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Our comprehensive meta-analysis combined prevalence figures of childhood sexual abuse (CSA) reported in 217 publications published between 1980 and 2008, including 331 independent samples with a total of 9,911,748 participants. The overall estimated CSA prevalence was 127/1000 in self-report studies and 4/1000 in informant studies. Self-reported CSA was more common among female (180/1000) than among male participants (76/1000). Lowest rates for both girls (113/1000) and boys (41/1000) were found in Asia, and highest rates were found for girls in Australia (215/1000) and for boys in Africa (193/1000). The results of our meta-analysis confirm that CSA is a global problem of considerable extent, but also show that methodological issues drastically influence the self-reported prevalence of CSA.

Are immigrant families at elevated risk for child maltreatment, and if so, what role do socioeconomic and family composition factors play? In a national prevalence study on child maltreatment in the Netherlands, child maltreatment cases were reported by 1,121 professionals from various occupational branches. Maltreating families were compared to a national representative family sample on immigrant status and parental educational level and family composition factors. The authors differentiated between traditional immigrant families who immigrated as labor migrants from Turkey, Morocco, Suriname, and the Antillean Islands, and nontraditional immigrant families who more recently immigrated from countries with severe economic hardships or political turmoil (refugees). Traditional immigrant and nontraditional immigrant families were both significantly overrepresented among maltreating families, but this overrepresentation disappeared for the traditional immigrants after correction for educational level of the parents. Nontraditional immigrant families, however, remained at increased risk for child maltreatment even after correction for educational level. It is proposed that interventions to prevent child maltreatment in immigrant families should focus on decreasing socioeconomic risks associated with low levels of education.

The current meta-analytic study examined the differential impact of maltreatment and various socioeconomic risks on attachment security and disorganization. Fifty-five studies with 4,792 children were traced, yielding 59 samples with nonmaltreated high-risk children (n = 4,336) and 10 samples with maltreated children (n = 456). We tested whether proportions of secure versus insecure (avoidant, resistant, and disorganized) and organized versus disorganized attachments varied as a function of risks. Results showed that children living under high-risk conditions (including maltreatment studies) showed fewer secure (d = 0.67) and more disorganized (d = 0.77) attachments than children living in low-risk families. Large effects sizes were found for the set of maltreatment studies: maltreated children were less secure (d = 2.10) and more disorganized (d = 2.19) than other high-risk children (d = 0.48 and d = 0.48, respectively). However, children exposed to five socioeconomic risks (k = 8 studies, d = 1.20) were not significantly less likely to be disorganized than maltreated children. Overall, these meta-analyses show the destructive impact of maltreatment for attachment security as well as disorganization, but the accumulation of socioeconomic risks appears to have a similar impact on attachment disorganization.

The first nationwide prevalence study of child maltreatment in The Netherlands (NPM-2005) was designed as a replication of the National Incidence Studies (NISs) conducted in the United States. Child maltreatment cases were reported by 1,121 professionals from various occupational branches, trained in a detailed registration system of six types of abuse and neglect. In addition, cases registered by the Dutch Child Protection Services (CPS) were analyzed. For 2005, the overall prevalence rate was estimated to be 107,200 (95% CI 102,054-112,882) maltreated children aged 0-18 years, or 30 cases per 1,000 children. Neglect was the most prevalent type (56% of all cases) and sexual abuse had the lowest rate (4%). Of the maltreated children, 47% experienced more than one type of maltreatment. Major risk factors were very low parental education and unemployment. It is worrisome that CPS agencies only see the tip of the iceberg as only 12.6% of all maltreatment cases were reported to the CPS. Training of professionals in observing and reporting child maltreatment is badly needed. The absence of a legal obligation to report in The Netherlands needs reconsideration.