A meta-analysis of the prevalence of child sexual abuse disclosure in forensic settings

Child Abuse Negl. 2019 Jul;93:291-304. doi: 10.1016/j.chiabu.2018.11.020. Epub 2018 Dec 20.

Abstract

Background: Identification, substantiation, prosecution, and treatment of child sexual abuse often rely heavily on a disclosure from the victim in the absence of corroborating evidence. For some, disclosure can be impeded by developmental or motivational barriers, thus compromising child safety and wellbeing. The literature on disclosure prevalence and mitigating influences does not yield a coherent picture. A more accurate estimate will help to inform investigation strategies to facilitate disclosure.

Objective: This study provides a meta-analysis of available research examining the prevalence of sexual abuse disclosure in forensic interviews with children under 18 years, and examines a range of factors that may influence the likelihood of disclosure.

Method: Databases were searched for published and unpublished studies up to May 2017. In total, 2393 abstracts were assessed for eligibility, 216 full-text articles were reviewed, and 45 samples (with 31,225 participants) provided estimates of effect sizes.

Results: The mean prevalence of child sexual abuse disclosure in forensic settings was 64.1% (95% CI: 60.0-68.1). Between-study variability was explained by: (1) child age and gender, with higher prevalence in older children and females; (2) prior disclosure, with higher prevalence when present; and (3) study year, with higher prevalence in more recent studies.

Conclusions: This meta-analysis confirms an upward trend in child sexual abuse disclosure prevalence. However, more than a third of children do not disclose when interviewed, with those who are younger, male, and without a prior disclosure at greatest risk. Important implications for forensic interviewing protocols and future research are discussed.

Keywords: Abuse disclosure; Child sexual abuse; Disclosure prevalence; Forensic interviews; Meta-analysis.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Child Abuse, Sexual / statistics & numerical data*
  • Child, Preschool
  • Disclosure / statistics & numerical data*
  • Female
  • Forensic Medicine*
  • Humans
  • Male
  • Motivation
  • Prevalence
  • Self Disclosure