Abstract
The prevalence of child sexual abuse (CSA) is difficult to assess, and rates vary widely across studies due to methodological and sample differences. In Spain, prevalence data from representative samples are lacking. The objective of this study was to determine the prevalence of different CSA experiences in a sample that was representative of the Spanish population in terms of gender, age, and region. The sample comprised 1,071 (539 male and 532 female) Spanish adults (Mage = 45.37; SD = 14.84). Participants completed an anonymous online survey about different types of CSA and were asked whether they had disclosed the experience at the time. Prevalence was analyzed as a function of gender and generation. Results indicated prevalence rates ranging from 2.8% to 18.5%, depending on the type of experience. The most common experience suffered during childhood was being shown pornographic material, while that with the lowest prevalence was being forced to perform a sexual act involving penetration. Prevalence was higher in females than males for eight of the ten experiences considered. Young adults from Generation Z were the most likely to report having suffered three of the CSA experiences, two of them related to technology. Only 27.5% of respondents said that they had told someone about the abuse at the time, mainly their mother (more common among females) or a friend/peer (more frequent among males). The results suggest that CSA is prevalent in Spain, with considerable rates for several types of abusive experience, especially among females and the youngest generation. The implications of the results are discussed. The findings may inform social policy and the development of effective prevention programs.
Introduction
Child sexual abuse (CSA) is a form of maltreatment that engages a minor in sexual activity with the aim of satisfying the sexual needs or interests of another person who by age, authority or development is in a position of power over the minor (WHO, 1999, 2003). It covers a range of experiences, which may or may not include physical contact, for example, sexual harassment, forced exposure to sexual content, sexual touching, and even completed sex acts (Murray et al., 2015).
Sexual abuse of children remains a major public health, social, and human rights problem in the world today (Selengia et al., 2020). It has been linked to important physical and psychological health consequences affecting both children’s development (Friedrich et al., 2001; Putnam, 2003) and their later adult lives (Easton et al., 2011; Hornor, 2010; Maniglio, 2009; Martin et al., 2004; Mullers & Dowling, 2008; Noll et al., 2008; Ortiz-Tallo & Calvo, 2020; Sapp & Vandeven, 2005; Sarasua et al., 2013). Many victims of CSA subsequently experience difficulties in intimate relationships, and they often struggle to feel joy, as if they had no right to love and/or to sex (Echeburúa-Odriozola, 2020). Although the specific impact of CSA may depend on variables such as the victim’s age when the abuse started, the relationship to the perpetrator, and the frequency and duration of abuse (Hornor, 2010), the experience is known to be associated with a high suicide risk throughout the life span (Dube et al., 2001; Sapp & Vandeven, 2005).
CSA is a serious violation of the child’s rights and it is usually kept secret, which makes it difficult to analyze (Save the Children, 2012a). It is estimated that only one third of victims disclose the abuse while still a child (London et al., 2003; Ullman, 2007), and of those who do, 40% talk to a peer rather than to an adult or someone in authority (Broman-Fulks et al., 2007). These results highlight the difficulty of analyzing this type of maltreatment, especially with official data, since a high percentage of CSA incidents are never reported to authorities (Finkelhor et al., 2012). Importantly, disclosure during childhood has been linked to better recovery in terms of the victim’s health and well-being (Broman-Fulks et al., 2007; Ruggiero et al., 2001; Sciolla et al., 2011), and it may also stop the abuse from continuing. Disclosure is therefore considered an important factor to assess. One of the variables that have been found to predict a prompt disclosure during childhood is gender, since girls are more likely than boys to disclose a CSA experience (Alaggia, 2005; Hébert et al., 2009). However, it is not only disclosure that is important, since other people’s reactions, such as believing the victim and the kind of support offered, also predict the negative effects and the victim’s ability to cope with the traumatic experience (Ullman, 2007).
The European Council estimates that across the continent one in five children suffer CSA (European Council, 2020), although published meta-analyses suggest that prevalence rates vary considerably around the world. Pereda et al. (2009) included 65 studies from 22 different countries, reporting a general mean CSA prevalence of 7.9% in males and 19.7% in women. Stoltenborgh et al. (2011) analyzed 217 studies involving a total of 331 samples and reported a combined prevalence of 11.8%. Barth et al. (2013) examined 55 studies with CSA information from 24 countries and found that prevalence ranged from 0% to 69% in females and from 0% to 47% in males. The first two of these meta-analyses included some studies conducted in Spain, but the latter one did not.
