Disclosure of child sexual abuse
Disclosure rates of child sexual abuse vary as much as between 24% and 96% (London, Bruck, Wright & Ceci, 2008). These varying rates may be due to a number of factors, including use of differing sources of information (e.g. retrospective surveys; forensic evaluations) and differing definitions of both child sexual abuse and disclosure (Lahtinen, Laitila, Korkman & Ellonen, 2018).
Results of an online survey with male child sexual abuse survivors showed that the length of time until first disclosure ranged from 0 to 63 years with a mean of more than two decades (21.45 years). Only 8.2% of participants told someone within one year of when the sexual abuse started (Easton, 2019).
There is a significant relationship between age at time of abuse and age at time of disclosure: children are more likely to tell within the developmental period during which they were abused than within any other period. This pattern has also been found to increase across each age category (McElvaney et al., 2020).
A systematic review of 37 studies examining pathways and recipients of child sexual abuse disclosures showed that children and youth follow a gradual pattern of disclosure, first disclosing to peers before disclosing to a parent or trusted adult, who can then assist in formal reporting to authorities. Older children and adolescents are significantly more likely to disclose to peers, keeping sexual abuse largely hidden from adults. Girls are also more likely to disclose to peers for emotional support, while boys are less likely to disclose altogether and when they do so, it is more likely for practical reasons (Manay & Collin-Vezina, 2021).
A study of sexual abuse and assault among a US nationally representative sample of over 13,000 youth found that among those aged 10-17 years who had been sexually abused or assaulted, 66.3% did not disclose to a parent or any other adult. Among all youth aged 0-17 years who had been sexually abused or assaulted, 19.1% was reported to the police (Gewirtz-Meydan & Finkelhor, 2019).
A population-based survey study with a representative sample of Finnish youth showed that among those who reported experiencing child sexual abuse, 80% had disclosed to someone, usually a friend (48%). Only 26% had disclosed to adults, and just 12% had reported the experiences to authorities (Lahtinen et al., 2018).
Among survivors participating in private sessions for the Royal Commission into Institutional Responses to Child Sexual Abuse, 57% said they did not disclose about the abuse until they were an adult. Further, survivors took, on average, 23.9 years to disclose the abuse, with men taking longer to disclose than women (25.7 years for men and 20.6 years for women). Some survivors (10%), most of them male, reported that they were disclosing for the first time to the Royal Commission (Royal Commission, 2017).
McElvaney’s (2015) review of disclosure studies showed that significant proportions of adults had never disclosed their experiences of child sexual abuse, either officially or informally.
A study of Swiss adolescents found that less than 10% of victims reported their experience of child sexual abuse to police. Victims were most likely to disclose to peers, followed by family (Mohler-Kuo et al., 2014).
U.S. data suggests that 95 – 97% of child sexual abuse occurrences are “below the surface” and that at least 95% are not reported to authorities (Martin & Silverstone, 2013).
As with disclosure, access to support services following experiences of child sexual abuse is frequently delayed or does not occur at all. Research with adults in England and Wales who self-identified as victims and survivors of child sexual abuse found that most (73%) victims and survivors had not accessed support services. Those who had accessed support services also took a long time to do so: the average time between first child sexual abuse victimisation and contact with a support service was 19 years and there was substantial variation in time between sexual abuse and access to support services, ranging from 0 – 58 years (Gekoski, McSweeney, Broome, Adler, Jenkins & Georgiou, 2020).
Barriers to disclosure
Recent research reviewing studies relating to disclosure of child sexual abuse has shown that barriers to disclosure continue to outweigh facilitators. Barriers identified in this review included younger age, male gender and associated perceived stigma, familial relationship with the perpetrator, internal factors including shame, self-blame and fear, family dynamics including dysfunction and abuse, and environmental and cultural context factors including lack of involvement from neighbours and school, and stigma perpetuated by societal perceptions (Alaggia, Collin-Vézina & Lateef, 2017).
A review of classified RCMP case files on child sexual abuse from British Columbia, Canada, found that delayed disclosure was related to both the age and gender of the child (disclosure delay was increased for boys and for younger children). Additionally, disclosure delay increased when abuse was more severe, occurred at a higher frequency, and when perpetrators were more closely related to the child victim (Wallis & Woodworth, 2020). A recent systematic review of qualitative research with children exploring barriers to disclosure of sexual abuse revealed six primary barriers. These included a fear of the consequences of disclosure; a fear of others’ reactions including disbelief; emotions including shame, embarrassment, guilt and responsibility; not having had an opportunity to tell; concern for their own or others’ safety; and personal feelings toward the abuser (Morrison, Bruce & Wilson, 2018).
