write a brief Abstract on each of the two articles you located in the school library. The seminal article can be older than five years and the se

Child Abuse & Neglect 32 (2008) 1095–1108

Contents lists available at ScienceDirect

Child Abuse & Neglect

Child sexual abuse is largely hidden from the adult society An epidemiological study of adolescents’ disclosures�

Gisela Priebe a,∗, Carl Göran Svedin b

a Department of Child and Adolescent Psychiatry, IKVL, Lund University, Sofiavägen 2 D, S-221 41 Lund, Sweden b Department of Child and Adolescent Psychiatry, IMK, Faculty of Health Sciences, Linköping University, Linköping, Sweden

a r t i c l e i n f o

Article history: Received 6 February 2007 Received in revised form 1 April 2008 Accepted 17 April 2008

Keywords: Child sexual abuse Disclosure Adolescence Gender

a b s t r a c t

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 com- mon 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.

© 2008 Elsevier Ltd. All rights reserved.

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)

� The authors would like to acknowledge the Committee into knowledge concerning sexual exploitation of children in Sweden (S 2003:5) at the Swedish Social Ministry, the Crime Victim Compensation and Support Authority in Sweden and Her Majesty Queen Silvia’s Jubilee Foundation for their financial support to the project.

∗ Corresponding author.

0145-2134/$ – see front matter © 2008 Elsevier Ltd. All rights reserved. doi:10.1016/j.chiabu.2008.04.001

1096 G. Priebe, C.G. Svedin / Child Abuse & Neglect 32 (2008) 1095–1108

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 house- hold 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 disclo- sure 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.

G. Priebe, C.G. Svedin / Child Abuse & Neglect 32 (2008) 1095–1108 1097

Method

Participants

This study was a part of the Swedish base for comparative studies under the aegis of the Baltic Sea Regional Study on Adolescent Sexuality and the aim was to obtain a representative sample of high school seniors (3rd year high school students) in each country. Following the common guidelines the capital (Stockholm), one large port (Malmö) and some smaller cities (Luleå, Haparanda and Falköping) were chosen in Sweden. All 3rd year students (high school seniors) in all high schools in these cities were included in the initial group. Ninety-eight percent of all students finishing grade 9 in the Swedish compulsory school system enter the high school system (grades 10–12) each year. According to official statistics, about 90% of Swedish 18 year olds are enrolled in high school, 2% are studying in other education alternatives such as university and 8% are not studying (Sweden’s Statistical Database, 2003).

In the high schools of the participating cities 10,751 high school seniors were registered. At the time of the implementation of the study in the year 2003, there were 17 different national educational programs which can be classified as either academic or vocational at high school in Sweden. According to the sampling plan, only whole classes were selected, representing 50% of all students at each of the national educational programs in each town. If there was only one class in a program in a town, the whole class was selected. This resulted in a selection of 5,623 students (52.3% of the enrolled students), and 4,377 of them choose to participate in the study. Thirty-eight questionnaires were excluded as being incompletely filled-in. The final number of participants was consequently 4,339 (n = 2,324 girls and n = 2,015 boys), resulting in a response rate of 77.2%. The mean age of the participants was 18.15 years (SD = .74). In this study a subsample is used that consists of all participants who reported experience of sexual abuse and who answered to questions about disclosure of the abuse (n = 1,493, mean age 18.17 years, SD = .68).

Procedure

The director of the entire school system in each participating community was asked to grant permission to present the research project to the principal of each high school. Once permission was given by the principal of a school, all students in the selected classes were asked for and gave consent to participate based on their consideration of oral and written information. One assistant from the research group visited each class to distribute the questionnaires and then collect them after the students had finished them. In order to ensure that the students could not influence each other, they completed the questionnaires at the same time in the classroom. If the classroom was too small to guarantee privacy another room was chosen. The anonymous questionnaires were placed in unmarked envelopes, sealed by the students, and collected by the omnipresent research assistant. The students were given oral and written information about where to get counseling if participation had caused feelings of distress.

