Non Violent Childhoods Evaluating research CBSS 8/5 2017 Carl Göran Svedin, professor

Forms of child abuse Child physical abuse Child sexual abuse Family violence Child neglect

Prevalences of Child Maltreatment Stoltenborgh et al., 2014 Type All % Girls Boys Sexual abuse 12.7 18,0 7,6 Physical abuse 22.6 Emotional abuse 36,3 Physical neglect 16,3 Emotional neglect 18,4

Child physical abuse

Prevalence Sweden (Jansson et al.,) Hit by Never Few times Often No answer mother 1994 66 % 25 % 5 % 4 % 2000 86 % 8 % 1 % 4 % 2006 88 % 5 % 1 % 6 % 2011 87% 4 % 2 % 7 % father 1994 65 % 25 % 5 % 5 % 2000 86 % 7 % 2 % 5 % 2006 87 % 5 % 1 % 7 % 2011 86 % 5 % 2 % 7 % 13 % slagna 1,4 % ofta 3 % med tillhyggen Vanligare i låginkomstområden, särskilt stor skillnad för allvarlig kroppslig bestraffning ( 6 % jmfrt 2 % i höginkomstområden). Utlandsfödda Ensamstående (mammor) 14 % jmfrt 5 %. Störst riskfaktor: våld i hemmet mellan vuxna 5

Child Physical Abuse E-M Annerbäck 15% of children aged 13-17 years report being hit at least once by a parent Only 7% had told anyone Family violence increased the risk 7-8 times for being hit Mother and father hit their child as often

Annerbäck et al, 2012 IngenØ N= 3420 aOR Physical abuse (FM) n= 354 Physical ill health 1 1.3 2.7*** 2.9*** 7.7*** Mental ill health 2.0*** 3.5*** 5.0*** 9.1*** Self harm behavior 2.4*** 8.1*** 10.3*** 132.1*** Smoking 2.2*** 2.8*** 4.6*** 6.5*** Alcohol 1.6*** 2.1*** 1.2 Drugs 5.7*** 25.6*** Shop lifting 3.3*** 4.2*** 4.0*** 14.8*** Violent behavior 3.2*** 4.9*** 29.9*** Ø= Adjusted for: unemployment, immigrant status, living situation # = Other form of abuse: mobbing, family violence, sexual abuse

“students who reported experiences of CPA were more likely to report symptoms of mental illness and negative perceptions of their parents’ parenting. However, there were no mental health differences depending on whether their mother, father or both parents were the perpetrators of CPA. Still, there were differences in perceived parenting indicating that mothers’ parenting was perceived as more negative when mothers only or both parents were perpetrators of the abuse than when only fathers were perpetrators” Nilsson et al, under review

Lack of research Very few studies on intervention and therapy for abused children D-vitamin research, normative data Abusive head trauma (AHT) Child death reviews Different outcome in relation to the perpetrator

Child sexual abuse

A Global perspective on Child Sexual Abuse 12,7% (18,0% among girls and 7,6% among boys). Lowest rates for both girls (11,3%) and boys (4,1%) were found in Asia Highest rates were found for girls in Australia (21,5%) and for boys in Africa (19,3%). Stoltenborgh et al, 2011

Sexuella övergrepp över tid   2004 n= 4 343 2009 n= 3 498 2014 n= 5 839 Penetrerande sexuella övergrepp* % i U-grupp 95% Konfidens-intervall Totalt 9,8 8,8 – 10,8 6,9 6,1 – 7,7 6,6 6,0 – 7,2 Män 5,5 4,5 – 6,5 3,1 2,2 – 3,9 3,0 2,2 – 3,8 Kvinnor 13,5 12,1 – 14,9 10,0 8,6 – 11,4 9,2 7,6 – 9,6 Könsindelningen passar inte 21,4 5,9 – 36,9 20,0 8,8 – 31,2 * orala, anala och genitala samlag

5 873 young people in 3rd grade in the gymnasium (18 years)

Mental health in clinical range, 2009 (SCL-25, > 80 percentile) %

Sexual abuse from a perpetrator just over the Internet From the 2014 study 5,8 % had had sex on the Internet with a contact during the last 12 months 9,8 % of these had been persuaded, forced or pressed (coercion) The perpetrator were usually somewhat older or more than five years older No difference in sociodemographic background or use of the Internet Differences concerning sexual abuse, physical abuse, mental health self- esteem and the relation to the parents

Lack of research Boys as victims of sexual abuse Women as perpetrators Sexual abuse over the Internet Support/therapy: shame, attachment Sex as self-harm - destructiveness Screening instrument on sex as self-harm How do young people evaluate risk over the Internet Forensic interviewing Integrering

Child neglect

Förekomst av famikljevåld 10% av mellanstadieelever och 20 åringar rapporterar att vuxna i hemmet slagits vid något enstaka tillfälle 5% svarar att det hänt ofta 20% av utlandsfödda 20 åringar rapporterar att vuxna slagits i hemmet Kommittén mot barnmisshandel, 2001

Polyvictimization Students reported a mean number of 4.1 (SD=4.0) different types of victimization events during their lifetime (boys M=3.8, SD 3.8 and girls M=4.5, SD 4.2, p<0.001).

Polyviktimisering (JVQ) och symtom enligt TSCC (Trauma Symtom Checklist For Children)

Vulnerable groups Disabled children HBTQ hildren Small children

2 times as common with child physical abuse and mobbing

Lack of research in general Very few studies on intervention an therapy for abused children Improve children’s reporting capacity Recilience!! Physical symptoms and signs of physical and/or sexual abuse D-vitamin research, normative data Abusive head trauma (AHT) Child death reviews

Barn som utsätts för sexuella kränkningar Rapport Barn som utsätts för sexuella kränkningar och övergrepp på nätet   Linda Jonsson Carl Göran Svedin 2017