A further systematic review of the barriers and facilitators relating to child and adolescent disclosures of sexual abuse showed that barriers included limited support, perceived negative consequences, and feelings of self-blame, shame and guilt. A primary facilitator of disclosure was directly asking a child about their experiences while providing active listening and support, in order to minimise feelings of guilt and shame, and to reduce fear of negative consequences (Lemaigre, Taylor & Gittoes, 2017).
A qualitative meta-analysis of studies conducted between 1998-2018 exploring facilitators of disclosure suggests that six key themes are important: access to someone you can trust; realising it’s not normal; inability to cope with emotional distress; wanting something to be done about it; expecting to be believed; and being asked (Brennan & McElvaney, 2020).
A study of the perceptions of therapists specialising in treatment of men with histories of child sexual abuse showed that barriers to men’s disclosure of child sexual abuse fell into three categories: intrapersonal experience (difficult feelings such as fear, shame, embarrassment, guilt and self-blame; and lack of language to articulate the abuse and their feelings, and/or lack of self-engagement), social milieu (internalised social stigma including myths, misinformation and stereotypes; negative responses to previous disclosures; fear of social loss or judgement; and masculine identity dissonance) and the health care environment (structural barriers limiting successful therapeutic disclosure; relational challenges with therapists; and unhelpful therapeutic strategies) (Gruenfeld, Willis & Easton, 2017).
In a population-based survey study with a representative sample of Finnish youth, the most common reason for non-disclosure of child sexual abuse (defined as having sexual experiences with a person at least five years older) was that the experience was not considered serious enough for reporting (41%). Just 14% indicated that they did not have the courage to tell anyone. Half of the youth who reported child sexual abuse did not self-label their experiences as abuse (Lahtinen et al., 2018).
Research by Tashjian and colleagues (2016) showed that having experienced emotional or physical abuse by a parental figure may delay disclosure of non-parental child sexual abuse.
Collin-Vézina and colleagues (2015) presented a model of barriers to disclosure of child sexual abuse through an ecological lens, with barriers identified as being ‘within’ (e.g. mechanisms to self-protect), in relation to ‘others’ (e.g. family violence and dysfunction), and in relation to the ‘social world’ (e.g. fears of being labelled).
Research with young victims of child sexual abuse has shown that the most common reasons given for delaying disclosure include fear of not being believed and feelings of shame and self-blame. Other reasons include fear of upsetting family members, and wanting to protect the offender (McElvaney, Greene, & Hogan, 2014).
In the case of familial child sexual abuse, victims may delay disclosure due to the fear of family breakdown, and of disrupting relationships with those to whom a sense of loyalty and strong emotional ties may exist (Lyon & Ahern, 2011; Smallbone, Marshall, & Wortley, 2008).
In-depth research involving 20 interviews with German and Israeli adult survivors of child sexual abuse by religious authority figures found specific barriers to disclosure in these cases where the perpetrators were a symbol of a parent or God and faith. The survivors in this research reported various familial, cultural, and community inhibitors, such as fear of social stigmatisation, inability to recognise the abuse, and the taboo of sexuality discourse within the religious community (Lusky-Weisrose, Kowalski, Tener & Katz, 2022).
Males are less likely than females to disclose and take longer to do so – 45% of men and 25% of women took more than 20 years to disclose about child sexual abuse (O’Leary & Barber, 2008). Such research has shown a particular sense of shame and stigma among male survivors that leads many to maintain the secret of their abuse well into adulthood (O’Leary & Barber, 2008). Gagnier and Collin-Vézina (2016) summarise the particular challenges that male survivors experience in relation to disclosure of child sexual abuse, including that the role of victim goes against gender norms and is perceived as a weakness, that the common experience of sexual abuse by a male perpetrator in the context of homophobia and an atmosphere of judgement reinforces feelings of shame, and that gender norms dictate that men do not express pain, vulnerability or helplessness, all of which contribute to concealment of sexual abuse experience.
Although there are many similarities between males and females in reasons for not disclosing experience of child sexual abuse, Alaggia (2005) found some differences in a qualitative study of disclosure. For women, confusion about guilt and responsibility, and fears of being blamed or not being believed were key factors. Men were more focused than women on issues relating to sex and gender; such as fear of being seen as homosexual, of becoming an abuser, and a belief that boys are rarely victims of sexual abuse (Alaggia, 2005).
Specifically for male victims of male perpetrators, the stereotypical assumptions that surround the concept of masculinity may lead to confusion over sexual identity and concerns with homosexuality, and associated feelings of guilt and shame (Dorahy & Clearwater, 2012; O’Leary & Barber, 2008).
Results of an online survey with male survivors of child sexual abuse showed that early disclosure (i.e., within one year of the sexual abuse) was a protective factor against mental distress, accounting for approximately a three-unit decrease in adverse psychological symptoms (Easton, 2019). Easton discussed that while early disclosure may introduce short-term problems (e.g., family disruption and conflict) or fail to end the abuse, the evidence suggests that early disclosure is associated with improved long-term mental health for male survivors.
