The validity of the Child Sexual Behaviour Inventory as a diagnostic tool for child sexual abuse in children with suspected sexual abuse: A systematic review

Child sexual abuse (CSA) is a worldwide problem that remains unrecognized in most cases. Deviant sexual behaviour can indicate CSA, which can be measured with the Child Sexual Behaviour Inventory (CSBI). We conducted a... [ view full abstract ]

Child sexual abuse (CSA) is a worldwide problem that remains unrecognized in most cases. Deviant sexual behaviour can indicate CSA, which can be measured with the Child Sexual Behaviour Inventory (CSBI). We conducted a systematic review to assess whether the CSBI is useful to differentiate abused from non-abused children in children with suspected CSA. We searched the electronic databases MEDLINE and PsychInfo for studies comparing CSBI-scores in sexually abused children and non-abused children (2-12 years old). Two independent reviewers extracted data and assessed the methodological quality. We included seven (out of 1048) articles. CSBI-total scores were significantly higher in CSA-victims compared with non-abused children (in case-control settings). However, in children with suspected CSA results were ambiguous. One study reported significant differences, a second study did not. One study reported on the diagnostic ability in children with suspected CSA, which were weak (sensitivity and specificity both 0.5, positive and negative predictive values 28% and 72% respectively). Conclusion: One study reported on diagnostic ability in children with suspected CSA, too sparse to draw definite conclusions. Until more research is done, the CSBI should not be used as a diagnostic instrument in children with suspected CSA and only to measure sexual behaviour.