Sexual Victimization of Youth With a Physical Disability

Abstract

Children with disabilities have been shown to be at greater risk of victimization than those without. Although much of the research combines disability of any type into a single disability category, recent evidence suggests that not all types of disabilities are equally associated with victimization. To date, little knowledge exists about the victimization of youth with physical disabilities. This study used data from a national school-based survey of adolescents (n = 6,749, mean age = 15.41, SD = .66) in Switzerland to investigate sexual victimization (SV) among physically disabled youth. Two subtypes of SV were differentiated: contact SV, including penetration or touching/kissing, and non-contact SV, such as exhibitionism, verbal harassment, exposure to sexual acts, or cyber SV. A total of 360 (5.1%) youth self-identified as having a physical disability. Lifetime prevalence rates for contact SV were 25.95% for girls with a physical disability (odds ratio [OR] = 1.29 compared with able-bodied girls), 18.50% for boys with physical disability (OR = 2.78 compared with able-bodied boys), and 22.35% for the total sample with physical disability (OR = 1.74 compared with able-bodied youth). For non-contact SV, the lifetime prevalence was 48.11% for girls with a physical disability (OR = 1.44 compared with able-bodied girls), 31.76% for boys with physical disability (OR = 1.95 compared with able-bodied boys), and 40.28% for the total sample with physical disability (OR = 1.67 compared with able-bodied youth). After controlling for other risk factors, physical disability was a significant predictor of contact and non-contact SV for boys, but not for girls.

Keywords

sexual victimization physical disabilities adolescents prevalence risk factors

Disability has been linked to higher rates of sexual victimization (SV) for both children and adults (Hughes et al., 2012; Jones et al., 2012; McEachern, 2012). According to the United Nations’ Standard Rule on the Equalization of Opportunities for Persons With Disabilities (United Nations, 1994), the term disability captures

a great number of different functional limitations occurring in any population in any country of the world. People may be disabled by physical, intellectual or sensory impairment, medical conditions or mental illness. Such impairments, conditions or illnesses may be permanent or transitory in nature. (p. 6)

Most studies exploring the role of disabilities in SV do not differentiate between different types of disabilities (e.g., intellectual, physical, emotional; Mitra, Mouradian, & Diamond, 2011; Reinke, 2005). However, recent evidence suggests that not all disability categories are associated with the same risk for SV (Jones et al., 2012; Turner, Vanderminden, Finkelhor, Hamby, & Shattuck, 2011). For example, Turner and colleagues (2011) observed that only physically disabled children and those with internalizing disorders showed higher rates of SV but not those with attention deficit disorder/attention deficit hyperactivity disorder (ADD/ADHD) or those with developmental/learning disorders. These findings suggest that it is crucial to distinguish between different types of disability when investigating these links. When exploring SV with respect to one specific type of disability, the majority of studies have focused on individuals with developmental and/or intellectual disabilities (McEachern, 2012). Much less is known about the SV among individuals with physical disabilities. Even less is known about links between physical disability and SV in children and adolescents. In this article, we begin to fill this significant gap in the SV literature.

The term sexual victimization is often used as an umbrella term for a wide range of experiences of coercive, offensive, or unwanted sexual transgressions ranging from completed vaginal or anal penetration at the most serious end to exhibitionism at the least serious end of the continuum. One widely used distinction in the SV literature refers to victimization with and without physical contact (Finkelhor, 1994). Victimization with physical contact includes acts where the perpetrator has contact with the body of the victim, ranging in severity from forced penetration of body parts to unwanted touching. Non-contact victimization includes a range of behaviors, such as exhibitionism, verbal or written harassment, and exposure to sexual acts or pornography. To our knowledge, no analysis has yet been conducted on whether young people with physical disabilities present with higher rates of contact victimization only or both types of victimization. In the present study, we examine both of these types of SV.

Two recent meta-analyses examined the prevalence and risk of violent victimization among people with disabilities (Hughes et al., 2012; Jones et al., 2012). The study by Hughes et al. (2012) reviewed evidence from 21 studies with adult samples. It found that the overall odds ratio (OR) for violent victimization among disabled adults (any type of disability) as compared with non-disabled adults was OR = 1.5. Thus, an adult with a disability is 1.5 times (or 50%) more likely to be victimized than a non-disabled adult. However, none of the studies specifically examined the relationship between physical disability and SV. The meta-analysis by Jones et al. (2012) found 11 studies that allowed estimates of violent victimization risk in samples with children with disability (aged < 18 years). This review found even larger average effects. For combined violence measures of physical and sexual violence, the OR of victimization among disabled children (any type of disability) as compared with non-disabled children was OR = 3.68, for sexual violence measures the OR was 2.88. For SV of youth with physical disabilities, Jones et al. (2012) reported a pooled prevalence rate of 11% across three studies. In terms of relative risk, physical disability appears to at least double the risk of lifetime forced sexual intercourse, both based on official records (Sullivan & Knutson, 2000, OR = 2.0) and on self-report studies (Everett Jones & Lollar, 2008; OR = 2.4; Cheng & Udry, 2002, 6% for able-bodied vs. 12.9% for mildly physically disabled girls).

Since Jones and colleagues (2012) completed their meta-analysis, another study explored the experiences of SV in physically disabled children and adolescents (Turner et al., 2011). Using data from the U.S. National Survey of Children’s Exposure to Violence (N = 4,046), Turner et al. (2011) distinguished between four types of disability: physical disability, internalizing disorders, ADD/ADHD, and developmental/and learning disorders. The sample included 6.2% children with a physical disability, defined as “a physical health or medical problem that affects the kinds of activities the child can do” (Turner et al., 2011, p. 279). They assessed SV by utilizing the Juvenile Victimization Scale (Finkelhor, Hamby, Ormrod, & Turner, 2005). The Juvenile Victimization Scale is a frequently used childhood victimization self-report inventory, which consists of questions tapping four different types of victimization, including SV by a non-caregiver. Ten percent of children with physical disabilities reported to have been sexually victimized, compared with 6.4% of children without a physical disability, thus also demonstrating a higher risk of SV among children with a physical disability.

Sex differences in the link between physical disability and risk of SV have so far not been explored. Following an extensive search, we only found two studies, which reported data specifically for girls and none for boys. One of the studies, which focused on girls, explored forced sexual intercourse in a national sample of adolescent girls in the United States and documented an OR of 1.57 for physically disabled versus able-bodied girls (Alriksson-Schmidt, Armour, & Thibadeau, 2010). The second study (Cheng & Udry, 2002) included both male and female youth in their examination of sexual behavior of physically disabled adolescents, but only reported SV rates for girls—6% for able-bodied versus 10.9% for minimally physically disabled, 12.9% for mildly physically disabled, and 11.1% for more severely physically disabled girls. For physically disabled boys, this study only documented rates of perpetration of forced sex but not of victimization. Therefore, it is not known whether physical disability affects the risk of SV differently for girls versus boys. Furthermore, to our knowledge, no detailed prevalence data exist, which would differentiate among the different types of SVs of youth with physical disabilities.

