Saturday, February 8, 2003
By Alison McCook
NEW YORK (Reuters Health) - Most boys who were sexually abused do not become abusers themselves, but researchers said Friday certain factors may increase the risk, such as a lack of basic needs in childhood and violence in the home.
What's more, if the child was abused by a woman-which occurs in a minority of cases-the risk is also higher that the child will go on to become an abuser in adulthood.
Early sexual abuse can be devastating, and the current study findings are "hopeful," in that they provide clues in how to best prevent future incidents, study author Dr. Arnon Bentovim of the Institute of Child Health in London told Reuters Health.
Most boys who suffer sexual abuse do not go on to become abusers, Bentovim said. However, some do, and Bentovim recommended that extra attention be given to former victims of sexual abuse who have other risk factors for later abuse, such as those who live in a home plagued with domestic violence.
When faced with boys who were sexually abused, the researcher said officials should ask: "'Do they live in the context of other risk factors?"'
"And if they do, they need to be focused on," Bentovim said.
Estimates of how many boys are sexually abused range widely, likely due to the boys' hesitation to discuss their experience. As such, childhood abuse may strike between 3% and 37% of boys--and the actual incidence is likely toward the high end of the range, Bentovim said.
Bentovim and his colleagues followed 224 male former victims of sexual abuse, and noted how those who committed later abuses differed from those who did not.
A total of 26 of the boys included in the study--12%--eventually committed sexual abuse during the follow-up period, which ended when the men were between 18 and 34 years old.
The authors found that sexually abused boys who spent their childhood in homes that lacked material necessities like clothing or heat were more than three times as likely as those who were more comfortable in childhood to become later abusers.
Abused boys who became abusers also tended to have been less supervised as children, and to have suffered sexual abuse from a female abuser, Bentovim and his colleagues report in the February 8th issue of the British journal The Lancet. About 8 of the 26 boys who went on to become abusers had been sexually abused by a woman.
Later abusers were also three times as likely as boys who did not become abusers to have witnessed serious violence between family members--a factor that likely played an especially significant role in the cycle of abuse, Bentovim said in an interview with Reuters Health.
Witnessing violence between family members can be very confusing to young boys, Bentovim said. In the case where a father is hitting a mother, the researcher said that domestic violence can almost give boys "permission" to be violent toward women or other people considered to be less physically powerful.
A family is a close unit, Bentovim noted, and seeing domestic violence may cause boys to associate closeness with violence, perhaps encouraging them to be violent toward the people they care about later in life.
Based on these findings, Bentovim said he believed sexual abuse in childhood itself may not increase the risk of being an abuser as much as the combination of the sexual abuse and other risk factors like domestic violence.
"It's the combination of sexuality and violence that is the killer, in my view," he said.
In an accompanying editorial, Paul Bouvier of the Service de Sante de la Jeunesse in Geneva writes that it is also important to investigate what allows a young boy to overcome such a devastating experience in childhood.
Between 20% and 40% of abused children are mentally healthy in adulthood, he writes. "There is much to be learned from resilient individuals."
SOURCE: The Lancet 2003;361:471-476,443,446-447.