Childhood experience of sexual abuse among Hong Kong Chinese college students

Child sexual abuse and its relationship with health risk behaviors among rural children and adolescents in Hunan, China

OBJECTIVE

The current study was designed to explore the prevalence of child sexual abuse (CSA) and its association with health risk behaviors (i.e., smoking, alcohol use, binge drinking, suicidal ideation, and suicide attempt) among rural children and adolescents in China.

METHODS

A sample of 683 rural children and adolescents (8 to 18 years of age) completed an anonymous questionnaire which assessed experiences of CSA and 5 health risk behaviors. Data on several potential confounding factors were also collected.

RESULTS

A total of 123 (18%) respondents reported experiencing at least 1 kind of CSA before 16 years of age, with more boys reporting CSA than girls (21.5% vs. 14.2%). In addition, attending non-boarding schools, lower levels of self-esteem, and higher levels of perceived peer pressure for engagement in health risk behaviors were associated with higher rates of CSA. Multivariate logistic regression analyses revealed that CSA experience was significantly associated with cigarette smoking (aOR=2.14), binge drinking (aOR=2.68), suicidal ideation (aOR=1.69), and suicide attempt (aOR=2.69) after controlling for several demographic and psychological factors.

CONCLUSION

More attention should be paid to the issues of CSA among rural children and adolescents in China. Effective CSA prevention intervention needs to address the vulnerabilities of the population, increase children's and parents' awareness of CSA and ability of self-protection.

A global perspective on child sexual abuse: meta-analysis of prevalence around the world

Our comprehensive meta-analysis combined prevalence figures of childhood sexual abuse (CSA) reported in 217 publications published between 1980 and 2008, including 331 independent samples with a total of 9,911,748 participants. The overall estimated CSA prevalence was 127/1000 in self-report studies and 4/1000 in informant studies. Self-reported CSA was more common among female (180/1000) than among male participants (76/1000). Lowest rates for both girls (113/1000) and boys (41/1000) were found in Asia, and highest rates were found for girls in Australia (215/1000) and for boys in Africa (193/1000). The results of our meta-analysis confirm that CSA is a global problem of considerable extent, but also show that methodological issues drastically influence the self-reported prevalence of CSA.

Correlates of Childhood Sexual Abuse and Intimate Partner Sexual Victimization

This study investigated the relationship between childhood sexual abuse (CSA) and sexual intimate partner violence (IPV) victimization among Chinese university students in Hong Kong, Beijing, and Shanghai. It used a cross-sectional design. To complete a self-report questionnaire, 3,388 university students from Hong Kong, Beijing, and Shanghai were recruited through convenience sampling. The results showed that 28.6% of participants experienced some form of CSA, and no gender difference was found in the prevalence of CSA. Significantly, more female have been reported being victims of sexual IPV than male (24.2% vs. 18.2%); however, when considering severe sexual victimization only, females did not report higher prevalence than men did. Results of the multiphase logistic regression showed that CSA had an independent association with an increased risk of sexual IPV victimization during adulthood. In addition, gender, having had sex with the partner of the referred intimate relationship, and current posttraumatic stress symptoms were associated with sexual IPV victimization when other factors were adjusted. Conclusion: Intervention with IPV should include an assessment of CSA history. Prevention of revictimization for IPV victims with CSA history was discussed.

Childhood sexual abuse and its relationship with psychosocial outcomes among children affected by HIV in rural China

This study assessed the prevalence of childhood sexual abuse (CSA) and its association with psychosocial outcomes among children residing in communities with a high prevalence of HIV in rural China. Data were collected from HIV orphans (n = 417; children who had lost one or both parents to HIV), vulnerable children (n = 326; children living with HIV-infected parents), and comparison children (n = 276; children who had not experienced HIV-related familial illness or death). Approximately 30% of the children reported having experienced at least one form of CSA; boys (37%) reported more cases of CSA as compared with girls (24%); 24% reported experiencing only nonphysical CSA, 5% reported both physical and nonphysical CSA, and 2% reported only physical CSA. Multivariate analysis revealed that CSA was significantly associated with problem behaviors and quality of life independent of key demographic factors. These findings suggest that the children in this study were vulnerable to CSA and also highlight the need to address the issues of CSA in this population.

