The prevalence of potentially traumatic events in the seventh survey of the population-based Tromsø study (Tromsø 7).

Aims: Potentially traumatic events (PTEs) can have detrimental consequences for an individual's physical and mental health. Exposure to PTEs is therefore increasingly assessed in population-based studies. Consistent with this trend, the most recent wave of the longitudinal population-based Tromsø study (Tromsø 7) in Northern Norway included a list of PTEs. The aim of the present study was to describe the prevalence of PTEs in the sample and examine demographic correlates of reported PTE exposure in this group. Methods: In Tromsø 7, a total of 21,083 participants aged ⩾40 years (52.5% female, mean age 57.3 years) were asked about exposure to nine PTEs that occurred in childhood, in adulthood and in the previous year. Differences between demographic groups in exposure to PTEs were examined using chi-square tests and logistic regression analyses. Results: Overall, 67% of the participants reported at least one PTE across the three time intervals. A life-threatening illness or serious accident of a loved one (36.8%) or of the respondent (24.0%) and bullying (21.5%) were the most frequently reported PTEs. Female sex, younger age, indigenous or immigrant ethnicity and higher education were associated with an increased likelihood of reporting at least one PTE. Group differences with respect to specific PTEs were observed. Conclusions: The experience of PTEs is common among the participants in the Tromsø 7 study. The current study lays the foundation for further research into the associations between PTEs and physical and mental health within the Tromsø study.

"They were the ones that saw me and listened." From child sexual abuse to disclosure: Adults' recalls of the process towards final disclosure.

BACKGROUND: When child sexual abuse (CSA) is not disclosed, children run the risk of being subjected to longer or repeated abuse, not receiving necessary treatment, and being re-victimized. OBJECTIVE: This study examines what adults exposed to child sexual abuse in hindsight evaluate as important for disclosure. The aim was to explore exposed own experiences of steps towards final disclosure. PARTICIPANTS AND SETTING: Data were obtained from adult users of Norwegian Sexual Abuse Support Centers. Included were users exposed to CSA before the age of 18 (N=23). METHODS: Data were collected through anonymous questionnaires at each support center. The material was transcribed and analyzed in the tradition of Interpretative Phenomenological Analysis. RESULTS: The study illustrates a process towards disclosure as a dialogically anchored process evolving over time and along life-course inside encounters with important others towards whom the exposed pays attention, attunement, and adjustment whether to tell, delay, re-try, turn towards others, or actually disclose. Their experiences elucidate processes towards exploring and telling through direct and indirect hints and signs, decisions to tell, re-decisions and delaying, or withholding until adulthood, and the dependency on trusted confidants who ask and listen for final disclosure to occur. CONCLUSION: Thus, the present study sends an important message to exposed, confidants, and professionals when questions of CSA appear. That is to know of, facilitate, trust, and tolerate the dialogical dependency on being asked and heard by trusted persons and the many steps a process towards disclosure of CSA may entail in order to succeed.

"It's My Responsibility, But " A Qualitative Study of Perpetrators' Understanding of Child Sexual Abuse.

The present study looked at child sexual abuse (CSA) from the perpetrator's perspective, focusing on precursors to, sustaining mechanisms, and inhibitors of CSA. Individuals serving sentences for sexual abuse of children under the age of 16 were interviewed (N = 8). A qualitative design using interpretative phenomenological analysis was employed. Negative childhood events such as poly-victimization, poor social skills, loneliness, and insecure sexual identity were reported as predisposing elements. Abuse was sustained due to a strong conviction of not being responsible for doing anything wrong. Respondents conveyed few salient inhibitors for the abuse, though not wanting to physically harm the child was often cited as important. Implications for the prevention of CSA in risk groups suggest the need to increase the understanding of children from a child's perspective, changing conceptions leading to disavowal of adult responsibility toward children, strengthening social competency, integration into a social context, and increasing knowledge about the harmful consequences of CSA.

Where is the Child in Family Therapy Service After Family Violence? A Study from the Norwegian Family Protection Service.

Extensive documentation on consequences of family violence laid the ground for a politically decided mandate for the Norwegian Family Protection Service (FPS) to prioritize families with children and violence. This study explores the practice of one of the country's larger FPS offices following this mandate and its kick-off start. Data from all cases in 1 year with families with children and violence were gathered (106) as to what were cases referred, services provided, main cross-points, dilemmas, and challenges. Descriptive statistical analyses were utilized and qualitative analysis conducted. The study shows success in supplying a direct, much used route both for private persons and main collaborative agencies, although all abusers need others as promoters for change. The service succeeds to pioneer brief treatment combined with taking a stand against violence. However, while services are provided fairly quickly when violence is reported, several changes are called for: A more violence-sensitive intake procedure, stronger cooperation with specialty mental health service and primary health service, extended use of assessment tools and outcome measures. Given the nature of violence, particularly follow up measures are required. However, first and foremost, the study calls for a better inclusion of the child. Despite mandated priority, a major neglect of children takes place. In line with the UN Convention on the Rights of the Child, the Norwegian Family Protection Services in a country complying with this Convention is obliged to take the child more successfully into account in its own right. Future efforts are required to safeguard child-focused services.

Test balloons? Small signs of big events: a qualitative study on circumstances facilitating adults' awareness of children's first signs of sexual abuse.

This research examined caregivers' awareness of children's first signs of sexual abuse. The aim was to explore circumstances that facilitate adults' awareness of first signs in everyday natural settings. Data were obtained from a Norwegian university hospital's outpatient specialty mental health clinic. Included were all cases (N=20) referred during a two-year period for treatment after the disclosure of sexual abuse that was reported to the police and child protective service. Nonabusing caregivers' awareness of first signs were recollected in hindsight as part of therapy. Qualitative analysis was conducted to capture caregivers' experiences. As identified by caregivers, all children gave signs. Thereafter, children either stopped, delayed, or immediately disclosed sexual abuse. At first signs, each child had time and attention from trusted adults, connection to the abuser, and exhibited signs of reservation against that person or related activities. Then, if met with closed answers, first signs were rebuffed as once-occurring events. If met with open answers and follow-up questions, children continued to tell. Unambiguous messages were prompted only in settings with intimate bodily activity or sexual abuse related content. In sum, when trusted adults provided door-openings, children used them; when carefully prompted, children talked; when thoughtfully asked, children told. The study suggests that children's signs of sexual abuse can be understood as "test balloons" to explore understanding and whether anything is to be done. A disclosing continuation hinges on the trusted adult's dialogical attunement and supplementary door-openings. Divergent from an idea of behavioural markers, or purposeful versus accidental disclosures, this study calls for a broader attention: Moments of first signs are embedded in dialogue. A uniqueness at moments of first signs appears: Both to form such moments and to transform them into moments of meeting for joint exploration and telling, hinge upon how trusted caregivers scaffold opportunities for the child to disclose. Subsequently, support offers need to be addressed not only to strengthen children to tell, but also for caregivers and professionals to take into account the necessity of a dialogically oriented sensitivity towards children, both for telling to occur and for hearing to take place.