Topic: Violence and abuse

Violence and rape during childhood: A national interview survey of 16-and 17-year-olds.

Myhre, M. C., Thoresen, S., & Hjemdal, O. K. (2015). Vold og voldtekt i oppveksten: En nasjonal intervjuundersøkelse av 16- og 17-åringer [Violence and rape during childhood: A national interview survey of 16-and 17-year-olds.] Norwegian only. Oslo: Nasjonalt kunnskapssenter om vold og traumatisk stress. (Rapport 1/2015).

In 2013, NKVTS carried out a prevalence survey of violence in the Norwegian population. This report presents the results from the youngest respondents, who were 16 and 17 years of age at the time of the survey.

Background
Violence is a severe burden to the individual and to society. The use of violence is
prohibited by Norwegian law, and is an attack on fundamental human rights. Physical
violence, sexual abuse, psychological violence and neglect, have negative consequences
in terms of health, social relationships and societal costs.

In the Government’s Report no 15 (2012 – 2013) to the Storting (The Norwegian Parliament): «Forebygging og bekjempelse av vold i nære relasjoner – Det handler om å
leve» (Prevention of and the fight against violence in close relationships – It’s all about
living», authors translation) it is concluded that more knowledge is needed about the
prevalence of violence in close relationships in Norway.

In the Governmental action plan « Vendepunkt – Regjeringens handlingsplan mot
vold i nære relasjoner 2008 – 2011» («Turning point – the Government’s plan of action
against violence in close relationships 2008 – 2001», authors translation), the Norwegian
Center for Violence and Traumatic Stress Studies was appointed to carry out a
prevalence study of violence in Norway. This report presents the results from the youngest respondents who were 16 and 17 years of age at the time of the survey. The results from the study of the adult population is published in the report «Vold og voldtekt i Norge». The study was approved by the Regional Committee for Medical and Health Research Ethics.

Methods
This is a cross-sectional study of Norwegian adolescents 16 and 17 years of age. Structured phone interviews were conducted during the winter of 2013. Altogether, 1012
girls and 1050 boys participated. Of those who we were able to contact by phone, 61.7%
agreed to participate in the study (65.0% girls and 58.8 % boys). The telephone interview
comprised direct and specific questions concerning violence and abuse experiences,
as well as mental health, social support, and sociodemographics.

One reason for the choice of telephone interviewing was that this data collection
method allows for flexible interviewing, for example in follow-up questions for those
who reported exposure to violence. In several other countries, prevalence studies using
telephone interviews as their primary method has been performed for many years, yet not till now has this been done in Norway on such sensitive topics. The telephone
interviews were conducted by IPSOS MMI. More than 85% of the study participants
were willing to be contacted again. The proportion of participants who were willing to
be re-contacted were somewhat higher in violence-exposed compared to non-exposed
adolescents. This indicates that the method used was acceptable by the vast majority
of participants. Nevertheless, it was important to ensure a system that provided care
for individuals who might need support after completion of the telephone interview.
As has been observed in similar studies from other countries, we found that very few
participants needed or wanted this type of support, but for those who did need it, it
is important that a follow-up system is in place. In cases where the teenager reported
ongoing familial violence, he or she was contacted for a further assessment by an
external psychologist who then evaluated if a report to child protection services was
needed. In this study, the interviewers at IPSOS-MMI were instructed to refer individuals
in need of follow-up and assessment to the Center for Stress and Trauma Psychology
in Oslo.

Results
Please note that prevalences might be underestimated (see discussion).

Violence from parents in childhood
Physical violence
• One out of ten 16 and 17 year olds reported that they had been exposed to
some form of physical violence by their parents (9.6%).
• The majority of those exposed to violence had been subjected to «less severe»
violence alone (hair pulling, pinching, slapping) (7.8%).
• Severe violence (hit with a fist, kicked, beaten up) was less common (1.7%).
• Four out of five of those who had been subjected to severe violence had been
subjected several times (83.3%), in addition most of them were also subjected
to less severe violence (94,4%).
• As many girls as boys reported physical violence from their parents
• Both mothers and fathers subjected their children to physical violence, yet
fathers accounted for more violence than mothers.
• In cases of severe violence, the majority were male perpetrators, particularly in
cases of severe violence against boys.
• In one out of five children who had experienced violence, both parents had
used violence against their child.
• Preschool or primary school age was the predominant period of first incident
of parental violence.