Research on risk and protective factors for SV has so far not investigated whether children and youth with physical disabilities have different risk and protective factors for SV than able-bodied children. There is a considerable body of literature on risk factors for SV in the general child and adolescent population. Due to space considerations, this is only reviewed briefly here (for a review, see, for example, Black, Heyman, & Smith Slep, 2001). Following Bronfenbrenner’s ecological model of human development (e.g., Bronfenbrenner, 1994), one can conceptualize such risk factors as occurring at different levels (i.e., at the individual level, the immediate environment level which includes family factors and closest relationships, the community level, and the society level). In this article, we focused on individual- and family-level risk factors. For instance, girls are at a higher risk than boys (e.g., Finkelhor, 1980; Finkelhor, Turner, Ormrod, & Hamby, 2009), as are children who have experienced violent victimization or witnessed violence in the home (Boney-McCoy & Finkelhor, 1995; Finkelhor, 1980; Fleming, Mullen, & Bammer, 1997). Meeting friends in unsupervised settings has been linked to SVs among adolescents (Ribeaud & Eisner, 2009), as has been getting drunk (Champion et al., 2004; Finkelhor & Asdigian, 1996) or marijuana use (Champion et al., 2004). Having been in a fight has been linked to SV for adolescent girls (Champion et al., 2004), while in a mixed sex sample no link between violent delinquency and SV was found (Ribeaud & Eisner, 2009).

At the family level, living in a single-parent household has been also found to be associated with a greater risk (Choquet, Darvez-Bornoz, Ledoux, Manfredi, & Hassler, 1997; Finkelhor, 1980; Finkelhor, Hotalling, Lewis, & Smith, 1990; Tschumper, Narring, Meier, & Michaud, 1998), while other studies did not replicate this finding (Boney-McCoy & Finkelhor, 1995; Madu & Peltzer, 2000). Further studies reported that it may not be living in a single-parent household, but living with a step-parent which increases the risk of SV (Finkelhor & Asdigian, 1996; Turner, Finkelhor, & Ormrod, 2007). In terms of family climate, poor parent–child relationships have been documented to increase risk (Boney-McCoy & Finkelhor, 1995; Finkelhor, 1980; Vogeltanz, Wilsnack, & Harris, 1999). Social isolation and absence of friends in whom to confide have also been shown in some studies to increase risk (Finkelhor & Baron, 1986; Fleming et al., 1997), although some studies did not find such an effect (Bergner, Delgado, & Graybill, 1994; Finkelhor et al., 1990; Madu & Peltzer, 2000). The mechanism behind a link may be either that these children stand out and are vulnerable to grooming from would-be extra-familial offenders or, in cases of intra-family offending, children might be prohibited from developing friendships and are thus socially isolated. It is so far unknown whether physical disability is a risk factor in the presence of these other established risk factors.

As outlined, there are several significant unanswered questions in the still emerging literature on physical disability and SV. To address these gaps, the goals of the current study were threefold. The first goal was epidemiological: Here we examined, for boys and girls separately, the prevalence rates for contact and non-contact SV in youth with physical disabilities versus youth without physical disabilities. In a second step, we investigated the extent to which girls and boys with physical disabilities are exposed to a range of social-demographic, lifestyle, and family-related risk and protective factors that have generally been found to be associated with SV of young people. In a third step, we examined whether differential exposure to risk and protective factors can explain the higher prevalence of victimization experiences among girls and boys with a physical disability, or if physical disability remains a significant predictor in the presence of these other risk factors.

Method

Participants

Participants for this study were drawn from a Swiss national sample of ninth graders attending state schools who completed a survey conducted in the 2009/2010 school year (Mohler-Kuo, Landolt, Maier, Meidert, Schoenbucher, & Schnyder, 2013; Schnyder, Mohler-Kuo, Landolt, & Maier, 2011). The sampling frame was based on a list from the Swiss Federal Statistical Office with all state schools and classes in Switzerland. Private schools were not included in this study. However, 94% of all Swiss ninth graders attended state schools in the 2009/2010 school year, meaning that the exclusion of private schools from this study is unlikely to have caused significant bias (Bundesamt fuer Statistik, 2011). According to the Swiss Federal Statistical Office Statistics, about 2% of pupils in Switzerland attend special needs school, which were not included in this study, while children attending special needs classes within regular schools were part of the study. This means that the present study does not include the most severely disabled children.

Sampling was stratified based on the seven Swiss “great regions.” For each stratum, a Probability Proportion to Size (PPS) cluster sampling approach based on school size was used to draw schools and classes. This resulted in a target sample of 9,857 students in 562 classes in 215 schools (for more information on the methodological aspects of the survey, see Averdijk, Mueller-Johnson, & Eisner, 2011; Mohler-Kuo et al., 2013). Several levels of approval were necessary for the survey to proceed: In four out of the 26 Swiss cantons, the cantonal authorities declined to participate in the study, 1 canton allowed the collection of data from one half of the planned sample, while 21 cantons gave permission for full access to the targeted schools. Furthermore, the headmasters of each school and individual teachers within schools were also able to decline participation for their schools or classes, respectively, and in 23 schools this was the case. This resulted in a sample size of 7,441 students from 445 classrooms in 161 schools who were eligible to be approached to take part in the survey. On the chosen data collection dates, a total of 537 students were absent from school, as data collection coincided with an outbreak of swine flu. On the day of data collection of course students themselves were also able to decline to participate, and 63 students did so. A further 15 questionnaires had to be excluded because of laptop malfunctioning on the day of data collection. Finally, during data collection, it became apparent that some students did not take the questionnaire seriously. This may have been related to the explicit questions about different types of SV and is an issue that has also been reported by other researchers (e.g., Barter, McCarry, Berridge, & Evans, 2009). As some of these answers reported severe victimization, the research team took great care only to exclude those questionnaires which reported extremely unlikely situations or which provided descriptions in the open comments fields which made clear that the details given were meant as a joke. Examples of such excluded questionnaires were where boys reported having become pregnant as a result of victimization or where a boy said that he lived in one household together with the Pope and Bin Laden. A total of 77 questionnaires were excluded on this basis. Thus, there were valid responses from n = 6,749 students, which is equivalent to a response rate of 91% (6,749/7,441). The sample included 52.2% males. The mean age was 15.41 years, SD = 0.66. About three quarters of the sample (74.1%) were of Swiss nationality, 25.9% were non-Swiss nationals. Among the non-Swiss nationals, the biggest group were from Southern Europe (Italy, Spain, Portugal, Greece) with 7.9% of the total sample, 6.59% were from the countries of the former Yugoslavia, 1.88% were from Eastern Europe (Poland, Czech Republic, Slovakia, Rumania, Albania), and 1.80% were of Turkish nationality. A further 1.56% were from Asian countries and 1.36% were from African countries.

Two levels of ethical approval were obtained for the study. First, the study was approved by each of the cantonal ethics committees in the participating cantons. Then each of the cantonal education departments independently reviewed the study.

Procedure

Students responded to the questionnaire in their class setting, during regular school hours. The questionnaires were programmed onto laptops and filled out by the respondents in one of the three official languages in Switzerland—German, French, or Italian. The survey focused on adolescents’ experience of abuse and victimization, and included a range of questions related to violent, sexual, and property-related victimization. It also contained sections on respondents’ own delinquent behavior, their psychological functioning, as well as their experiences with different ways of being parented. There were always two researchers present while the students filled out the questionnaires. This was to answer arising questions, to ensure that students would respect each others’ privacy while completing the survey, and to monitor whether any of the students showed any signs of distress. It took between 60 and 75 min to complete the survey. After the questionnaires were finished, all students received a leaflet with information about local providers of youth services and of free counseling.

Measures

SV

Two measures of SV were used in the survey and utilized in this study. The first was based on the Juvenile Victimization Questionnaire (JVQ; Hamby, Finkelhor, Ormrod, & Turner, 2004). The JVQ consists of 34 items tapping different types of victimization, including seven items assessing SV. It has been found to have adequate test/retest reliability (mean re-test κ = .63) and construct validity (Finkelhor et al., 2005). In this survey, both lifetime prevalence and past-year prevalence data were elicited.

