Jill Hodges

Development of sexually abusive behaviour in sexually victimised males: a longitudinal study

BACKGROUND Sexual maltreatment is one of the most common forms of child abuse. To identify risk factors for sexually abusive behaviour by adults, we prospectively assessed childhood experiences and personal characteristics of male child victims who became abusers in later life. METHODS In a longitudinal study (7-19 years duration), we included 224 former male victims of sexual abuse. Risk factors contemporaneous with the abuse, and putative protective influences, were identified from social service and clinical records. Evidence of later criminal acts was obtained from a nationwide search of official records. FINDINGS Of the 224 former victims, 26 had subsequently committed sexual offences (victim-abusers), in almost all cases with children, mainly outside their families. Risk factors during childhood for later offending included material neglect (odds ratio 3.4, 95% CI 1.2-9.7), lack of supervision (3.0, 1.1-8.3), and sexual abuse by a female person (3.0, 1.1-8.7). Victim-abusers had more frequently witnessed serious intrafamilial violence (3.1, 1.0-10.0). Six (29%) of 21 victim-abusers on whom we had relevant data had been cruel to animals (7.9, 2.0-31.4). No single putative protective factor, nor a composite protective index, significantly reduced the risk of paedophilic behaviour. INTERPRETATION Most male victims of child sexual abuse do not become paedophiles, but particular experiences and patterns of childhood behaviour are associated with an increased risk of victims becoming abusers in later life. Our findings have implications for the design of selective interventions with a vulnerable subgroup of male victims, aimed at reducing the risk of paedophilic behaviour in later life.

Changes in Attachment Representations Over the First Year of Adoptive Placement: Narratives of Maltreated Children:

Children who develop their ‘internal working models’ of attachment in situations of neglect or abuse, carry the effects of these models into new placements if they are then adopted or fostered. This article reports on the assessment of these effects using the story stem technique, which provides children with a way of displaying their expectations and perceptions of attachment figures using both verbal and non-verbal means of representation. An outline of the story stem assessment technique is given, and the ‘Little Pig’ stems and a summary of the rating system are presented. The article then reports preliminary findings from a larger ongoing research project, comparing themes in the stories of previously maltreated children placed for adoption with those of a group of children adopted in the first year of life, and using the technique to track changes in the children’s attachment representations, and some other aspects of their ‘internal working models’, over the first year of placement in their new families.

Risk factors for development of sexually abusive behaviour in sexually victimised adolescent boys: cross sectional study

Abstract Objective: To identify factors that may increase the risk of a sexually victimised adolescent boy developing sexually abusive behaviour. Design: Sexually victimised boys who had sexually abused other children were compared with sexually victimised boys who had not done so. Setting: Social services departments in south east England were invited to refer sexually abused and sexually abusing boys to a London postgraduate teaching hospital. Subjects: 25 adolescent boys aged between 11 years and 15 years and 11 months. Main outcome measures: Adjusted odds ratios estimated from unconditional logistic regression. Results: Unadjusted odds rations for witnessing (8.1) as well as experiencing (18.0) intrafamilial violence and discontinuity of care (7.2) discriminated boys who had sexually abused from others who were solely victims of sexual abuse. Only the adjusted odds ratios for witnessing intrafamilial violence (39.7)discriminated the two groups. Conclusions: The risk of adolescent boys who have been victims of sexual abuse engaging in sexually abusive behaviour towards other children is increased by life circumstances which may be unrelated directly to the original abusive experience, in particular exposure to a climate of intrafamilial violence. Our findings have implications for the management of boys found to have been sexually abused and raise important questions about the possibility of secondary prevention of subsequent abusive behaviour in those at greatest risk.

Mental Representation and Change: Developing Attachment Relationships in an Adoption Context

This article presents an attachment theory and research-based perspective on the utility of assessing qualities of mental representations as indexes of change in an adoption context. The article reviews findings from a large, longitudinal and intergenerational study of attachment relationships of previously maltreated children who were adopted in latency. An attachment perspective provides a secure base from which to explore how old objects were carried into these new relationships, by both adoptive parents and the children recently placed with them. The study has the potential to inform a wider area of interest, namely to add to our knowledge base concerning the assessment of mental representations in both children and adults. The possibility to provide empirical evidence for intergenerational links and changes in representations over time in relation to a new environment is helpful, especially if we can chart relationships that can facilitate or inhibit the emergence of trust, growth, and the development of corresponding representations.

Understanding boys who sexually abuse other children: A clinical illustration

SUMMARY The therapeutic assessment of a 12-year-old boy who sexually abused, is described. He was one of forty-eight boys who took part in the psychotherapeutic assessment stage of a large multi-disciplinary research project, funded by the Department of Health. For a period of some years, at a young age, ‘Frank’ was brutally sexually abused by his father. Having been severely traumatised, he became traumatising for others when he started at puberty to sexually abuse. The twelve-session assessment consisted of semi-structured interviews and standardised questionnaires within the framework of more open-ended psychotherapeutic consultations. The authors discuss the clinical and theoretical implications of this work.

Children after adoption: Exploring their psychological needs

Children adopted from care are known to be at increased risk for mental health difficulties although relatively little research has been carried out to explore this question. This study assessed the mental health and psychological development of children placed for adoption by one UK Local Authority. We compared the pattern and prevalence of difficulties to existing data including that on Looked-After Children (LAC) children. Totally, 106 families were initially approached and parent interviews and at least partial questionnaire data were gathered on 47 children, 72.3% of whom were known to have been maltreated prior to adoption. Of the 34 children with a complete data set including Development and Well-Being Assessment (DAWBA), 76.4% met full criteria for at least one neurodevelopmental or mental health diagnosis, a markedly higher rate than comparison data on LAC or community samples. Less than half of those identified with a mental health diagnosis had received any prior diagnosis, and only a minority had received appropriate services. Despite the children’s difficulties, the great majority of parents reported high enjoyment of bringing up their child.

Evaluación de las representaciones mentales de apego a través de las historias incompletas: aplicación española de Story Stem Assessment Profile (SSAP)

Ministerio de Economia, Industria y Competitividad y Fondo Europeo de Desarrollo Regional SEJ2006-12216; PSI2010-19287; PSI2015-67757-R