Psychological violence
• A total of 6.6% reported psychological violence from their parents.
• Considerably more girls (10.0%) than boys (3.3%) reported psychological
violence from their parents.

Neglect
• In total 8.5% reported experiencing at least one form of neglect.
• As many girls as boys had experienced neglect.

Witnessing violence between parents
• More than 3% of the adolescents had seen or heard violence between their
parents.
• More girls than boys reported to have witnessed violence between their parents.

Sexual Abuse
• Altogether, 13.5% of the girls and 3.7% of the boys reported some form of sexual
abuse or assault lifetime (sexual assault before the age of 13, rape, touching of
genitalia by use of force or by threatening to harm, intoxicated assault, being
pressured to sexual acts, and/or other forms of sexual offences or assaults).
• In total, 3.4% of participants had experienced sexual abuse that can be defined
as rape in accordance with Norwegian Law, which was defined as 1) being
forced to sexual acts (intercourse, oral sex or anal sex) by the use of physical
force or threats of bodily harm, 2) sexual intercourse while the victim was in
an reduced conscious or unconscious state and not able to consent or stop what
happened, and/or 3) sexual acts before the age of 13 with a person at least five
years older.
• The age of 13 to 16 years appears to be a vulnerable age period with a large risk
of being raped or being subjected to other types of sexual assault.
• Girls, more often than boys, were victims of sexual abuse, and the perpetrator
was usually a male- acquaintance or a friend.

Forcible rape
• One out of 30 girls (3.5 %), yet almost none of the boys (0.2 %), had been raped
by the use of physical force or threats of bodily harm.
• Almost half of the female rape victims had been raped more than once.
• All perpetrators of rape against girls were male.
• Three-fourths of the perpetrators were a friend or an acquaintance of the
victim.
• About one-fourth of the victims had never told anyone about the rape.

Sexual assault before the age of 13 by someone who was at least five years older
• Sexual contact before the age of 13 was reported by 1.9% of the girls and 0.8%
of the boys.
• In two out of five victims the sexual contact included attempted or full vaginal
or anal penetration or oral sex.
• More than one-third of those who had experienced sexual contact before their
13th birthday had experienced this type of abuse more than once.
• Almost all of the perpetrators were male.

Intoxicated sexual assault
• One out of 20 girls (5.0 %) and one out of 50 boys (1.9 %) had experiences this
type of abuse.
• This was the type of sexual abuse boys most often reported.
• For half of the girls, the abuse involved vaginal penetration, oral sex or anal
penetration (intoxicated rape). Penetration was less common amongst boys
(30.0 %).

Other types of sexual assault
• 2.6 % of the girls and 0.1 % of the boys reported forced sexual fondling.
• 5.3 % of girls and 0.7 % of boys reported having been pressured to sexual acts. In about two-thirds of those exposed, this involved vaginal, oral, or anal penetration.
• 2.9 % of girls and 0.7 % of boys had experienced other forms of sexual violation/
assaults.

«Less severe» physical violence last year (non-parental)
• Approximately ten percent of participants reported «less severe» physical
violence from someone other than their parents last 12 months
• The majority of the exposed adolescents had been subjected to only one type
of violence.
• In this group, the most common types were pinching and slapping.
• Boys (12.3%) were somewhat more often exposed than girls (8.9 %).
• The perpetrators were most often friends or acquaintances.
• It was very uncommon to be subjected to violence from authorities or a
stranger.

Severe physical violence lifetime (non-parental)
• One out of ten girls and three out of ten boys had been subjected to severe
physical violence from someone other than their parents, and a majority had
been exposed repeatedly.
• Almost two-thirds of all the female victims and half of the male victims
sustained physical injuries resulting from the violence.
• Girls (nearly half) much more often than boys (one-sixth), reported that they
had been afraid of being severely physically injured or killed while the violence
took place.
• Friends or acquaintances were responsible for most of this violence for both
boys and girls.

Violence, controlling behavior or stalking from a boy/girlfriend
Violence from a boy/girlfriend
• In total 3.4% of the adolescents described that they had at some time been
subjected to «less severe» physical violence from their boyfriend/girlfriend.
• Almost twice as many boys than girls had experienced this.
• Nearly half of the boys who had experienced «less severe» physical violence
had only experienced this once, while three-fourths of the girls who had experienced
this had been subjected to this type of violence several times.
• Very few had been subjected to severe physical violence from a boy/girlfriend.
• The perpetrator was in all of these incidents the opposite sex of the victim.