The second measure, the Sexual Abuse and Victimization Questionnaire (SAVQ), was created by the Swiss project team specifically for this survey (see Averdijk et al., 2011; Mohler-Kuo et al, 2013; Schnyder et al., 2011). It contains 15 additional questions about lifetime and past-year exposure to different forms of SV. We grouped items from both measures into two main types of SV (see the appendix; also see Averdijk et al., 2011): Contact sexual victimization included 11 items asking about touching of body/or “private parts,” kissing against one’s will, as well as attempted or completed penetration. The resulting Cronbach’s alpha was .67.

Non-contact victimization included 10 items asking about experiences of exhibitionism perpetrated against the youth, exposure to sexual acts (i.e., having been forced to watch masturbation or sex or to view pornographic material), verbal or written sexual harassment (someone saying or writing sexual things about the respondent or his/her body; including communications by text message, email or phone), exposure of self (being forced or pressured into undressing and showing one’s genitals to another person, having been photographed or filmed in the nude against one’s will, or having another person pass on or publish intimate pictures or films against the respondent’s will), and cyber victimization (having been clearly sexually harassed or molested when chatting or communicating online). As this measure asks about more diverse victimization experiences than contact SV, its Cronbach’s alpha is lower, at .59. Although this alpha is low, we kept this categorization, as it is important to distinguish non-contact SV from contact victimization and the distinction is a common one in SV research.

Physical disability

Physical disability was defined and operationalized as each individual’s self-reported health condition. It was established using youths’ self-reported endorsement of the following question: “Do you have a physical disability that in some way limits the functioning of your body?” In total, 360 young people (5.1%) identified themselves as having a physical disability. Of these, 186 were girls (5.8% of girls in the sample) and 174 were boys (5.0% of the boys in the sample). The disability was reported to be congenital by n = 154, due to an accident by n = 100, and due to illness by n = 101 young people. The cause was not stated by 5 respondents.

Risk factors

Based on the literature on risk factors of SV and based on previous work (Averdijk et al., 2011), we included a total of 17 potential individual-level and family-level risk factors in the present analyses. For ease of interpretation, we grouped them into three clusters, namely, socio-demographic variables, lifestyle-related variables, and variables related to parenting and family characteristics. To facilitate interpretation of the results and following the recommendations by Farrington and Loeber (2000), we dichotomized all continuously measured risk factors for subsequent analyses.

Socio-demographic risk factors included sex, non-Swiss nationality, living in a single-parent family, and having a stepfather, as well as being of small stature (defined in this study as one standard deviation below the mean on height). Non-Swiss nationality was coded if respondents had only non-Swiss nationality. Those with dual nationality including Swiss nationality were coded as Swiss.

Lifestyle-related variables included few friends, hanging out with friends often, spending a lot of time at home watching TV or reading, frequent internet use, self-reported own violent delinquency, alcohol use, and drug use. Few friends was defined as answering “does not apply” or “does partially apply” to an item whether the respondent had one or more good friends (3-point scale, third answer option “clearly applies”). Spending a lot of time at home watching TV or reading (books, newspaper, magazines) was elicited by asking for the number of hours spent on this activity. Groups were created by median split. The same procedure was used for the variable internet use. Self-reported own violent delinquency was based on six items which measured lifetime perpetration of sexual violence, robbery, assault, threats with a weapon, and injury by a weapon. Alcohol use was measured as having drunk alcohol once a month or more often in the last 12 months. The drug use variable is a summary score for whether or not the respondent had ever taken any Cannabis, Cocaine, Crack, Freebase, Amphetamines, Ecstasy, Heroin, Morphine, Methadone, drugs to inhale or sniff (e.g., solvents, glue), Magic Mushrooms, PCP, or LSD.

Family/parenting-related variables included warm parenting, harsh parenting, poor parental monitoring, physical child maltreatment by a parent, and inter-parental violence. Warm and harsh parenting measures were derived from the Parental Acceptance-Rejection Questionnaire (PARQ; Rohner & Khaleque, 2005). This included 24 items each on the mother’s and on the father’s behavior, which were answered on a 4-point Likert-type scale from “(almost) never applies” to “(almost) always applies.” Exploratory factor analysis showed that in the present sample, the 48 items could be reduced to two underlying factors, one indicating harsh and disinterested parenting (e.g., my mother punishes me severely when she is angry, my mother says many unfriendly things to me; 30 items, Cronbach’s α = .91) and the other indicating warm parenting (e.g., my mother lets me know that she loves me; 18 items, Cronbach’s α = .92). Parental monitoring was assessed based on three items rated on a 5-point scale ranging from “always” to “(almost) never”: until what hour respondents were allowed to stay out during the week; until what hour respondents were allowed to stay out during the weekend; and the extent to which parents knew with whom the respondent was out. Physical maltreatment was measured with three dichotomous items of the JVQ (Finkelhor et al., 2005), namely, whether the respondent had ever been hit, kicked, or physically injured by an adult in his or her environment; whether the respondent had ever been afraid because an adult in his or her environment had insulted or said mean things to him or her; and whether the respondent had ever been neglected. Having witnessed inter-parental violence was assessed based on the response to one item: “Did you ever see one of your parents get hit by another parent, or their boyfriend or girlfriend? How about getting slapped, punched, or beaten up?”

The survey materials were translated into German, French, and Italian by project team members with a social science background who were fluent in German and either French or Italian, and were also proficient in English. After being checked by a second project member, translations were sent for back-translation by a professional translator with a specialization in the field. Finally, the translations and back translations were sent to the instrument developers for approval (Schnyder et al., 2011).

Analytical Plan

The first aim of the current study was to assess the lifetime prevalence rates for different types of SV in physically disabled and non-physically disabled youth. Given the considerable differences in the prevalence of SV between girls and boys (Finkelhor et al., 2009), analyses for prevalence rates were split by sex. The second goal was to compare lifetime prevalence and past-year prevalence rates of different types of SV in physically disabled versus able-bodied youth. To do so, a set of chi-square tests were conducted to investigate differences between physically disabled and able-bodied youth and ORs were calculated for different types of SV comparing the two groups (see Table 2).

The final objective of this study was to investigate whether physical disability was a significant risk factor independent of other known risk factors of SV and to see whether this was the case for both boys and girls. To address this, we first examined whether youth with disabilities was more exposed to risk factors of SV than youth without physical disabilities. Two sets of logistic regression analyses were then carried out, predicting past-year prevalence for contact and for non-contact SV for girls and boys separately. Past-year, rather than lifetime, prevalence was chosen in an effort to establish as much temporal precedence of the putative risk factors (Murray, Farrington, & Eisner, 2009) with regard to the victimization outcome as this cross-sectional survey allows.

Results

Prevalence Rates of SV

The lifetime prevalence rates for two types of SV as well as their subtypes for physically disabled and able-bodied youth are presented in Table 1. In addition, Table 2 presents the associated ORs of lifetime SV for physically disabled versus able-bodied youth. It also reports ORs for past-year prevalence.

Table 1.

Lifetime Prevalence for Sexual Victimization for Disabled Versus Able-Bodied Youth.

