Abstract

There are important scientific gaps in the understanding of the role of familial dysfunction in intrafamilial child sexual abuse perpetration and victimisation. We present the findings of a systematic review and a comparative (k = 18) and prevalence (k = 39) meta-analysis of intrafamilial child sexual abuse and familial dysfunction. We compared 3676 families in which intrafamilial child sexual abuse had occurred with 1120 families in which extrafamilial and 1145 families in which no (intrafamilial) child sexual abuse had occurred. We found that families with intrafamilial child sexual abuse experienced more familial dysfunction across all domains compared to comparison families, with odds ratios ranging from 1.10 (lower educational attainment) to 5.06 (parental alcohol abuse). Families with intrafamilial child sexual abuse experienced more socio-ecological stressors (e.g., homelessness), disorganised family structures (e.g., non-intact parental structures), dysfunctional relationships (e.g., spousal conflict), nonsexual abuse (e.g., exposure to intimate partner violence), and parental vulnerabilities (e.g., mental health and substance abuse problems) than the comparison families. The prevalence meta-analysis indicated that almost half of the families with intrafamilial child sexual abuse also experienced one or more co-occurring forms of nonsexual abuse - 48 % physical abuse, 37 % emotional abuse, 34 % neglect, and 42 % exposure to intimate partner violence - and that this was significantly higher than the comparison families. The results of this meta-analysis highlight gaps and directions for further research on the role of familial dysfunction in intrafamilial child sexual abuse, and the aetiology and prognosis of polyvictimisation.