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INTRODUCTION

Today, the Internet is an important socializing tool with its various functions including information, trading, education, communication, and entertainment (1,2). According to the Turkish Statistical Institute’s Household Survey of Information Technology Use, 82.4% of Internet users’ most common activities are creating profiles in social media, sending messages, and sharing visual content (3). Particularly adolescents use the Internet for various purposes such as online gaming, chatting, and making new friends (1,4,5).

Adolescents have a variety of developmental needs such as being liked, making friends, or finding information about sex (6). While being a useful tool for adolescents to cater for these needs, the Internet also poses significant risks. The most relevant of these risks include exposure to cyberbullying and encountering sexual abusers while surfing in order to meet new people (7-11). In one study, 13.7% of female adolescents and 9.2% of males were reported to have been exposed to online sexual abuse in flirt-type relationships (7). In addition, a study in adolescents reported a rate of online victimhood as high as 27.0% and a rate of sexual abuse of 16.0% in females and 5.0% in males (8). A study performed with 210 children aged 10 to 17 reported that about 14.0% of subjects had close relationships with individuals met through the Internet (5). In a retrospective review of forensic records, 129 adolescents (aged 12-17 years) were found to have been exposed to sexual crime among 2574 cases of Internet-based sexual abuse. The survey also reported that victims most commonly belonged to the age group 13-15; 75.0% of the victims were girls and 99.0% of the abusers were men.

While some of the sexual abuse events during childhood occur in an online setting, others may continue in real life (13). A study reported that 74.0% of the victims met people personally after getting to know them on the Internet; 89.0% of the adolescents meeting these persons were found to be exposed to sexual abuse, with a penetration rate as high as 71.0% (12). However, adolescents tend not to report sexual abuse that they have been exposed to on the Internet for several reasons, including embarrassment, and only less than 10.0% notify the authorities, such as legal units or service providers (14).

A search of the Turkish literature found no study regarding adolescents’ behaviors of finding friends/partners via the Internet; studies rather focused on problematic Internet use (4,15) and cyberbullying in adolescents (16-18). Just one study evaluating the psychiatric health of children exposed to sexual abuse via Internet reported that the probability of developing a psychopathology increased 4.2-fold in cases where the abuser was met on the Internet and/or was reported to use a digital device compared to cases where the abuser was met in a manner other than a digital environment like the Internet (19). On the other hand, the international literature contains a limited number of studies regarding finding friends/partners via Internet and being exposed to sexual abuse during adolescence. However, the rate of online sexual victimization could not be estimated as adolescents do not know which behaviors could be regarded as sexual abuse, or they feel emotionally close to an abuser in an online chat (11,12). Nevertheless, abusers seducing adolescents by various tactics other than violence may prevent victims from protecting themselves or comprehending the importance of the situation (20). The same study reported that only 5.0% of the abusers committed violence against the victims, while 16.0% applied psychological pressure; some of the abusers hid the actual purpose of sexual abuse and lied about their age, physical appearance, and true identities. The rate of victims that had eloped with their abusers was found to be 24.0%, while 40.0% had been forced to use alcohol and substances (20).

Exposure to neglect and low level of parental monitoring may be factors that affect victimization via Internet or meeting individuals in real life after having known them online (8,10). Several studies reported that girls who experienced problems or conflicts with their families were more likely to establish close relationships with people they met on the Internet (5). Similarly, another survey study including adolescents between 14 and 17 years of age (n=2238) reported that girls, adolescents from broken families, of foreign origin, homosexuals or bisexuals, or adolescents with a lower level of perceived social support were more likely to be exposed to online sexual abuse (11). In another study, 45.0% of male adolescents and 41.0% of female adolescents were found to have met with people they had come to know on the Internet, and 4.5% of these girls and 7.1% of boys reportedly had been exposed to sexual abuse, with nearly 1.0% of those meeting in real life having received money or gifts in exchange for sexual activity (8). The same study detected that being female, being exposed to physical and sexual abuse, having a family history of alcohol use, using the internet for longer periods, and experiencing self-reported problems of emotional and anti-social behaviors were weakly associated with online victimization, whereas there was a strong association between risky online behaviors and online victimization. A study by de Santisteban and Gamez-Guadix (21) determined that adolescents being exposed to online sexual abuse may exhibit different characteristics compared to those having sexual intercourse with the abusers. The authors, however, also reported that these two groups had characteristics in common, such as being in a higher age group, manifesting symptoms of depression, being exposed to cyberbullying, becoming friends and chatting with people they do not know, and spending more time on the Internet.

