Child Sexual Abuse: Crimes, Victims, Offender Characteristics, and Recidivism

Sammanfattning: Background: Epidemiological research on child sexual abuse relies on health care surveys, anonymized population surveys, and criminal statistics, each with its methodological limitations. This study aims at compensating for these limitations by combining a population-based cohort from a large, representative region of Sweden and a clinic-referred group from the whole of Sweden. Subjects and Methods: For all 196 individuals in the Västra Götaland region who were convicted of child sexual abuse between 1993 and 1997, basic crime data, including relationships between victims and offenders, were collected. For all 185 individuals who were referred for a major forensic investigation for child sexual abuse during the same period, data covering mental health problems, including pedophilia according to the DSM-IV, were collected, as were sociodemographic and crime characteristics. For both study groups, the number of reconvictions for sexual and violent reoffending, as well as other criminality, was assessed. Results: Girls were the victims in 85% of all cases of sentenced child sexual abuse, boys in 12%, and both sexes in 3%. Crimes were overall severe, with sexual penetration as the most common act. In most cases, the offenders were well known to the children. The crimes committed by total strangers, 27% of all cases, were most often hands-off in nature. Only 8% of all offenders were referred for a pre-trial forensic psychiatric investigation, and the sentences were mild in many cases. Immigrant offenders were at significantly increased risk for severe sentences, even after controlling for severity of crimes and criminal histories. The relapse frequency in the two study groups was quite low, ranging from 10% to 14% for sexual recidivism and approximately 12% for violent recidivism. Conclusion: Sentenced child sexual abuse most often involves a severe sexual crime against a girl and is committed by a male relative or a male family friend. Compared to international studies, the relapse risk in sexual crimes was low, given the long follow-up period, but highest among offenders with extrafamilial victims compared to those with intrafamilial victims.