Prevalence and characteristics of sexual abuse in a national sample of Swedish seventeen-year-old boys and girls

The aims of this study, which was part of a survey on adolescent sexual beh aviour, were to investigate adolescents' experience of child sexual abuse a nd to present possible abuse-related problems. Representative samples of 2% of Swedens 17-y-old male and female students and school non-attenders were selected in a two-step procedure. In all, 1943 students and 210 school non -attenders answered a self-administered anonymous questionnaire, distribute d by school nurses. Six out of 170 questions dealt with personal experience s of child sexual abuse, i.e. age at onset, frequency of abuse and relation ship to the offender. Peer abuse was excluded by the definitions used. The overall response rare was 92.2% for students and 44.2% for school dropouts. Among male and female students, 3.1% and 11.2%, respectively acknowledged sexual abuse, 2.3% and 7.1%, respectively, when exhibitionism was excluded. Mean age at onset was 9.1 y (SD 4.3) for boys and 9.0 y (SD 3.9) for girls ; 1.2% of the boys and 3.1% of the girls reported abusive oral, vaginal and /or anal intercourse. Suicide attempts or other acts of self-harm were repo rted by 33.3% of the male students reporting abuse and by 5.1% (p < 0.001) of those who had not been abused, and by 30.4% of the abused student girls compared to 9.1% of the non-abused (p < 0.001). Sleep and eating disorders, use of alcohol at an early age and/or experimentation with illicit drugs a nd consensual coitarche before age 15 y was reported significantly more oft en by abused than non-abused girls (p < 0.001, differences not round among the student boys). Of school non-attenders, 4% of the boys and 28% of the g irls reported sexual abuse. Of the abused girls, 49% reported abusive vagin al intercourse and 64% reported self-destructive behaviour or suicide attem pts. No abused boys and few abused girls had confided in a reacher, health professional or social worker. Results from the student sample should be interpreted as markers of "minimu m prevalence", as female school non-attenders report significantly higher p revalence of sexual abuse. Potential high-risk groups are better included i n prevalence investigations of child sexual abuse. The fact that so few ado lescents: confided in "professionals" about the abuse. despite having sever e symptoms and signs of distress, underlines the need to address sexual abu se when recording the social, medical and psychiatric histories of adolesce nts.