A UK study published in this week's issue of THE LANCET confirms that maltreatment and revictimisation of children and women are not rare problems, and identifies factors that are specifically associated with specific types of revictimisation in adulthood.
Previous research has shown that women who are physically and sexually abused in childhood are at an increased risk of victimisation in adulthood. However, research has concentrated on sexual revictimisation, and has neither included investigation of other abusive experiences, nor examination of prevalence and effects of abuse on adult revictimisation. Jeremy Coid and colleagues from St Bartholomew’s Hospital, London, UK, examined the relation between childhood trauma and adult revictimisation using a cross-sectional survey of women attending primary care general practices in Hackney, east London.
Around 1200 women were recruited and completed a self-administered questionnaire, which included questions about physical and sexual abuse in childhood, domestic violence, rape, indecent assault, and other traumatic experiences in adulthood. Abusive experiences co-occurred in both childhood and adulthood; repetition and severity of childhood abuse were independently associated with specific types of adult revictimisation. Women who had experienced unwanted sexual intercourse in childhood, for example, were around three times more likely to experience domestic violence or rape in adulthood. Physical abuse was also associated with abuse in later life; severe childhood beatings by parents or carers were linked to domestic violence in adulthood, and with rape and other trauma. The investigators conclude that the identification of women who have undergone childhood abuse is essential for the prevention of further abuse.
In an accompanying Commentary (p 434), Richard Krugman from the University of Colorado and Felicia Cohn from the University of California, Irvine, USA, conclude: "The cycle of neglect with respect to the present state of research, education, and practice in the field of family violence helps perpetuate the cycle of violence that Coid and colleagues’ research reveals. Ending both cycles will occur only when the topic of violence is included in the core activities-research, education, and clinical care-of academic institutes for health professionals. Government policymakers need not set up any more commissions to study the issue of family violence; rather, they must seek ways to stimulate the interest of the health professions in addressing this problem."
Contact: Professor Jeremy Coid, Forensic Psychiatry Research Unit, St Bartholomew's Hospital, William Harvey House,61 Batholomew Close,London,EC1A 7BE,UK;T) 44-20-7601-8138;F) 44-20-7601-7969; E)j.w.coid@mds.qmw.ac.uk
Dr Richard Krugman, University of Colorado School of Medicine, Room 1803F Campus Box C290,Denver,CO-80262,USA;T) 1-303-315-7563;F) 1-303-315-8494;E) richard.krugman@uchsc.edu
Journal
The Lancet