	Females		Males		Total
	Disabled (n = 186)	Able-Bodied (n = 3,037)	Disabled (n = 174)	Able-Bodied (n = 3,335)	Disabled (n = 360)	Able-Bodied (n = 6,372)
	% (CI)	% (CI)	% (CI)	% (CI)	% (CI)	% (CI)
Contact sexual victimization	25.95 [19.57, 32.32]	21.42 [19.46, 23.39]	18.50 [.12.11, 24.88]	7.54 [6.47, 8.62]	22.35 [17.53, 27.17]	14.16 [13.02, 15.30]
Attempted or completed penetration	11.35 [6.87, 15.83]	6.16 [5.28, 7.04]	2.94 [0.37, 5.51]	1.03 [0.61, 1.44]	7.32 [4.79, 9.86]	3.48 [2.97, 3.98]
Non-contact sexual victimization	48.11 [40.67, 55.55]	39.19 [36.41, 41.98]	31.76 [24.96, 38.57]	19.26 [17.69, 20.83]	40.28 [34.74, 45.83]	28.77 [27.08, 30.46]
Indecent exposure	15.14 [10.36, 19.91]	8.50 [7.26, 9.74]	6.94 [3.10, 10.77]	4.42 [3.31, 5.53]	11.17 [8.24, 14.11]	6.36 [5.49, 7.24]
Verbal/written harassment	29.19 [22.17, 36.21]	20.79 [18.94, 22.64]	11.18 [6.45, 15.90]	8.11 [7.07, 9.16]	20.56 [16.15, 24.98]	14.16 [13.01, 15.31]
Exposure to acts	3.80 [1.13, 6.48]	3.37 [2.72, 4.01]	3.52 [0.76, 6.30]	2.95 [2.32, 3.59]	3.67 [1.64, 5.71]	3.15 [2.69, 3.60]
Exposure of self	7.07 [3.71, 10.42]	4.19 [3.49, 4.90]	2.96 [0.37, 5.54]	1.72 [1.26, 2.18]	5.10 [3.01, 7.18]	2.90 [2.49, 3.32]
Cyber victimization	29.19 [22.18, 36.20]	27.53 [24.77, 30.29]	17.26 [11.29, 23.23]	9.08 [7.69, 10.47]	23.51 [18.43, 28.60]	17.88 [16.10, 19.66]

Note. CIs were calculated using robust standard errors to take into account the cluster sampling at school level. CI = confidence interval.

Table 2.

Odds Ratios of Lifetime and Past-Year Sexual Victimization for Disabled Versus Able-Bodied Youth for Different Types of Sexual Victimization.

	Lifetime Prevalence			Past-Year Prevalence
	Females	Males	Total	Females	Males	Total
	Disabled Vs. Able-Bodied	Disabled Vs. Able-Bodied	Disabled Vs. Able-Bodied	Disabled Vs. Able-Bodied	Disabled Vs. Able-Bodied	Disabled Vs. Able-Bodied
	OR (CI)	OR (CI)	OR (CI)	OR (CI)	OR (CI)	OR (CI)
Contact sexual victimization	1.29 [0.92, 1.81]	2.78** [1.86, 4.17]	1.74** [1.35, 2.26]	1.16 [0.77, 1.74]	2.19** [1.33, 3.62]	1.49** [1.09, 2.05]
Attempted or completed penetration	1.95** [1.21, 3.15]	2.92* [1.13, 7.56]	2.19** [1.44, 3.34]	2.30** [1.33, 3.96]	2.68 [0.80, 9.05]	2.47** [1.51, 4.04]
Non-contact sexual victimization	1.44 * [1.07, 1.94]	1.95** [1.40, 2.73]	1.67** [1.34, 2.08]	1.32 [0.96, 1.81]	1.98** [1.37, 2.86]	1.59** [1.25, 2.02]
Indecent exposure	1.92** [1.26, 2.93]	1.61 [0.88, 2.97]	1.85** [1.31, 2.61]	2.28** [1.32, 3.93]	0.99 [0.40, 2.47]	1.76** [1.11, 2.79]
Verbal/written harassment	1.57** [1.13, 2.18]	1.43 [0.87, 2.33]	1.57 **[1.20, 2.05]	1.30 [0.87, 1.92]	1.52 [0.83, 2.80]	1.41* [1.02, 1.96]
Exposure to acts	1.14 [0.52, 2.48]	1.20 [0.52, 2.78]	1.17 [0.66, 2.08]	1.03 [0.37, 2.86]	1.49 [0.59, 3.76]	1.25 [0.63, 2.47]
Exposure of self	1.74 [0.96, 3.14]	1.74 [0.69, 4.41]	1.80* [1.10, 2.96]	1.89 [0.85, 4.19]	3.06* [1.06, 8.88]	2.28* [1.21, 4.32]
Cyber victimization	1.09 [0.78, 1.51]	2.19** [1.38, 3.17]	1.41** [1.09, 1.82]	1.03 [0.71, 1.51]	2.01** [1.27, 3.18]	1.36* [1.02, 1.82]

Note. OR = odds ratio; CI = confidence interval.

p < .05. **p < .01.

Victimization lifetime prevalence rates were quite high in both the disabled and able-bodied group. The prevalence of contact SV for physically disabled youth was 22.35%, which was 1.74 times higher than the able-bodied group, for whom the prevalence rate was 14.16%. For non-contact SV, lifetime prevalence rates were 40.28% for the disabled group and 28.77% for the able-bodied group, OR = 1.67.

Sex Differences in Prevalence Rates of SV

There were marked differences in prevalence rates between boys and girls. Consistent with the literature, girls reported higher lifetime prevalence rates than boys across all types of SV. Boys with physical disabilities were nearly 3 times more likely to suffer lifetime contact victimization and nearly twice more likely ever to experience non-contact victimization than able-bodied boys. Girls with physical disabilities, on the other hand, were not more likely to experience lifetime contact SV and 1.4 times more likely to experience lifetime non-contact SV than able-bodied girls. The ORs for past-year victimization were largely similar to lifetime victimization.

Disabled Youth’s Exposure to Risk and Protective Factors for SV

In a next step, we examined the extent to which disabled boys and girls differ in their exposure to risk and protective factors from able-bodied adolescents. Table 3 lists the ORs for 16 risk and protective factors for SV in youth with disabilities compared with youth without disabilities.

Table 3.

Prevalence of Risk and Protective Factors in Youth With Physical Disabilities Compared With Youth Without Physical Disabilities.

	All Youth With Disabilities		Males With Disabilities		Females With Disabilities
	OR	95% CI OR	OR	95% CI OR	OR	95% CI OR
1. Socio-demographic risk factors
Single-parent family	1.36*	[1.02, 1.80]	1.60*	[1.08, 2.39]	1.15	[0.76, 1.72]
Stepfather	0.90	[0.60, 1.35]	0.91	[0.50, 1.66]	0.88	[0.51, 1.52]
Non-Swiss nationality	0.87	[0.67, 1.11]	0.91	[0.63, 1.30]	0.82	[0.58, 1.16]
Small stature	1.20	[0.92, 1.56]	1.35	[0.82, 2.23]	1.08	[0.78, 1.49]
2. Lifestyle risk factors
At home watching TV or reading	1.04	[0.84, 1.29]	0.99	[0.73, 1.36]	1.04	[0.77, 1.41]
Internet use	0.96	[0.78, 1.19]	0.91	[0.67, 1.24]	0.99	[0.74, 1.34]
Few friends	1.43*	[1.04, 1.96]	1.74**	[1.14, 2.65]	1.14	[0.70, 1.86]
Hanging out with friends often	0.87	[0.71, 1.08]	0.76	[0.56, 1.04]	0.98	[0.73, 1.32]
Violent delinquency	1.35**	[1.09,1.67]	1.68**	[1.21, 2.33]	1.30	[0.94, 1.79]
Alcohol	1.11	[.89,1.39]	0.99	[0.72, 1.35]	1.32	[0.97, 1.79]
Drugs	1.11	[0.87, 1.40]	1.21	[0.88, 1.67]	1.06	[0.74, 1.52]
3. Family/parenting-related risk factors
Warm parenting	0.72**	[0.58, 0.90]	0.61**	[0.44, 0.84]	0.86	[0.63, 1.16]
High parental monitoring	0.96	[0.77, 1.19]	0.85	[0.62, 1.16]	1.09	[0.81, 1.47]
Child maltreatment	2.18**	[1.34, 3.55]	3.90**	[1.88,8.10]	1.47	[0.76, 2.86]
Harsh parenting	1.41**	[1.13, 1.75]	1.38*	[1.00, 1.89]	1.42*	[1.04, 1.93]
Witnessed inter-parental violence	1.48*	[1.09, 2.01]	2.22**	[1.42, 3.46]	1.05	[0.68, 1.61]

Note. OR = odds ratio; CI = confidence interval.

p < .05. **p < .01.