Disclosure attitudes and social acknowledgement as predictors of posttraumatic stress disorder symptom severity in Chinese and German crime victims

OBJECTIVE

Only rare data exist comparing cross-cultural aspects of civilian traumatization. We compared prevalence rates of posttraumatic stress disorder (PTSD) in German and Chinese crime victims, and investigated the cross-cultural effect of 2 interpersonal predictors.

METHOD

German (n = 151) and Chinese (n = 144) adult crime victims were assessed several months postcrime. The parallel questionnaire set assessed PTSD symptom severity, disclosure attitudes, social acknowledgement, and demographic and crime characteristics.

RESULTS

German and Chinese participants differed significantly in their PTSD symptom severity. However, in both samples, disclosure attitudes and social acknowledgement predicted PTSD symptom severity with a similar strength, in addition to the effects of other PTSD predictors.

CONCLUSIONS

The results suggest that interpersonal variables are predictors of PTSD symptom severity in both cultures and should be included in etiologic models of PTSD.

To unfold a hidden epidemic: prevalence of child maltreatment and its health implications among high school students in Guangzhou, China

OBJECTIVE

This study investigated the prevalence of child maltreatment as perpetrated by parents, its associated health outcomes, and its resilient factors among high school students in China.

METHODS

A multi-level stratified random school-based survey was conducted in 2005. Twenty four high schools were randomly chosen from eight districts in Guangzhou, South China (three from each district). Two classes were randomly selected from each of Form 1 to Form 3 (aged 12-16) in each selected school. Data from 6,593 students were analyzed. A number of locally validated tools were used to measure various types of maltreatment as well as physical and psychological conditions of students.

RESULTS

The half-year prevalence of psychological aggression, minor physical maltreatment, severe physical maltreatment, and very severe physical maltreatment were 78.3%, 23.2%, 15.1%, and 2.8% respectively; while the half-year prevalence of sexual abuse was .6%. Maltreated students were more likely to report physical and psychological problems, and a positive relationship was also found between the severity of maltreatment and the likelihood of negative health outcomes. Male gender or having higher levels of social support and life satisfaction were identified as resilient factors to physical health of maltreated students.

CONCLUSIONS

Child maltreatment as perpetrated by parents is common among high school students in Guangzhou, China. More public education programs are needed to raise public awareness of this problem. Intervention programs that target at improving social support and life satisfaction of students are potentially beneficial.

The international epidemiology of child sexual abuse: a continuation of Finkelhor (1994)

OBJECTIVE

The purpose of this paper was to compare the prevalence rates of child sexual abuse reported by [Finkelhor, D. (1994). The international epidemiology of child sexual abuse. Child Abuse & Neglect, 18 (5), 409-417] with those found in recent publications in order to confirm the widespread prevalence of child sexual abuse.

METHODS

Relevant articles about prevalence of child sexual abuse were identified through searches of computerized databases and a handsearch of Child Abuse & Neglect and the Journal of Child Sexual Abuse.

RESULTS

Thirty-eight independent articles were identified, corresponding to 39 prevalence studies; these articles report the prevalence of childhood sexual abuse in 21 different countries, ranging from 0 to 53% for women and 0 to 60% for men.

CONCLUSIONS

Comparison of the present study with that of [Finkelhor, D. (1994). The international epidemiology of child sexual abuse. Child Abuse & Neglect, 18 (5), 409-417] shows a similarity between prevalence distributions; there appears to be a general pattern that remains more or less constant over the years, especially in women.

PRACTICE IMPLICATIONS

Twelve years after the first revision study about the international prevalence of child sexual abuse, there is still a need for new data about this topic. The present study shows child sexual abuse is still a widespread problem in the society. In this research, carried out on 38 independent studies, there is new data for 21 countries over the world, being especially relevant the results obtained from other countries different from those pertaining to North America or Europe. It is important to point out the high prevalence found in most of the countries, so this information could be a new warning to make society and governments aware of this problem and undertake actions to prevent sexual abuse in childhood.

