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Self-reported frequency of sex as self-injury (SASI) in a national study of Swedish adolescents and association to sociodemographic factors, sexual behaviors, abuse and mental health
Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping. Linköping University, Department of Clinical and Experimental Medicine, Barnafrid. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Barnafrid. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Barnafrid. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
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2017 (English)In: Child and Adolescent Psychiatry and Mental Health, ISSN 1753-2000, E-ISSN 1753-2000, Vol. 11, no 1Article in journal (Refereed) Published
Abstract [en]

Sex as self-injury has become a concept in Swedish society; however it is a largely unexplored area of research, not yet conceptualized and far from accepted in the research field. The use of sex as a way of affect regulation is known in the literature and has, in interviews with young women who sell sex, been compared to direct self-injury, such as cutting or burning the skin. The aim of this study was to investigate the self-reported frequency of sex as self-injury and the association to sociodemographic factors, sexual orientation, voluntary sexual experiences, sexual risk-taking behaviors, sexual, physical and mental abuse, trauma symptoms, healthcare for psychiatric disorders and non-suicidal self-injury.

Place, publisher, year, edition, pages
BioMed Central, 2017. Vol. 11, no 1
National Category
Neurosciences Rheumatology and Autoimmunity Psychiatry
Identifiers
URN: urn:nbn:se:liu:diva-134927DOI: 10.1186/s13034-017-0146-7ISI: 000395328600001OAI: oai:DiVA.org:liu-134927DiVA, id: diva2:1078138
Available from: 2017-03-02 Created: 2017-03-02 Last updated: 2018-12-21Bibliographically approved
In thesis
1. Adolescents Selling Sex and Sex as Self-Injury
Open this publication in new window or tab >>Adolescents Selling Sex and Sex as Self-Injury
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

There are today only a few population-based studies in the world investigating the prevalence of and associated risk-factors with adolescents selling sex and so far no earlier population-based study has been found investigating adolescents motives for selling sex. Further, to use sex in means of self-injury (SASI) is a behaviour that has been highlighted in Sweden the last years but it is a new field of research and a behaviour in need of conceptualization.

The aim of this thesis was to investigate the prevalence of, associated risk factors with, motives for and manifestations of adolescents selling sex and the use of sex as self-injury (SASI). For the thesis, two nationally representative cross-sectional population surveys with third year students at Swedish high schools were collected in 2009 (n = 3498, mean age 18.3 +/- 0.6 years, response rate 60.4%) and in 2014 (n = 5839, mean age 18.0 +/- 0.6 years, response rate 59.7%). Further, the motives and manifestations of SASI were investigated in an anonymous self-selected, open-ended questionnaire published on websites of non-governmental organizations offering help and support to women and adolescents (n = 199, mean age 27.9 +/- 9.3 years). Quantitative and qualitative methods were used for data analyses.

In the 2009 population-based survey, 1.5% (n = 51) of the adolescents reported having sold sex on at least one occasion, but in 2014 the prevalence was slightly lower at 0.9% (n = 51). SASI was reported by 3.2% of girls (n = 100) and 0.8% of boys (n = 20). Both selling sex and SASI were associated with various adverse factors such as experience of sexual abuse, emotional and physical abuse, poor mental health and self-injury. Adolescents selling sex had sought help and support for different problems and worries to a greater extent compared to peers. Contact with healthcare for various psychiatric problems such as suicide attempts, depression and eating disorders was common for adolescents using SASI. Further analysis showed that adolescents selling sex are a heterogeneous group in regard to underlying motives for selling sex, which included emotional and material reasons as well as pleasure. Depending on their underlying motives, adolescents selling sex were found to differ in regard to compensation received, age of the buyer, means of contact with the buyer, sexual orientation, experience of sexual abuse and the use of SASI. By using data from an open-ended questionnaire, SASI was described as deliberate or self-inflicted sexual situations that could include psychological and physical harm. SASI was used as a way to regulate negative feelings, such as anxiety, or to get positive or negative confirmation and the behaviour could be hard to stop.

In conclusion, selling sex and SASI occurs among Swedish adolescents and the behaviours are associated with sexual, physical and emotional abuse and poor mental health, including trauma symptoms. In regard of the motives and manifestations of SASI, the behaviour could be compared to direct self-injurious behaviours. Data from this thesis suggest that more attention should be paid in healthcare to recognizing adolescents selling sex and SASI in order to prevent further traumatization and victimization.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2019. p. 76
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1645
Keywords
Adolescents, Selling sex, Sex as self-injury, Child sexual exploitation, Sexual abuse
National Category
Psychiatry Public Health, Global Health, Social Medicine and Epidemiology Substance Abuse Psychology (excluding Applied Psychology) Geriatrics
Identifiers
urn:nbn:se:liu:diva-153569 (URN)10.3384/diss.diva-153569 (DOI)9789176852040 (ISBN)
Public defence
2019-01-18, Berzeliussalen, ingång 65, Campus US, Linköping, 09:00 (Swedish)
Supervisors
Available from: 2018-12-21 Created: 2018-12-20 Last updated: 2018-12-21Bibliographically approved

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Fredlund, CeciliaSvedin, Carl GöranPribe, GiselaJonsson, LindaWadsby, Marie

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Fredlund, CeciliaSvedin, Carl GöranPribe, GiselaJonsson, LindaWadsby, Marie
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Center for Social and Affective NeuroscienceFaculty of Medicine and Health SciencesDepartment of Child and Adolescent Psychiatry in LinköpingBarnafrid
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