Summary in English below, the report is in Norwegian only.
Background
The present report is based on results from the first national survey on child abuse and neglect among a representative sample of Norwegian 12–16-year-olds (the UEVO study). The Norwegian Ministry of Child and Family Affairs gave the Norwegian Centre for Traumatic Stress Studies (NKVTS) the task to map the prevalence of child abuse and neglect in a Norwegian youth sample. It is a national priority to prevent child abuse and neglect. However, we lack reliable prevalence figures on child abuse and neglect in the Norwegian youth population. Such data constitutes an essential vantage point for the planning of targeted prevention and treatment measures.
Methods
The study had a cross-sectional design and participants were recruited from schools. The survey was conducted during school hours, and data collection took place during the months of January and February 2019. A total of 9,240 adolescents participated in the study. This constitutes 94.6 % of all students attending school the day of the survey, and 75.5 % of the total gross sample. The survey was web-based, and was administered on PCs or tablets in the classroom. A digital survey format allows for flexibility in follow-up questions, and specifically tailored questions for respondents yielding experiences with child abuse and neglect. The survey comprised five thematically distinct parts: 1) background variables, 2) experiences with child abuse and neglect (including physical violence, psychological violence, sexual abuse by adults and peers, and neglect), 3) health, well-being and quality of life, 4) help-seeking experiences, 5) daily functioning as it pertains to sleep and school. We made use of behavior specific questions which is the recommended survey methodology, also in research on child abuse and neglect.
Adolescents provided independent consent, without parental consent. To ensure adolescents’ informed consent, several measures were taken to make sure that the information given prior to participation was understandable, relevant, age appropriate and as coherent as possible across different schools and class rooms. A five-minute animation film was developed to meet the ethical standards for informed consent in a youth population. The film was shown to all invited adolescents prior to consent, and contained information about the purpose of the study, the participants’ rights (including the right to decline participation or withdraw at a later time), as well as information about the webbased survey format.
Due to the young age of the participants, as well as the sensitivity of the themes covered in the survey, a careful follow-up plan was developed for the study in cases were the young individuals needed someone to talk to after participation. Another important aspect of the follow-up was to ensure that adolescents living in a difficult situation at home and wanted to disclose to someone after participation in the study, were given the opportunity for timely and adequate help. To meet the adolescents’ potential needs for follow-up, a contact form was developed allowing all invited students to respond if they wanted to be contacted by a professional helper after the survey. A total of 480 individuals, 5 % of all invited youth, made use of this invitation.
Results
The prevalence of child abuse and neglect in Norway
Overall, the study results show that one episode of violence or abuse rarely happens in isolation. The majority of those having experienced one type of child abuse or neglect, had experienced other types of abuse as well. More than half of the adolescents who had been exposed to physical violence as a child, had also been subject to psychological violence. Girls more frequently reported being exposed to more than one violent act compared to boys. This newly acquired knowledge is central when planning preventative measures combatting child maltreatment, and in cases where it is not prevented, ameliorate the consequences of such experiences.
Results showed that about 1 in 20 adolescents had experienced physical violence such as being beaten up, beaten with an object, or beaten with a fist. 1 in 5 had experienced physical violence such as pulling hair, pinching, or slapped. The more severe types of physical violence, such as beaten up and beaten with an 20 Summary object, is reported to be experienced earlier in life than the less severe forms of physical violence, such as pulling hair and pinching. Additionally, risk factors such as low socioeconomic status and parental substance abuse, psychiatric illness and incarceration, as well as parents’ immigrant status is more strongly related to severe compared to less severe physical violence.
About 1 in 5 have experienced psychological violence from their parents, including being repeatedly been humiliated, ridiculed, belittled or threatened. More girls than boys had experienced psychological violence. Almost 1 in 5 (18 %) had witnessed their mother being exposed to physical or psychological violence at home, whereas 17 % reported similar experiences with witnessing violence against their father at home. 7 % had witnessed their sibling been beaten, and 4 % had experienced that their parent had been violent towards the family pet.
Just over 6% had experiences of sexual abuse by an adult. The adult perpetrator was most often someone outside the home, however almost 1 in 4 out of those having experienced sexual abuse by an adult reported a parent (most frequently their father) as the offender. Compared to physical violence, which most frequently staring during early childhood, onset of sexual abuse experiences is mainly reported in adolescence. Still, it is important to note that several adolescents report onset of sexual abuse already during childhood.
Results describing sexual abuse among peers reveal a clear picture. More than 1 in 5 have experienced sexual transgressions and abuse from peers, and far more girls than boys are exposed to sexual peer victimization. Exposure to sexual abuse by peers escalates significantly during adolescence, and girls are more at risk compared to boys from an early age. The offender is most often known to the victim, and in 2 of 3 reported incidents a boy is the offender.
One in ten (10 %) of the participating adolescents have sent «nudes», pictures of themselves naked, via the internet or social media, whereas 3 % have experienced their pictures being shared on social media and the internet.
The most vulnerable groups
Socioeconomic status and parents’ substance abuse, psychiatric illness or incarceration are the factors most strongly related to adolescents’ child abuse and neglect experiences, also when adjusting for each other and other risk factors such as the child’s gender, parental divorce and parents’ ethnicity. Adolescents having a physical disability also report more abuse experiences compared to peers with no disabilities. Gender diversity is also significantly associated with child abuse and neglect, adolescents not identifying as boys or girls are far more exposed to child abuse and neglect, compared to peers who identify as boys and girls.
Associations with health, functioning and quality of life
The present results are unambiguous when it comes to the association between child abuse, neglect and health. There is a positive association between the number of abusive experiences and health concerns, both psychological and somatic, even at a young age. A similar pattern is evident for school absence and sleep problems. There is a negative association with reported quality of life. There is a clear dose–response relationship between exposure to violence and difficulties in life. Adolescents with exposure to several types of violence during their childhood report more difficulties at the time of the survey.
Experiences with help-seeking
More than half of all adolescents exposed to physical abuse at home have not told anyone about their abusive experiences. Whereas 44 % of the adolescents who are victims of sexual abuse by an adult, and 30 % of adolescents been victimized by a peer have not yet disclosed their abusive experiences. Two of the main reasons for not disclosing their abuse experiences is that they did not think the abusive experience was severe enough or they felt guilt. Children exposed to physical violence at home also frequently report that they were afraid of the involvement of the child protective services as one of the reasons for not disclosing abuse. Feelings of shame, guilt and fear were reasons for why sexually abused adolescents had not yet disclosed. Nearly 1 in 6 adolescents reported lack of a confidant if they had a difficult problem that made them sad. Only 1 in 5 adolescents exposed to child abuse and neglect had seen a health professional after experiencing the abuse.
Conclusions
The results we present in this report indicate that children and adolescents are still not sufficiently protected against child abuse and neglect, and that some groups of children and adolescents are more at risk than others. Most of the youth who had been subjected to one type of violence or abuse had also experienced other forms of violence or abuse. Girls had more often been exposed to several types of violence, than boys. Only a minority of youth who were subjected to violence and abuse say that they have been in contact with health care services after the abuse had ended. This is central knowledge when measures to prevent child abuse and neglect, and in the next instance, the consequences thereof, are developed and implemented. To conclude, the present findings make a solid vantage point for the recommendation of preventative measures, future research and priorities for policy makers.