How Common Is Childhood Sexual Abuse?
The exact rates of childhood sexual abuse in the general population are not known for certain, in large part because incidents are not often reported at the time they occur. In 1997, there were more than 98,000 substantiated cases of childhood sexual abuse in the United States. Sexual abuse cases accounted for approximately 12% of all substantiated child maltreatment cases. These statistics suggest that 1.4 per 1000 children have sexual abuse experiences that are considered substantiated by law enforcement or other child protection agencies. In population surveys that assess for childhood sexual abuse experiences, the rates are significantly higher. In a national survey of adolescents(1), 13% of females and 3.4% of males reported being sexually assaulted before the age of 18. These rates vary some across studies and are dependent on how childhood sexual abuse is defined and the sample of individuals who are assessed. In general, approximately 1 in 4 women and 1 in 7 men report a history of some form of childhood sexual abuse(2). Multiple incidents of abuse are relatively common, and occur in 50-75% of cases.

What Are the Characteristics of Sexual Abuse Offenders?
Sexual abuse can occur by persons known to the child, such as teachers, ministers, coaches, siblings, and other family members; as well as by strangers(3). Most commonly, the offender is someone known to the child. Surveys of the general population indicate that in approximately 16% of childhood sexual abuse cases the offender is a parent or stepparent. In approximately 39% of cases, the offender is a non-relative who is known to the child. A relatively small proportion of sexual abuses cases (about 11%) are perpetrated by a stranger(4). The majority of childhood sexual abuse offenders are male, however boys are more likely than girls to be abused by a female(5).

Who Is At Risk for Sexual Abuse?
A number of variables have been investigated to determine what, if any, factors are associated with increased risk for childhood sexual abuse. Females are three times more likely to be sexually abused during childhood than males. In general, children who live away from both of their natural parents have been found to be at increased risk for being sexually victimized(3). Families in which there is a stepparent living in the household have been associated with increased risk. In addition, specific characteristics of families with a child who has been sexually abused have been given some attention in the literature. For example, families of child sexual abuse victims have been found to be less cohesive, more socially isolated, and generally more dysfunctional than families of nonabused children(6). Children who have a physical disability are almost twice as likely to be sexually abused than children without a disability are. Socioeconomic status and race have not been found to be risk factors.

What Are the Effects of Childhood Sexual Abuse?
Research investigating the effects of childhood sexual abuse has found a number of both short and long term psychological and interpersonal consequences that are associated with a history of sexual victimization(7, 8). Much of the information we have regarding the longer term impact of childhood sexual abuse is provided by adults who report a history of childhood sexual abuse. The information we have regarding the impact sexual abuse has on children is obtained primarily from clinical samples. In general, children who are sexually abused display signs of fear, anxiety, and concentration problems consistent with symptoms of post-traumatic stress disorder (PTSD). They tend to be more aggressive and difficulties in peer relationships than nonabused children. In addition, sexually abused children are reported to have more behavioral problems in comparison to nonabused children, and specifically have been found to display more sexual behavior problems(9).

A history of childhood sexual abuse is also associated with a number of longer term difficulties in adult life(2). Depression is the most commonly reported symptom by adults who report childhood sexual abuse experiences. Sexual abuse victims may have four times greater risk to have symptoms of major depression than individuals without such a history. Sexually abused individuals are also five times as likely to be diagnosed with an anxiety disorder than nonabused individuals(10). These individuals also report chronic irritability and difficulty controlling their anger. Along with increased risk of PTSD, adult survivors of sexual abuse have been found to have higher levels of dissociation, higher rates of suicidal ideation and suicide attempts, as well as higher rates of tension-reducing self-injurious behaviors such as cutting or burning oneself. Women who report a history of childhood sexual abuse also report more difficulties in sexual functioning and are at increased risk for being revictimized. It should be noted that some individuals with a reported history of sexual abuse do not report any significant problems as adults.

