Prevalence of physical, psychological, and sexual abuse among a nationwide sample of Arab high school students: association with family characteristics, anxiety, depression, self-esteem, and quality of life

The objectives were first, to assess the lifetime and 12-month prevalence of physical, psychological, and sexual abuse among a stratified random sample of Kuwaiti high school students and second, to explore the association of child abuse with parental characteristics, subjective quality of life (QOL), self-esteem, anxiety, and depression. We assessed the students for experience of abuse by their mothers, fathers, and others, using standard scales on psychological, physical and sexual abuse. They also completed the short version of the World Health Organization's QOL Instrument; the Rosenberg self-esteem scale, and a scale for anxiety and depression. We obtained responses from 4,467 students (49% boys), mean age 16.9 years. About 18, 15, and 18%, indicated that for at least six times in the past 12 months, they experienced psychological abuse by their mothers, fathers and others, respectively. The corresponding figures for lifetime experience were similar. The respective figures for experience of physical abuse during the past 12 months were 4.3, 5.8, and 6.4%. For lifetime experience, the corresponding figures were 3.4, 5.3, and 5.8%. The girls had significantly higher physical/psychological abuse scores. There were no significant gender differences in the prevalence of sexual attacks (8.6%) and someone threatening the subjects with sex (5.9%). The prevalence of someone sexually exposing themselves to the students (15.3%) and unwanted touching of sexual parts (17.4%) was significantly higher among the boys. Over one-third of those abused had experienced multiple abuses. Child abuse was significantly associated with parental divorce, diminished QOL and self-esteem, high scores on anxiety/depression, and difficulty with studies, and social relationships. In the regression analysis involving only the abuse indices, psychological abuse by mothers was the most important predictor of depression, anxiety, and self-esteem (11.5-19.7% of variance). Good quality of parental relationship seemed protective. The findings support the impression that, despite the conservative culture, child abuse is being experienced by a significant number of children in the Arab world. Preventive education in this culture should include limits on child disciplinary measures, the vulnerable groups identified, the impact on psychosocial functioning, and the protective effect of parental harmony.