The analyses were also conducted separately for girls and for boys. Boys with a physical disability were more likely to come from a single-parent family than able-bodied boys (OR = 1.60). They were also more likely to have few friends (OR = 1.74) and to be involved in violent behaviors than their able-bodied peers. The most important differences were found for exposure to family and parenting risks: Disabled boys were less likely to experience warm parenting (OR = 0.61), more likely to experience child maltreatment (OR = 3.90), and more likely to be exposed to inter-parental violence (OR = 2.22) than able-bodied boys. In contrast, physically disabled girls were not more exposed to risk factors than able-bodied girls with one exception: Girls with physical disabilities had a higher chance of being exposed to harsh parenting compared with girls without physical disabilities (OR = 1.42).

Predictors for SV

In the final step, we examined whether differential exposure to risk factors explains the higher victimization of disabled adolescents. For each sex separately, two logistic regression analyses investigated whether physical disability remained a significant risk factor for contact SV and non-contact SV, respectively, once other risk factors were taken into account. The results are presented in Table 4. We also ran the model in Table 4 for the overall sample which revealed, as expected from the literature, that sex was a significant predictor of SV with girls having the higher risk compared with boys (OR = 3.3, p < .05 for contact SV, OR = 2.68, p < .05 for non-contact SV). For this reason, the subsequent analyses were carried out for each sex separately.

Table 4.

Risk Factors for Last-Year Prevalence of Contact and Non-Contact Sexual Victimization, Split for Male and Female Youth.

	Contact Sexual Victimization		Non-Contact Sexual Victimization
	Males	Females	Males	Females
Physical disability	1.82*	1.12 (n.s.)	1.65*	1.22 (n.s.)
Socio-demographic variables
Single parent	1.09 (n.s.)	1.09 (n.s.)	1.05 (n.s.)	0.98 (n.s.)
Stepfather	1.24 (n.s.)	0.83 (n.s.)	1.40 (n.s.)	1.40*
Non-Swiss nationality	1.73**	1.48**	1.23 (n.s.)	0.92 (n.s.)
Small stature	1.06 (n.s.)	0.75*	1.17 (n.s.)	0.97 (n.s.)
Lifestyle variables
At home watching TV or reading	0.97 (n.s.)	0.67***	1.19 (n.s.)	0.97 (n.s.)
Internet use	1.61**	1.67***	1.73***	1.91***
Hanging out with friends	1.21 (n.s.)	1.19 (n.s.)	1.09 (n.s.)	1.23*
Few friends	1.25 (n.s.)	1.37 (n.s.)	1.36 (n.s.)	1.03 (n.s.)
Violent delinquency	1.68 **	1.15 (n.s.)	1.54***	1.45***
Alcohol	1.18 (n.s.)	1.58***	1.33*	1.56***
Drugs	1.72**	2.06***	1.49**	1.76***
Parenting variables
Warm parenting	0.79 (n.s.)	0.89 (n.s.)	0.82 (n.s.)	0.89 (n.s.)
Harsh parenting	1.87**	1.65***	1.45**	1.51***
Parental monitoring	1.45**	1.00 (n.s.)	1.10 (n.s.)	1.01 (n.s.)
Child maltreatment	3.83**	2.32***	2.90**	3.21***
Witnessed inter-parental violence	1.65*	1.54**	1.36 (n.s.)	1.54**
Constant
n	3,185	3,025	3,184	3,025
Model df	17	17	17	17
Model χ²	128.03***	263.83***	179.14***	382.64***
Nagelkerke R²	.117	.156	.100	.175

p < .05. **p < .01. ***p < .001.

The pattern of findings differed for boys versus girls (see Table 4). For boys, physical disability remained a significant risk factor for both contact SV and non-contact victimization even when other potential risk factors were taken into account. For girls, however, physical disability was not a significant predictor of contact SV or of non-contact SV.

Apart from physical disability, which was only a predictor for boys, the most important risk factors for SV for boys and girls were child maltreatment, harsh parenting, witnessing inter-parental violence, alcohol and drug use, violent delinquency as well as frequent internet use. Significant protective factors only emerged in the case of contact SV and only for girls: here being of smaller than median stature and spending more than median time at home reading or watching TV was related to a reduction of victimization risk.

Discussion

The goal of the current study was to examine separately for boys and girls whether physical disability is associated with a greater risk of sexual contact and non-contact victimization among a large sample of adolescents in Switzerland, whether physically disabled adolescents are exposed to different risk factors than able-bodied adolescents, and whether physical disability remains a significant risk factor for SV after other risk factors are taken into account.

The analyses showed that 22% of the physically disabled youth and 14% of the able-bodied sample reported to have experienced at least one incident of contact SV in their life. Lifetime prevalence of non-contact victimization was 40% in the disabled sample and 29% in the able-bodied sample. At first glance, the prevalence rates found in this study seem relatively high in comparison with other studies (see meta-analysis by Stoltenborgh, van IJzendoorn, Euser, & Bakermans-Kranenburg, 2011). We believe that this is mainly due to two points: First, studies differ in their definition of SV. The meta-analysis by Stoltenborgh and colleagues (2011) documented that prevalence rates varied by operationalization of SV. In our study, contact victimization was defined broadly and included unwanted sexual touching and kissing, while other studies define SV very narrowly, for instance, as forced sexual intercourse (Cheng & Udry, 2002). When examining prevalence rates “like for like” the current prevalence rates are in line with previous work: For example, Cheng and Udry (2002) reported forced sexual intercourse prevalence rates of 6% for able-bodied girls and 10.9% to 12.9% for girls with physical disabilities (depending on the severity of their disability). Our prevalence rates for sexual penetration were similar with 6.2% for able-bodied and 11.4% for physically disabled girls. For studies which adopted the definition of SV used in the National Incidence Study of Child Abuse and Neglect (which includes penetration, genital touching, other sexual touching, and kissing, see the appendix in Stoltenborgh et al., 2011), Stoltenborgh and colleagues (2011) reported a combined prevalence rate of 21.2% (95% confidence interval [CI] = [17.8, 25.0]) for girls and of 10.7% (95% CI = [6.6, 16.8]) for boys. Our measure of contact victimization is similar to this measure and yielded comparable rates for the able-bodied sample of girls (21.4%; 95% CI = [19.5, 23.4]) and of boys (7.5%; 95% CI = [6.5, 8.6]). The biggest difference to other studies thus appears to be related to the non-contact victimization measure, which in our study also included cyber victimization, a relatively recent offense type, which is not included in many studies. Second, differences in prevalence rates could also result from the large number of items used to measure SV in the present study, independent of the definition of SV. For example, Stoltenborgh et al. (2011) showed that prevalence estimates of child sexual abuse are significantly affected by the number of survey items.

