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Ripples of abuse

Ripples of abuse

Picture of Kate  Benson

The Boy Scouts of America are in trouble – to say the least. But, do the boy scouts who were molested and abused have even more far reaching troubles?  After all, according to files released by the organization, many of the child abusers were not prosecuted, their misdeeds covered up for years.  Their victims on the other hand have had to live with lifelong consequences of disbelief and possibly a higher risk of medical, mental and social problems as adults.

Last week, ROH writer Jane Stevens posted “The Adverse Childhood Experiences Study -- the largest public health study you never heard of.” The authors of the study correlated childhood trauma such as sexual abuse with increased risk of mental health issues and negative behavioral and social outcomes.

The higher the ACE score, the higher the risk.  Without doing a survey of boy bcouts who were sexually abused it is difficult to determine just how high each abused individual’s score was or is in this particular population. But according to one published ACE study looking specifically at childhood sexual abuse it is significant even alone.

In this study, researchers found that compared to men reporting no sexual abuse, a history of suicide attempt was more than twice as likely among men (and women) who experienced childhood sexual abuse.

As well, survivors of childhood sexual abuse may be at a 40% increased risk of marrying an alcoholic, and a 40% to 50% increased risk of reporting current problems with their marriage according to the study.

And it may be even more nuanced than that. A 2012 ACEs study also found that whether there was physical force, penetration, and physical injury in addition to higher scores was related to adult stressors. 

The ACE study publication on child sexual abuse did not specifically look at medical outcomes in this specific group although in the larger overall study they did find a correlation with some chronic diseases.  This is not the same as adverse events directly causing disease however, but rather possible increased risk tempered by other variables. Many people with an ACEs score of zero also have chronic disease. 

As well there may have been mitigating factors in the ACES childhood sexual abuse study. For example suicide attempts were much higher in sexually abused study respondents (16% of men in the larger cohort) compared to non-abused respondents which is significant. However it was still only four percent of male respondents who reported childhood sexual abuse.  Mitigating factors could be speculated to be individual levels of resiliency, family support, education levels, severity of the abuse, or number of incidents among others.

Childhood sexual abuse isn’t limited to boy scouts of course with 21% of the total ACES cohort reporting childhood sexual abuse. And in general estimates of sexual abuse are tricky for many reasons and the limitations and caveats, as well as conclusions, of studies should be part of the reporting.

What may make the Boy Scouts of America documentation of interest to health researchers is that it is less subject to recall bias, although without follow up lifetime outcomes are most likely unknown in most survivors. As would whether the social and behavioral impact trickled down to the next generation. It would be interesting to know.

Photo courtesy of Tjook.

Comments

Picture of Deborah Leader

This story struck a chord with  me as it brings back memories of my own personal experience with my son who was abused by a boy scout leader when he was very young. He did not share about the abuse until he was 16 years old. The man, who was 24 at the time the abuse started, was prosecuted and ended up doing a couple of years in jail, but not once did the boy scouts ever acknowledge the secret, much less apologize for it. My son suffers from depression and low self esteem to this day. I don't think a person ever fully recovers from sexual abuse. Thank you for shedding light on this very sensitive topic.  

Picture of Kate  Benson

Thanks for reading my post. 

Former New York Times journalist David Shipler has an entire chapter devoted to the economic ramifications of sexual abuse in his book, The Working Poor: Invisible in America, Although his examples were women - most people don't realize that males are also raped and sexually abused or that it is about power not sex - but he makes some relevant points. 

And it is not just about the economic impact, it circles back around. When you are the working poor, your access to healthcare is limited to nonexistent and the ACE scores are often through the roof. These are very tangled, interelated issues with no clear or quick and easy fixes. 

Picture of

Thanks for the shout-out, and for reviewing the study that was in the Journal of Prevention and Intervention in the Community. I'll put a link to this on ACEsConnection. That whole issue was devoted to aspects of ACEs, which was very interesting. I haven't read all the papers yet, but they're on the list.
One thing I'd like to know is this: if someone who's been sexually abused speaks up right away, is believed and action is taken, is the damage lessened? That came up in the NYTimes Sunday Magazine story about sex abuse of boys at the Horace Mann School -- http://www.nytimes.com/2012/06/10/magazine/the-horace-mann-schools-secre.... The boys who told their parents immediately, whose parents believed them and raised hell with the school, which took action against the abuser....those boys weren't saddled with guilt, shame or depression.
If that's true, then all the more reason to find better language to talk about this, to realize that people who abuse have likely experienced severe and chronic abuse themselves, and to be able to talk about and deal with childhood trauma and the effects of childhood trauma the same way we do a broken leg.

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