Measures

The self-report questionnaire used in the study was based on a Norwegian survey of young people’s attitudes towards sexuality and sexual abuse (Mossige, 2001). Questions from other Nordic surveys concerning young people’s sexual experi- ences (Edgardh, 2001; Hammarén & Johansson, 2001, 2002; Tambs, 1994) and questions especially formulated for the study were added. The survey included questions about background variables, consensual sexuality, sexual abuse experiences, own sexual abusive behavior, sexual attitudes, experiences with pornography and experiences with sexual exploitation (to sell sex for compensation). There were in total 65 questions. The participants needed between 30 and 60 minutes to complete the questionnaire. In the analyses for this paper, variables about background and sexual abuse experiences were used.

A wide definition of sexual abuse including lifetime prevalence of non-contact abuse, contact abuse without penetration and penetrating abuse by both adult and peer offenders was used. The participants were asked if they had been exposed to any of the following against their will: (1) non-contact abuse “somebody exposed him/herself indecently towards you,” (2) contact abuse “somebody has pawed you or touched your body in an indecent way,” “you masturbated somebody else,” (3) penetrative abuse (not specifying if for example fingers or devices were used) “you have had sexual intercourse,” “you have had oral sex,” “you have had anal sex.”

Participants who had reported any of the above mentioned experiences of sexual abuse were asked to answer a question about how many times they had been exposed against their will and to describe the abuse characteristics on the first abuse occasion (participant’s age, offender’s age and gender, relation to the offender, victim or offender on alcohol or drugs, kinds of persuasion/pressure/force, including physical force or physical violence, used by the offender). Finally, two questions about disclosure of any abuse occasion were asked. The first question was “Could you talk to someone about what happened?” with “yes” or “no” as possible answers. The second question was “If yes, whom did you talk to?” It was possible to check several of the eight different alternatives for an answer (see Table 2) and to indicate if the incident was reported to social authorities or police.

The survey included questions about background variables such as gender, the educational program, immigrant status (first or second generation), family structure and parents’ socio-economical status. The International Socioeconomic Index (ISEI) was used to classify the occupational status of the parent or parents (Ganzeboom, de Graaf, & Treiman, 1992). The ISEI

1098 G. Priebe, C.G. Svedin / Child Abuse & Neglect 32 (2008) 1095–1108

has values ranging from 0 to 90 and measures the attributes of occupation that convert a person’s education into income and status.

The Mental Health scale consisted of six slightly modified items from the SCL-90 (Derogatis, 1977) about symptoms of anxiety and depression experienced during the preceding week (see Table 4). Each question was scored from 1 (does not correspond at all) to 4 (corresponds exactly) and consequently the total score of the Mental Health scale ranged from 6 to 24. The internal consistency, assessed using Cronbach’s alpha, was .83. A cut off was set at the 80th percentile received by the participants in the total sample, resulting in a cut off point of ≥19.

Nine of 25 items from the Parental Bonding Instrument (Parker, 1990; Parker, Tupling, & Brown, 1979) were included in the questionnaire. The Parental Bonding Instrument measures two fundamental parenting dimensions, care and overprotection. Five items from the care dimension (item 2, 5, 6, 14 and 18 in the original scale, Parker et al., 1979) and four items from the overprotection dimension were used (item 9, 13, 15 and 23 in the original scale, Parker et al., 1979). Each question was scored from 1 (does not correspond at all) to 6 (corresponds exactly). The score for the caring dimension ranged between 5 and 30, high values indicating high care, and between 4 and 24 for the overprotection dimension, high values indicating high overprotection. Cronbach’s alpha was .70 for the care dimension and .75 for the overprotection dimension. Cut off values based on the data from the total sample were ≤20 for the care score (at the 25th percentile) and ≥16 for the overprotection score (at the 80th percentile). The cut off values were used in the calculation of the four types of parental bonding (Table 4).

The data for girls and boys were analyzed separately. This does not mean that girls and boys as a group are assumed to have the same experiences concerning disclosure and related variables. When differences between girls and boys are described in the paper, usually the term “gender” is used instead of “sex” in order to not confuse sex and sexual activity.

Ethical considerations

The study was approved by the Regional Ethics Review Board in Lund.

Results

Sexual abuse rates

Of the total sample of 2,324 girls and 2,015 boys, 65% of the girls and 23% of the boys reported some form of sexual abuse experience. Of the girls who reported experiences of sexual abuse, 10.0% reported non-contact abuse, 69.2% contact abuse without penetration and 20.8% penetrating abuse. Non-contact abuse was reported by 18.4% of the boys who reported sexual abuse, while 57.3% reported contact abuse and 24.3% penetrating abuse (Table 1). Participants with experiences of different kinds of abuse were categorized according to the most severe kind of abuse they had reported.