Across all types of SV, youth with physical disabilities had higher prevalence rates than their able-bodied counterparts. For the subtypes, apart from exposure to sexual acts, this difference was statistically significant. For all types of non-contact SV combined, physically disabled youth was 67% more likely to report having been victimized. A similar increase in odds was observed for contact victimization, where disabled youth were 74% more likely to be victimized than were able-bodied youth. The biggest difference was documented for the most severe forms of sexual violence. Physically disabled youth were 2.73 times more likely than able-bodied youth to have been the victims of acts involving completed penetration. These results are broadly in line with the findings from studies conducted on samples in the United States utilizing global measures of SV (e.g., Cheng & Udry, 2002; Everett Jones & Lollar, 2008; Turner et al., 2011). They hence suggest that the increased risk of SV among physically disabled adolescents can be found in different cultures, highlighting this link as a significant global concern. Furthermore, we believe the present study is the first to demonstrate that the higher risk of victimization is not limited to experiences that involve physical contact, but also extends to non-contact SV including indecent exposure, verbal harassment, exposure of self, and cyber victimization. These findings further underscore the heightened vulnerability of young people with disabilities to experiences of victimization.

Analyses split by sex revealed that physical disability affected the risk of SV differentially for boys versus girls. Overall, disabled girls were at a greater risk than disabled boys, just as girls generally were at greater risk than boys. However, the increase in the odds of victimization associated with disability tended to be larger for boys than it was for girls. While for disabled girls the odds of being the victim of lifetime sexual contact victimization were not significantly increased compared with able-bodied girls, for disabled boys there was a near 3 times increase in the prevalence of victimization. Similarly, while for disabled girls the odds of ever being the victim of attempted or completed penetration were nearly twice as high as for able-bodied girls, for disabled boys there was a nearly 3 times increase. These data suggest that it is particularly boys for whom physical disability brings an increase in risk of SV. This interpretation was further strengthened by the logistic regression analyses examining whether disability presents a unique risk factor for SV or whether increased rates of victimization would be explained by an increased exposure of youth with physical disabilities to other known risk factors. Although boys with disabilities were more exposed to particular risk factors, such as child maltreatment, having witnessed domestic violence, and experienced harsh parenting, than able-bodied boys, physical disability remained a significant predictor for SV once these and other potential risk factors were taken into account. This was the case for contact and for non-contact SV. For girls, on the other hand, physical disability was not a significant risk factor once other potential risk factors were taken into account. With the exception of harsh parenting, disabled girls also did not seem to be exposed more frequently to the chosen risk factors than able-bodied girls. One possible reason for the greater exposure to family-related risk factors for both boys and girls, such as harsh parenting, could be related to increased caregiver stress because caring for a child with a physical disability might be more challenging. Our data cannot answer this question, but this may be an important area for future study.

The sex differences in the impact of physical disability on SV could be accounted for by several different explanations. Interviews with sex offenders have shown that one criterion for victim choice is their vulnerability (e.g., Conte, Wolf, & Smith, 1989; Elliott, Browne, & Kilcoyne, 1995; Stevens, 1994). Girls may be perceived as more vulnerable than boys, just by being girls, which often stereotypically suggests a smaller, weaker stature and as indicated by their higher rate of being sexually victimized. Physical disability increases the risk of victimization less for girls than for boys, which may suggest that girls are already regarded as more vulnerable, and any additional vulnerability due to physical disability may not pose much additional risk. Boys on the other hand may, in general, not be regarded as particularly vulnerable. Here, physical disability may provide an indication of vulnerability, and thus physically disabled boys have nearly as high a prevalence of SV as girls.

Another potential explanation for these findings draws on a different victim choice mechanism for male and female victims. In a previous study, which utilized the current sample, Averdijk and colleagues (2011) reported that the majority of perpetrators were males of approximately the same age as the victims. This suggests that a significant proportion of both contact and non-contact SV occurs within interactions with peers. Furthermore, in another study utilizing a different sample, Cunningham and colleagues (2010) found that in this age-group SV, in particular sexual bullying and sexual harassment, is differentially related to attractiveness for boys and girls. Specifically, they reported that girls who rate themselves as more attractive are more likely to experience sexual bullying and sexual harassment, while among boys it is those who rate themselves different from the average (i.e., worse or better looking than average) who are most often victimized. As the majority of sexual bullying is perpetrated by boys (e.g., Cunningham et al., 2010; McMaster, Connolly, Peplar, & Craig, 2002), this difference in the role of attractiveness was explained with male-on-male sexual bullying being reflective of dominance-related strategies to gain status within the peer group, while cross-gender sexual bullying may be related to romantic/sexual attraction.

These findings may partly account for the differential association between physical disability and SV among boys and girls in the present study. Thus, sexual aggression against male disabled peers may be more strongly influenced by dominance-related strategies among males, while sexual aggression by male peers against females may be more strongly influenced by perceived attractiveness rather than disability.

For both boys and girls, the most important risk factors were child maltreatment, harsh parenting, witnessing inter-parental violence, alcohol and drug use, violent delinquency as well as frequent internet use. Non-Swiss nationality emerged as a significant predictor for contact SV for both boys and girls. We do not have a good explanation for this finding. One possibility may be that respondents of non-Swiss nationality, and especially those of non-Western nationality, may be more exposed to norms and values associated with patriarchal ideologies and masculinity, which in turn may lead to higher levels of child maltreatment and SV.

The biggest risk factor for both sexes and for both contact and non-contact SV was child maltreatment, drawing attention to the fact that many victims experience multiple forms of victimization. Physical disability was, for boys only, the third most important risk factor for both contact SV (after maltreatment and harsh parenting), and for non-contact SV (after child maltreatment und internet use) and thus was more important than witnessing inter-parental violence, parental monitoring, or lifestyle factors such as alcohol and drug use, or own violent delinquency.

Despite the study’s strengths in documenting important findings on physical disability and SV, it also has its limitations. Given the cross-sectional and non-experimental design, it is impossible to make inferences about the causal nature of associations between victimization and the variables included as potential risk factors—a common limitation of victimization research. It may be possible, for instance, that maltreatment and contact SV are due to the same underlying third factor (risk heterogeneity hypothesis) or that early maltreatment increases vulnerability for SV (state dependence hypothesis). Furthermore, it is possible that some of these potential risk factors may in fact be consequences of the abuse. For instance, it is possible that the reported alcohol and drug use as well as the violent behavior are in fact reactions to the victimization experience.

The majority of the literature on SV has thus far either looked at SV as one overall category tapping a variety of different experiences, or differentiated between contact and non-contact SV. In the area of physical disabilities, research has so far not made this distinction between contact and non-contact victimization and this article therefore advances the field in this regard. However, some limitations as to the measurement of these types of SV apply: Utilizing an existing data set, our goal was to maximize the use of available information related to these types of SV. For this reason, we combined information from the JVQ with relevant information from the SAVQ, a measure developed by the survey authors (Schnyder et al., 2011), for which no prior psychometric information was available to us on this or another sample. Combined with the low reliability based on our analyses, the findings should be interpreted with caution and warrant further replication and validation of measures. Furthermore, our findings regarding the low Cronbach’s alpha for both the contact and non-contact victimization measure suggest that future research may benefit from further distinguishing between different types of SV beyond just these two categories.

