Typology and correlates of sexual abuse in children and youth: multivariate analyses in a prevalence study in Geneva.

OBJECTIVE: Child sexual abuse (CSA) encompasses a variety of distinct situations, which should be differentiated. There is a need for a working classification, taking into account various parameters. METHODS: The Geneva CSA prevalence study was based on 1116 randomly selected adolescents aged 14 to 16. Secondary analyses of the 252 reported cases of abuse was carried out using a multivariate approach combining multiple correspondence analysis and automatic classification, leading to descriptive analyses and to a new classification of CSA. RESULTS: Global prevalence of CSA, using a broad definition, was 10.9% for boys, and 33.8% for girls. Classification of cases of abuse differentiated 5 classes: (A) exhibitionism or other abuse without contact, by an adult (proportion of cases in boys: 22%; girls: 32%); (B) abuse of an adolescent boy by a peer without contact (62%); (C) abuse of an adolescent girl by a peer with physical contact (38%); (D) abuse inside the family, repeated (boys: 10%, girls: 16%); (E) child abuse with genital penetration, lasting 2 years or more (boys: 7%; girls: 14%). CONCLUSIONS: CSA is a complex and heterogeneous problem. Reported abuse situations can be classified into five classes, with different degrees of severity, causes, and consequences. Classification is essential in clinical research as well as in the design and conception of prevention programs.

Common risk factors in adolescent suicide attempters revisited.

The principle risk factors for suicide attempts in adolescents discussed in the literature are examined on the basis of data from a study carried out at the Geneva University Hospitals. 148 adolescents aged between 15 and 19 years form the sample. The results concerning mental disorders at the time of the suicide attempt confirm the clear predominance of affective disorder as well as the elevated frequency of comorbidity. Other main risk factors include suicidal behavior in family members and among acquaintances, poor state of health, poor integration into school or professional life, as well as sexual abuse.

Prevalence of child sexual abuse among adolescents in Geneva: results of a cross sectional survey.

OBJECTIVE: To measure the cumulative prevalence of child sexual abuse in a representative sample of the adolescent population of Geneva. DESIGN: Cross sectional survey with an anonymous self administered questionnaire centred on a factual description of sexual activities. SETTING: 68 classes (17 schools) randomly selected from the 201 ninth grade classes of the public school system in Geneva. SUBJECTS: 1193 adolescents aged 13-17 years, of whom 1116 (93.5%; 568 girls, 548 boys) consented to the study and returned completed questionnaires. RESULTS: 192 (33.8%) girls and 60 (10.9%) boys reported having experienced at least one sexually abusive event. The prevalence of abuse involving physical contact was 20.4% (116 cases) among girls and 3.3% (18) among boys. The prevalence of abuse involving some form of penetration was 5.6% (32 cases) among girls and 1.1% (six) among boys. One third of the abused adolescents had experienced more than one abusive event and 46.5% (92/198) had experienced the first event before age 12. Abuse by a family member was reported by 20.5% (36/176) of abused girls and 6.3% (3/48) of abused boys. Abusers were known to victims in two thirds of cases. Ninety per cent of abusers were male and 35.3% (71/201) came from the victim's peer group. Over 80% of participants found the questionnaire interesting, clearly formulated, and useful. CONCLUSIONS: Child sexual abuse is a universal social phenomenon. Adolescents themselves can contribute to research and so help in the search for more efficient prevention and intervention strategies.