions is associated with lower prevalence rates of sexual abuse than are more behaviorally specific questions (Fricker, Smith, Davis, & Hanson, 2003). Furthermore, both the context in which sexual victimization questions are asked (Koss, 1993) and the number of questions asked (Finkelhor, 1979) affect endorsement rates.
The gender of participants also seems to affect prevalence rates. Some authors have argued that the study of male sexual victimization was relatively neglected until fairly recently (Dhaliwal et al., 1996, Holmes and Slap, 1998, Romano and De Luca, 2001), although there are important publications that do address this potential bias (Finkelhor, Hotaling, Lewis, & Smith, 1990). Several problems have been considered when examining the rates of sexual abuse of males (Violato & Genuis, 1993), for example, substantially varying prevalence rates (Dhaliwal et al., 1996), the small numbers of sexually abused males who seek professional help for abuse-related difficulties (Holmes, Offen, & Waller, 1997), and lower rates than those obtained among female victims (e.g., Bouvier et al., 1999, Briere and Elliott, 2003, Robin et al., 1997). These confounding variables have resulted in insufficient reporting, recognition and treatment of these samples (for a review of the absence of males in maltreatment research, see Haskett, Marziano, & Dover, 1996).
Many studies on the prevalence of sexual abuse of minors have been published since 1994, with the strong North American and European contribution being complemented by reports from many other countries (e.g., China, Malaysia, Israel, Palestine, Turkey, and El Salvador). Nevertheless, the situation in most non-English speaking countries remains relatively unexplored (Tang, 2002). The present paper includes studies published subsequent to Finkelhor's review (1994), the aim being to compare his prevalence rates of child sexual abuse with those found in recent publications. We sought to test the hypothesis, as stated by Finkelhor (1994), that child sexual abuse continues to be one of the most important public health problems in all societies in which it has been measured (MacMillan, 1998). In this regard, it was hypothesized that the rates found would be very similar to those obtained over a decade ago and would confirm the widespread prevalence of child sexual abuse.
Section snippets
Selection of studies
Relevant articles about prevalence of child sexual abuse were identified through searches of computerized databases including Medline, Psycinfo, and Science Citation Index and Social Sciences Citation Index of the Web of Science. These databases were searched using the key words prevalence, child sexual abuse, andchildhood sexual abuse. In order to cover all the available citations, two more strategies were adopted: a reference list review and handsearch in the two journals most relevant to the
Results
The present research found a high variability between studies. Thirty-eight independent articles (see * at reference list) were included, corresponding to a total of 39 prevalence studies, the main characteristics of which are shown in Table 1.
These articles present the prevalence of childhood sexual abuse in 21 different countries. The response rates per study range from 65 to 100% with a mean of 83%, and the number of participants from 65 to 9,953 with a mean of 1646.97 per study. Table 2
Discussion
This study examined the prevalence of child sexual abuse since 1994 and compared the findings to those obtained in a comparable review by Finkelhor (1994). The results obtained from a variety of countries suggest that child sexual abuse remains an international problem. Twelve years ago there was a strong North American and European contribution to the study of child sexual abuse prevalence, this reflecting the level of social science research resources in these countries. Although the present
References (*Published studies included in the present review) (80)
- et al.
Higher prevalence of childhood sexual abuse among Latino men who have sex with men than non-Latino men who have sex with men: Data from the Urban Men's Health Study
Child Abuse & Neglect
(2005) - et al.
Child sexual and physical abuse among college students in Singapore and the United States
Child Abuse & Neglect
(2003) - et al.
Prevalence and effects of child sexual abuse in a poor, rural community in El Salvador: A retrospective study of women after 12 years of civil war
Child Abuse & Neglect
(1999) - et al.
The impact of child sexual abuse. A study of a random sample of Norwegian students
Child Abuse & Neglect
(1994) - et al.
The effects of disclosure and intervention on sexually abused children
Child Abuse & Neglect
(1995) - et al.
Typology and correlates of sexual abuse in children and youth: Multivariate analyses in a prevalence study in Geneva
Child Abuse & Neglect
(1999) - et al.
Prevalence and psychological sequelae of self-reported childhood physical and sexual abuse in a general population sample of men and women
Child Abuse & Neglect
(2003) - et al.
Child sexual abuse in China: A study of adolescents in four provinces
Child Abuse & Neglect
(2004) - et al.