Another limitation of the current study is that it was based on a classroom survey rather than a household based survey—a context, which may highlight school-related events and lead to under-reporting of family events. However, the classroom setting provides more anonymity than a household setting, and parents are not present who could influence the child’s answers. For this reason, classroom-based surveys may lead to more valid results. Furthermore, the sampling frame only included state schools. While this comprised 94% of all 9th grade students in 2009, it did not include private schools. Perhaps most importantly, the study did not include the most severely disabled young people in Switzerland who attend special needs schools, although it included those with disabilities severe enough that they needed to attend special classes within mainstream schools. It is therefore impossible to say whether the findings reported in the present study generalize to the most severely disabled youth and future studies should be carried out on a broader sample. The survey also did not include any information about the nature of the physical disability involved or about how much school these youth missed as a result of their disability. Such information about the nature and level of severity of the physical disability may elucidate the mechanisms linking physical disability with higher risk factors for SV.

Conclusion

The present study has several implications for prevention and intervention policy. While girls with a physical disability have a higher risk than boys with a physical disability to experience SV, the findings suggest that the increase in risk of SV among physically disabled youth is larger for boys than for girls. In fact, once other risk factors, such as for instance child maltreatment and harsh parenting, are taken into account, physical disability is not a significant predictor for SV of girls, but it remains a significant risk factor for boys. To our knowledge, this is the first study to report data on the SV of boys with physical disabilities. While more research is needed to examine whether this finding can be generalized to a broader sample of young people with physical disabilities, it demonstrates that this group merits more focused research and implies that more attention should be paid to adequate prevention measures for physically disabled boys specifically.

The study also underscores the importance of family-related risk factors. This suggests that strategies for the successful reduction of SV of physically disabled adolescents should primarily target domains such as child maltreatment, the quality of child–parent bonds, and dysfunctional relationships between the parents.

Footnotes

Appendix

Categorization of Sexual Victimization Items

Contact sexual victimization

1. Did a grown-up YOU KNOW ever touch your private parts when you didn’t want it or make you touch their private parts? Or did a grown-up YOU KNOW force you to have sex? (JVQ)

2. Did a grown-up you did NOT KNOW ever touch your private parts when you didn’t want it, make you touch their private parts or force you to have sex? (JVQ)

3. Now think about kids your age, like from school, a boyfriend or girlfriend, or even a brother or sister. Did another child or teen ever make you do sexual things? (JVQ)

4. Did anyone ever TRY to force you to have sex, that is, sexual intercourse of any kind, even if it didn’t happen? (JVQ)

5. Have you ever been touched or kissed with sexual intention on your body and/or your private parts against your will? (SAVQ)

6. Have you ever been forced or pressured to touch or kiss another person on his/her body and/or his/her private parts? (SAVQ)

7. Has someone ever tried to insert his/her finger/-s or an object in your vagina or your anus against your will? (SAVQ)

8. (Only for females) Has someone ever tried to have vaginal intercourse with you against your will? (SAVQ)

9. Has someone ever tried to have anal intercourse with you against your will? (SAVQ)

10. Has someone ever pressured you to take his penis or another person’s penis in your mouth? (SAVQ)

11. Have you ever been forced or pressured by another person to prostitute yourself (sex for money)? (SAVQ)

Non-contact sexual victimization

Exhibitionism

12. Did anyone ever make you look at their private parts by using force or surprise, or by “flashing” you? (JVQ)

13. Were you ever forced or pressured to look at the genitals of an adult or another kid? (SAVQ)

Exposure to sexual acts

14. Have you ever been forced or pressured to watch one or several people masturbating or having sex? (SAVQ)

15. Have you ever been forced or pressured to look at pornographic pictures, drawings, films, DVDs or magazines (also on a cell phone)? (SAVQ)

Verbal/written sexual harassment

16. Did anyone ever hurt your feelings by saying or writing something sexual about you or your body? (JVQ)

17. Has anyone ever harassed you by saying or writing sexual things to you (also by text messages, email, or phone)? (SAVQ)

Exposure of oneself

18. Were you ever forced or pressured to undress yourself and to show your genitals to an adult or other youths? (SAVQ)

19. Did anyone ever take nude pictures of you against your will (photos, film, also with a cell phone)? (SAVQ)

20. Did anyone ever pass on intimate pictures or films of you to other people or published them publicly on the internet against your will? (SAVQ)

Cyber victimization

21. Have you ever been clearly sexually harassed or molested when you were chatting (MSN, Netlog, etc.) or during some other type of internet based communication)? (SAVQ)

Note. JVQ = Juvenile Victimization Questionnaire (Hamby et al., 2004); SAVQ = Sexual Abuse and Victimization Questionnaire (Schnyder, Mohler-Kuo, Landolt, & Maier, 2011).

Acknowledgements

This paper presented data from the Optimus Study, which was initiated and funded by the UBS Optimus Foundation ().

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Author Biographies

Katrin Mueller-Johnson is a senior lecturer in applied criminology at the University of Cambridge, Institute of Criminology. Her areas of research are victimization, investigative interviewing, and policing. Within these areas, she focuses particularly on vulnerable participants in the criminal justice system as well as on sexual offences.

Manuel P. Eisner is professor of comparative and developmental criminology at the Institute of Criminology, University of Cambridge. His research interests include the history of violence, individual development and aggression, cross-cultural comparative analysis of violence, and violence prevention. He is the PI of the Zürich Project on the Social Development of Children, a longitudinal study of 1,200 children from ages 7 to 15.

Ingrid Obsuth is a research associate at the Institute of Cambridge, University of Cambridge. Her academic interests are in the area of adolescent mental health with a focus on crime prevention and programme evaluation, trauma and victimization, and parent–child relationships.

References

Alriksson-Schmidt

A. I.

Armour

B. S.

Thibadeau

J. K.

(2010). Are adolescent girls with a physical disability at increased risk for sexual violence. Journal of School Health, 80, 361-367.

Averdijk

Mueller-Johnson

Eisner

(2011). Sexual victimisation of children and adolescents in Switzerland (Final Report for the UBS Optimus Foundation). Retrieved from http://www.optimusstudy.org/fileadmin/user_upload/documents/Full_Report_Schweiz/Optimus_Study_Final_Report_2012_e.pdf

Barter

McCarry

Berridge

Evans

(2009). Partner exploitation and violence in teenage intimate relationships. NSPCC. Retrieved from http://www.nspcc.org.uk/Inform/research/findings/partner_exploitation_and_violence_report_wdf70129.pdf

Bergner

R. M.

Delgado

L. K.

Graybill

(1994). Finkelhor’s risk factor checklist: A cross-validation study. Child Abuse & Neglect, 18, 331-340.

Black

D. A.

Heyman

R. E.

Smith Slep

A. M.

(2001). Risk factors for child sexual abuse. Aggression and Violent Behavior, 6, 203-229.

Boney-McCoy

Finkelhor

(1995). Prior victimization: A risk factor for child sexual abuse and for PTSD-related symptomatology among sexually abused youth. Child Abuse & Neglect, 19, 1401-1421.

Bronfenbrenner

(1994). Ecological models of human development. In Husen

Postlethwaite

T. N.

(Eds.), International encyclopedia of education (2nd ed., Vol. 2, pp. 1643-1647). Oxford, UK: Elsevier.

Bundesamt fuer Statistik. (2011). Schuelerinnen, Schueler und Studierende 2009/2010 [School and university students 2009/2010] (Vol. 15). Neuchatel, Switzerland: Author.