As there have been no studies on children exposed to sexual abuse induced through online meetings in Turkey, this kind of research is very timely, especially considering that the rate of home Internet access is 73.1% and active Internet users constitute 61.2% of the population (3). Therefore, our study aimed to examine the individual and family characteristics of children who met people on the Internet and were exposed to sexual abuse, as well as the characteristics of the incidents.

METHOD

The study was approved by the ethics committee of Yenimahalle Training and Research Hospital, belonging to Yildirim Beyazit University. The records of 3429 children who had been referred to the Ankara Child Monitoring Center between January 2011 and December 2015 for criminal interviews were scanned retrospectively. The study includes 135 children who, according to forensic examination or statements by witnesses or the victims themselves, had been exposed to sexual abuse and had met their abusers through the Internet. An exclusion criterion was if the victim had got into contact with the abuser in a way other than Internet use. This study population corresponded to 3.9% of the 3429 files. Of this group, 94.8% were girls (n=128) and the remaining 5.2% boys (n=7). The mean age of the victims was 15.6±2.12 years (range: 9-18 years).

Data were analyzed applying descriptive statistics using SPSS 18.0.

Data Sources

Victim’s Record of Statement: This is the judicial record in which the information given by the children who have been (or are suspected to have been) exposed to sexual abuse is recorded during the judicial interrogation. This record contains basic information on criminal elements such as identity of the defendant, presence of threat or violence, type or way of abuse.

Family Interview Form: This is the standard form used in interviews with parents of children who come to the center with their parents. This form contains information on the parents (e.g. marital status, education level, employment status), victimized children (e.g. school status, presence of chronic illness), and familial characteristics (e.g. socio-economic level, familial risks). It was determined that for 39 victims (28.9%), family interviews were not performed and there was limited data as their parents did not come to the center.

Forensic Examination and Psychiatric Assessment Reports: These are one-page reports in which the victims are assessed according to judicial and psychiatric aspects by a forensic physician and a child and adolescent psychiatrist under the prosecutor’s directives. It was determined that 95 of the victims (70.4%) had undergone forensic examination and 74 of the victims (54.8%) had been evaluated psychologically.

RESULTS

Event-Related Findings

While 71.1% (n=96) of the victims who met on the Internet were exposed to penetration, 28.9% (n=39) had undergone harassment. In addition, 5.2% of the victims (n=7) were used for sex trade, while 94.8% (n=128) of the victims were not involved in the sex trade.

Twenty-one victims (15.7%) stated that their intimate areas had been recorded by the abuser either as photos or videos, and 6.0% of the victims reported that their footage was streamed online; 34.3% declared that they had been threatened by the abuser, 24.4% had been exposed to violence, and 28.9% had been deceived by the abuser in various ways like receiving a promise of marriage (Table 1).

Eighty-three percent of the victims (n=112) did not report the event within the first 24 hours and 21.5% (n=29) of the victims kept it hidden for more than six months. Forensic findings (e.g. injury signs, hymen perforation, or pregnancy) were detected by forensic medicine specialists in 40.0% of victims (n=54) after examination and 15 victims (11.1%) had become pregnant due to the incident.

All abusers (100%) of the victims who had been met on the Internet were male. A history of alcohol and substance use was present in 13.2% (n=17) and 11.7% (n=15) of the abusers, respectively. The mean age of the abusers was 21.6±6.0 (range: 15-48 years).

Individual and Familial Characteristics of the

Victims

Five victims (3.7%) had a history of suicide attempt, 11.1% (n=16) had a history of eloping from home, and 8.9% (n=12) had a history of physical abuse by their parents (Table 2). Among the 74 victims who had undergone a psychiatric evaluation, 51 (68.9%) had a psychiatric disorder and 16 (21.6%) did not, according to the assessment by the child and adolescent psychiatrist. No clear diagnosis could be made for the remaining seven victims (5.2%), as they did not attend the follow-up visit in the psychiatric outpatient clinic. In addition, 6.7% (n=9) of the victims were diagnosed with mental retardation.

The socio-economic status of the victims’ parents showed that the socio-economic status was of an intermediate level only in three victims (2.2%), while the rest had a low socio-economic status (Table 2). Of the parents interviewed about the level of communication with their victimized children 21.9%reported a poor level, 43.8% intermediate, and 34.4% a good level of communication. In addition, it was found that 58.5% of the victims (n=79) had family risk factors (e.g., single parent, low parental education level), 6.7% (n=9) had experienced the loss of at least one parent, 17.5% (n=25) had experienced their parents’ divorce, 59.3% (n=80) had parents with a low education level, 8.9% (n=12) had witnessed violence within the family, 13.3% (n=18) were exposed to alcohol abuse among family members, 7.4% (n=10) had family members with a psychiatric disorder, and 13.3% (n=18) had family members with a chronic disease (Table 2). Only 20.0% of the victims’ mothers were employed (n=27) and 8.9% (n=12) of the fathers were unemployed. The proportion of victims who were decided to be taken into institutional care after the forensic interview was 3.7% (n=5).

