The purpose of this thesis was to investigate aspects of self-reported sexual abuse during childhood and adolescence in a population-based study of Swedish high school students. The aim of this thesis was first to investigate the lifetime prevalence of sexual abuse of varying severity and characteristics as well as the associations between sexual abuse, gender, socio-demographic characteristics and consensual sexual experiences. The next aim was to investigate disclosure rates and disclosure patterns as well as predictors of non-disclosure. A further aim was to study the associations between sexual abuse and different aspects of psychosocial health. One of the measures of psychosocial health used in the study was the Strengths and Difficulties Questionnaire (SDQ) and a further aim of the thesis was to examine its psychometric properties when used with young people at age 17 – 19 years. Finally, it was an aim of this thesis to highlight ethical aspects of research about sexual abuse by investigating vulnerable participants’ experience with the survey.
A school-based sample of more than 4,000 high school seniors in five Swedish towns completed the questionnaire “Adolescents’ Sexuality – Attitudes and Experiences”. The same questionnaire was completed by young people in six other countries as part of The Baltic Sea Regional Study on Adolescents’ Sexuality. Data from both the Swedish and the Estonian sample were used when vulnerable participants’ experience of the survey were examined. A sub-sample of more than 1,000 participants in one of the Swedish towns completed additional questionnaires (SDQ, Sense of Coherence and I think I am).
Lifetime prevalence rates were shown for three different categories of sexual abuse: non-contact abuse, contact abuse and penetrating abuse. Penetrating abuse was related to more severe abuse characteristics, less frequent disclosure, more emotional and behavioural symptoms, weaker sense of coherence and poorer self-esteem when compared to non-abuse, non-contact or contact abuse. A substantial portion of the sexual abuse was committed by peers. At the same time, peers were the most often mentioned recipients of disclosure of sexual abuse. Few sexually exposed adolescents had talked to a professional. The SDQ had acceptable reliability and validity for use with adolescents at age 17 – 19 years. Sense of Coherence was found to be the measure of psychosocial health that was most clearly associated with sexual abuse, even after adjustment for confounding variables. Family factors, in particular parental bonding, were shown to be strongly related to different aspects of sexual abuse. A model of the participants’ experience with the survey did not support the idea that vulnerable young people should be protected from participation in research about sensitive issues.
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