These differences in reported prevalence may be attributed to the sample characteristics, the data collection methods used, and, especially, to the types of CSA experience that are analyzed, since rates vary significantly across different kinds of abuse. In general, noncontact experiences are the most common, with rates around 30% for females and 15% in males, whereas the prevalence for contact experiences is approximately 15% in females and 6% in males (Barth et al., 2013; Mohler-Kuo et al., 2014). Studies that analyzed clinical or exclusively female samples report a higher prevalence than do those involving general samples (Ferragut et al., 2021; Pan et al., 2020; Pereda et al., 2009), and rates are also considerably higher when data are obtained through anonymous self-report measures rather than face-to-face interviews (Collin-Vézina et al., 2013; Ferragut et al., 2021; Pan et al., 2020; Pereda et al., 2009; Stoltenborgh et al., 2011). Notwithstanding these differences, research has systematically found a higher CSA prevalence in females than males (Chiu et al., 2013; Collin-Vézina et al., 2013; Conklin, 2000; Guziak, 2020; Martin & Silverstone, 2013; Miller et al., 2007; Putnam, 2003; Singh et al., 2014; Stoltenborgh et al., 2011; Townsend & Rheingold, 2013; WHO, 2016). It is estimated that females have a two-to-three-fold higher risk of being sexually abused in childhood (Barth et al., 2013).
The literature also shows that the prevalence of CSA differs across geographical regions and sample sources, with the lowest rate by continent corresponding to Europe (Pan et al., 2020; Pereda et al., 2009; Stoltenborgh et al., 2011). Once again, the results are heterogeneous and depend on many factors (number of studies in each country, sample characteristics, data collection procedure, etc.). Some authors suggest that these regional differences may indicate that certain societies are doing more to address the problem of CSA, raising awareness of its existence and/or implementing prevention programs (Pan et al., 2020; Pereda et al., 2009).
Prevalence studies in Spain are scarce and the results are heterogeneous, varying according to sample characteristics and the data collection procedure used (Pereda, 2016). Moreover, no up-to-date information is available, since the studies that report CSA experiences among Spanish adults were published one or even two decades ago (Cantón & Justicia, 2008; Cantón et al., 2012; De Paúl, et al., 1995; Ferragut et al., 2021; López et al., 1995; Pereda & Forns, 2007). Furthermore, only one of these studies included a representative sample (López et al., 1995); the remainder gathered data from specific populations such as women or university students. The prevalence reported in these studies varies, with overall percentages of 18.9% (López et al., 1995), 17.9% (Pereda & Forns, 2007), 13.4% (De Paúl et al., 1995), 12.2% (Cantón et al., 2012), and 9.46% (Cantón & Justicia, 2008), although consistent with data from other countries, rates were always higher in females.
Society is changing and greater attention is being paid to children’s safety and rights (World Vision, 2019). A number of authors have highlighted the importance of tracking changes over time in relation to CSA experiences (Barth et al., 2013; Kloppen et al., 2016). In Spain, CSA prevention strategies and information campaigns are now being implemented through government and civil initiatives (Save the Children, 2012b), and the population seems to be better informed and more aware of the problem of CSA (Dunne et al., 2003; Ferragut et al., 2021, 2022). Given these strategies and increased societal awareness, it is possible that CSA is less prevalent in the youngest generation, in comparison with older generations. However, few studies have specifically analyzed whether the reported prevalence of CSA experiences differs across generations of adults in representative samples. To the best of our knowledge, only one study, published recently, has analyzed these differences in Spanish women, finding a decreased prevalence among the youngest respondents (Ferragut et al., 2021). This contrasts with previous meta-analyses that have compared the results obtained in different time periods and which suggest that prevalence rates remain relatively stable (Pereda et al., 2009).
In summary, the prevalence of CSA is difficult to assess and reported rates vary across studies. A further issue to consider is the need for data based on representative samples (Collin-Vézina et al., 2013; Hébert et al., 2009; Selengia et al., 2020). Prevalence studies in Spain are scarce and outdated, and almost all the published data were obtained from specific samples of women or university students. Also, more information is needed about differences across generations.
