Ripples of abuse

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.