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L. Dennison Reed, Psy.D. . CSA INCIDENCE and Prevalence. “ INCIDENCE” OF CHILD SEXUAL ABUSE . The number of CSA cases that are reported to and substantiated by child welfare authorities (i.e., DCF, CPS) in a given year.
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L. Dennison Reed, Psy.D. CSA INCIDENCE and Prevalence
“INCIDENCE” OF CHILD SEXUAL ABUSE The number of CSA cases that are reported to and substantiated by child welfare authorities (i.e., DCF, CPS) in a given year.
NATIONAL ESTIMATE OF THE NUMBER OF CSA CASES SUBSTANTIATED BY CPS from 1976 to 1986 There were more than 20 times as many reports of CSA in 1986 as there were in 1976. This represents an increase in reporting of over 2,000% in a single decade!
NATIONAL ESTIMATE OF THE NUMBER OF CSA CASES SUBSTANTIATED BY CPS from 1990 to 2000
Why was there such a dramatic decline in the number of substantiated CSA cases? Major factor: Dramatic increase in the number of child molesters ‘incarcerated’ (tripled between 1986 and 1997) Parents and child-related organizations have become more aware and may have made it harder for molesters to operate with impunity Some children have received prevention education
PROBLEMS WITH CSA INCIDENCE STUDIES Exclusionary reporting criteria, e.g., in Florida CSA perpetrated by a non-family member is referred to law enforcement and is not included in incidence data Most CSA is never reported to the authorities Only 12% of the child sexual assaults in a nationally representative survey of 4008 American women were ever reported to the authorities. Rochelle F. Hanson et al., (1999) Factors Related to the Reporting of Childhood Rape, 23 Child Abuse & Neglect, 559, 564
PROBLEMS WITH CSA INCIDENCE STUDIES Parents/Caretakers often do not report the known/suspected abuse of children in their care. Other non-mandated reporters often do not report abuse they know about or suspect. Mandated reporters, including mental health professionals, often do not report abuse they know about or reasonably suspect.
“PREVALENCE” OF CSA Estimate of the proportion of adults who were sexually abused as children. Based on retrospective surveys of adults.
PREVALENCE STUDIES Note: PREVALENCE studies are generally considered to be far more complete and more accurate than Incidence studies.
Estimates of Prevalence of CSA in North America Vary widely due to differences in: Definitions of "CSA” Samples studied Research methodology - especially regarding # of CSA questions in survey
VARIABLES IN DEFINING CSA “Child” “Sexual Abuse” < 16 years old < 18 years old Contact and non-contact abuse Age difference between perpetrator and victim
ALL CSA INVOLVES: Exploitation of a relationship of unequal power. Lack of informed consent.
The Prevalence Estimates for Child Sexual Abuse Vary Widely Range of estimates for general population: 3-33% of males 6-66% of females
The more methodologically sophisticated studies using multiple screen questions and random samples have found that at least: 20% of women experienced sexual abuse in childhood 5-10% of men experienced sexual abuse in childhood
Prevalence of a CSA History in Clinical Populations 36-51% Inpatient and outpatient populations (across studies) 70% Randomly selected non- psychotic psychiatric E.R. patients (Briere)
Weaknesses with self-report data concerning child sexual abuse experiences “False Positives” People claiming they were abused when, in fact, they were not. May mistakenly believe they were abused as a result of suggestion, etc. May knowingly make false allegations for secondary gain, i.e., for sympathy, to “belong,” to excuse them from responsibility for behavior.
“False Negatives” Abused individuals denying they were abused. May be too embarrassed, ashamed or fearful to disclose their abuse-especially to an unfamiliar researcher. May have “amnesia” for their abuse, i.e., trauma-related amnesia (PTSD) or dissociation. *False negatives (false denials of CSA) are believed to be far more common than false positives (false claims of CSA)
Prevalence Statistics vs. Incidence Statistics • Despite the limitations of CSA Prevalence statistics, they are still considered to be far more complete than incidence studies which only include a fraction of the small proportion of cases that are actually reported to the authorities and are substantiated