Prevelance

How common is sexual abuse?

Until the late 1970s, it was common to hear from research studies and mental health professionals the belief that child sexual abuse was rare – even that it might affect "one in a million" children. It was also assumed largely to happen among females, among the poor working-class and isolated families living on rural farmsteads. Since that time, due to growing professional and public awareness, publicised court cases, media scrutiny and the courage of survivors themselves in coming forward to campaign for change, it has become clear that sexual abuse is common through all levels of society and occupations, and affects both women and men.

What do "prevalence" and "incidence" mean?

"Prevalence" refers to the proportion of any defined population who have been sexually abused in childhood, and is the measure more commonly used.

"Incidence" refers to the number of known new cases happening to children within any defined population in the course of a year.

What do prevalence studies and other estimates tell us?

A bewildering and confusing variety of statistics! For example, two recent World Health Organisation studies have estimated that approx. 20% of women and 5% of men have been sexually abused as children. Baker and Duncan's pioneering British study of 1985 suggested 12% of females and 8% of males suffered CSA. Cawson's UK study (2000) found 21% of females and 11% of males had suffered any form of CSA, (i.e. including "non-contact abuse", such as making children watch pornography or sexual activity) while 16% of females and 7% of males had suffered contact sexual abuse.

McGhee's Irish study (2003) found 30% of females, 24% of males for any form of CSA, and 20% of females, 16% of males for contact abuse. Fergusson's 1996 study in New Zealand (1996) found 13% of women and 3% of men experienced contact abuse. A wide range of American studies has estimated, for instance, rates for women between 6% and 38%.

Attempts may also be made to estimate CSA from numbers of offenders. For instance, Scotland in 2007 currently has approx. 3200 registered sex offenders. However, looking at offenders also produces varied estimates of CSA. This is because only a small percentage of sex offenders is detected, convicted or registered – some think as few as 2% – because some sex offenders molest adults rather than children, and because some have assaulted hundreds of child victims while others have had a single victim.

Why have studies produced such varied statistics, and why are most still likely to be under-estimates?

This is not because studies are poorly or carelessly done (although some may be), but for valid reasons about different definitions and methods, and the very secretive nature of CSA.

1. "Childhood sexual abuse" itself has been defined in a range of ways. For instance some studies include "non-contact" abuse while others do not. Age limits for "childhood" or for "consent" have been set differently. There are diverse ideas about what constitutes "serious" sexual abuse, and whether or not child perpetrators and their victims should be included in the statistics.
2. The questions asked, the language used, the comfort and privacy of the setting, the gender of interviewer and the degree to which he/she is trained affects the extent to which people are willing to disclose past abuse to a research study.
3. Females have been studied far more than males: information about abuse against males is still continuing to emerge.
4. When estimates are compiled from criminal justice, courts, social work or other child protection records, the problem is that only a small percentage of sexual crime against children is detected and recorded – according to some estimates, between 2% and 5%. Recorded rates also vary between countries, and even within the UK.
5. Much of CSA (indeed of any other criminal activity which is secretive, unobserved, uncorroborated and shameful for victims) is always likely to remain undetected. Most perpetrators never admit their actions, and many survivors feel too ashamed to tell of their experiences. Boys and men, especially, have found disclosure difficult.

Thus we shall never know the exact extent of CSA, and what is currently known is always likely to be an under-estimate. However, it is important that lack of knowledge about exact figures is not used as an excuse for inaction, because there remains a great unmet need for services, even among those survivors who are identified.

Are prevalence rates higher among certain groups?

Yes – but not necessarily in the way it's been assumed. Prejudiced and racist assumptions were (sometimes still are) made about incestuous behaviour being a "way of life" among whole classes of people, such as the "lower working classes," certain races, or people on remote hill farms and distant islands! We know now, from more soundly-based research and practice, that abuse is common throughout society, and that very high rates of CSA are most often found among groups of people who are already damaged by their childhood trauma experiences. In other words for example, among children in care, people in psychiatric hospitals or prisons, homeless people, or those with severe drink or drug problems. That raises important issues for services in those areas – are they sensitively identifying survivors, and what levels of support and therapeutic help exist to meet their needs in the community or institutions.