Survivors face both positive and negative reactions from others upon disclosure of child sexual assault. A qualitative study with male survivors showed that the majority of participants described at least one positive disclosure experience – positive experiences were associated with feelings of being listened to, of being safe, believed and not judged. Meanwhile, however, most participants also reported at least one negative disclosure experience – negative experiences were related to the emotions linked to disclosing, as well as not being believed (Gagnier & Collin-Vézina, 2016).
Analysis of archival data from the US-based National Sexual Assault Online Hotline, using a sample of 224 intrafamilial child sexual abuse victims who had previously disclosed, showed that nearly three quarters (73%) reported receiving a negative reaction to their disclosure. Victim were more likely to discuss negative reactions from non-offending family members than from friends and intimate partners, and negative reactions included distracting or distressing the victim (33%), no believing the victim )29%), and retaliating or responding violently following the disclosure (10%) (Elliott, Goodman, Bardwell & Mullin, 2022).
Adolescents attending a children’s advocacy center in the United States were more likely to report non-supportive responses from caregivers than from friends. Non-supportive responses from caregivers were associated with self-blame, while non-supportive responses from both caregivers and friends were associated with increased trauma symptomology (Jouriles, Sitton, Adams, Jackson, & McDonald, 2022).
Easton and Parchment (2021) found in their study with 487 adult male survivors of CSA that for most men (59 %), their most helpful discussant was not a mental health professional but rather a family member, spouse or partner, friend, or fellow survivor. Overall, more than seven in ten men (71.7 %) mentioned that actions taken by discussants were beneficial, especially listening and believing the survivors’ CSA narrative, validating men’s feelings, demonstrating empathy, and encouraging help seeking (Easton & Parchment, 2021).
Easton’s (2014) study of over 400 male survivors of child sexual abuse showed that the number of years until disclosure was negatively associated with mental health, but that the degree of helpfulness of their disclosure was positively associated with wellbeing.
The reaction of the person being told about the child sexual abuse is critically important, as positive, supportive responses can promote the recovery and future wellbeing of survivors though the reduction of feelings of shame, self-blame and isolation (Easton, 2014).
A study of 146 police-reported child sexual abuse cases in Canada showed that higher levels of non-offending caregiver support (following informal disclosure to that caregiver) were found to lead to shorter delays of formal disclosure to police. Non-offending caregivers were found to be significantly less supportive, however, when the abuser was more closely related (e.g. when the abuser was a partner or family member) (Wallis & Woodworth, 2021).
Some studies suggest that mothers are less likely to support their children when the perpetrator is a current partner or someone with whom they have an intimate or dependant relationship (Reitsema & Grietens, 2015).
A child’s early disclosure of sexual abuse may be particularly beneficial, as it can lead to cessation of the abuse, and also potential prosecution of the perpetrator. Importantly however, disclosure at any stage, whether in childhood or adulthood, can also enable connection with mental health services and may enable treatment or early intervention (Sorsoli, Kia-Keating, & Grossman, 2008; Paine & Hansen, 2002).
There are very few false allegations of sexual abuse – in 2014 there were 3,940,920 cases of child abuse/neglect that were investigated by Child Protective Services in the United States. Of these, just 2,242 (0.06%) were found to be intentionally false (Administration for Children and Families, 2014). Further, a review of all child sexual abuse reports to the Denver Department of Social Services over 12 months was conducted, showing that of 551 cases, just 2.5% were found to be erroneous (including several cases where innocent events were misinterpreted as sexual abuse, and just 1.5% of cases involving false allegations) (Oates, Jones, Denson, Sirotnak, Gary & Krugman, 2000). O’Donohue and colleagues’ (2018) critical review of false allegations of child sexual abuse found that across multiple studies, rates of false allegations usually fell in the range of 2-5%.
In a 1995 study, Faller and colleagues found 14.4% of 215 allegations of child sexual abuse in the context of divorce had the appearance of falsehood, with an additional 6.5% possibly false. Of the total 45 probable or possible false allegations, the majority – 76% – were based on misinterpretation by the adult, while 22% were “knowingly false allegations”. In the majority of cases (60%), the false allegation appeared to be unrelated to the divorce (cited in Petherick, 2019).
“Deliberately false” allegations of child sexual abuse are shown to be relatively uncommon in some studies, but higher in others among certain subgroups – particularly, allegations that are made by non-resident fathers. Faller and DeVoe (1995), for example, classified 5% of cases in their clinical sample as “knowingly made false”, and Trocmé et al. (1994) classified 1% of allegations made by resident mothers against non-resident fathers as “malicious”, compared with 21% of allegations made by non-resident fathers against resident mothers (cited in Moloney, Smyth, Weston et al., 2007).
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