The aim of this study was to determine, retrospectively, the prevalence of CSA in a sample that was representative of the Spanish population in terms of gender, age, and region. Specifically, it was sought to analyze the prevalence of different abuse experiences, both contact and noncontact, and to examine differences by gender and across generations, considering four cohorts of individuals born at a similar time (Generation Z, Millennials, Generation X, and Boomers). This study also provides data about disclosure during childhood, specifically, whether victims told anyone about the abuse, who they told, if they were believed, and whether anything was done to help them.
Method
Participants
Sociodemographic Variables for the Sample.
Instrument
Child Sexual Abuse Experiences Questionnaire (CSAEQ).
This instrument gathers both demographic information (gender, age, educational level, employment status, marital status, and town/city of residence) and data about experiences of sexual abuse during childhood or adolescence. It was an extension of the instrument designed previously by Ferragut et al. (2021). Participants were asked about experiences that (a) occurred when they were still a legal minor (less than 18 years old), (b) involved an adult or an older child who surpassed them in terms of strength, development, or authority, and (c) were felt to be inappropriate (i.e., not playing with a peer under conditions of equality). A total of 10 events were assessed, and respondents had to answer yes or no to the following questions:
Did anyone ever rub their private parts against you? Did anyone ever fondle any part of your body? Did anyone ever touch your private parts? Did anyone ever ask you to touch his/her private parts? Did anyone ever kiss you or ask you to kiss him/her? Did anyone ever show you his/her private parts? Did anyone ever ask you to show him/her your private parts? Did anyone ever force you to perform a sexual act involving penetration? Did anyone ever take photos or record a video of you with a sexual content, or ask you to give them personal material of this kind? Did anyone ever show you pornographic material?
If participants responded yes to any of these questions, they were then asked to indicate whether they had told anyone about the experience at the time (specifically: “Did you tell anyone about the experience at that time, when you were still a child or teenager?”) and if so who, whether they had been believed, and whether anything had been done to help them.
This instrument was used to assess every single experience of CSA independently, in line with the recommendation of previous authors to assess CSA by asking multiple behaviorally specific questions (Stoltenborgh et al., 2011).
Procedure
A specialist market research company was hired to administer an online survey to a representative sample of the adult population (18 years or older). This company has a panel of people who have signed a collaboration and data protection agreement to carry out voluntary surveys, and it has been awarded the ISO 26362 certification for access panels in market, opinion, and social research. Participants receive incentives for completing surveys, in the form of points that can be redeemed in an online store. The present survey took between 5 and 15 minutes to complete. All participants were informed about the aim of the study (i.e., to collect information about unwanted sexual experiences during childhood) and told that the data would be treated anonymously for research purposes. Informed consent was obtained. The study was carried out in accordance with the Declaration of Helsinki, and it was approved by the Research Ethics Committee of the University of Málaga, number 18-2020-H.
Data Analysis
Percentages for each of the 10 types of CSA experience were computed in order to analyze prevalence. Respondents were considered to have suffered sexual abuse when they answered yes for any of these experiences. Prevalence was also analyzed by gender and generation, using the χ2 test. Here four generations of individuals born at a similar time were considered, based on the criteria used by the Pew Research Center (Dimock, 2019): Generation Z (born since 1997; age 23 years old or less; n = 87), Millennials (born 1981-1996; age 24-39 years old; n = 303), Generation X (born 1965-1980; age 40-55 years old; n = 385), and Boomers (born 1946-1964; age 56-74 years old; n = 296). None of the participants were older than 74 years old (Silent Generation, born 1928-1945). The indicated age is the age of the participants at the time of the survey.
Finally, prevalence rates for telling someone about the experience at the time, the identity of that person (e.g., mother), whether this person had believed them, and whether anything had been done to help them were computed.
Results
The prevalence for each type of CSA experience is shown in Table 2. The most common experience was being shown pornographic material (18.5%), while that with the lowest prevalence was being forced to perform a sexual act involving penetration (2.8%).
Prevalence as a function of gender and generation is shown in Table 3. In general, the prevalence was significantly higher in females, except for two experiences: being forced to perform a sexual act involving penetration, with equivalent rates in women and men, and being shown pornographic material, which was more commonly reported by males. As regards the different generations, the prevalence of kissing, experiences involving personal photos or videos of sexual content, and being shown pornographic material was significantly higher in Generation Z.
Prevalence for the Sexual Abuse Variables (N = 1,071).
Percentage for the Sexual Abuse Variables as a Function of Gender and Generation.
Note. Generation Z (born from 1997), Millennials (born 1981-1996), Generation X (born 1965-1980), and Boomers (born 1946-1964).