Child maltreatment among Asian Americans: characteristics and explanatory framework

This article systematically reviews the characteristics of child maltreatment among Asian Americans and provides a theoretical explanatory framework. The reported rate of child maltreatment among Asian Americans is disproportionately low. A high rate of physical abuse and low rates of neglect and sexual abuse are found among Asian American victims. Some protective factors (e.g., the emphasis on family harmony and reputation and the indulgence to infants and toddlers) may lead to low probability of child maltreatment among Asian Americans. Some others (e.g., parental authority and beliefs in physical punishment) may be risk factors of child maltreatment, especially physical abuse. Meanwhile, many other coexisting factors (e.g., children's obedience to parents and families' invisibility to authorities) may prohibit child maltreatment from being disclosed. Therefore, the overall low reported rate of child maltreatment among Asian Americans may be a combination of low incidence and underreporting. Implications for practice and research are discussed.

The prevalence of child sexual abuse in community and student samples: a meta-analysis

BACKGROUND

Studies conducted internationally confirm that child sexual abuse is a much more widespread problem than previously thought, with even the lowest prevalence rates including a large number of victims that need to be taken into account.

OBJECTIVE

To carry out a meta-analysis of the prevalence of child sexual abuse in order to establish an overall international figure.

METHODS

Studies were retrieved from various electronic databases. The measure of interest was the prevalence of abuse reported in each article, these values being combined via a random effects model. A detailed analysis was conducted of the effects of various moderator variables.

RESULTS

Sixty-five articles covering 22 countries were included. The analysis showed that 7.9% of men (7.4% without outliers) and 19.7% of women (19.2% without outliers) had suffered some form of sexual abuse prior to the age of eighteen.

CONCLUSIONS

The results of the present meta-analysis indicate that child sexual abuse is a serious problem in the countries analysed.

Sexual violence against women and children in Chinese societies

This article provides a comprehensive overview of the reported patterns of sexual violence against women and children in China. It reviews the prevalence of and risk factors for various types of sexual violence and discusses community knowledge and perceptions of these violent acts. It also critically examines three major problems of sexual violence research in China. First, the diversity of findings and study methods reported by surveys and criminal reports reflects the problems in obtaining accurate figures on the scope of the problem. Second, precautions must be taken in reading studies on Chinese culture-specific risk factors for domestic violence. Third, the study of culture-specific factors should not focus solely on cultural factors in a vacuum but rather, should examine traditional culture in the context of modern societies and consensus international standards of human rights. Recommendations for future research are also discussed.

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

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 common 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.

Unwanted early sexual experiences among Belgian and South African university women students

This study examined the unwanted early sexual experiences of 736 South African and 1,587 Belgian women students. The Early Sexual Experiences Checklist was administered to all consenting women students attending orientation programmes at a Belgian and a South African university. Respondents were Belgians (M age = 18.2 yr., SD = 1.0) and South Africans (M age = 19.6 yr., SD = 4.1). Such experiences were found for 31.3% (231) of South African respondents and 14.2% (226) of Belgian respondents. 64% of South African women indicated that such an experience occurred only once, and 65% of Belgian women reported this also. 34% of Belgian and 32% of South African respondents reported not being bothered at all by the unwanted experience at the time the event took place; 23% of Belgian and 36% of South African respondents were extremely bothered by the experience.

Prevalence and determinants of child maltreatment among high school students in Southern China: a large scale school based survey

BACKGROUND

Child maltreatment can cause significant physical and psychological problems. The present study aimed to investigate the prevalence and determinants of child maltreatment in Guangzhou, China, where such issues are often considered a taboo subject.

METHODS

A school-based survey was conducted in southern China in 2005. 24 high schools were selected using stratified random sampling strategy based on their districts and bandings. The self-administered validated Chinese version of parent-child Conflict Tactics Scale (CTSPC) was used as the main assessment tool to measure the abusive experiences encountered by students in the previous six months.

RESULTS

The response rate of this survey was 99.7%. Among the 6592 responding students, the mean age was 14.68. Prevalence of parental psychological aggression, corporal punishment, severe and very serve physical maltreatment in the past 6 months were 78.3%, 23.2%, 15.1% and 2.8% respectively. The prevalence of sexual abuse is 0.6%. The most commonly cited reasons for maltreatment included 'disobedience to parents', 'poor academic performance', and 'quarrelling between parents'. Age, parental education, places of origins and types of housing were found to be associated with physical maltreatments whereas gender and fathers' education level were associated with sexual abuse.

CONCLUSION

Though largely unspoken, child maltreatment is a common problem in China. Identification of significant determinants in this study can provide valuable information for teachers and health professionals so as to pay special attention to those at-risk children.

