Child sexual abuse is largely hidden from the adult society

Abstract

Objectives

The aim of this study was to investigate disclosure rates and disclosure patterns and to examine predictors of non-disclosure in a sample of male and female adolescents with self-reported experiences of sexual abuse.

Method

A sample of 4,339 high school seniors (2,324 girls, 2,015 boys) was examined with a questionnaire concerning sexual experiences in this study with a focus on disclosure of sexual abuse (non-contact, contact or penetrating abuse, and including peer abuse).

Results

Of the sample, 1,505 girls (65%) and 457 boys (23%) reported experience of sexual abuse. The disclosure rate was 81% (girls) and 69% (boys). Girls and boys disclosed most often to a friend of their own age. Few had disclosed to professionals. Even fewer said that the incident had been reported to the authorities. Logistic regression showed that it was less likely for girls to disclose if they had experienced contact sexual abuse with or without penetration, abuse by a family member, only a single abuse occasion or if they had perceived their parents as non-caring. Boys were less likely to disclose if they studied a vocational program, lived with both parents or had perceived their parents as either caring and overprotective or non-caring and not overprotective.

Conclusions

Disclosing sexual abuse is a complex process. Much is hidden from the adult society, especially from professionals and the legal system. Since peers are the most common receivers of abuse information, programs for supporting peers ought to be developed. Differences in disclosure patterns for girls and boys indicate that a gender perspective is helpful when developing guidelines for professionals.

Practice implications

Professionals, especially in the school system, need to be more aware of the finding that few sexually abused children seek help from professionals or other adults and that support offers should be directly addressed not only to the vulnerable young persons themselves but also to peers who wish to help a friend.

Introduction

Most studies of disclosure of sexual abuse during childhood either focus on children's disclosure in a professional setting such as in a forensic or clinical interview (Berliner & Conte, 1995; Bradley & Wood, 1996; DeVoe & Faller, 1999; Jensen, Gulbrandsen, Mossige, Reichelt, & Tjersland, 2005; Sjöberg & Lindblad, 2002; Sorensen & Snow, 1991; Svedin & Back, 2003) or on population-based retrospective reports from adults (Arata, 1998, Collings, 1995; Finkelhor, Hotaling, Lewis, & Smith, 1990; Hanson, Resnick, Saunders, Kilpatrick, & Best, 1999; Roesler, 1994, Ruggiero et al., 2004, Smith et al., 2000; Somer & Szwarcberg, 2001; Tang, 2002).

An advantage of population-based studies is that they can collect information even from participants who never disclosed their experience of sexual abuse prior to their participation in the study and who have never been in contact with the professional system. This may be of great interest for public health policy and for support services intended for sexually abused persons. The disclosure rates in the above named retrospective studies with adults are between 31% and 41% for disclosure during childhood and between 58 and 72% for lifetime disclosure. Peer abuse (peer defined as a person not more than five years older than the victim) is included in some of these studies, while it is not specified in other studies and excluded in one (Arata, 1998).

Although it can be expected that there is less recall bias in adolescent retrospective studies since the self-reported sexual abuse is closer in time there are surprisingly few retrospective studies with adolescent participants. It is difficult to compare the few available studies since, for example, Kogan (2004) only included girls, Edgardh and Ormstad (2000) included both boys and girls while others do not present separate results for boys and girls (Fergusson, Lynskey, & Horwood, 1996; Helweg-Larsen & Larsen, 2006; Kellogg & Huston, 1995). The lowest disclosure rate (56%) is reported for boys (Edgardh & Ormstad, 2000) while the other studies present disclosure rates ranging between 74% and 87%. All adolescent studies included both adult and peer abuse.

Disclosing adolescents usually talk to friends or parents (Edgardh & Ormstad, 2000; Fergusson et al., 1996; Kellogg & Huston, 1995). Friends as recipients of disclosure are of increasing importance for adolescents while younger children disclose more often to an adult (Kogan, 2004). Few disclosing adolescents, between 3% and 13%, had talked to an adult professional (Edgardh & Ormstad, 2000; Kellogg & Huston, 1995; Kogan, 2004). This is in line with findings from retrospective studies with adults (Arata, 1998, Collings, 1995, Hanson et al., 1999, Smith et al., 2000, Tang, 2002).

Few retrospective studies of adolescents have analyzed variables other than disclosure rates and recipients of disclosure. Kogan (2004) investigated how survivor characteristics, abuse characteristics and family context attributes were related to the timing and the recipient of disclosure. The identity of the recipient of the disclosure (adult, peer only, none) was related to age of onset, penetration, fear for one's life during the abuse, injury during the abuse, family structure, and the age differential between the victim and the perpetrator while the timing of disclosure was related to age of onset, a known perpetrator, a familial relationship with the perpetrator, and a history of drug abuse in the household. The disclosure recipient or disclosure timing were not associated with race/ethnicity, parental education, household income and household alcohol abuse. Kellogg and Huston (1995) studied the reasons for disclosure or non-disclosure. In general, fear and embarrassment were the most common reasons for delay or non-disclosure, but there were also differences between ethnic groups.

Disclosure of sexual abuse is usually regarded as beneficial to the exposed child (Arata, 1998; Paine & Hansen, 2002). However, previous studies with children in forensic samples (Elliott & Briere, 1994; Nagel, Putnam, Noll, & Tricket, 1997), undergraduate female students (Sinclair & Gold, 1997) and adult women (Ruggiero et al., 2004) have not shown any direct link between disclosure and a positive mental health outcome. Association between current perceived mental health and disclosure and the role of general parental support for young persons’ disclosure has not yet, to our knowledge, been investigated in population-based studies with adolescents.

Studies about the role of abuse-specific parental support in relation to disclosure have shown that the child's willingness to disclose in a professional context increased when the mother was supportive and believed in the child's disclosure (Elliott & Briere, 1994; Lawson & Chaffin, 1992). General parental support and care seem to be a good predictor for recovery after sexual abuse (Lynskey & Fergusson, 1997; Spaccarelli & Kim, 1995). Sinclair and Gold (1997) found that general parental support was not related to withholding disclosure from others, but it is unclear if parental support at the time of the study or during childhood was measured.

Previous studies of adolescents about disclosure of sexual abuse include female-only samples or mixed samples that either include small groups of boys who reported sexual abuse or that do not show separate results for boys or girls. As group differences between boys and girls concerning prevalence and sexual abuse characteristics are well-documented (Watkins & Bentovim, 1992), it can be expected that there are differences concerning disclosure rates, disclosure patterns and predictors for disclosure or non-disclosure, too. There is a need for studies that include and show sufficient numbers of both boys and girls who report sexual abuse.

This study is intended to contribute data about disclosure of sexual abuse from a large population-based sample of adolescents with self-reported experiences of child sexual abuse including peer abuse. The specific aims of this study were

• to investigate disclosure rates and disclosure patterns associated with recipients of disclosure, abuse characteristics, socio-demographic variables, perception of parents when growing up and current perceived mental health, separate for boys and girls,

• to examine predictors of non-disclosure, separate for boys and girls.

No specific hypotheses are stated as the approach is basically exploratory. All variables in the analysis are expected to be associated with disclosure.