The prevalence of child sexual abuse in community and student samples: A meta-analysis

doi:10.1016/j.cpr.2009.02.007

Clinical Psychology Review

Volume 29, Issue 4, June 2009, Pages 328-338

https://doi.org/10.1016/j.cpr.2009.02.007 Get rights and content

Abstract

Background

Studies conducted internationally confirm that child sexual abuse is a much more widespread problem than previously thought, with even the lowest prevalence rates including a large number of victims that need to be taken into account.

Objective

To carry out a meta-analysis of the prevalence of child sexual abuse in order to establish an overall international figure.

Methods

Studies were retrieved from various electronic databases. The measure of interest was the prevalence of abuse reported in each article, these values being combined via a random effects model. A detailed analysis was conducted of the effects of various moderator variables.

Results

Sixty-five articles covering 22 countries were included. The analysis showed that 7.9% of men (7.4% without outliers) and 19.7% of women (19.2% without outliers) had suffered some form of sexual abuse prior to the age of eighteen.

Conclusions

The results of the present meta-analysis indicate that child sexual abuse is a serious problem in the countries analysed.

Section snippets

Selection of studies

The present study included papers published in scientific journals and which met the following inclusion criteria: a) their main or secondary objective was to determine the prevalence of child sexual abuse; b) they used non-clinical samples; c) they reported the prevalence of child sexual abuse separately for men and women; and d) they reported sufficient data to determine the corresponding prevalence and sample size.

Studies were located via the databases Psycinfo, Medline, and Science Citation

Characteristics of the studies

Of the eligible articles, those which did not meet one or more of the previously-established inclusion criteria were excluded. Two studies were also excluded because they were based on the same data as another publication that had already been included, along with a further two in which it was impossible to distinguish between the prevalence of child sexual abuse and that of sexual abuse in adulthood.

The final sample thus comprised 65 original articles that met the inclusion criteria (see ⁎ in

Discussion

The results obtained in the present study confirm that the experience of child sexual abuse is a problem of considerable magnitude in all the societies analysed. Although the epidemiological data from the studies reviewed do not enable definitive prevalence rates to be established this fact should not be used to underestimate the scale of the problem revealed by the data presented here. The results of the present meta-analysis, the first to be carried out with respect to the epidemiology of

Limitations

The present study has several limitations. According to Finkelhor (1993) one of the main problems faced by retrospective studies is that since they are conducted with adults and their results cannot be generalised to the current population of children, for whom the indices and circumstances of victimisation may be very different.

The use of retrospective studies also runs the risk of underestimating the number of real cases of sexual abuse, since in this type of research the percentage of false

Conclusions and future research

Despite the limitations described above, the results of the present meta-analysis remain highly relevant since they indicate that child sexual abuse is a serious problem in each of the countries analysed, this being consistent with the findings of previous reviews (Finkelhor, 1994, Pereda et al., in press).

Although the potential moderator variables do not, on their own, explain the total variability observed in prevalence rates they do reveal certain aspects of relevance as regards the wide

References² (132)

⁎AndersonJ. et al.
Prevalence of childhood sexual abuse experiences in a community sample of women
Journal of the American Academy of Child and Adolescent Psychiatry
(1993)
⁎ArreolaS.G. 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)
ArriolaK.R.J. et al.
A meta-analysis of the relationship of child sexual abuse to HIV risk behaviour among women
Child Abuse & Neglect
(2005)
⁎BackS.E. et al.
Child sexual and physical abuse among college students in Singapore and the United States
Child Abuse & Neglect
(2003)
⁎BakerA.W. et al.
Child sexual abuse: A study of prevalence in Great Britain
Child Abuse & Neglect
(1985)
⁎BarthauerL.M. 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)
BeitchmanJ.H. et al.
A review of the short-term effects of child sexual abuse
Child Abuse & Neglect
(1991)
BeitchmanJ.H. et al.
A review of the long-term effects of child sexual abuse
Child Abuse & Neglect
(1992)
⁎BendixenM. et al.
The impact of child sexual abuse. A study of a random sample of Norwegian students
Child Abuse & Neglect
(1994)
⁎BouvierP. et al.
Typology and correlates of sexual abuse in children and youth: Multivariate analyses in a prevalence study in Geneva
Child Abuse & Neglect
(1999)

⁎BriereJ. 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)

⁎BriereJ. et al.

