Prevalence, Case Characteristics, and Long-Term Psychological Correlates of Child Rape Among Women: A National Survey

Reviewed by
Priscilla Schulz, LCSW

from an article of the same title by:
Benjamin E. Saunders, Dean G. Kilpatrick, Rochelle F. Hanson, Heidi S. Resnick, Michael E. Walker, Medical University of South Carolina

Child Maltreatment, V. 4, (3), 187-200, August 1999

What is the scope of this article?
This article reviews earlier studies suggesting that women raped in childhood are more vulnerable to depression, substance use, PTSD and other problems. It then presents survey results. Three questions are answered by the new data. 1) How common is child rape? 2) What are some of the characteristics of these assaults? 3) Are women raped as children more likely to develop particular psychological problems?

How was the survey conducted?
A representative national sample of women was contacted by telephone and interviewed. They were screened for a history of child rape and answered questions about the assaults, current functioning, and their mental health history. They were also assessed for the presence of specific diagnosable disorders using standard criteria.

What are some of the statistically significant findings?
  1. 8.5% reported being raped as children.
  2. Child rape was equally common among all racial, ethnic, and income groups.
  3. The younger a subject, the more likely she was to report having been raped as a child (see discussion below).
  4. Victims were younger than non-victims and therefore:
    • more likely to be unemployed, divorced (not entirely attributable to their youth), and less educated;
    • less likely to be retired, widowed.

Characteristics (rounded to whole percentages)

  1. 42% of rapes belonged to a series: same victim, same rapist, repeated rapes.
  2. Repeated rapes were most likely to be committed by fathers or stepfathers and least likely to be committed by strangers.
  3. Average (mean and median) age for the first child rape was 11 years. Mode was 16.
  4. A known non-relative was the most frequent perpetrator for all victim age groups.
  5. Known non-relatives committed 39% of the assaults, strangers 11%. Relatives committed the rest: fathers and stepfathers 16%, boyfriends or husbands 9%, brothers 5%, others 20%.
  6. During almost half of the rapes, victims believed they would be killed or seriously injured, but physical injuries were reported in less than 1/4 of the rapes.
  7. Life threatening fear was most likely during rapes by strangers and next most likely during rapes by fathers or stepfathers.
  8. Likelihood of injury did not vary by perpetrator.
  9. Victims reported rapists as under the influence of alcohol and/or drugs in less than 1/3 of the rapes. Victims reported being under the influence of alcohol and/or drugs in less than 6% of the rapes.
  10. 12% of rapes were reported to authorities. The younger a subject, the more likely she was to have reported a childhood rape to authorities. Likelihood of reporting to authorities did not vary by racial identity.

Psychological Correlates (even after controlling for the relative youth of victims)

  1. Child rape victims were more likely than non-victims to meet diagnostic criteria for major depression and PTSD at some time in their lives and at the time of the interview.
  2. Child rape victims were more likely than non-victims to meet criteria for current and lifetime drug and alcohol use, and to have sought treatment for substance abuse.
It is estimated that 8.33 million American women were raped before they were 18 years old. This number is consistent with previous estimates given the differences in definitions and methods used. That younger women reported more child rape may mean that the rate of child rape has increased considerably over the last half century. On the other hand this may be due to victims dying younger, or older women forgetting or being less forthcoming about traumatic childhood experiences. That childhood sexual abuse is a risk factor for developing depression, PTSD and substance abuse is supported, though the former has not been shown to cause the latter.

What are the implications of this study?
Prevention efforts may be tailored to the circumstances. At different ages children appear to be vulnerable to different perpetrators. Younger children are at more risk than teenagers from sexual assaults by their own fathers and brothers. Teens are at more risk than other groups from boyfriends, peers, and strangers. All are at greatest risk from known non-relatives.

The number of child rapes reported to authorities is distressingly low.

A history of victimization ought to be routine during clinical mental health examinations. All adult mental health clients should be screened for a history of child rape.

Results give clinicians a better overall picture of child rape, allowing them to put a particular case into a realistic context, which may affect assessment and treatment.

Reviewed by Priscilla Schulz, September 1999
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