Some Methodological Problems in Estimating Incidence and Prevalence in Child Sexual Abuse Research

Journal of Sex Research, Nov, 2000 by Juliette D. G. Goldman, Usha K. Padayachi

In a national study in the United States by National Centre on Child Sexual Abuse and Neglect (NCCAN) (1981), of all the cases known to professionals it was estimated that 44,700 children are sexually abused every year. Again, data from this study may be unreliable as it is often found that families from lower socio-economic class with fewer resources would turn to public institutions such as a Department of Social Security for help, whereas families from middle and higher socio-economic class would resort to private means (De Jong, Hervada, & Emmett, 1983; Scherzer & Lala, 1980). Further, physicians often may not report, or advise the family of the victim to report the abuse to the appropriate authorities. For instance, James, Womack, and Stauss's (1978) study of physicians revealed that only one third of physicians urged the family of sexual abuse victims to report the matter, and less than half indicated that they would do so. A recent study in Australia found that physicians had very little knowledge of the experience of sexual abuse in their female patients (Mazza, Dennerstein, & Ryan, 1996). These findings clearly demonstrate that the incidences of child sexual abuse are underreported, and cannot be accurately estimated from recorded cases.

Overreporting of cases of child sexual abuse is also not uncommon, as found in the much publicized Cleveland Inquiry in Britain (see O'Hagan, 1989). It was found that within a 5-month period, 121 children who were diagnosed as victims of child sexual abuse on limited medical examination were removed from their homes. Of these, 98 were returned to their homes at the time of the inquiry as it was found that they appeared not to have been abused. This appears to be an example of a case of overreporting.

In Australia, some attempts were made by Harrold (1987) to estimate a national incidence figure for child abuse, including child sexual abuse, by examining notification records in each state. Harrold found that, similar to the USA, it was not possible to obtain an accurate assessment of the incidence of child sexual abuse or compare the reported rates between states. This was due to differences in the definition of child abuse and administrative procedures for handling cases once the authorities had been notified. For instance, in Queensland, a case is notified and recorded as soon as the initial complaint is made, whereas some other Australian states only notify and record after initial investigations have been made. Since it was methodologically unsound to compare reported rates across states in Australia, Harrold presented some information on incidence figures for child abuse in Queensland only. Based on the data from the Central Register, Harrold concluded finding a dramatic increase in the confirmed cases of child sexual abuse from 60 cases for the period 1981 to 1982 to 184 cases for the 1983 to 1984 period.

Although reported cases of child sexual abuse do not give a good estimation of the magnitude of the problem, they help to keep track of the number of cases which come to the attention of professionals and social agencies. However, many researchers believe that reported cases of child sexual abuse represent only a fraction of its true occurrence. Only the most severe cases are reported to the legal authorities and social agencies. Beneath the visible tip of child sexual abuse is a larger portion of unknown cases (Finkelhor, 1984). Since so many cases are unreported due to the nature of the problem, a much broader population study may determine prevalence. A number of prevalence studies will now be reviewed which represent significant attempts to sample the general population, and illustrate how different methodologies, definitions, and samples influence results.