Childhood maltreatment:

Does the story of abuse end in childhood?

“I am 13 years old, lived with mom 10 years of my life and with my dad 3 years in the summers, 9 years of mom telling me how worthless I am…… Every morning after yelling at me for hours until I almost go insane she says sorry and I always forgave her. But it never stopped, I’m sorry, I’ve changed………. I’ve cut twice, tried to die once, and have no self-esteem………….. I’ve never had anybody hug me and say they love me, that they care and that they’re here for me. So now I’m broken…………..”

The quote above is written by a girl on social media, as a comment to a video about childhood maltreatment. Childhood maltreatment remains a social concern around the world, with previous studies showing a global prevalence between 3% and 31% (Barth et al., 2013).

Childhood maltreatment can include sexual, physical, and emotional abuse, as well as emotional and physical neglect (Dannlowski et al., 2000). Childhood maltreatment can have long-term adverse consequences for psychological well-being. It is one of the most significant risk factors for re-victimization, such that around 50% of people with traumatic childhood experiences have reported further cases of abuse in adulthood (Walker et al., 2017).

Why does victimization happen over and over again?

This topic has received increasingly more attention over the last decades, and researchers have tried to explore the factors that make people with a history of childhood maltreatment vulnerable to further victimization later in life. Research has shown that a variety of factors are involved, and it is not possible to attribute such a vulnerability to one or two risk factors. Three important risk factors associated with re-victimization will be discussed here: risk detection, emotion regulation, and self-destructive behaviors.

Are re-victimized individuals hyper- or hypo-sensitive to cues signaling threat in their everyday life?

As the ability to detect risks in a relational context is one of the most significant factors determining how people may respond to ambiguous social interactions (Messman-Moore et al., 2006), prior research has focused on risk-detection abilities in re-victimized individuals. One might think that victimized people are vulnerable because they cannot detect risks in their interpersonal relationships, and this hypo-sensitivity is what gets them into trouble, i.e. increases the risk of re-victimization. Indeed, studies have found that re-victimized people are slower in detecting threat than people without such a history (Soler-Baillo, 2005).

However, other studies have shown that re-victimized individuals do not differ significantly from people without a history of re-victimization in their ability to recognize risk (e.g., Chu et al., 2013). Moreover, one might also predict that a hypersensitivity to threat interferes with risk recognition, and with how to respond appropriately to the situation at hand. Thus, when considering the research to date, there are inconsistencies.

Moreover, both cited studies examined risk recognition in a dating scenario. Participants were instructed to indicate when the man in the scenario had gone too far. This means it is not yet known how re-victimized people respond to such a situation in real life.

Does emotion regulation matter?

Throughout the day, we are exposed to many stimuli evoking positive and negative emotions. Emotion regulation abilities determine “which emotions we have, and how we experience, and express these emotions” in response to everyday events (Gross, 2001). Re-victimized people may have limited access to adaptive emotion regulatory strategies, and be more likely to behave impulsively while experiencing negative emotions (Messman-Moore et al., 2013).

However, it is still unclear whether emotion regulation is necessary for modifying only negative emotions, or whether positive emotions also should be regulated. This has also not been studied.

How are emotions and sexual behavior related to re-victimization?

Considering the difficulties with emotion regulation that re-victimized people may have, it is not surprising that self-destructive behaviors such as non-suicidal self-injury and risky sexual behaviors have been related to re-victimization (Noll et al, 2003; Messman-Moore et al. 2010). Sexual behaviors may function as coping strategies for ameliorating negative emotions (Miron et al, 2014). However, having a tendency to behave rashly while experiencing positive emotions, can predict risky sexual behaviors (Zapolski et al, 2009). If re-victimized individuals also have difficulties with regulating positive emotion, this might put them in more risky sexual contexts. This hypothesis needs further study, too.

I started my PhD project in 2018 under the supervision of Dr. Judith Daniels. My project looks at risk factors of re-victimization. I hope that, at the end of my project, I can propose a theory that helps explain how child maltreatment ultimately predicts adult re-victimization. I am specifically interested in finding out how emotion regulation vulnerabilities and self-destructive behaviors interfere with risk recognition, thereby possibly leading to the “being broken” described by the girl quoted at the beginning of this blog post.

References:

Barth, J., Bermetz, L., Heim, E., Trelle, S., & Tonia, T. (2013). The current prevalence of child sexual abuse worldwide: A systematic review and meta-analysis. International Journal of Public Health, 58, 469-483. doi: 10.1007/s00038-012-0426-1

Chu, A. T., DePrince, A. P., & Mauss, I. B. (2014). Exploring revictimization risk in a community sample of sexual assault survivors. Journal of Trauma & Dissociation, 15(3), 319-331. doi:10.1080/15299732.2013.853723

Dannlowski, U., Stuhrmann, A., Beutelmann, V., Zwanzger, P., Lenzen, T., Grotegerd, D., et al. (2012). Limbic scars: Long-term consequences of childhood maltreatment revealed by functional and structural magnetic resonance imaging. Biological Psychiatry, 71(4), 286-293. doi:10.1016/j.biopsych.2011.10.021

Gross, J. J. (2001). Emotion regulation in adulthood: Timing is everything. Current Directions in Psychological Science, 10(6), 214-219. doi:10.1111/1467-8721.00152

Messman-Moore, T. L., Ward, R. M., & Zerubavel, N. (2013). The role of substance use and emotion dysregulation in predicting risk for incapacitated sexual revictimization in women: Results of a prospective investigation. Psychology of Addictive Behaviors, 27(1), 125-132. doi:0.1037/a0031073

Messman-Moore, T. L., Walsh, K. L., & DiLillo, D. (2010). Emotion dysregulation and risky sexual behavior in revictimization. Child Abuse & Neglect, 34(12), 967-976.

Messman-Moore, T. & Brown, A. L. (2006). Risk perception, rape, and sexual revictimization: A prospective study of college women. Psychology of Women Quarterly, 30(2), 159-172. doi:10.1016/j.chiabu.2010.06.004

Noll, J. G., Horowitz, L. A., Bonanno, G. A., Trickett, P. K., & Putnam, F. W. (2003). Revictimization and self-harm in females who experienced childhood sexual abuse: Results from a prospective study. Journal of Interpersonal Violence, 18(12), 1452-1471.

Soler-Baillo, J. M., Marx, B. P., & Sloan, D. M. (2005). The psychophysiological correlates of risk recognition among victims and non-victims of sexual assault. Behaviour Research and Therapy, 43(2), 169-181.

Walker, H. E., Freud, J. S., Ellis, R. A., Fraine, S. M., & Wilson, L. C. (2018). The prevalence of sexual revictimization: A meta-analytic review. Trauma, Violence, & Abuse, in press. doi:10.1177/1524838017692364

Miron, L. R., & Orcutt, H. K. (2014). Pathways from childhood abuse to prospective revictimization: Depression, sex to reduce negative affect, and forecasted sexual behavior. Child Abuse & Neglect, 38 (11), 1848-1859. doi:10.1016/j.chiabu.2014.10.004

Note:

Image by danna § curious tangles licenced under CC BY 2.0.