Adverse mental health outcomes are the most recognized and researched effects of abuse. These can include post-traumatic stress disorder, depression, anxiety and feelings of guilt, shame, anger and low self-esteem.

Revictimization, or the likelihood that child sexual abuse survivors will experience further sexual abuse later in life, is a particularly tragic consequence that is rarely mentioned or considered.

To prevent this cycle of victimization, we must understand the scope of the links between child sex abuse and revictimization later in life, why it exists and which survivors are most vulnerable. Our research aimed to answer some of these questions.

What we already know and what our research did

Previous studies have confirmed a strong relationship between child sexual abuse and adult sexual re-victimization. A 2017 review of research on these links found that about half of child survivors have been sexually victimized later in life.

Previous studies, however, have been limited since they typically:

• ask adults to recall their experiences of child sexual abuse, which many find difficult to remember accurately or to disclose

• have asked people to recall experiences of both abuse and revictimization at the same time, which doesn’t provide a picture of these relationships over time

• consider only female survivors, meaning we know little about revictimization in men who have been abused as children

• do not explore factors that make revictimization more or less likely to occur.

We attempted to remedy these limitations in our research by reanalyzing data of 2,759 Australian boys and girls who were medically confirmed to have been sexually abused between 1964 and 1995. The files were drawn from children examined by independent medical practitioners from the Victorian Institute of Forensic Medicine as part of legal investigations.

To determine whether they had been revictimized later in life, we then traced their contacts with police as victims of crimes as adults (to an average age of 35) – and considered the lifetime frequency and types of crimes they were victims of.

We compared these findings to a sample from the general population not known to have been sexually abused in childhood. This is what we found:

Revictimization is not limited to sexual offenses or just women

Overall, most (64 percent) child sexual abuse survivors in our study were not revictimized later in life. This percentage was consistent with the control group (67 percent were not victims of crimes).

Unfortunately, though, child sexual abuse survivors were much more likely than those in the control group to be re-victimized in what are considered medium and high harm personal injury crimes.

For instance, they were five times more likely to have been victims of sexual assault later in life, twice as likely to be victims of physical assault, four times as likely to be threatened with violence and twice as likely to be stalked.

We also found the increased risk of revictimization was not just experienced by women. For example, male survivors of child sex abuse were seven times more likely to be the victims of a further sexual assault than the men in the control group.

Why child sex abuse survivors are more vulnerable

The reasons why child sexual abuse is linked to revictimization are not well known. Nor are the factors that determine which survivors are more vulnerable to crimes later in life.

Prevailing theories suggest revictimization is not the result of any one factor. Rather, it is the combination of different factors in survivors’ lives – some having to do with personal characteristics and experiences, others having to do with their environments.

We investigated the role of certain personal factors in whether child sex survivors were revictimized later in life.

Specifically, we studied the impact of three things: gender, the characteristics of the child sex abuse (such as the age when it occurred, type, frequency), and different types of mental illness. Three overall patterns emerged:

First, female survivors were more likely than male survivors to experience sexual revictimization. In contrast, male survivors were at greater risk for being the victims of non-sexual violent crimes and non-violent crimes, such as property crimes.

Second, the age when child sexual abuse occurred played a significant role in predicting later revictimization. Survivors who were younger than 12 when they were abused were more likely to be the victims of both sexual and violent crimes later in life.

Third, and perhaps most concerning, child sex abuse survivors who developed mental illness were more vulnerable to revictimization.

How mental illness factors into revictimization

The links between mental illness and revictimization, however, were complex.

Child sex abuse survivors who developed personality disorders or anxiety disorders, for example, were roughly twice as likely to be victims of all types of crimes as adults compared to survivors who did not develop these conditions.

Other mental illnesses were linked to some forms of revictimization, but not others. Post-traumatic stress disorders, for example, were linked with higher rates of sexual revictimization. Mood disorders were linked to violent re-victimization.

And survivors who developed substance abuse issues were more likely to become victims of both violent and non-violent crimes later in life.

There are at least two explanations for these links.

First, symptoms of mental illness may impair a survivor’s capacity to recognize and respond to risky situations and people. Offenders are also more likely to target child sex abuse survivors because of their vulnerability.

Second, survivors who suffer revictimization later in life may be more prone to serious mental health problems due to the cumulative impacts of repeat abuse. That is, mental illness may be a consequence of, not a contributor to, this continuous cycle of abuse.

The truth is that both explanations likely contribute to the relationship between mental illness and revictimization.

Meeting the needs of survivors

It is difficult to establish a direct causal link between child sexual abuse and revictimization over one’s lifespan. But it’s clear that for some survivors, victimization is an ongoing problem rather than just an isolated event.

Victoria’s Royal Commission into the Mental Health System has highlighted the barriers trauma survivors experience in accessing appropriate support services. The strong links we found between mental illness and revictimization support further integration of mental health and victim services.

More research into why child sexual abuse is linked with revictimization – and which survivors are most at risk – may help to better focus prevention and treatment efforts.

A final word about resilience

Despite the odds, most abuse survivors are not revictimized later in life, according to our study. However, we understand that many people who are victims of child sex abuse – likely including some in our control group – do not report these crimes. As such, our estimates of revictimization are doubtless conservative.

We mustn’t lose sight of the strength and resilience shown by survivors in the face of adversity. Understanding how this process of resilience occurs may provide useful insights about how to support other survivors to lead positive and fulfilling lives – without being revictimized.

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Nina Papalia, Postdoctoral Research Fellow, Centre for Forensic Behavioural Science, Victorian Institute of Forensic Mental Health (Forensicare), Swinburne University of Technology and James Ogloff, University Distinguished Professor of Forensic Behavioural Science, Director of the Centre for Forensic Behavioural Science, Swinburne University of Technology

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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