Elsevier

Child Abuse & Neglect

Volume 33, Issue 6, June 2009, Pages 331-342
Child Abuse & Neglect

The international epidemiology of child sexual abuse: A continuation of Finkelhor (1994)

https://doi.org/10.1016/j.chiabu.2008.07.007Get rights and content

Abstract

Objective

The purpose of this paper was to compare the prevalence rates of child sexual abuse reported by [Finkelhor, D. (1994). The international epidemiology of child sexual abuse. Child Abuse & Neglect, 18 (5), 409–417] with those found in recent publications in order to confirm the widespread prevalence of child sexual abuse.

Methods

Relevant articles about prevalence of child sexual abuse were identified through searches of computerized databases and a handsearch of Child Abuse & Neglect and the Journal of Child Sexual Abuse.

Results

Thirty-eight independent articles were identified, corresponding to 39 prevalence studies; these articles report the prevalence of childhood sexual abuse in 21 different countries, ranging from 0 to 53% for women and 0 to 60% for men.

Conclusions

Comparison of the present study with that of [Finkelhor, D. (1994). The international epidemiology of child sexual abuse. Child Abuse & Neglect, 18 (5), 409–417] shows a similarity between prevalence distributions; there appears to be a general pattern that remains more or less constant over the years, especially in women.

Practice implications

Twelve years after the first revision study about the international prevalence of child sexual abuse, there is still a need for new data about this topic. The present study shows child sexual abuse is still a widespread problem in the society. In this research, carried out on 38 independent studies, there is new data for 21 countries over the world, being especially relevant the results obtained from other countries different from those pertaining to North America or Europe. It is important to point out the high prevalence found in most of the countries, so this information could be a new warning to make society and governments aware of this problem and undertake actions to prevent sexual abuse in childhood.

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)

  • G.K. Dhaliwal et al.

    Adult male survivors of childhood sexual abuse, prevalence, sexual abuse characteristics, and long-term effects

    Clinical Psychology Review

    (1996)
  • D.M. *Fergusson et al.

    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

    (1996)
  • B. *Figueiredo et al.

    History of childhood abuse in Portuguese parents

    Child Abuse & Neglect

    (2004)
  • D. Finkelhor

    The international epidemiology of child sexual abuse

    Child Abuse & Neglect

    (1994)
  • D. Finkelhor et al.

    Sexual abuse in a national survey of adult men and women: Prevalence, characteristics, and risk factors

    Child Abuse & Neglect

    (1990)
  • S.N. Gold et al.

    Abuse characteristics among childhood sexual abuse survivors in therapy: A gender comparison

    Child Abuse & Neglect

    (1998)
  • J.D.G. *Goldman et al.

    The prevalence and nature of child sexual abuse in Queensland, Australia

    Child Abuse & Neglect

    (1997)
  • M.E. Haskett et al.

    Absence of males in maltreatment research: A survey of recent literature

    Child Abuse & Neglect

    (1996)
  • G.R. Holmes et al.

    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

    (1997)
  • J.M. Leventhal

    Epidemiology of sexual abuse of children: Old problems, new directions

    Child Abuse & Neglect

    (1998)
  • M.A. *Lodico et al.

    Childhood sexual abuse and coercive sex among school-based adolescents in a Midwestern state

    Journal of Adolescent Health

    (1996)
  • J.T. Manly

    Advances in research definitions of child maltreatment

    Child Abuse & Neglect

    (2005)
  • C. *May-Chahal et al.

    Measuring child maltreatment in the United Kingdom: A study of the prevalence of child abuse and neglect

    Child Abuse & Neglect

    (2005)
  • J.M. *Niederberger

    The perpetrator's strategy as a crucial variable: A representative study of sexual abuse of girls and its sequelae in Switzerland

    Child Abuse & Neglect

    (2002)
  • R.K. Oates et al.

    Erroneous concerns about child sexual abuse

    Child Abuse & Neglect

    (2000)
  • R.W. *Robin et al.

    Prevalence, characteristics, and impact of childhood sexual abuse in a southwestern American Indian tribe

    Child Abuse & Neglect

    (1997)
  • E. Romano et al.

    Male sexual abuse: A review of effects, abuse characteristics, and links with later psychological functioning

    Aggression and Violent Behavior

    (2001)
  • D.K. Runyan

    Prevalence, risk, sensitivity and specificity: A commentary on the epidemiology of child sexual abuse and the development of a research agenda

    Child Abuse & Neglect

    (1998)
  • D.E.H. Russell

    The incidence and prevalence of intrafamilial and extrafamilial sexual abuse of female children

    Child Abuse & Neglect

    (1983)
  • H. *Sariola et al.

    The prevalence and context of incest abuse in Finland

    Child Abuse & Neglect

    (1996)
  • M. *Schein et al.

    The prevalence of a history of child sexual abuse among adults visiting family practitioners in Israel

    Child Abuse & Neglect

    (2000)
  • C.S. *Tang

    Childhood experiences of sexual abuse among Hong Kong Chinese college students

    Child Abuse & Neglect

    (2002)
  • N.D. *Vogeltanz et al.

    Prevalence and risk factors for childhood sexual abuse in women: National survey findings

    Child Abuse & Neglect

    (1999)
  • G.E. Wyatt

    The sexual abuse of Afro-American and White-American women in childhood

    Child Abuse & Neglect

    (1985)
  • G.E. Wyatt et al.

    Issues in the definition of child sexual abuse in prevalence research

    Child Abuse & Neglect

    (1986)
  • G.E. *Wyatt et al.

    The prevalence and circumstances of child sexual abuse: Changes across a decade

    Child Abuse & Neglect

    (1999)
  • L.E. Aaro et al.

    Health behavior among school children: A World Health Organization cross-national survey

    Health Promotion

    (1986)
  • M. *Alami et al.

    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

    (2004)
  • J.A. *Arroyo et al.

    Childhood sexual abuse among Hispanic and Non-Hispanic white college women

    Hispanic Journal of Behavioral Sciences

    (1997)
  • D. Bernstein et al.

    Initial reliability and validity of a new retrospective measure of child abuse and neglect

    American Journal of Psychiatry

    (1994)
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    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”.

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