CHILDHOOD SEXUAL ABUSEto obtain because many cases are never reported.
Thus, available statistics represent only those cases
reported to child protection agencies or to law
enforcement, and therefore underestimate the
true magnitude of the problem.
There are two official sources of incidence
data for cases in the United States: The National
Incidence Study of Child Abuse and Neglect (NIS), a
federally funded research project; and statistics
from state child protection agencies (Finkelhor
1994a). The NIS conducted in 1993 documented
over 300,000 cases of sexual abuse among children
known to professionals in the course of a year, or a
rate of approximately forty-five cases per 10,000
children (Sedlak and Broadhurst 1996). Child pro-
tective services data suggest that approximately
140,000 cases of childhood sexual abuse occur
annually, or twenty-one cases per 10,000 children
(Leventhal 1998). An editorial by Finkelhor (1998)
suggested that the incidence may be declining.
However, this remains to be substantiated. In
general, reports suggest that the rate of childhood
sexual abuse has increased substantially over the
past decades (Sedlak and Broadhurst 1996).
Retrospective surveys provide a second source
of information on the occurrence of childhood
sexual abuse. Reported rates depend upon how it
is defined and operationalized in any given survey.
When childhood sexual abuse has been assessed
with a single item that narrowly defines it as rape
or sexual intercourse, reported prevalence rates
tend to be low (e.g., less than 12 percent). Con-
versely, when it is defined more broadly (e.g.,
touching genitalia) and assessed using multiple
items, prevalence rates tend to be much higher,
but with a wide range. The discrepancies observed
in the estimated prevalence of childhood sexual
abuse points to the need for increased standardiza-
tion and the use of better assessment instruments
in this research.
Because rates of childhood sexual abuse are
substantially greater among females than males
(e.g., Cosentino and Collins 1996; Finkelhor et al.
1990; Sedlak and Broadhurst 1996), the majority
of this research has focused on women. Surveys
suggest that anywhere from 18 percent to 30 per-
cent of college women and 8 percent to 33 percent
of male and female high school students report
having experienced this abuse at some point in
their lives (Ferguson 1997; Finkelhor 1994a; Gib-
bons 1996; Green 1993; Gorey and Leslie 1997).
Among the general adult female population, preva-
lence rates range from 2 percent to 62 percent
(Finkelhor 1987; Finkelhor et al. 1990; Saunders et
al. 1992). Rates are even higher within various
clinical populations, with 35 percent to 75 percent
of female clients reporting a history of some form
of sexual abuse during childhood (Gibbons 1996;
Wurr and Partridge 1996).The number of males who have been sexually
abused is difficult to estimate because it has been
the subject of fewer high-quality studies (Holmes
and Slap 1998; Watkins and Bentovim 1992). None-
theless, a few studies have examined this issue
among men and estimate that approximately 3
percent to 16 percent of all men in the United
States were sexually abused during childhood
(Finkelhor et al. 1990; Gibbons 1996; Holmes and
Slap 1998). As is the case for women, rates are
higher when studying clinical populations, with
estimates ranging from 13 percent to 23 percent
(Holmes and Slap 1998; Metcalfe et al. 1990).In sum, based on the evidence available in the
literature, Finkelhor (1994a) estimates that 20 per-
cent of adult women and 5 percent to 10 percent
of adult men are survivors of childhood sexual
abuse. Similarly, a synthesis of sixteen cross-sec-
tional surveys on the prevalence of it among
nonclinical populations reported unadjusted esti-
mates of 22.3 percent for women and 8.5 percent
for men (Gorey and Leslie 1997).SEQUELAEResearch conducted over the past decade indi-
cates that a wide range of psychological and inter-
personal problems are more prevalent among those
people who have been sexually abused than among
those who have not been sexually abused. Al-
though a definitive casual relationship between
such problems and sexual abuse cannot be estab-
lished using retrospective or cross-sectional re-
search methodologies (Briere 1992a; Plunkett and
Oates 1990), the aggregate of consistent findings
in this literature has led many investigators and
health care providers to conclude that childhood
sexual abuse is a major risk factor for a variety of
problems, both in the short-term and in later