Champion

H. L. O.

Foley

K. L.

Durant

R. H.

Hensberry

Altman

Wolfson

(2004). Adolescent sexual victimization, use of alcohol and other other substances, and other health risk behaviors. Journal of Adolescent Health, 35, 321-328.

10.

Cheng

M. M.

Udry

J. R.

(2002). Sexual behaviors of physically disabled adolescents in the United States. Journal of Adolescent Health, 31, 48-58.

11.

Choquet

Darvez-Bornoz

J. M.

Ledoux

Manfredi

Hassler

(1997). Self-reported health and behavioral problems among adolescent victims of rape in France: Results of a cross-sectional survey. Child Abuse & Neglect, 21, 823-832.

12.

Conte

J. R.

Wolf

Smith

(1989). What sexual offenders tell us about prevention strategies. Child Abuse & Neglect, 13, 293-301.

13.

Cunningham

N. J.

Taylor

Whitten

M. E.

Hardesty

P. H.

Eder

Delaney

(2010). The relationship between self-perception of physical attractiveness and sexual bullying in early adolescence. Aggressive Behavior, 36, 271-281.

14.

Elliott

Browne

Kilcoyne

(1995). Child sexual abuse prevention: What offenders tell us. Child Abuse & Neglect, 19, 579-594.

15.

Everett Jones

Lollar

D. J.

(2008). Relationship between physical disabilities or long-term health problems and health risk behaviors or conditions among US high school students. Journal of School Health, 78, 252-257.

16.

Farrington

D. P.

Loeber

(2000). Some benefits of dichotomization in psychiatric and criminological research. Criminal Behavior and Mental Health, 10, 100-122.

17.

Finkelhor

(1980). Risk factors in the sexual victimization of children. Child Abuse & Neglect, 4, 265-273.

18.

Finkelhor

(1994). The international epidemiology of child sexual abuse. Child Abuse & Neglect, 18, 409-417.

19.

Finkelhor

Asdigian

N. L.

(1996). Risk factors for youth victimization: Beyond a lifestyles/routine activities theory approach. Violence and Victims, 11, 3-19.

20.

Finkelhor

Baron

(1986). High-risk children. In Finkelhor

(Ed.), A sourcebook on child sexual abuse (pp. 60-88). Beverly Hills, CA: SAGE.

21.

Finkelhor

Hamby

S. L.

Ormrod

Turner

(2005). The Juvenile Victimization Questionnaire: Reliability, validity and national norms. Child Abuse & Neglect, 29, 383-412.

22.

Finkelhor

Hotalling

Lewis

I. A.

Smith

(1990). Sexual abuse in a national survey of adult men and women: Prevalence, characteristics and risk factors. Child Abuse & Neglect, 14, 19-28.

23.

Finkelhor

Turner

Ormrod

Hamby

S. L.

(2009). Violence, crime, and exposure in a national sample of children and youth. Pediatrics, 124, 1411-1423.

24.

Fleming

Mullen

Bammer

(1997). A study of potential risk factors for sexual abuse in childhood. Child Abuse & Neglect, 21, 49-58.

25.

Hamby

S. L.

Finkelhor

Ormrod

Turner

(2004). The Juvenile Victimization Questionnaire (JVQ): Administration and Scoring Manual. Durham, NH: Crimes Against Children Research Center.

26.

Hughes

Bellis

M. A.

Jones

Wood

Bates

Eckley

. . . Officer

(2012). Prevalence and risk of violence against adults with disabilities: A systematic review and meta-analysis of observational studies. The Lancet, 379, 1621-1629.

27.

Jones

Bellis

M. A.

Wood

Hughes

McCoy

Eckley

. . . Officer

(2012). Prevalence and risk of violence against children with disabilities: A systematic review and meta-analysis of observational studies. The Lancet, 380, 899-907.

28.

Madu

S. N.

Peltzer

(2000). Risk factors and child sexual abuse among secondary school students in the Northern Province (South Africa). Child Abuse & Neglect, 24, 259-268.

29.

McEachern

A. G.

(2012). Sexual abuse of individuals with disabilities: Prevention strategies for clinical practice. Journal of Child Sexual Abuse, 21, 386-398.

30.

McMaster

L. E.

Connolly

Peplar

Craig

W. M.

(2002). Peer to peer sexual harassment in early adolescence: A developmental perspective. Developmental Psychopathology, 14, 91-105.

31.

Mitra

Mouradian

V. E.

Diamond

(2011). Sexual violence victimization against men with disabilities. American Journal of Preventive Medicine, 41, 494-497.

32.

Mohler-Kuo

Landolt

Maier

Meidert

Schoenbucher

Schnyder

(2013). Child Sexual Abuse Revisited: A population-based cross-sectional study among Swiss adolescents. Journal of Adolescent Health, 54, 304-311.

33.

Murray

Farrington

D. P.

Eisner

M. P.

(2009). Drawing conclusions about causes from systematic reviews of risk factors: The Cambridge Quality Checklists. Journal of Experimental Criminology, 5, 1-23.

34.

Reinke

D. C.

(2005). Similarities and differences between children with and without disabilities on identified clinical findings. Developmental Disabilities Bulletin, 33(1-2), 44-70.

35.

Ribeaud

Eisner

(2009). Entwicklung von Gewalterfahrungen Jugendlicher im Kanton Zuerich. [The development of experiences of violence among adolescents in the canton of Zuerich] Oberentfelden, Switzerland: Sauerlaender.

36.

Rohner

R. P.

Khaleque

(2005). Parental Acceptance-Rejection Questionnaire (PARQ): Test manual. In Rohner

R. P.

Khaleque

(Ed.), Handbook for the study of parental acceptance and rejection (4th ed., pp. 43-106). Storrs, CT: Rohner Research Publications.

37.

Schnyder

Mohler-Kuo

Landolt

Maier

(2011). Final report of UBS Optimus Foundation: Population survey (Unpublished report). Psychiatrische Polyklinik USZ, Zurich, Switzerland.

38.

Stevens

D. J.

(1994). Predatory rapists and victim selection techniques. Social Science Journal, 31, 421-433.

39.

Stoltenborgh

van IJzendoorn

M. H.

Euser

E. M.

Bakermans-Kranenburg

M. J.

(2011). A global perspective on child sexual abuse: Meta-analysis of prevalence around the world. Child Maltreatment, 16, 79-101.

40.

Sullivan

P. M.

Knutson

J. F.

(2000). Maltreatment and disabilities: A population-based epidemiological study. Child Abuse & Neglect, 24, 1257-1273.

41.

Tschumper

Narring

Meier

Michaud

P. A.

(1998). Sexual victimization in adolescent girls (age 15-20 years) enrolled in post-mandatory schools or professional training programs in Switzerland. Acta Paediatrica, 87, 212-217.

42.

Turner

H. A.

Finkelhor

Ormrod

(2007). Family structure variations in patterns and predictors of child victimization. American Journal of Orthopsychiatry, 77, 282-295.

43.

Turner

H. A.

Vanderminden

Finkelhor

Hamby

S. L.

Shattuck

(2011). Disability and victimization in a national sample of children and youth. Child Maltreatment, 16, 275-286.

44.

United Nations. (1994). Standard Rules on the Equalization of Opportunities for Persons with Disabilities (Resolution 48/96). Retrieved from http://www.un.org/disabilities/default.asp?id=26

45.

Vogeltanz

N. D.

Wilsnack

S. C.

Harris

T. R.

(1999). Prevalence and risk factors for childhood sexual abuse in women: National survey findings. Child Abuse & Neglect, 23, 579-592.