The Evolving Evidence Base for Child Protection in Chinese Societies

Child maltreatment is a substantial public health problem worldwide. Although extensively studied in Western countries, until recently little systematic research had been published about the situation in the world's most populous nation and ethnic diaspora. In this review, we examine trends from community-based research with Chinese young people and parents in mainland China, Hong Kong SAR, Taiwan, Singapore, and Malaysia. It is clear that many Chinese adolescents experience a substantial burden from various forms of maltreatment and the psychological and behavioral correlates are similar to those found in other cultures. However, the research reveals a large gap between this reality and Chinese adults' perceptions about emotional, physical, and sexual abuse. Comprehensive awareness programs are needed to close this information gap and thereby mobilize support for prevention and care initiatives.

A population-based study of childhood sexual contact in China: prevalence and long-term consequences

OBJECTIVES

This study provides national estimates of the prevalence of childhood sexual contact and its association with sexual well-being and psychological distress among adults in China.

METHOD

A national stratified probability sample of 1,519 women and 1,475 men aged 20-64 years in urban China completed a computer-administered survey in 1999-2000. The data from this survey on both adult-to-child and peer-to-peer sexual contact before age 14 were subjected to descriptive and multivariate analyses that were adjusted for both sampling weights and sampling design.

RESULTS

The overall prevalence of reported childhood sexual contact was 4.2%, with prevalence higher among men (5.1%) than among women (3.3%) and higher among those aged 20-29 years (8.3%). Childhood sexual contact was associated with multiplex consequences, including hyper-sexuality (high levels of masturbation, thoughts about sex, varieties of sexual practices, partner turnover), adult sexual victimization (unwanted sex, unwanted sexual acts, sexual harassment), sexual difficulties (genitor-urinary symptoms, sexually transmitted infections, sexual dysfunctions), and psychological distress. Psychological distress was largely mediated by adult sexual victimization, sexual difficulties, and hyper-sexuality.

CONCLUSIONS

Despite the relatively modest prevalence of childhood sexual contact among Chinese adults, the association with multiplex adult outcomes suggests that much as in the West early sexual contact is a significant issue.

PRACTICE IMPLICATIONS

The findings underscore the importance of public education about childhood sexual contact and abuse in China. The findings suggest a need for public health campaigns that tackle the stigma associated with being abused and encourage victims to report abusive behavior to proper sources. The findings are also consistent with new efforts to alleviate the negative long-term impact of childhood sexual abuse.

Violence and desire in Beijing: a young Chinese woman's strategies of resistance in father daughter incest and dating relationships

In Mainland China, there is a lack of public awareness of and systematic research on dating violence and incest. This article fills a gap in the research in this area by examining a woman's lived experience of father-daughter incest and dating violence. The article adopts the standpoint of third-wave feminists and highlights women's agency and resistance to abuse. Meng Xi, the subject of the case study in this article, is regarded as a "survivor" rather than a "victim," and her various strategies of resistance--in particular, how she talks about her body and linghun (intelligence soul), and uses the two as sites of resistance--are examined. The article sheds light on the desire and sexuality of women in contemporary China, and especially the struggle between spiritual and material pursuits.

Prevention of child sexual abuse in China: knowledge, attitudes, and communication practices of parents of elementary school children

OBJECTIVE

Active involvement by parents may contribute substantially to the success of school-based programs to prevent child sexual abuse (CSA). In China, little is known about parental understanding of CSA. This study investigated Chinese parents' knowledge, attitudes, and communication practices with their children about CSA.

METHOD

Six hundred and fifty-two parents of Grade 3 pupils of seven elementary schools in Jingzhou city, Hubei province (central China), completed an anonymous questionnaire (response rate=81%).

RESULTS

More than 95% of respondents agreed that elementary schools should provide programs to prevent CSA and were willing to have their children participate in such programs. Although nearly all parents talked with their children about stranger danger, they were much less likely to talk specifically about sexual abuse. Many parents personally lacked basic knowledge about characteristics of perpetrators, the sexual abuse of boys, and nonphysical consequences of CSA. About half (46.8%) expressed some concern that CSA preventive education could cause their children to know "too much about sex." Contrary to expectations from research in western nations, parents who talked with their children about CSA did not have better knowledge or more supportive attitudes to CSA prevention than did parents who said they never discussed CSA with their children.