What Is Physical Abuse?
The definitions of child physical abuse vary widely and it is often difficult to come to a consensus as to what is meant when we talk about physical abuse. There is often a fine distinction between what constitutes physical abuse and extreme or harsh parental discipline practices (Kolko, 1996). The onus is often on individual child welfare professionals to determine when parental behaviors are sufficiently excessive and dangerous to be considered abusive. According to Snyder and Sickmund (1999), "physical abuse includes physical acts that caused or could have caused physical injury to the child." In general, there are four different, but not wholly unique, types of child physical abuse: 1) intentional infliction of physical injury on a child; 2) examples of "discipline gone wrong" which results in unintentional physical injury to the child; 3) negligence that results in physical injury (e.g., the child is not given proper supervision and falls from a high place); and 4) negligence that presents a risk of physical injury.

How Common Is Childhood Physical Abuse?
Because of the difficulties in defining physical abuse, the incidence and prevalence rates of childhood physical abuse vary somewhat. In 1997, approximately 24% of the substantiated cases of child maltreatment were physical abuse cases. Thus, approximately 197,500 cases, or 2.7 per 1000 children, had childhood physical abuse experiences that warranted child protective services. In a national population survey(1), 9.4% of adolescents surveyed reported experiences of severe physical abuse that occurred in the context of parental discipline. Extrapolating these findings to the general population suggests that approximately 2.1 million adolescents have been physically abused. Additional survey methods(11) have found that 7.5% of youth have experienced a serious family physical assault and 74.5% report corporal punishment discipline practices in their homes. The rates of physical abuse are relatively equal across girls and boys.

What Are the Characteristics of Physically Abusive Parents?
The research literature suggests that males and females are equally likely to commit acts of physical abuse. It has been hypothesized that excessive punishment in childhood is associated with increased risk of using aggressive parenting practices with one’s own children. Indeed, an estimated 30% of physically abused children become abusive parents. However, it should be noted that most children who are physically abused do not grow up to use abusive parenting practices(12). Single parent homes are only at marginally greater risk for child physical abuse than dual parent homes. In one study investigating characteristics of offenders in infant maltreatment deaths(13), 84% of the offenders were male, 23% reported being abused as children themselves, and they were typically young, married, first-time parents. In addition, it has been noted that abusive parents often exhibit inconsistent child-rearing practices and are more likely to use critical or aggressive behavior management strategies with their children. Heightened levels of stress, depression, and substance abuse have also been identified as risk characteristics of abusive parents.

Who Is At Risk for Physical Abuse?
Children who have an early history of medical problems may be at particular risk for physical abuse. Although medical, intellectual, and development problems among children are characteristics of physically abusive parent-child interactions, it is not clear whether these are causes or consequences of abuse. Indeed, such problems may contribute to stressful family environments, which may result in harsh parenting practices. However, such problems may occur or be exacerbated by physically abusive interactions. Similarly, while difficult temperament and conduct problems among children are specific characteristics of children who are physically abused, it is not clear whether these problems precede or follow physically abusive discipline practices(14).

What Are The Effects of Childhood Physical Abuse?
The effects of childhood physical abuse are seen across a variety of domains. First, the definitional features of what is meant by "physical abuse" imply that one of the significant consequences is physical harm or injury to the child. Children with a history of childhood physical abuse are more likely to have neonatal problems, head injuries, serious physical injuries, and skin markings or scars than children who are not abused(15). Death is another potential outcome for children in physically abusive home environments. In 1997, 1,196 childhood deaths were attributed to physical abusive parenting practices.

In addition to these physical outcomes, there are additional potential effects for child physical abuse victims. Children who are raised in physically abusive environments are more likely to have attachment problems, which may be a basis for longer-term adjustment problems(14). Physically abused children have more academic-related difficulties, including intellectual deficits, poorer academic achievement, and lower test scores(16). Additionally, there are several psychological and emotional/behavioral problems that have been associated with a history of child physical abuse. These include depression, chronic and excessive fear and anxiety, recurring anger, aggressive behavior, hyperactivity, and difficulty establishing and maintaining friendships.

