CLINICAL SUMMARY: CLINICAL INTEGRATION GROUP READINGS
AUTHOR(S):Merrick, Litrownik, Everson & Cox
TITLE:Beyond sexual abuse: The impact of other maltreatment experiences on sexualized behaviors
SOURCE:Child Maltreatment, Vol.13(2), p.122-132.
YEAR:2008
THEORETICAL FRAMEWORK (IF APPLICABLE)
None specified.
SAMPLE, DESIGN, MEASURES (IF APPLICABLE)
Target population: Children (boys and girls) 4-8 yrs.
Description of sample:Data used in the study came from the Longitudinal Studies of Child Abuse and Neglect (Longscan) multisite longitudinal study composed of 5 sites.
At each site, children who had been maltreated early in life or who were at risk for early maltreatment and their caregivers were interviewed in person every two years beginning when the children were about 4 years old. Inclusion required that the children had completed an interview at age 8 years. In addition, each participant had to have a completed CPS record review through to 8 years of age without a sexual abuse allegation on file (N=690). The MW site was excluded from these analyses as participants were younger than 8 yrs old.
Measures used:
- Modified maltreatment classification system – reports made to CPS in the narrative were coded with the MMCS as emotional abuse, sexual abuse, physical abuse or neglect. For the purposes of this study, children with reports before age 4 were considered early reports and those between 4 and 8 were considered late reports.
- Child sexual behavior inventory – II - used to assess the frequency of child sexual behaviors in the past 6 months.
Procedure:
Primary caregivers were interviewed when the children were approx. 8 yrs old. Logistic regression was used to investigate the impact of the timing and type of maltreatment on each group of sexualized behaviors.
SUMMARY / MAJOR FINDINGS / THEMES
- Maltreatment characteristics were found to predict sexualized behaviors. Specifically, children with late physical abuse reports were almost twice as likely to display boundary problems than those without;
- Displaying private parts was significantly predicted by early and late physical abuse reports;
- Early emotional abuse reports predicted displaying private parts;
- Sexual intrusiveness was predicted by late physical abuse reports and early reports of neglect;
- Children with late emotional abuse reports were twice as likely to demonstrate age-inappropriate behavior than those without;
CLINICAL IMPLICATIONS / RELEVANCE TO PRACTICE
Overall, late and early reports of physical abuse and late reports of emotional abuse consistently increased the odds of engaging in sexualized behaviors.
Possible explanations include the fact that children who were victims of physical abuse may experience increased anxiety and use sexualized behaviors to self-soothe and/or to gain closeness. This may be adaptive, helping children cope with trauma. However, sexualized behaviors that include others or that are aggressive are considered maladaptive and maltreatment is often a marker of family characteristics related to an increase in exposure to sexuality. It may also indicate undetected sexual abuse.
Children who had early reports of emotional abuse were significantly less likely to demonstrate sexualized behaviors and those with late reports were significantly more likely. It could be that early emotional abuse leads to inhibition of behaviors because of rigid boundaries or threat of discipline; later emotional abuse may be more likely to be internalized because of increased understanding with age; sexualized behaviors may be self-soothing.
STRENGTHS AND LIMITATIONS OF THE STUDY/READING
Limited to CPS reports, which likely underestimates incidence.
Relied on caregiver reports of sexualized behaviors - could have been underreported.
OCTOBER, 2009