CONCLUSION

This study confirms and extends two recent surveys indicating strong support for the concept of school-based CSA prevention in China. However, given the apparently low levels of knowledge about CSA, even among those who talk about this problem with their children, future prevention programs should include community-wide efforts to educate adults to ensure that parental advice is accurate and hopefully, effective.

Exploring the disclosure of child sexual abuse with alleged victims and their parents

OBJECTIVE

The goal of the present study was to examine how children disclosed sexual abuse by alleged perpetrators who were not family members.

METHODOLOGY

Thirty alleged victims of sexual abuse and their parents were interviewed. The children were interviewed using the NICHD Investigative Interview Protocol by six experienced youth investigators. The same principles were followed when the parents were asked to describe in detail what had happened since the abusive incidents. The statements made by the children and parents were then content analyzed. Major characteristics of the children's and parents' reported behaviors were identified by two independent raters.

FINDINGS

More than half (53%) of the children delayed disclosure for between 1 week and 2 years, fewer than half first disclosed to their parents, and over 40% did not disclose spontaneously but did so only after they were prompted; 50% of the children reported feeling afraid or ashamed of their parents' responses, and their parents indeed tended to blame the children or act angrily. The disclosure process varied depending on the children's ages, the severity and frequency of abuse, the parents' expected reactions, the suspects' identities, and the strategies they had used to foster secrecy.

CONCLUSIONS

The children's willingness to disclose abuse to their parents promptly and spontaneously decreased when they expected negative reactions, especially when the abuse was more serious. A strong correlation between predicted and actual parental reactions suggested that the children anticipated their parents' likely reactions very well.

Childhood sexual abuse among university students in Tanzania

OBJECTIVES

There are no prevalence data for childhood sexual abuse among Tanzanian university students. This investigation addressed this paucity. The nature of sexual abuse was also investigated.

METHOD

Participants (N=487) from a university in Tanzania completed a questionnaire which assessed abusive childhood sexual experiences, gathering information about age of victim, duration of abuse, perpetrators, amount of force or persuasion involved, and potential causes of child sexual abuse. A number of individuals were also interviewed about their experiences.

RESULTS

The overall prevalence rate for child sexual abuse was 27.7%, with rates being higher for females than for males. The average age of the victim when abuse occurred was 13.8 years. Perpetrators were generally unidentified by respondents; nonetheless, a surprisingly high proportion of female perpetrators was noted. There was a considerable amount of force or persuasion involved in the abusive behavior: betrayal of trust, bribes and physical force were cited frequently. Poverty and superstition were the primary explanations given for child sexual abuse.

CONCLUSION

The study provides evidence for the existence of child sexual abuse in Tanzania. Poverty feeds the "sugar daddy/mammy" phenomenon and combined with various forms of superstition is an important factor in child sexual abuse in Tanzania.

Child sexual abuse in Henan province, China: associations with sadness, suicidality, and risk behaviors among adolescent girls

PURPOSE

To assess the prevalence of child sexual abuse (CSA) and possible effects on mental health and risky behavior among female adolescents living in China.

METHOD

A retrospective survey was conducted among 351 female students in a medical secondary school in the central China province of Henan in June 2004. The anonymous, self-administered questionnaire included items about unwanted sexual experiences before age 16, depression, suicidality, and risky health-related behaviors.

RESULTS

Over one in five young women (21.9%) reported at least one type of CSA (any one of 12 forms of nonphysical contact and physical contact CSA) before the age of 16 years, with one in every seven (14.0%) reporting CSA involving physical contact. Risk of CSA was not associated with parents' education level, existence of siblings, or rural/urban residence during childhood. Although some indicators of poor mental health were slightly elevated among girls who had experienced noncontact CSA only, the most significant impact is among victims of contact CSA, including higher rates of depression, overwhelming sadness, suicidal thinking and planning, alcohol drinking, smoking, fighting, and having sexual intercourse.

CONCLUSIONS

The risk of CSA in this sample of Chinese female adolescents seems similar to young women in many Western countries, and the pattern of associated mental health and behavioral problems is entirely consistent with international research.

The experience of abuse and mental health in the young Thai population A preliminary survey

OBJECTIVES

The aims of this study were to examine the prevalence of child abuse exposure among Thai people in a suburban community and to describe the association of abuse experiences with common mental disorders (CMD), alcohol use disorders and substance use.

METHODS

A population-based cross-sectional survey was conducted in Northern Bangkok on a representative sample of 202 young residents, aged 16-25 years.