Disclosure rates and recipients of disclosure

Table 1 shows that out of the 1,962 participants who reported experience of sexual abuse, 261 (17.3%) of the girls and 208 (45.5%) of the boys did not answer the questions about disclosure. A data analysis of these non-completers was done by carrying out a logistic regression analysis separately for girls and boys including abuse severity, parents’ employment, family structure, educational program, perceived mental health and immigrant background as independent variables and non-completers as dependent variable. Boy non-completers were about two times more likely to have one or both parents unemployed than completers (aOR = 2.18, CI = 1.49–3.19). Girl non-completers were significantly more often enrolled in a vocational educational program (aOR = 1.40, CI = 1.05–1.86) and reported less often exposure to penetrating abuse compared to completers (aOR = .40, CI = .23–.68). Concerning all other variables in the analyses, there were no significant differences between completers and non-completers.

All participants had very low numbers of missing answers for questions not related to sexual abuse, for example back- ground variables, perception of parents when growing up and questions about perceived mental health (0–2.8% of those who had not answered to the disclosure questions and .4–1.8% of those who had answered to the disclosure questions).

In the following, results from those adolescents who completed the questions about disclosure are presented. Table 2 shows that girl completers reported that they had talked to somebody about the sexual abuse significantly more often than boys. Most of them named one or two of the recipients listed in Table 2 (girls, 75.9%, boys 78.1%). Six or more different recipients were marked by 2.1% of the disclosing girls and 4.8% of the disclosing boys. Both girls and boys mentioned most often a friend of their own age as the person they had disclosed to.

Table 2 also shows that few young persons (8.3%) had talked to a professional about the abuse. Professionals included teachers, social workers, nurses or other persons working professionally with children and adolescents. These persons are required by Swedish law (mandatory reporting) to report to the social authorities all cases of child sexual abuse that come to their attention. A disclosure made to a professional resulted significantly more often (33.9%) in a report to the social authorities or the police, compared to a disclosure made to someone other than a professional, 4.4% (OR = 11.17, CI = 7.10–17.58). In all, 6.8% of the adolescents answered that the incident had been reported to the social authorities or police.

Table 3 shows that the severity of the sexual abuse seemed to influence the young person’s decision to at least disclose the experience to someone. The severity also affected disclosure to a member of their families, to a professional, and if the abuse was reported to the social authorities or to the police.

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3 2

(2 0

0 8

) 10

9 5

– 110

8 10

9 9

Table 1 Participants: completers and non-completers.

Type of sexual abuse Could talk to someone about the sexual abuse

Girls, n = 1,505 Boys, n = 457

All, n (%) Completers, n (%) Non-completers, n (%) OR (CI 95%) All, n (%) Completers, n (%) Non-completers, n (%) OR (CI 95%)

Non-contact 150 (10.0) 116 (9.3) 34 (13.0) 1.46 (.97–2.19) 84 (18.4) 45 (18.8) 39 (18.7) 1.05 (.65–1.68) Contact 1,042 (69.2) 848 (68.2) 194 (74.3) 1.35 (1.00–1.83) 262 (57.3) 152 (61.0) 110 (52.9) .72 (.49–1.04) Penetrating 313 (20.8) 280 (22.5) 33 (12.7) .50 (.34–.74) 111 (24.3) 52 (20.9) 59 (28.4) 1.50 (.98–2.30)

Total 1,505(100) 1,244 (100) 261 (100) 457 (100) 249 (100) 208 (100)

1100 G. Priebe, C.G. Svedin / Child Abuse & Neglect 32 (2008) 1095–1108

Table 2 Disclosure of sexual abuse, rates (n = 1,493).