***p < .001, **p < .01, *p < .05.
Results for Disclosure Variables as a Function of Gender.
Note. ***p < .001, *p < .05. aBootstrapping probability.
Discussion
The aim of this study was to determine, retrospectively, the prevalence of CSA in a sample that was representative of the Spanish population in terms of gender, age, and region, as recorded in the 2018 census report by Spain’s National Statistical Institute. Based on data obtained from 1,071 adults in an anonymous online survey, the prevalence was calculated for the 10 different types of abuse that were considered, in both cases as a function of gender and generation. Data about disclosure of abuse during childhood were also provided.
The prevalence of CSA in the Spanish population ranged from 2.8% to 18.5%, depending on the type of experience. Between 15% and 18% of the Spanish adults surveyed said that an adult or an older child in a position of power or authority had shown them pornographic material, had shown them his or her private parts, or had fondled some part of their body. Between 10% and 14% of respondents had experienced an adult or older child rubbing his or her private parts against them, had been kissed or asked to kiss such a person, had been asked to touch the other person’s private parts or had had their own private parts touched. The experiences with the lowest prevalence (less than 10%) involved personal photos or videos with a sexual content (either being filmed or photographed or asked to share such material), being asked to show their private parts, and being forced to perform a sexual act involving penetration.
Meta-analyses that take into account different types of CSA experiences indicate that noncontact forms of abuse are more prevalent than are those involving contact (Barth et al., 2013; Singh et al., 2014). However, there is considerable heterogeneity across studies, and thus it is important to distinguish between types of abuse so as to gain a more accurate picture (Barth et al., 2013; Selengia et al., 2020). Previous prevalence studies in Spain either did not specify the different kinds of CSA that were experienced (Cantón & Justicia, 2008; De Paúl et al., 1995), only considered contact experiences (Pereda & Forns, 2007), or categorized experiences broadly as contact, noncontact or involving penetration (Cantón et al., 2012). Only López et al. (1995) and Ferragut et al. (2021) analyzed each type of CSA in Spain separately.
López et al. (1995) found in a representative sample that the most prevalent form of abuse was being fondled (around 10%), followed by noncontact abuse (reported by around 6% of participants), and acts involving penetration (prevalence of 1%). All these percentages are lower than the rates obtained in the present study. However, the study by López et al. (1995) was carried out more than two decades ago and it used face-to-face interviews to collect data. This may account for the differences because reported prevalence rates are notably higher when using anonymous self-report methods (Collin-Vézina et al., 2013; Pan et al., 2020; Pereda et al., 2009; Stoltenborgh et al., 2011), as it was done here. More similar is the procedure followed by Ferragut et al. (2021) with women. They found higher rates for the contact experiences of someone rubbing their private parts against you (53.1%), being fondled (47%), or being touched in your private parts (31.9%), while the lowest prevalence corresponded to being shown pornographic material (9.8%). The authors acknowledged that the higher prevalence rates they obtained could be due to the data collection procedure and the use of snowball sampling, insofar as women who had suffered some kind of CSA may have been more likely to self-select, leading to an overestimate of the prevalence of CSA.
In regards to the prevalence by gender, rates of CSA experiences ranged from 3.4% to 24.8% in women and from 2.2% to 24.5% in men. These figures are slightly higher than the percentages reported in other Spanish studies, which may be due to methodological and sample differences. Previous studies conducted in Spain found a prevalence of between 9.96% and 22% in women and between 6.5% and 15.5% in men (Cantón & Justicia, 2008; Cantón et al., 2012; De Paúl et al., 1995; López et al., 1995; Pereda & Forns, 2007). In the present study, prevalence rates were higher among women for eight of the ten types of experience that were considered, a finding that is consistent with previous studies (Barth et al., 2013; Pereda et al., 2009; Stoltenborgh et al., 2011). However, males of this sample were significantly more likely than women to have been shown pornographic material. This appears to reflect current research showing worryingly high levels of unwanted exposure to pornography among recent generations of children, especially boys (Flood, 2009).
It is important to note that approximately one in 35 of the Spanish adults (2.8%) surveyed here had been forced during childhood to perform a sexual act involving penetration, without gender differences in this respect. These findings contrast with previous studies: the meta-analysis by Barth et al. (2013) found prevalence rates for penetrative sexual abuse of 3% for males and 9% for females, while Mohler-Kuo et al. (2014) reported rates of 0.6% for males and 2.5% for females. Once again, these differences may be due to sample characteristics or methodological aspects.