References

1. Kilpatrick, D. G., & Saunders, B. E. (April, 1997). The prevalence of consequences of child victimization. National Institute of Justice Research Preview. U.S. Department of Justice .
   
   
2. Polusny, M. A., & Follette, V. M. (1995). Long term correlates of child sexual abuse: Theory and review of the empirical literature. Applied and Preventive Psychology , 4, 143-166 .
   
   
3. Finkelhor, D., Hotaling, G., Lewis, I. A., & Smith, C. (1990). Sexual abuse in a national survey of adult men and women: Prevalence, characteristics, and risk factors.Child Abuse and Neglect, 14, 19-28 .
   
   
4. Saunders, B. E.; Kilpatrick, D. G.; Hanson, R. F.; Resnick, H. S., & Walker, M. E. (1999) Prevalence, case characteristics, and long-term psychological correlates of child rape among women: A national survey. Child Maltreatment, 4, 187-200.
   
   
5. Finkelhor, D., & R ussell, D. E. H. (1984). Women as perpetrators: Review of the evidence. In D. Finkelhor (Ed.), Child sexual abuse: New theory and research (pp. 171-185). New York: Free Press .
   
   
6. Madonna, P. G., Van Scoyk, S., & Jones, D. P. H. (1991). Family interactions within incest and nonincest families. American Journal of Psychiatry, 148, 46-49 .
   
   
7. Beitchman, J. H., Zucker, K. J., Hood, J. E., daCosta, G. A., & Ackman, D. (1991). A review of the short-term effects of child sexual abuse. Child Abuse and Neglect , 15, 537-556.
   
   
8. Finkelhor, D. (1990). Early and long-term effects of child sexual abuse: An update.Professional Psychology, 21, 325-330.
   
   
9. Friedrich, W. N., Grambsch, P., Damon, L., Koverola, C., Hewitt, S. K., Lang, R. A., & Broughton, D. (1992). Child sexual behavior inventory: Normative and clinical comparisons. Psychological Assessment, 4, 303-311 .
   
   
10. Saunders, B. E., Villeponteaux, L. A., Lipovsky, J. A., & Kilpatrick, D. G. (1992). Child sexual assault as a risk factor for mental disorder among women: A community survey. Journal of Interpersonal Violence, 7, 189-204.
    
    
11. Finkelhor, D. (1998). A comparison of the responses of preadolescents and adolescents in a national victimization survey. Journal of Interpersonal Violence, 13, 362-382.
    
    
12. Kaufman, J., & Zigler, E. (1987). Do abused children become abusive parents? American Journal of Orthopsychiatry , 57, 186-192 .
    
    
13. Brewster, A. L., Nelson, J. P., Hymel, K. P., Colby, D. R., Lucas, D. R., McCanne, T. R., Milner, J. S. (1998). Victim, perpetrator, family, and incident characteristics of 32 infant maltreatment deaths in the United States Air Force. Child Abuse and Neglect, 22, 91-101 .
    
    
14. Youngblade, L. M., & Belsky, J. (1990). Social and emotional consequences of child maltreatment. In R. T. Ammerman & M. Hersen (Eds.), Children at risk: An evaluation of factors contributing to child abuse and neglect (pp. 109-140). New York: Plenum.
15. Kolko, D. J., Moser, J. T., & Weldy, S. R. (1990). Medical/health histories and physical evaluation of physically and sexually abused child psychiatric patients: A controlled study. Journal of Family Violence , 5, 249-267 .
    
    
16. Erickson, M. F., Egeland, B., & Pianta, R. (1989). The effects of maltreatment on the development of young children. In D. Cicchetti & V. Carlson (Eds.),Child maltreatment: Theory and research on the causes and consequences of child abuse and neglect (pp. 647-684). New York: Cambridge University Press.