Symptomatology associated with childhood sexual victimization in a nonclinical adult sample

Child Abuse & Neglect

(1988)

BrownJ. et al.

A longitudinal analysis of risk factors for child maltreatment: Findings of a 17-year prospective study of officially recorded and self-reported child abuse and neglect

Child Abuse & Neglect

(1998)

⁎ChenJ. et al.

Child sexual abuse in China: A study of adolescents in four provinces

Child Abuse & Neglect

(2004)

⁎ChenJ. et al.

Child sexual abuse in Henan province, China: Associations with sadness, suicidality, and risk behaviours among adolescent girls

Journal of Adolescent Health

(2006)

⁎ChoquetM. 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)

ColemanL. et al.

The measurement of puberty: A review

Journal of Adolescence

(2002)

⁎De PaúlJ. et al.

Childhood maltreatment, childhood social support, and child abuse potential in a Basque sample

Child Abuse & Neglect

(1995)

DhaliwalG.K. et al.

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

Clinical Psychology Review

(1996)

⁎FanslowJ.L. et al.

Prevalence of child sexual abuse reported by a cross-sectional sample of New Zealand women

Child Abuse & Neglect

(2007)

⁎FigueiredoB. et al.

History of childhood abuse in Portuguese parents

Child Abuse & Neglect

(2004)

FinkelhorD.

Epidemiological factors in the clinical identification of child sexual abuse

Child Abuse & Neglect

(1993)

FinkelhorD.

The international epidemiology of child sexual abuse

Child Abuse & Neglect

(1994)

⁎FinkelhorD. et al.

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

Child Abuse & Neglect

(1990)

FlemingJ. et al.

A study of potential risk factors for sexual abuse in childhood

Child Abuse & Neglect

(1997)

⁎GoldmanJ.D.G. et al.

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

Child Abuse & Neglect

(1997)

GoreyK.M. et al.

The prevalence of child sexual abuse: Integrative review adjustment for potential response and measurement biases

Child Abuse & Neglect

(1997)

Hetzel-RigginM.D. et al.

A meta-analytic investigation of therapy modality outcomes for sexually abused children and adolescents: An exploratory study

Child Abuse & Neglect

(2007)

JumperS.A.

A meta-analysis of the relationship of child sexual abuse to adult psychological adjustment

Child Abuse & Neglect

(1995)

⁎KercherG.A. et al.

The prevalence of child sexual abuse victimization in an adult sample of Texas residents

Child Abuse & Neglect

(1984)

LalorK.

Child sexual abuse in Tanzania and Kenya

Child Abuse & Neglect

(2004)

LeventhalJ.M.

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

Child Abuse & Neglect

(1998)

⁎LodicoM.A. et al.

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

Journal of Adolescent Health

(1996)

⁎LópezF. et al.

Prevalencia y consecuencias del abuso sexual al menor en España

Child Abuse & Neglect

(1995)

⁎May-ChahalC. et al.

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

Child Abuse & Neglect

(2005)

⁎McCrannD. et al.

Childhood sexual abuse among university students in Tanzania

Child Abuse & Neglect

(2006)

⁎MullenP.E. et al.

Impact of sexual and physical abuse on women's mental health

The Lancet

(1988, April 16)

⁎NiederbergerJ.M.

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)

OatesR.K. et al.

Erroneous concerns about child sexual abuse

Child Abuse & Neglect

(2000)

⁎PeredaN. et al.