Controlling behavior from boy/girlfriend
• While relatively few had had been subjected to physical violence from their
boy/girlfriend/partner, and very few subjected to severe physical violence, it
was considerably more common to experience controlling behavior from a
boy/girlfriend/partner.
• In total, almost 18% had experienced one of the three forms of controlling
behavior. Both girls and boys were equally affected.
• 6.8 % of the girls and 4.4 % of the boys had experienced all three types of
controlling behavior from their boy/girlfriend/partner.
• Three-fourths of both girls and boys who had been subjected to physical
violence from a boy/girlfriend had also been subjected to at least one type of
controlling behavior from them.

Stalking
• In total over one-fifth of the adolescents, and nearly one-fourth of the girls had
experienced at least one type of stalking.

Violence exposure across various categories
• About one out of seven girls and one out of four boys reported at least one
incident of violence or abuse.
• The most common category of violence reported by boys was severe physical
violence by someone other than their parents. Sexual abuse was uncommon
in boys.
• The most common category of violence reported by girls was sexual abuse.
• There was a large overlap between the different types of violence for both sexes.
Nearly half of the girls and about one-fourth of the boys who had experienced
one form of violence had experienced two of more types of violence.
• Girls carried a heavier burden of violence compared to boys: More girls than
boys had experienced three of more types of violence or abuse.
• Sexual abuse in girls was strongly associated with exposure also to other types
of violence.
• Violence-exposure in adolescence was associated with increased exposure to
other potentially traumatic events.

Sociodemographics and alcohol use
• Adolescence living in low-income families experienced physical violence more
often.
• Parental physical violence occurred more often in non-Nordic families
• Both physical and sexual abuse occurred more often in youth who did not live
with both of their parents.
• Most adolescents felt safe at school and in their neighborhood.
• There was a significant association with being exposed to violence and not
feeling safe, both at school and in the neighborhood.
• Violence-exposure was associated with more alcohol consumption, both in
terms of frequency of drinking and frequency of intoxication.
• Exposure to violence before the age of 15 was associated with later increased
alcohol consumption, both in terms of frequency of drinking and frequency of
intoxication.

Mental health, shame, guilt and social support
• There was a clear cumulative association between number of violence categories
and level of mental health problems, both in terms of anxiety/depression
and posttraumatic stress reactions.
• Psychological violence and emotional neglect were as important as physical
violence and sexual abuse for mental health.
• Many victimized adolescents reported shame and guilt about the abuse.
• Both shame and guilt increased with the burden of violence.
• Violence-related shame and guilt were strongly associated with mental health
problems.
• A substantial subgroup of victimized youth had experienced that others had
distanced themselves from them or blamed them for what had happened.
• Loneliness, feeling let down, and poor social support is not uncommon in
violence-exposed adolescents.

Police reporting and medical assistance
• Less than one-fifth of rape victims and less than one-tenth of those exposed to
severe violence reported the incident to the police.
• Only one out of four rape victims went to seek medical treatment or a medical
examination the first few days or weeks following the rape.

Conclusions
• Violence and sexual abuse affect a significant number of children and youth in
Norway, and for many the violence starts in early childhood.
• The prevalence of violence and sexual abuse was lower than that found in
similar surveys. There are few other indicators that such a strong reduction
has taken place and the prevalence numbers found in this survey should be
interpreted with caution, as they may be too optimistic.
• Victimized children often experience several types of abuse.
• Girls are far more often exposed to sexual abuse than boys are. Girls also experience
a larger total burden of the violence and abuse experienced.
• Sexual abuse is almost exclusively committed by men.
• Shame and guilt, loneliness and social exclusion is prevalent in violence-
exposed adolescents, and may contribute to mental health problems.
• Violence and sexual abuse is associated with mental health problems in youth,
and constitute an important challenge for public health. This is particularly the
case for women’s health, because women are subjected to several more types of
violence- and abuse than men are.
• Sexual abuse in particular, but also other types of violence are still kept hidden.
Few seek medical attention, few report the incident to the police, and some
never tell anyone about what happened.