Background
Self-injurious behaviors
Sexual risk-taking behaviors and affect regulation
“When I feel bad I contact someone who wants to meet me. I feel so bad than that I’ll do just anything to relieve that pressure. Before the meetings the anxiety is so strong that I barley remember how I got there […] then I shut down. Let someone else take me over and decide. […]. Afterwards I feel like crap. Feel disgusting and empty. Often I am in a lot of pain. […].” [13, p. 23].
“[…] and I was the good one who didn’t self-harm anymore. Everyone was so pleased, but I felt just as bad, I just found other ways […] that weren’t that visible [selling sex] […] things that almost killed me for real.” [13, p. 23].
Child sexual abuse and sexual-risk behavior
Aim of the study
Methods
Participants
Procedure
Measures
Analyses
Results
Sex as self-injury
Sociodemographic data
SASI n = 123–125 | Non-SASI n = 5599–5625 | Total n = 5724–5750 | χ2
|
df
|
p value
| ||||
---|---|---|---|---|---|---|---|---|---|
n
|
%
|
n
|
%
|
n
|
%
| ||||
Total nr of participants | 125 | 2.2 | 5625 | 97.8 | 5750 | 100 | |||
Gender | 50.9 | 2 | <.001 | ||||||
Boy | 20 | 16.0 | 2522 | 44.8 | 2542 | 44.2 | |||
Girl | 100 | 80.0 | 3054 | 54.3 | 3154 | 54.9 | |||
“This division doesn’t fit me” | 5 | 4.0 | 48 | .9 | 53 | .9 | |||
Study program | ns | ||||||||
Theoretical | 84 | 67.2 | 4002 | 71.1 | 4086 | 71.1 | |||
Practical | 41 | 32.8 | 1623 | 28.9 | 1664 | 28.9 | |||
Adolescents from Stockholm | 35 | 28.0 | 1531 | 27.2 | 1566 | 27.2 | ns | ||
Fathers working | 106 | 86.2 | 4931 | 87.9 | 5037 | 87.9 | ns | ||
Mothers working | 103 | 83.1 | 4894 | 87.3 | 4997 | 87.2 | ns | ||
Fathers with university education | 44 | 35.2 | 2262 | 40.4 | 2306 | 40.3 | ns | ||
Mothers with university education | 59 | 47.2 | 2932 | 52.3 | 2991 | 52.1 | ns | ||
Family financial situation | 26.6 | 2 | <.001 | ||||||
Good | 83 | 66.4 | 4477 | 79.6 | 4560 | 79.3 | |||
Poor | 42 | 33.6 | 952 | 16.9 | 994 | 17.3 | |||
Do not know | 0 | .0 | 193 | 3.4 | 193 | 3.4 | |||
Adolescents with immigrant background | 11 | 8.8 | 489 | 8.7 | 500 | 8.7 | ns | ||
Mothers with immigrant background | 25 | 20.0 | 1219 | 21.7 | 1244 | 21.6 | ns | ||
Fathers with immigrant background | 26 | 20.8 | 1221 | 21.7 | 1247 | 21.7 | ns | ||
Living situation | 53.3 | 3 | <.001 | ||||||
With both parents or alternating | 61 | 48.8 | 4036 | 71.8 | 4097 | 71.3 | |||
With one parent with or without new partner | 37 | 29.6 | 1194 | 21.3 | 1231 | 21.4 | |||
Alone or with siblings or partner | 23 | 18.4 | 358 | 6.4 | 381 | 6.6 | |||
In foster care or institution | 4 | 3.2 | 32 | .6 | 36 | .6 |
Sexual orientation
SASI n = 119–125 | Non-SASI n = 3654–5625 | Total n = 3773–5750 | χ2
|
df
|
p value
| ||||
---|---|---|---|---|---|---|---|---|---|
n
|
%
|
n
|
%
|
n
|
%
| ||||
Sexual orientation | 124.5 | 3 | <.001 | ||||||
Heterosexual | 75 | 60.0 | 4943 | 87.9 | 5018 | 87.3 | |||
Homosexual | 7 | 5.6 | 74 | 1.3 | 81 | 1.4 | |||
Bisexual | 29 | 23.2 | 240 | 4.3 | 269 | 4.7 | |||
Other or unsure | 14 | 11.2 | 368 | 6.5 | 382 | 6.6 | |||
Voluntary sexual experiences | |||||||||
Oral intercourse | 115 | 92.0 | 3232 | 58.0 | 3347 | 58.7 | 58.4 | 1 | <.001 |
Anal intercourse | 65 | 52.4 | 1025 | 18.5 | 1090 | 19.2 | 89.8 | 1 | <.001 |
Vaginal intercourse | 112 | 89.6 | 3441 | 61.8 | 3553 | 62.4 | 40.3 | 1 | <.001 |
Total number of sexual partnersa
| 66.2 | 2 | <.001 | ||||||
One | 12 | 10.1 | 1186 | 32.5 | 1198 | 31.8 | |||
2–5 | 40 | 33.6 | 1572 | 43.0 | 1612 | 42.7 | |||
More than 5 | 67 | 56.3 | 896 | 24.5 | 963 | 25.5 | |||
Use of contraceptives last intercoursea
| 70 | 58.3 | 2500 | 68.3 | 2570 | 68.0 | 5.3 | 1 | .021 |
