Читать книгу Pediatric Epidemiology - Группа авторов - Страница 31

Child sexual abuse (CSA) is common throughout the world, and must be dealt with as one of the ways in which children are exposed to maltreatment. Studies of sexual abuse are fraught with a number of difficulties. The overall estimated prevalence of CSA is 127/1,000 in self-report studies and 4/1,000 in informant studies (agencies, official organs). This massive difference may partly be explained by the fact that most informant studies are based on reports of CSA during the last year (i.e., 1-year prevalence), while most self-reports rely on longer periods, often reporting lifetime prevalence. Another important reason for this discrepancy is that many informant studies probably miss most of the offences due to underreporting [21].

Self-reported CSA is more common among female (180/1,000) than among male participants (76/1,000). The lowest reported rates for both girls and boys have been found in Asia and the highest for girls in Australia and for boys in Africa. Girls are probably much more often exposed to sexual abuse, but it is probably also so that men are more reluctant to disclose CSA, especially in countries with a more traditional view of men as aggressors rather than victims. The fairly low CSA rates for both genders in Asia seem to be consistent with the idea that abuse experiences are less often disclosed in collectivistic cultures, and this also has to be kept in mind when studies are performed in western states with fairly large subculture populations.

As in other maltreatment studies, evidence points at the use of multiple behaviourally specific questions instead of single-item labelled questions to obtain more accurate results. The use of behaviourally specific questions about CSA also diminishes the risk that the participants’ subjective perceptions and definitions will affect their interpretation of “sexual abuse,” a potential drawback of self-report studies [22].