RESULTS

Thirty eight percent of the respondents reported experiencing some form of abuse during childhood, with 5.8% having been subjected to sexual penetration, 11.7% having been physically abused and 31.8% emotionally abused. A graded relationship was found between the extent of exposure to abuse during childhood and mental problems. After controlling for potential confounders, CMD remained significantly associated with emotional abuse, and alcohol use disorders remained associated with sexual abuse. Strong but non-significant trends were present for associations between CMD and sexual abuse and all forms of abuse with substance use.

CONCLUSION

Child abuse experiences were common among the respondents. Childhood abuse, particularly sexual abuse, has a potentially devastating impact on adult mental health.

A life history assessment of early childhood sexual abuse in women

Life history theory provided a framework for examining the relations among child sexual abuse (CSA), childhood adversity, and patterns of reproductive development and behavior. A community survey that assessed CSA, life history variables (e.g., age of menarche), and social and family background was administered to 623 women (mean age=26.9 years). Independent of social and family background, CSA was associated with earlier age of (a) menarche, (b) first sexual relationship, (c) desire to have children, (d) first childbirth, and (e) lower self-evaluated physical attractiveness. Cluster analyses revealed different patterns of experiential correlates of reproductive development within the group of abused women, suggesting CSA may operate in combination with other childhood circumstances to modify the timing and pattern of individual maturation.

Awareness of child sexual abuse prevention education among parents of Grade 3 elementary school pupils in Fuxin City, China

Several recent studies on child sexual abuse (CSA) in Chinese society have shown that the problem is not uncommon, and is associated with poor mental health and health-related risk behaviors of abused youth. It is very important to understand and improve public awareness of CSA prevention, especially for the parents. However, there are few published reports on the problem of parents' awareness. To fill this gap, knowledge, attitudes and practice of CSA prevention education were explored in 385 parents of Grade 3 pupils from four schools in Fuxin City of Liaoning Province in the northeast part of China by self-administered anonymous questionnaires. Among this sample, more than 80% of parents approved of school CSA prevention education. However, at the same time, 47.3% of parents expressed some concern that this education may induce the children to learn too much about 'sex'. Overall, about 60% of parents had told their children that their 'private parts' should not be touched by others and discussed strategies of 'Say "No!", Leave and Tell' in dealing with CSA situations or the situations that may lead to CSA. Only 4.2% of parents had provided books or other material about CSA prevention for their children. The parents' CSA prevention knowledge was inadequate. The findings from this research will be useful in developing CSA prevention education programs in schools and communities, designed to improve parents' knowledge and practice of CSA prevention.

Child sexual abuse in China: a study of adolescents in four provinces

OBJECTIVE

Little is known about Child Sexual Abuse (CSA) in Chinese societies. This study examined CSA experiences and associations with demographic factors, self-reported health and risky behaviors among senior high school students in four provinces in central and northern China.

METHOD

Students in four schools in Hubei, Henan, Hebei, and Beijing provinces participated in an anonymous, self-completed questionnaire survey. From a total enrollment of 3,261 students in the target classes in years 11 and 12, 2,300 (70.5%) returned valid questionnaires. Mean age was 17.2 years. The questionnaire was adapted from prior CSA research in Australia and utilized standard scales for depression, self-esteem, and youth risk behavior.

RESULTS

Prevalence of any unwanted sexual experience before the age of 16 years was higher among females (16.7%) than males (10.5%). Sexual penetration was rarely reported (1%), while 7% reported at least one type of physical contact abuse (female 8.9%, male 5.0%). Risk of any CSA was not associated with the existence of siblings (one-child vs. two- or more child families), rural/urban residence during childhood, or parental education. Males and females with CSA were more depressed and suicidal, and drank alcohol more often, than unaffected adolescents. Contact CSA was strongly associated with sexual intercourse (ever) for both males and females. Females with CSA were more likely than others to engage in anorexic and bulimic behaviors, while males with CSA were often involved in violence.

CONCLUSION

Social norms for consensual sexual experiences differ between Eastern and Western societies. CSA experiences also differ, with substantially less penetrative and physical contact abuse in China. However, the psychological and behavioral profile of abused, young Chinese people, including the additional burden associated with contact abuse, is similar to that found in other cultures.

