1. Violence and Rape in Norway A National Prevalence Survey Mia Cathrine Myhre Siri Thoresen Ole Kristian Hjemdal

2. Background: Initiative in «Turning Point», the Government Action Plan against Domestic Violence Aims of the survey: Study the Prevalence of violence and abuse in Norway in childhood and among adults Relations between victims and perpetrators Consequences for health

3. Methodology Random sample of population between 18-75 drawn from the national population register Letter of invitation sent by mail Telephone interviews (CATI) conducted by Ipsos MMI Response rate 43 % 2435 women and 2092 men

4. WHO: We measured: Physical violencePhysical violence from caretaker Sexual violenceSexual abuse before age 13, forcible rape, intoxicated rape and other sexual assults Psychological violencePsychological violence from caretaker Neglect Witnessing parental IPV Violence

5. Telephone interview structure adapted after national studies in the USA (Kilpatrick et al, 2004) Expanded to include a detailed assessment of childhood violence Affirmative answers followed by supplementary question Direct and behaviorally specific questions, sample item rape: « “Has anyone ever forced you into intercourse by use of physical force or by threatening to hurt you or someone close to you?” First time in Norway Strategy for measuring violence

6. Results 1. Prevalences 2. Polyvictimization 3. Overlap 4.Consequenses

7. Physical and psychological abuse from parents MenWomen Less severe violence pulled hair, pinched, shaken/pushed violently, slapped 33 %28 % Severe violence Hit with fist or hard object, kicked, battered, strangled, or physically attacked in other ways 5 % Witnessing violence between parents Slapped, hit with fist or hard object, kicked, battered, strangled, or physically attacked in other ways 10 % Psychological abuse parents repeatedly ridiculed you, humiliated you, ignored you, said you were a failure 11 %15 %

8. Age- cohorts Less severe violence from parents (%) Severe violence from parents (%) Witnessing parental IPV (%) WomenMenWomenMenWomenMen 1939 - 1949 a 28,532,76,55,97,37,4 1950 – 195933,338,47,04,813,410,3 1960 – 196931,139,35,16,114,813,7 1970 – 197927,036,63,66,113,112,7 1980 – 198922,630,02,64,28,010,9 1990 – 199520,616,94,72,79,48,2

9. Physical violence - gender of the perpatrator Perpetrator TotalGirlsBoys %N%N%N Less severe violence (N=1356) women34,646942,928726,5182 man47,264041,127453,3366 both17,423615,810618,9130 Severe violence (N=220) women25,55634,24015,516 man52,711642,75064,166 both21,84823,12720,421

10. Sexual abuse in childhood Sexual abuse before the age of 18 years TotalwomenMen  2 p- verdi %N%N%N Sexual contact before the age of 13 with someone at least 5 years older 7,132210,2 (4,.0) 248 3,5 (1,5) 74<0,001 Rape 2,91324,71130,919<0,001 Other sexual assults a 8,940512,33005,0105<0,001 Any sexual abuse 15,068121,25177,8164<0,001

11. Lifetime prevalence of rape: 9,4 % women 1,1 % men Of the female victims:  Half (49 %) had been raped before the age of 18  44 % had been in fear of being seriously injured or killed  29 % were physically injured

12. Classified knowledge… Of women who had been raped:  11 % had been to a medical examination or treatment the following days  11 % reported the rape to the police  29 % had never told anyone about the rape

13. Sexual abuse of children Sexual assault before the age of 13 with someone at least 5 years older: –10 % women, 4 % men – Approximately half of the cases were attempted or completed intercourse or oral or anal sex –Median age of sexual intercourse before the age of 13 was 8 years. –On out of four had never told anyone

14. Age- cohorts Sexual contact before age 13 (%) b Rape before age 18 (%) Other sexual assults befor age 18 (%) Women MenwomenMenWomenMen 1939 - 1949 a 9,15,13,60,67,65,1 1950 - 195910,13,46,10,911,94,0 1960 - 196915,44,93,81,614,07,1 1970 - 197910,93,03,70,713,94,0 1980 - 19897,02,84,90,512,14,8 1990 - 19956,61,96,61,114,35,2

