Mental health articles

Estimated Prevalence of Child Sexual Abuse
The purpose of this chapter was to provide an estimate of the scope of the problem of
child sexual abuse. The scope of child sexual abuse is traditionally defined by its
incidence rate or prevalence. Incidence rates give an estimate of the cases of child
sexual abuse that, on a yearly basis, come to the attention of authorities. Prevalence,
on the other hand, is an estimate of the number of lifetime victims of child sexual
abuse. Because of their reliance upon cases coming to the attention of authorities,
incidence rates are considerably less accurate than prevalence estimates. Even
prevalence figures must be considered underestimates, however, because of the
known issue of traumatic amnesia of child sexual abuse events (Williams, 1994).
Respondents cannot report what they do not remember.
This section presented many different methods for estimating the prevalence of
child sexual abuse. Of the studies reported, prevalence estimates of female child
sexual abuse range from 2% to 62%, including noncontact abuse. Qualitative reviews
generally suggest that 20% or more of the female population is sexually abused by
the age of 18 and that 5% to 10% of the male population is sexually abused
(Finkelhor, 1994). Estimates provided by Gorey and Leslie (1997) are 12% to 17%
for female child sexual abuse and 5% to 8% for male child sexual abuse. All estimates
provided so far, however, are at least partially subjective.
The final method of estimating the prevalence of child sexual abuse was
included in the meta-analysis done by Bolen and Scannapieco (1999). One of the
strengths of the multiple regression analysis done in this study is that empirically
derived prevalence estimates of child sexual abuse can be computed based on
derivations of the independent variables (i.e., number of screen questions, sample
size, and year of study). Using this information, Bolen and Scannapieco developed
predictions of the prevalence of female child sexual abuse based upon a survey done
in 1997. Estimates of the prevalence of female child sexual abuse were 30% to 40%
for studies using a moderate level of rigor (i.e., 8 to 14 screen questions and 1,000 to
2,000 respondents) and were 23% to 29% for studies using only four screen questions.
For males, the empirically derived prevalence estimate for comparable studies was
3% to 13%, although it was suggested that the higher number probably was a low
estimate for male child sexual abuse.13
In summary, the most reliable estimates of child sexual abuse currently available
suggest that 30% to 40% of female children and 13% or more of male children are
sexually abused in childhood. Because these estimates are empirically derived from
all available random community-based prevalence studies done in North America
(Bolen & Scannapieco, 1999), they provide unmistakable evidence that child sexual
abuse is of epidemic proportions, especially for female children.
As discussed in the paper by Bolen and Scannapieco (1999), these high
prevalence estimates have at least three important implications. First, the debate concerning child sexual abuse “can now move from minimizing the social problem
to addressing its causes and treatment” (p. 299). Continued denial of the magnitude
of the problem is now irresponsible. Second, only the most methodologically rigorous
studies of prevalence of child sexual abuse should now be undertaken. Because
methodological rigor was shown to affect the stated prevalence across studies, “poorly
designed studies will only contribute to confusion” (p. 300). Finally, rigorous
analyses are needed to examine child sexual abuse trends over time. If child sexual
abuse is increasing, then the development of effective prevention programs becomes
even more compelling.