Could talk to . . .a Girls, n = 1,244 Boys, n = 249

n (%) n (%) OR (CI 95%)

Nobody 231 (18.6) 77 (30.9) 1.96 (1.45–2.66)

Somebody 1,013 (81.4) 172 (69.1) .51 (.38–.69) Friend of my age 781 (62.8) 111 (44.6) .48 (.36–.63) Mother 351 (28.2) 43 (17.3) .53 (.37–.75) Father 160 (12.9) 34 (13.7) 1.07 (.72–1.60) Sibling 187 (11.6) 29 (11.6) .75 (.49–1.13) Other person 128 (10.3) 48 (19.3) 2.08 (1.45–3.00) Professional 117 (9.4) 7 (2.8) .28 (.13–.61) Adult relative or friend 111 (8.9) 33 (13.3) 1.56 (1.03–2.36)

The incident was reported to social authorities or police 91 (7.3) 11 (4.4) .59 (.31–1.11)

a Several alternatives possible.

The more severe the sexual abuse was, the more seldom both girls and boys had talked to mother, father or a sibling. Disclosure to a professional was associated with higher rates of more severe abuse (contact abuse with or without penetration compared to non-contact abuse) for girls (OR = 3.12, CI = 1.13–8.61), but with lower rates of more severe abuse for boys (OR = .15, CI = .03–.71). Talking to a professional was also associated with being abused by an older person (age difference ≥5 years vs. <5 years) for girls (OR = 1.65, CI = 1.10–2.49), while there was no such association for boys.

For boys, all but one of the reports to social authorities or police concerned non-contact abuse. For girls, the proportion of reported incidents was highest for non-contact abuse, but even cases of more severe abuse were reported.

Of the disclosers, 42.6% of the boys and 37.9% of the girls mentioned “friend of my own age” as the only recipient. A friend of one’s own age may include both peer(s) and romantic partner. Disclosure to a friend of one’s own age was associated with higher rates of more severe abuse (non-contact abuse vs. contact abuse with or without penetration; girls OR = 1.92, CI = 1.22–3.03, boys OR = 2.58, CI = 1.04–6.43) and being abused by a peer (age difference ≥5 years vs. <5 years; girls OR = 2.35, CI = 1.80–3.05, boys OR = 2.40, CI = 1.22–4.73).

Univariate analyses

Table 4 shows the associations between disclosure and abuse characteristics, socio-demographic variables, parental bonding and mental health.

Non-disclosing girls reported more often penetrating abuse, less frequent abuse, and abuse by a family member, a relative or a friend, compared to disclosing girls. They also reported less frequently that the perpetrator had used alcohol or drugs at the first abuse occasion. Non-disclosing girls were more often first or second generation immigrants compared to native Swedes.

Girl non-disclosers had significantly lower scores on the care dimension and higher scores on the overprotection dimen- sion on the Parenting Bonding Instrument (t-test care: t(df) = 5.74(1235), p < .001, overprotection: t(df) = −2.91(1235), p = .007). Girl non-disclosers more often perceived their parents as less caring in combination with lower overprotection or higher overprotection, than girl disclosers.

Non-disclosing boys were sexually abused more often by a family member, a relative or a friend than boy disclosers. Boy non-disclosers were also more often studying at a vocational program and lived more often together with both parents than disclosing boys.

Boy non-disclosers had significantly lower scores on the care dimension and higher scores on the overprotection dimen- sion on the Parenting Bonding Instrument (t-test care: t(df) = 2.18(246), p = .030, overprotection: t(df) = −2.00(246), p = .046). Non-disclosing boys perceived their parents during their childhood more often as less caring in combination with lower overprotection, than boy disclosers.

Adolescents who reported sexual abuse experiences reported significantly more symptoms at the Mental Health Scale, indicating that their perceived mental health was poorer compared to adolescents without these experiences (girls: M(SD): abused 15.38 (4.68), not abused 14.00 (4.68), t (df) = −6.79 (2298), p < .001; boys: M(SD): abused 14.21 (4.71), not abused 12.65 (4.37), t (df) = −6.31 (703.20), p < .001). The effect sizes were moderate (girls: .30, boys: .34). Adolescents who reported sexual abuse had also significantly more often a total score above the cut off in the Mental Health Scale (girls: OR = 1.60, CI = 1.30–1.97; boys: OR = 2.10, CI = 1.60–2.77). In general, non-disclosers reported more symptoms than disclosers (girls: M(SD): discloser 15.27 (4.71), non-discloser 16.26 (4.7), t (df) = −2.89 (1232), p = .004; boys: M(SD): discloser 13.97 (4.55), non-discloser 15.53 (4.80), t (df) = −2.45 (246), p = .015). The effect sizes were low for girls (.21) and moderate for boys (.34). On the other hand, there were no significant differences between disclosers and non-disclosers when the results were analyzed separately for non-contact abuse, contact abuse and penetrating abuse. Disclosers and non-disclosers did not differ concerning a total score above the cut off in the Mental Health Scale (Table 4).