15. Sexual assault: Relation to perpetrator Sexual abuse Women Parent/ step- parent Other family member Friend Boy/girl- friend authority person acquaint ance, neighbor Unknown Sexual assaults before the age of 13 (N=248) 359013109940 Forcible rape (N=113) 5155184223 Other sexual assault (N=300) 193298199697

16. Stereotypes: –Father/stepfather as perpetrators –Women raped by strangers Our findings: –Sexual abuse of children: 14% were abused by their father or stepfather –Rape: 14% of victims were raped by strangers

17. Number of categories of violence before age 18* TotalWomenMen %N%N%N 077,6351374,8182280,91691 114,565516,039012,7265 25,32396,21514,288 32,0892,1891,838 4 or 50,7320,9230,49 Polyvictimization *Sexual contact before age 13 Rape before age 18 Severe violence from parents, Psycological violence from parents Witnessing violence between parents

18. Exposure to more than one type of violence Exposure to violence in childhood Witnessing parental IPV Psychological violence from parents % OR% Women Severe physical violence from parents No 7,3 8,90 ** 11,5 18,57 ** Yes 41,4 70,7 Men Severe physical violence from parents No6,9 14,80 ** 8,1 15,88 ** Yes52,5 58,3

19. Overlap between different types of violence and sexual abuse Exposure to violence and sexual abue in childhood Women Sexual contact before age 13 a Rape before age 18 %OR% Severe violence from parents No3,1 6,95 ** 3,8 4,76 ** Yes17,515,8 Witnessing parental IPV No3,0 4,95 ** 3,8 3,73** Yes13,212,8 Psycological violence from parent No2,9 4,00 ** 3,0 5,20** Yes10,613,9

20. Relation between exposure in childhood and re-victimization as adults. Women Exposed in childhood Rape as adultSevere violence as adult Sexual contact before 13 years.. Exposed Not exposed 27 % 5 % 33 % 10 % Severe violence from parents in childhood Exposed Not exposed 19 % 5 % 29 % 10 % Victimized youth carries an increased risk of being re-victimized later in life.

21. Results Violence and psychological health All forms of violence and abuse, both in childhood and as adults, were associated with psychological health problems. Psychological health problems increases with the volume of victimization. Violence and abuse are serious public health problems.

22. Violence and psychological health Anxiety/depression (1-4) Posttraumatic stress reaktions (0-4) Rape WomenMenWomenMen No rape reported1,321,240,340,28 Rape before age 181,65**1,01**0,86**1,45** Violence No violence reported1,291,180,320,22 Severe violence from parents before age 181,77**1,38**0,93**0,63**

23. Conclusions Women are far more exposed to sexual abuse than are men. Women also seem to have a heavier total burden of violence and sexual abuse. Perpetrators of sexual abuse are almost exclusively men. Rape is «a tragedy of youth» –half of victims raped before age 18

24. Violence-exposed children are often subject to several different types of abuse. Individuals who experienced violence or sexual abuse in their childhood were much more likely also to experience violence or sexual abuse as adults The results indicate a reduction over time in physical violence against children. However, the data did not indicate any reduction over time in rape against young women.

25. Physical violence and rape were associated with mental health problems, and constitute serious public health problems. Physical violence and sexual abuse are probably more important for women’s health, because women are exposed to a heavier burden of violence and abuse than are men. Rape and physical violence are still hidden. Few seek medical attention, few report the case to the police, and some never tell anyone.

26. Clinical implications Exposure to violence and abuse is not uncommon and affects mental health –> we must assess Violence and abuse is kept secret –> we must dare to ask Violence-exposed children are often subject to several different types of abuse. –> we must ask about all types

27. Some limitations: Cross-sectional study Non-response Selection bias Some strengths: Broad assessment of violence exposure Behavioural specific and direct way of questioning High-quality measures

28. A full report on adolescents soon to come (in Norwegian)

29. Thank you for listening