Cecilia Kjellgren

Sexually Coercive Behavior in Male Youth: Population Survey of General and Specific Risk Factors

Little is known about risk/protective factors for sexually coercive behavior in general population youth. We used a Swedish school-based population survey of sexual attitudes and experiences (response rate 77%) and investigated literature-based variables across sexually coercive (SEX), non-sexual conduct problem (CP), and normal control (NC) participants to identify general and specific risk/protective factors for sexual coercion. Among 1,933 male youth, 101 (5.2%) reported sexual coercion (ever talked or forced somebody into genital, oral, or anal sex) (SEX), 132 (6.8%) were classified as CP, and the remaining 1,700 (87.9%) as NC. Of 29 tested variables, 25 were more common in both SEX and CP compared to NC youth, including minority ethnicity, separated parents, vocational study program, risk-taking, aggressiveness, depressive symptoms, substance abuse, sexual victimization, extensive sexual experiences, and sexual preoccupation. When compared to CP youth only, SEX youth more often followed academic study programs, used less drugs and were less risk-taking. Further, SEX more frequently than CP youth reported gender stereotypic and pro-rape attitudes, sexual preoccupation, prostitution, and friends using violent porn. Finally, in a multivariate logistic regression, academic study program, pro-rape attitudes, sexual preoccupation, and less risk-taking independently remained more strongly associated with SEX compared to CP offending. In conclusion, several sociodemographic, family, and individual risk/protective factors were common to non-sexual and sexually coercive antisocial behavior in late adolescence. However, pro-rape cognitions, and sexual preoccupation, were sexuality-related, specific risk factors. The findings could inform preventive efforts and the assessment and treatment of sexually coercive male youth.

Sexual Coercion Experience and Sexually Coercive Behavior: A Population Study of Swedish and Norwegian Male Youth

The authors tested the hypothesis that experiencing sexual coercion and engaging in sexually coercive behavior are positively associated in a representative sample totaling almost 4,000 Swedish or Norwegian male high school students (estimated response rate 80%). In both surveys, youths who had experienced sexual coercion were approximately three times more likely to engage in sexually coercive behavior than those without such experience (10%—12% vs. 4%). The association between sexual coercion experience and sexually coercive behavior was attenuated but remained significant and moderately strong in both surveys when controlling for nonsexual antisocial behavior, substance use, and noncoercive sexual behavior in multivariate logistic regression models. The population attributable fraction (proportion of sexually coercive behavior that can be explained by sexual coercion experience) was 18%—25%. The findings support a robust link between having been sexually coerced and engaging in coercive sexual behavior in the general population.

Female Youth Who Sexually Coerce: Prevalence, Risk, and Protective Factors in Two National High School Surveys

INTRODUCTION Sexual coercion is recognized as a serious societal problem. Correlates and risk factors of sexually abusive behavior in females are not well known. AIM Etiological theory and empirical study of female perpetrators of sexual coercion are usually based on small or highly selected samples. Specifically, population-based data are needed to elucidate risk/protective factors. MAIN OUTCOME MEASURES Main outcome measures include a self-report questionnaire containing 65 items tapping socio-demographic and health conditions, social relations, sexual victimization, conduct problems and a set of normative and deviant sexual cognitions, attitudes, and behaviors. METHODS We used a 2003-2004 survey of sexual attitudes and experiences among high school students in Norway and Sweden to identify risk factors and correlates to sexually coercive behavior (response rate 80%); 4,363 females participated (Mean = 18.1 years). RESULTS Thirty-seven women (0.8%) reported sexual coercion (ever talked someone into, used pressure, or forced somebody to have sex). Sexually coercive compared with non-coercive women were similar on socio-demographic variables, but reported less parental care and more parental overprotection, aggression, depressive symptoms, and substance misuse. Also, sexually coercive females reported more sexual lust, sex partners, penetrative sexual victimization, rape myths, use of violent porn, and friends more likely to use porn. When using the Swedish subsample to differentiate risk factors specific for sexual coercion from those for antisocial behavior in general, we found less cannabis use, but more sexual preoccupation, pro-rape attitudes, and friends using violent porn in sexually coercive compared with non-sex conduct problem females. CONCLUSIONS Sexually coercive behavior in high school women was associated with general risk/needs factors for antisocial behavior, but also with specific sexuality-related risk factors. This differential effect has previously been overlooked, agrees with similar findings in men, and should have substantial etiological importance.

Child Physical Abuse—Experiences of Combined Treatment for Children and their Parents: A Pilot Study

This paper reports on the results of treatment for families where child physical abuse has occurred. The Combined Parent–Child Cognitive–Behavioral Therapy for Families at Risk for Child Physical Abuse (CPC-CBT) model includes parent and child interventions. Four teams (within child protection and child and adolescent psychiatry services, based in Sweden) were trained to run the treatment. CPC-CBT is a 16-session programme where children and parents receive treatment in parallel groups and joint family sessions. A pilot study, with pre and post measures for both children and parents, was carried out to evaluate the treatment effects (18 families, 26 adults and 25 children). Significantly decreased symptoms of depression among parents, less use of violent parenting strategies and less inconsistent parenting were reported after treatment. Children initially reported high levels of traumatic experiences and symptoms of post-traumatic stress disorder. After treatment, trauma symptoms and depression among children were significantly reduced. Children also reported that parents used significantly less violence and increased positive parenting strategies after completion of the treatment. The implications of the findings are discussed.

The pursuit of standardization in domestic violence social work: A multiple case study of how the idea of using risk assessment tools is manifested and processed in the Swedish social services:

This multiple case study examines how the idea of using risk assessment tools is manifested and processed in Swedish social services. Based on the analysis of interviews with different stakeholders and of organizational documents in two social service organizations, we investigate the actors who control local risk assessment practices. The findings illustrate that a relatively small group of social workers in the organizations have been able to forward their claims and decide how risk assessment work should be carried out without much intrusion from local managers or politicians. The findings also validate other studies that found that increased standardization can strengthen social workers’ ability to perform their professional task rather than lead to de-professionalization. This article ends with a discussion of what risk assessment practices might mean for domestic violence victims.

Outcomes for Treatment of Hypersexual Behavior Provided by Specialized Social Welfare Units

Purpose: This study explores outcomes of treatment provided by specialized units within the social welfare sector in Sweden to clients seeking help with hypersexual behavior. Method: The participants were 27 males and 1 female (M = 40.3 years) who sought help from one of the three specialized units within social welfare in Sweden. A pretest–posttest group design was used to assess changes after treatment. Quantitative data were collected through interviews and self-report forms. Results: At posttreatment stage (on average a 10-month follow-up), mental health was significantly improved and hypersexual behavior reportedly reduced. The treatment at the specialized units appeared to help the clients. Conclusions: The specialized units seemed to deliver favorable service without shaming and stigmatizing participants. As this study can be considered a pilot study, it needs to be replicated.