References: Some studies named above, and a sample of other literature which discusses issues about CSA prevalence.

• Baker, A. W. and Duncan, S. P. (1985) Child sexual abuse: a study of prevalence in Great Britain. Child Abuse and Neglect, 9: 453-467.
• Briere J and Elliott DM.2003. Prevalence and psychological sequelae of self reported childhood physical and sexual abuse in a general population sample of men and women. Child Abuse & Neglect 27, 1205-1222.
• Creighton, S. J. (2002b). Recognising changes in incidence and prevalence. In: Browne, K. D., Hanks, H., Stratton, P. and Hamilton, C. (eds) Early prediction and prevention of child abuse. A handbook. Chichester: Wiley.
• Fergusson DM and Mullen PE. (1999). Childhood sexual abuse: an evidence based perspective. California: Sage Publications Inc.
• Finkelhor, D. (1994) The international epidemiology of child sexual abuse. Child Abuse and Neglect, 18(5): 409-417.
• Jones LM, Finkelhor D, Kopiec K. (2001) Why is sexual abuse declining? A survey of state child protection administrators Child Abuse and Neglect, 25, 9.1139-1158
• Jones L, Finkelhor D. (2001) The Decline in Child Sexual Abuse Cases. OJJDP, Juvenile Justice Bulletin, January
• Kelly, L., Regan, L. and Burton, S. (1991) An exploratory study of the prevalence of sexual abuse in a sample of 16-21 year olds. Child Abuse Studies Unit. London: PNL.
• McGee, H.. et al. (2003) The SAVI Report: Sexual Abuse and Violence in Ireland. Dublin Rape Crisis Centre; Liffey Press.
• Martin, J. et al. (1993) Asking about child sexual abuse: methodological implications of a two stage survey. Child Abuse and Neglect, 17: 383-392.
• MacMillan HL. Fleming JE. et al. 1997 Prevalence of child physical and secual abuse in the community. Results from the Ontario Health Supplement. JAMA 278, 2.
• Moncrieff J et al. (1996). Sexual abuse in people with alcohol problems. Br Jnl Psychiatry, 169 (3) 35560)
• Pilkington, B. and Kremer, J. (1995) A review of the epidemiological research on child sexual abuse: community and college student samples. Child Abuse Review, 4(2): 84-98.
• Putnam FW. 2003. Ten-year Research Update Review: Child Sexual Abuse. Jnl of Am Acan Chd Adol Psychiat 42:3
• Siegal, J. M. et al.. (1987) The prevalence of childhood sexual assault: the Los Angeles epidemiologic catchment area project. American Journal of Epidemiology, 126: 1141-1153.
• Tonmyr, L. (1998) International studies on the incidence and prevalence of child maltreatment: Selected bibliography. Child Maltreatment Division, Health Protection Board, Health Canada. Ottawa.
• U.S. Department of Health and Human Services (1996) The Third National Incidence Study of child abuse and neglect (NIS-3). Washington DC: National Center on Child Abuse and Neglect.
• Windle M et al. 1995. Physical and sexual abuse and associated mental disorders among alcoholic inpatients. Am J Psychiatry 152:1322-1328
• Wilsnack SC et al. Childhood sexual abuse and women's substance abuse: national survey findings. J Stud Alcohol. 58 (3) 264-71.)
• World Health Organisation, 2002. World Report on Violence and Health.
• World Health Organisation, 2002. World Health Report.
• Wyatt GE. Loeb TB et al. 1999. The prevalence and circumstances of child sexual abuse: changes across a decade. Child Abuse & Neglect 23, 1, 45-60.

prevalence