Epidemiological factors in the clinical identification of child sexual abuse.

The main finding from epidemiological literature on child sexual abuse is that no identifiable demographic or family characteristics of a child may be used to exclude the possibility that a child has been sexually abused. Some characteristics are associated with greater risk: girls more than boys, preadolescents and early adolescents, having a stepfather, living without a natural parent, having an impaired mother, poor parenting, or witnessing family conflict. Class and ethnicity appear not be associated with risk. In any case, none of these factors bear a strong enough relationship to the occurrence of abuse that their presence could play a confirming or disconfirming role in the identification of actual cases.