ARCHIVED: Appendix B: Handbook on Sensitive Practice for Health Care Practitioners: Lessons from Adult Survivors of Childhood Sexual Abuse – Prevalence of childhood sexual abuse

Appendix B: Prevalence of Childhood Sexual Abuse

Because childhood sexual abuse is often unreported in childhood or adolescence, adult retrospective studies are the most common source of prevalence estimates. The most current and reliable lifetime prevalence estimates are that as many as one third of women and 14% of men are survivors of childhood sexual abuse.^25,31,62 Accurate accounting of the occurrence of childhood sexual abuse is hampered by methodological issues related to reporting barriers (e.g., shame, guilt, self-blame, fear, etc.), definitional controversies, population sampled (community vs. clinical), method of data collection (e.g., self-report questionnaire vs. interview), response rates, and the number of questions researchers ask about childhood sexual abuse.^{62,122,135,184} This helps to explain the wide range in reported results and suggests caution when interpreting results and making cross-study comparisons.

Large community-based studies of the incidence and prevalence of childhood sexual abuse among children and youth are rare, with the most comprehensive one being a telephone survey of 2,000 U.S. residents (aged 10-16 years) done by David Finkelhor and Jennifer Dziuba- Leatherman.⁶⁵ These authors report that in the year preceding the interview, 3.2% of girls and 0.6% of boys had experienced contact childhood sexual abuse, which was defined as "a perpetrator touching the sexual parts of a child under or over the clothing, penetrating the child, or engaging in any oral-genital contact with the child."^65p.419 In the overall sample, the combined prevalence of attempted and completed childhood sexual abuse categories was 10.5%.

Community-based probability samples typically find that 12%-35% of women and 4%-9% of men have had an unwanted sexual experience before the age of 18 years.¹²² After adjusting for sample- related variation, response rates, and differences in definitions across 16 cross-sectional community sample surveys, Kevin M. Gorey and Donald R. Leslie⁷⁰ determined that the prevalence of childhood sexual abuse was 16.8% for women and 7.9% for men. In his review of large community- based studies in 19 countries around the globe, Finkelhor⁶³ found that the prevalence of childhood sexual abuse was 7%-36% for females and 3%-29% for males, indicating that childhood sexual abuse is an international problem and has been found in every region where it has been studied. More recent studies in non-Western countries confirm this (e.g.,^41,98). David Murray Fergusson and Paul E. Mullen,⁶⁰ after examining community-based prevalence from several countries, concluded that between 15% and 30% of females and between 3% and 15% of males report exposure to some form of unwanted sexual attention in childhood. This is consistent with John Briere and Diana Elliot's recent study,³¹ which found 32.3% of women and 14.2% of men reported sexual abuse in childhood. In the latter work, 21% of adults who reported histories of childhood sexual abuse also experienced physical maltreatment.

The prevalence of childhood sexual abuse is even higher among individuals with disabilities. A review of literature regarding children with disabilities,⁸³ defined as "the full spectrum of physical, mental, and emotional impairment,"^83p.1018 cited research that reported children with disabilities are almost twice as likely to be neglected, 1.6 times more likely to be physically abused, and 2.2 times more likely to be sexually abused than are children without disabilities.⁸³ Other studies report even higher rates of sexual abuse for children with disabilities.