DISCUSSION

In this study, the characteristics of abuse incidents and the individual and familial characteristics of 135 adolescent victims who had met persons on the Internet and subsequently been exposed to sexual abuse were investigated retrospectively. Available findings indicate that the majority of victims were female and had been raped; nearly one-third of them had been threatened and deceived with marriage promises by their abusers; some of them were blackmailed with photographs and video shots (15.7%); private images or videos of victims was spreaded on the Internet by the abusers (6.0%); and most of the victims (83.0%) did not immediately report the abuse event. The findings obtained by this study, the first of its type in Turkey, are partially consistent with the available literature. Previous studies also reported manipulation of victims by abusers met online, establishing a close emotional relationship by threats or deception (12,20). In a study by Wolak et al. (12) one quarter of the victims were reported to be male, where the rate of deceiving was 52.0%, presence of violence 5.0%, psychological pressure 16%, and eloping with the abuser 24.0%. In our study, rates for threatening, violence, and eloping were 34.3%, 24.4%, and 11.9%, respectively. Accordingly, besides deceiving, abusers in Turkey were more likely to threaten and hurt the victims. Nevertheless, the predominance of female victims may be explained by the lower reporting rate of male victims for cultural reasons (8,12), as in patriarchal societies, certain ideologies and sexual beliefs like homophobia can prevent childhood sexual abuse from being reported (22). According to a Turkish study with 228 high school students aged between 14-19 years reporting higher rates of cyberbullying by boys and higher rates of exposure to cyberbullying for boys rather than girls, male victims of sexual abuse may be less likely to report the incidents, or the exposure of this cyberbullying’s type can vary depending on the gender (16). Another explanation for the lower rate of male victims may be the fact that the majority of sexual abusers are heterosexual males or that girls are more likely to prefer meeting via the Internet (12,20).

Another important finding of our study is the determination of several risk factors for sexual abuse of adolescents after meetings on the Internet. These risk factors include the victims having families with low socioeconomic status, parents with a low level of education, and mothers being housewives. Furthermore, while parent-child communication was described as good in some cases, it was found that such cases might be exposed to sexual abuse in a similar way to those with poor parent-child communication, which suggests that a good level of parent-child communication does not protect against sexual abuse through the Internet, implying involvement of other potential factors. In fact, a study by Helweg-Larsen et al. (8) reported that paternal physical abuse, a factor for parent-child communication, was weakly associated with online victimization. For this reason, while potentially originating from several familial factors such as a low level of parental guidance, exposure to sexual abuse via the Internet may also be caused by the children’s low level of awareness or knowledge about safe Internet use. However, there is a need for causal studies in order to reach a definite opinion on this issue.

This study has some limitations. Firstly, because of the retrospective design, information about individual and familial characteristics of some of the victims has not been reached. Secondly, it was determined that family interviews of some cases and information on familial variables were not available because the parents did not attend the interview. Finally, the lack of a comparison group is another limitation of the study. Therefore, profiles of victims and abusers meeting on the Internet might be identified more clearly by investigating determined possible risk factors in further prospective and causal studies.

In conclusion, this study was the first in Turkey to determine some of the possible individual and familial risk factors of victims that had been exposed to sexual abuse subsequently to meetings on the Internet. These findings may help professionals dealing with children and families to take precautionary actions for children and parents at particular risk. Considering that sexual abuse victims exhibit risky behaviors (23) and parents’ interest and preventive interventions by educational institutions raise awareness of adolescents about cyberbullying (24), education programs about safe Internet use and prevention of sexual abuse may be applied by psychological counselors particularly for children who exhibit risky behaviors and/or are at a general risk. Such programs may include advising adolescents about the potential consequences and dangers of meeting with people via the Internet, such as being exposed to sexual abuse, getting pregnant, or being used for sexual exploitation. In addition, they may also be advised against being manipulated by threatening, deceiving, and violent behaviors, or warned that abusers might hide their actual identities. Moreover, children’s potential risk behaviors may also be reduced by providing them with information about healthy dating relationships (12).

Informed Consent: Written consent was not obtained from the participants due to research method.

Peer-review: Externally peer-reviewed.

Conflict of Interest: Authors declared no conflict of interest.

Financial Disclosure: Authors declared no financial support.

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