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8 110

1

Table 3 Severity of the sexual abuse and disclosure rates (n = 1,493).

Could talk to . . .a Girls, n = 1,244 Boys, n = 249

Non-contact, n = 116 Contact, n = 848 Penetrating, n = 280 p Non-contact, n = 45 Contact, n = 152 Penetrating, n = 52 p n (%) n (%) n (%) n (%) n (%) n (%)

Nobody 6 (5.2) 153 (18.0) 72 (25.7) <.001b 10 (22.2) 47 (30.9) 20 (38.5) .226b

Somebody Friend of my age 77 (66.4) 539 (63.6) 165 (58.9) .267b 20 (44.4) 74 (48.7) 17 (32.7) .135b

Mother 76 (65.5) 232 (27.4) 43 (15.4) <.001b 21 (46.7) 20 (13.2) 2 (3.8) <.001b

Father 42 (36.2) 102 (12.0) 16 (5.7) <.001b 18 (40.0) 14 (9.2) 2 (3.8) <.001b

Sibling 35 (30.2) 125 (14.7) 27 (9.6) <.001b 11 (24.4) 17 (11.2) 1 (1.9) .003b

Other person 12 (10.3) 85 (10.0) 31 (11.1) .882b 7 (15.6) 31 (20.4) 10 (19.2) .770b

Professionalc 4 (3.4) 61 (7.2) 52 (18.6) <.001b 4 (8.9) 2 (1.3) 1 (1.9) .035d

Adult relative or friend 18 (15.5) 72 (8.5) 21 (7.5) .029b 10 (22.2) 19 (12.5) 4 (7.7) .099b

The incident was reported to social authorities or police 17 (14.7) 47 (5.5) 27 (9.6) <.001b 10 (22.2) 0 1 (1.9) <.001b

a Several alternatives possible. b �2 . c “Professional” includes teacher, social worker, nurse or some other person who professionally works with children and youth. d Fisher’s exact test.

1102 G. Priebe, C.G. Svedin / Child Abuse & Neglect 32 (2008) 1095–1108

Table 4 Disclosure and abuse characteristics, socio-demographic variables, parental bonding and mental health.

Variable Girls, n = 1,131–1,244 Boys, n = 227–249

Discloser, n (%) Non-discloser, n (%) Discloser, n (%) Non-discloser, n (%)

Abuse characteristics, ever Severity

Non-contact 110 (10.9) 6 (2.6)*** 35 (20.3) 10 (13.0) Contact 695 (68.6) 153 (66.2)** 105 (61.0) 47 (61.0) Penetration 208 (20.5) 72 (31.2)*** 32 (18.6) 20 (26.0)

Frequency Once 394 (39.3) 94 (41.8) 78 (47.0) 27 (38.6) 2–5 times 437 (43.6) 107 (47.6) 67 (40.4) 33 (47.1) >5 times 172 (17.1) 24 (10.7)* 21 (12.7) 10 (14.3)

Abuse characteristics, first abuse occasion Relation to perpetrator

Stranger 619 (63.0) 89 (41.4)*** 103 (64.0) 30 (43.5)** Family/relative 35 (3.6) 17 (7.9)*** 2 (1.2) 4 (5.8)* Friend/acquaintance 329 (33.5) 109 (50.7)*** 56 (34.8) 35 (50.7)*

Offender on alcohol/drugs No 561 (61.4) 149 (68.7) 88 (55.0) 46 (64.8) Yes 353 (38.6) 68 (31.3)* 72 (45.0) 25 (35.2)

Victim on alcohol/drugs No 787 (78.9) 180 (80.0) 110 (67.1) 52 (72.2) Yes 210 (21.1) 45 (20.0) 54 (32.9) 20 (27.8)

Age difference <5 years 397 (39.2) 97 (42.0) 94 (54.7) 41 (53.2)

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