Self-reported health and behavioural problems among adolescent victims of rape in France: Results of a cross-sectional survey
Child Abuse & Neglect
(1997) - et al.
Childhood maltreatment, childhood social support, and child abuse potential in a Basque sample
Child Abuse & Neglect
(1995)
Adult male survivors of childhood sexual abuse, prevalence, sexual abuse characteristics, and long-term effects
Clinical Psychology Review
Childhood sexual abuse and psychiatric disorder in young adulthood. I. Prevalence of sexual abuse and factors associated with sexual abuse
Journal of the American Academy of Child and Adolescent Psychiatry
History of childhood abuse in Portuguese parents
Child Abuse & Neglect
The international epidemiology of child sexual abuse
Child Abuse & Neglect
Sexual abuse in a national survey of adult men and women: Prevalence, characteristics, and risk factors
Child Abuse & Neglect
Abuse characteristics among childhood sexual abuse survivors in therapy: A gender comparison
Child Abuse & Neglect
The prevalence and nature of child sexual abuse in Queensland, Australia
Child Abuse & Neglect
Absence of males in maltreatment research: A survey of recent literature
Child Abuse & Neglect
See no evil, hear no evil, speak no evil: Why do relatively few male victims of childhood sexual abuse receive help for abuse-related issues in adulthood?
Clinical Psychology Review
Epidemiology of sexual abuse of children: Old problems, new directions
Child Abuse & Neglect
Childhood sexual abuse and coercive sex among school-based adolescents in a Midwestern state
Journal of Adolescent Health
Advances in research definitions of child maltreatment
Child Abuse & Neglect
Measuring child maltreatment in the United Kingdom: A study of the prevalence of child abuse and neglect
Child Abuse & Neglect
The perpetrator's strategy as a crucial variable: A representative study of sexual abuse of girls and its sequelae in Switzerland
Child Abuse & Neglect
Erroneous concerns about child sexual abuse
Child Abuse & Neglect
Prevalence, characteristics, and impact of childhood sexual abuse in a southwestern American Indian tribe
Child Abuse & Neglect
Male sexual abuse: A review of effects, abuse characteristics, and links with later psychological functioning
Aggression and Violent Behavior
Prevalence, risk, sensitivity and specificity: A commentary on the epidemiology of child sexual abuse and the development of a research agenda
Child Abuse & Neglect
The incidence and prevalence of intrafamilial and extrafamilial sexual abuse of female children
Child Abuse & Neglect
The prevalence and context of incest abuse in Finland
Child Abuse & Neglect
The prevalence of a history of child sexual abuse among adults visiting family practitioners in Israel
Child Abuse & Neglect
Childhood experiences of sexual abuse among Hong Kong Chinese college students
Child Abuse & Neglect
Prevalence and risk factors for childhood sexual abuse in women: National survey findings
Child Abuse & Neglect
The sexual abuse of Afro-American and White-American women in childhood
Child Abuse & Neglect
Issues in the definition of child sexual abuse in prevalence research
Child Abuse & Neglect
The prevalence and circumstances of child sexual abuse: Changes across a decade
Child Abuse & Neglect
Health behavior among school children: A World Health Organization cross-national survey
Health Promotion
Moroccan women with a history of child sexual abuse and its long-term repercussions: A population-based epidemiological study
Archives of Women's Mental Health
Childhood sexual abuse among Hispanic and Non-Hispanic white college women
Hispanic Journal of Behavioral Sciences
Initial reliability and validity of a new retrospective measure of child abuse and neglect
American Journal of Psychiatry
Cited by (367)
L'expérience subjective des femmes de diverses origines ethniques victimes d'agressions sexuelles intrafamiliales pendant l'enfance: Deux études de cas
2024, European Journal of Trauma and DissociationThe lifetime prevalence of child sexual abuse assessed in young adults in Lithuania
2023, Child Abuse and NeglectTo reveal a child's sexual abuse to a health professional: A metasynthesis
2022, Neuropsychiatrie de l'Enfance et de l'Adolescence
- ☆
This study was supported in part by grants SEJ 2005-09144-C02-01-01 and SEJ 2005-09144-C02-01-02 from the Spanish “Ministerio de Educación y Ciencia” under European Regional Development Fund (ERDF), and 2007FIC00736 and 2005SGR00365 from the “Departament d’Universitats, Recerca i Societat de la Informació de la Generalitat de Catalunya”.