Regarding differences between generations, young adults from Generation Z were the most likely to report having suffered three of the CSA experiences considered, those involving kissing, personal photos or videos of sexual content, and exposure to pornography. These results are not consistent with Ferragut et al. (2021), who found the lowest prevalence in this generation. However, their study considered a smaller number of CSA experiences and all their participants were women, hence the sample was not representative of the population as a whole. It should be highlighted that two of the three experiences that were found here to be more prevalent among Generation Z (those involving personal photos or videos of sexual content and exposure to pornography) may be explained by the increased access that these young adults have to technology. In the last two decades, children have increasingly had free access to technology, and as a result they are connected to others even when they are alone (Save the Children, 2017). Notwithstanding the benefits, this connectivity together with the development of technology is also associated with important risks such as online sexual solicitation, grooming or exposure to pornography (Hamilton-Giachritsis et al., 2020), and this can have serious implications and consequences for children’s sexual development (Hébert et al., 2016; Horvath et al., 2013).
Finally, regarding disclosure of abuse, fewer than one third of victims (27.5%) told someone about the experience at the time (whether they disclosed the abuse later in adulthood was not directly asked). Here there were gender differences, insofar as females were much more likely to talk about their experience; they mainly told their mother, whereas males tended to tell a friend or peer. The vast majority of these respondents felt they had been believed, although females were significantly more likely than males to report being helped, possibly because it was much more common for them to tell an adult, and notably their mother, rather than a friend or peer. Previous research has found similar general rates of disclosure during childhood (Hébert et al., 2009; London et al., 2003), which means that around 70% of victims of CSA delay speaking about the abuse or never talk about it at all, with the numerous consequences that this silence implies, such as psychological distress and posttraumatic stress disorder (Hébert et al., 2009).
Consistent with these findings, other authors have also found that females are more likely than males to talk about the abuse they have experienced (Alaggia, 2005; Hébert et al., 2009). In their examination of disclosure among men, Easton et al. (2014) suggest that predominant gender norms around masculinity push male victims to blame themselves, such that they are less likely to talk about their experience or even recognize it as abuse. Although, for some victims, merely disclosing the abuse may enhance their satisfaction and help them to cope with the experience, research suggests that the crucial factor in terms of measures taken and future consequences is whether or not they are believed (Stiller & Hellmann, 2017). Therefore, victims who do not disclose will not have the opportunity to be supported or to stop the abuse at that time, and merely telling a friend or peer is no guarantee that adequate help will be forthcoming. This highlights the need for programs or strategies that can help children to identify abuse and to talk about their experience so as to minimize the health implications.
One limitation of the present study is that it involves a cross-sectional analysis based on retrospective reports of adults, which may be affected by recall bias. Additionally, the fact that participants were informed about the purpose of the study, and hence were aware of the survey topic, may have introduced an element of self-selection. Notwithstanding these potential limitations, the study also has a number of strengths, since the data were obtained from a representative sample of the Spanish population including different age ranges and comparable percentages of men and women. Furthermore, different types of CSA experiences were assessed, and the use of an online survey both ensured anonymity and allowed participants to respond in a private setting of their own choosing. Consequently, the study provides what is currently the most up-to-date and generalizable data about the prevalence of CSA in the adult Spanish population, covering the experiences of four generations whose childhood/adolescence fell within the period 1946-2019.
This is an important contribution since prevalence studies in Spain are scarce, and those that have been published were conducted one or even two decades ago, and mainly involved specific samples comprised exclusively of university students or women. The results show that CSA is a prevalent problem in Spain, with important rates of different abusive experiences. Furthermore, differences between generations are reported, showing that rates for some types of abuse are higher in the youngest generation, which may reflect the fact that young people today are more exposed to certain dangers related to technology, such as exposure to pornography. This finding should serve as a warning with regard to protecting future generations. Finally, the fact that only a small percentage of victims disclosed the abuse while still a minor, highlights the importance of encouraging and enabling children to talk about their experiences, and the need for adults to be attentive and to believe them when they do.
Footnotes
Declaration of Conflicting Interests
Funding
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the FEDER 2014-2020 Program of the European Union and the Consejería de Economía y Conocimiento de la Junta de Andalucía [UMA18-FEDERJA-077].