Intention to participate in child sexual abuse prevention programs: a study of Chinese adults in Hong Kong

OBJECTIVES

This study aimed to explore factors relating to intention to participate in community child sexual abuse (CSA) prevention programs among Chinese adults in Hong Kong.

METHOD

A total of 1,606 Chinese adults (497 men and 1,109 women) were individually interviewed about their intention to participate in community CSA prevention programs, endorsement of myths about CSA, their acquaintance with CSA victims, worry about CSA, and perceived prevalence of CSA.

RESULTS

Among participants, nearly two-thirds believed CSA involved physical injuries of victims, 40% perceived boys as unlikely victims of CSA, and one-third were skeptical about children reports of CSA. About 24% of participants reported that they would definitely take part in CSA prevention programs. Participants who showed definite intention to participate in these programs endorsed fewer myths in relation to CSA, showed more worry about children being at risk of sexual abuse, perceived CSA as more prevalent and involving more physical injuries of victims, and were more likely to be women.

CONCLUSIONS

Attention should be addressed to predisposing factors of adult participation in CSA prevention programs.

Child sexual abuse

Child sexual abuse is a worldwide concern. It is an insidious, persistent, and serious problem that, depending on the population studied and definition used, affects 2-62% of women and 3-16% of men as victims. Pain and tissue injury from child sexual abuse can completely heal in time, but psychological and medical consequences can persist through adulthood. Associated sexually transmitted diseases (such as HIV) and suicide attempts can be fatal. All physicians who treat children should be aware of the manifestations and consequences of child sexual abuse, and should be familiar with normal and abnormal genital and anal anatomy of children. This aim is best accomplished through training and routine examination of the anus and genitalia of children. Because as many as 96% of children assessed for suspected sexual abuse will have normal genital and anal examinations, a forensic interview by a trained professional must be relied on to document suspicion of abuse.

The effects of child sexual abuse in later family life; mental health, parenting and adjustment of offspring

OBJECTIVE

To investigate links between child sexual abuse (occurring before 13 years), later mental health, family organization, parenting behaviors, and adjustment in offspring.

METHOD

The present study investigates a subsample of the Avon Longitudinal Study of Parents and Children an ongoing study of women and their families in the area of Avon, England. A sample of 8292 families met inclusion criteria for identifiable family type and completed self-report data on prior sexual assault. Further data were collected on life course variables, socioeconomic variables, psychological well-being, relationship quality, parent-child relationship quality, and children's adjustment.

RESULTS

After adjustment for other childhood adversity, prior child sexual abuse was associated with a range of outcomes in adulthood, including current membership of a nontraditional family type (single mother and stepfather) poorer psychological well-being, teenage pregnancy, parenting behaviors, and adjustment problems in the victim's later offspring. The relationship of child sexual abuse with aspects of the parent-child relationship in later life and with the offspring's adjustment difficulties were mediated in part by mother's mental health--chiefly anxiety.

CONCLUSION

Findings indicate that child sexual abuse has long-term repercussions for adult mental health, parenting relationships, and child adjustment in the succeeding generation.

Child sexual and physical abuse among college students in Singapore and the United States

OBJECTIVES

The purpose of this study was to explore differences in rates and characteristics of child sexual and physical abuse experiences among women in Singapore and the US.

METHOD

Participants (N=153) completed an anonymous questionnaire which assessed experiences of childhood sexual and physical abuse, abuse characteristics (e.g., victimization age, severity), and behavioral and subjective reactions to such experiences (e.g., labeling of experiences as abuse, psychological symptomatology). Exposure to other forms of traumatic life events was also assessed.

RESULTS

In comparison to Singaporean women, US women were more likely to report a history of child sexual abuse, and to report experiencing more severe forms of sexual abuse. Women in Singapore were more likely than women in the US to report a history of child physical abuse, to report experiencing injury as a result of the abuse, and to disclose the abuse. Singaporean women with a history of child sexual abuse reported elevated psychological symptom levels relative to their nonabused peers and to US women with a history of child sexual abuse, even after controlling for exposure to other types of traumatic events. No significant differences in symptomatology with regard to child physical abuse were observed.

CONCLUSIONS

Although preliminary in nature, the present findings are among the first to demonstrate differences in psychological adjustment between sexually abused and nonabused Asian women living in Asia. This study also provides some of the first support for cross-national differences in the psychological adjustment of child sexual abuse survivors.