Ever experiences abortion (self or partner) | 10 | 8.0 | 216 | 3.8 | 226 | 3.9 | .031* | ||
Ever treatment for Chlamydia | 7 | 5.6 | 214 | 3.8 | 221 | 3.8 | ns | ||
Ever sold sexual services | 14 | 11.3 | 37 | .7 | 51 | .9 | <.001* |
Voluntary sexual experiences
Sexual risk-taking behavior
Child abuse
SASI n = 122–125 | Non-SASI n = 5180–5611 | Total n = 5304–5736 | χ2
|
df
|
p value | ||||
---|---|---|---|---|---|---|---|---|---|
n
|
%
|
n
|
%
|
n
|
%
| ||||
Sexual abuse | |||||||||
Any sexual abuse
| 93 | 75.0 | 1014 | 19.6 | 1107 | 20.9 | 225.3 | 1 | <.001 |
Only penetrative | 59 | 48.4 | 290 | 5.3 | 349 | 6.2 | 379.7 | 1 | <.001 |
Emotional abuse | |||||||||
Any emotional abuse
| 109 | 87.2 | 3206 | 57.1 | 3315 | 57.8 | 45.3 | 1 | <.001 |
Insult | 106 | 84.8 | 3028 | 54.0 | 3134 | 54.7 | 46.9 | 1 | <.001 |
Threats of hitting | 55 | 44.0 | 1081 | 19.3 | 1136 | 19.8 | 47.1 | 1 | <.001 |
Isolation from friends | 48 | 38.4 | 908 | 16.2 | 956 | 16.7 | 43.4 | 1 | <.001 |
Physical abuse | |||||||||
Any physical abuse
| 86 | 69.4 | 1697 | 30.3 | 1783 | 31.2 | 86.2 | 1 | <.001 |
Pushed, shaken | 70 | 56.0 | 1293 | 23.1 | 1363 | 23.8 | 73.2 | 1 | <.001 |
Throw something | 40 | 32.3 | 738 | 13.2 | 778 | 13.6 | 37.7 | 1 | <.001 |
Hit with hands | 52 | 41.6 | 782 | 13.9 | 834 | 14.5 | 75.2 | 1 | <.001 |
Kick, bite, hit with fist | 21 | 16.8 | 310 | 5.5 | 331 | 5.8 | 28.6 | 1 | <.001 |
Hit with objects | 13 | 10.5 | 191 | 3.4 | 204 | 3.6 | <.001* | ||
Burn, scald | 7 | 5.6 | 100 | 1.8 | 107 | 1.9 | .009* | ||
Strangle | 22 | 17.6 | 197 | 3.5 | 219 | 3.8 | <.001* | ||
Other physical assault | 42 | 34.1 | 440 | 7.9 | 482 | 8.4 | 107.8 | 1 | <.001 |
Trauma symptoms, non-suicidal self-injury and psychiatric disorders
SASI n = 123–124 | Non-SASI n = 5514–5515 | Total n = 5635–5639 | |||||
---|---|---|---|---|---|---|---|
Mean | SD | Mean | SD | Mean | SD |
p value | |
Anxiety | 9.6 | 5.5 | 4.6 | 3.9 | 4.7 | 4.0 | <.001 |
Depression | 12.4 | 6.2 | 5.0 | 4.4 | 5.2 | 4.6 | <.001 |
Anger | 9.0 | 5.7 | 4.0 | 4.0 | 4.2 | 4.1 | <.001 |
Post-traumatic stress | 14.0 | 6.4 | 6.1 | 4.9 | 6.2 | 5.1 | <.001 |
Dissociation | 12.9 | 6.2 | 5.9 | 4.8 | 6.0 | 4.9 | <.001 |
Sexual concerns | 4.8 | 3.9 | 2.2 | 2.4 | 2.6 | 2.5 | <.001 |
SASI n = 117–125 | Non-SASI n = 5442–5618 | Total n = 5559–5743 | χ2
|
df
|
p value | ||||
---|---|---|---|---|---|---|---|---|---|
n
|
%
|
n
|
%
|
n
|
%
| ||||
Non-suicidal self-injury | 82 | 65.6 | 933 | 16.6 | 1015 | 17.7 | 201.7 | 1 | <.001 |
Healthcare for psychiatric disorders | |||||||||
Depression/anxiety | 75 | 61.0 | 1005 | 18.2 | 1080 | 19.2 | 141.8 | 1 | <.001 |
Eating disorders | 34 | 28.8 | 289 | 5.3 | 323 | 5.8 | 1 | <.001 | |
ADHD/ADD or similar | 21 | 17.6 | 387 | 7.1 | 408 | 7.3 | 116.8 | 1 | <.001 |
Autism/Asperger | 8 | 6.8 | 100 | 1.8 | 108 | 1.9 | .002* | ||
Suicide attempt | 38 | 31.4 | 191 | 3.5 | 229 | 4.1 | 19.2 | <.001* | |
Alcohol/drug abuse | 14 | 12.0 | 111 | 2.0 | 125 | 2.2 | <.001* |
Binary logistic regression analyses
B | S.E. | Wald | p value | aOR | 95% CI | |
---|---|---|---|---|---|---|
Selling sex | 1.61 | .47 | 12.0 | .001 | 5.00 | 2.01–12.42 |
Any sexual abuse | 1.12 | .29 | 14.6 | <.001 | 3.06 | 1.72–5.44 |
Penetrative sexual abuse | 1.26 | .27 | 21.4 | <.001 | 3.52 | 2.06–6.00 |
Physical abuse | .68 | .24 | 7.9 | .005 | 1.97 | 1.23–3.17 |
TSCC depression | .06 | .03 | 3.5 | .060 | 1.06 | 1.00–1.12 |
TSCC dissociation | .07 | .03 | 7.1 | .008 | 1.08 | 1.02–1.13 |
Healthcare for depression/anxiety | .64 | .25 | 6.7 | .010 | 1.90 | 1.17–3.10 |
Healthcare for eating disorders | .76 | .28 | 7.4 | .006 | 2.15 | 1.24–3.71 |
Non suicidal self-injury | .66 | .25 | 6.8 | .009 | 1.94 | 1.18–3.19 |