Prevalencia y características del abuso sexual infantil en estudiantes universitarios españoles

Child Abuse & Neglect

(2007)

PrescottA. et al.

The veridicality of punitive childhood experiences reported by adolescents and young adults

Child Abuse & Neglect

(2000)

PutnamF.

Ten-year research update review: Child sexual abuse

Journal of the American Academy of Child and Adolescent Psychiatry

(2003)

ReekerJ. et al.

A meta-analytic investigation of group treatment outcomes for sexually abused children

Child Abuse & Neglect

(1997)

⁎RewL. et al.

A comparative study among college students of sexual abuse in childhood

Archives of Psychiatric Nursing

(1991)

⁎AlamiM. 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)

⁎ArroyoJ.A. et al.

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

Hispanic Journal of Behavioral Sciences

(1997)

⁎BagleyC. et al.

Sexual abuse in childhood: Psychosocial outcomes and implications for social work practice

Social Work Practice in Sexual Problems

(1986)

⁎BasileK.C. et al.

Prevalence and characteristics of sexual violence victimization among U.S. adults, 2001–2003

Violence and Victims

(2007)

BeattyP.

The dynamics of cognitive interviewing

BerrickJ.D. et al.

Child sexual abuse prevention: Research review and recommendations

Social Work Research & Abstracts

(1992)

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^☆: This study was supported in part by grants 2005SGR00365 from the “Departament d'Universitats, Recerca i Societat de la Informació de la Generalitat de Catalunya”, and SEJ2005-09144-C02-01-02 from Spain's “Ministerio de Ciencia y Tecnología” under European Regional Development Found (ERDF).

^☆☆: The authors would like to thank all the researchers who kindly provided additional study data upon request. We are indebted to David Gallardo-Pujol for supplying the figures.

¹: Tel.: +34 93 312 51 13; fax: +34 93 402 13 62.

²: Articles marked with an asterisk were included in the meta-analysis (may not have been cited in the text).

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The prevalence of child sexual abuse in community and student samples: A meta-analysis☆,☆☆

Abstract

Background

Objective

Methods

Results

Conclusions

Section snippets

Selection of studies

Characteristics of the studies

Discussion

Limitations

Conclusions and future research

Journal of the American Academy of Child and Adolescent Psychiatry

Child Abuse & Neglect

Child Abuse & Neglect

Child Abuse & Neglect

Child Abuse & Neglect

Child Abuse & Neglect

Child Abuse & Neglect

Child Abuse & Neglect

Child Abuse & Neglect

Child Abuse & Neglect

Child Abuse & Neglect

Child Abuse & Neglect

Child Abuse & Neglect

Child Abuse & Neglect

Journal of Adolescent Health

Child Abuse & Neglect

Journal of Adolescence

Child Abuse & Neglect

Clinical Psychology Review

Child Abuse & Neglect

Child Abuse & Neglect

Child Abuse & Neglect

Child Abuse & Neglect

Child Abuse & Neglect

Child Abuse & Neglect

Child Abuse & Neglect

Child Abuse & Neglect

Child Abuse & Neglect

Child Abuse & Neglect

Child Abuse & Neglect

Child Abuse & Neglect

Child Abuse & Neglect

Journal of Adolescent Health

Child Abuse & Neglect

Child Abuse & Neglect

Child Abuse & Neglect

The Lancet

Child Abuse & Neglect

Child Abuse & Neglect

Child Abuse & Neglect

Child Abuse & Neglect

Journal of the American Academy of Child and Adolescent Psychiatry

Child Abuse & Neglect

Archives of Psychiatric Nursing

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

Sexual abuse in childhood: Psychosocial outcomes and implications for social work practice

Social Work Practice in Sexual Problems

Prevalence and characteristics of sexual violence victimization among U.S. adults, 2001–2003

Violence and Victims

The dynamics of cognitive interviewing

Child sexual abuse prevention: Research review and recommendations

Social Work Research & Abstracts