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RE: child victims of abuse becoming perpetrators
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<DIV><FONT face=Arial color=#0000ff size=2><SPAN class=856420918-22102001>Some
colleagues and I recently completed a chapter addressing this question and
related questions for the upcoming APSAC Handbook on Child Maltreatment.
Our conclusion was that the victim-to-victimizer cycle (aka "the vampire
theory") is not well supported as a major explanation for sexually abusive
behavior, nor does it appear to be a uniquely powerful risk factor,
although it may be a factor in some individual cases and may be more of a factor
for young children than for older children, adolescents or adults.
Although not without foundation, it is in large part "clinical lore"
which has taken on a life of its own and has become a sort of conventional
wisdom, disembodied from empirical support. Frankly, we "invented" this
victim-to-victimizer idea (and reified it in our clinical practice) in part
for political reasons (to make people see sex offenders as deserving of
treatment because they are "victim/offenders") and in part based on what we knew
about physical abuse where the connection is a bit more robust. In short,
I think the three big factual problems with the victim-to-victimizer cycle idea
in sexual abuse are:</SPAN></FONT></DIV>
<DIV><FONT face=Arial color=#0000ff size=2><SPAN
class=856420918-22102001></SPAN></FONT> </DIV>
<DIV><FONT face=Arial color=#0000ff size=2><SPAN
class=856420918-22102001> 1) the victim-to-victimizer notion
is based largely on retrospective self-report data from questionable sources
(e.g., incarcerated sex offenders) who have potential motives to fabricate for
exculpatory benefit. This is supported by two studies now which find that
retrospective self-reports of sexual abuse history in this population are
dramatically lower when polygraph confirmation is
used. </SPAN></FONT><FONT face=Arial color=#0000ff size=2><SPAN
class=856420918-22102001>
</SPAN></FONT></DIV>
<DIV><FONT face=Arial color=#0000ff size=2><SPAN
class=856420918-22102001> 2) aside from incarcerated or
residentially placed populations (where substantial percentages of inmates were
abused regardless or their reason for being an inmate), the overall
retrospective rate of CSA history is modest among most sex offender
groups--around 25% for adolescent and adult sex abuser populations in larger,
broader or meta-analytic studies. The retrospective rate does appear to be
higher for children with sexual behavior problems and may be inversely related
to age and/or may be related to referral source (of course, almost all CPS
referred kids are abused--duh). However, it is important to note that
"children with sexual behavior problems" are a diverse group and this behavior
may include inappropriate masturbation, etc. and is not limited to sexually
abusive behaviors. The connection between childhood abuse a later abusive
behavior may well fade over time and become less and less relevant as people
develop, just like the symptoms experienced by sexually abused children tend to
fade over time for many kids. Young children may be responding to a
variety of models for their behavior, and engaging in the behavior for a variety
of reasons, not all or even most of them traumagenic or abuse
reactive.</SPAN></FONT></DIV>
<DIV><FONT face=Arial color=#0000ff size=2><SPAN
class=856420918-22102001></SPAN></FONT><FONT face=Arial color=#0000ff
size=2><SPAN class=856420918-22102001> 3) risk factors are
really properly examined using prospective data, not retrospective. The
currently available prospective data, although limited, suggests two
things: first, as Bill suggested, the number of people in the resilient
group is bigger (actually a LOT bigger), and second, that sexual abuse
history is a modest factor and certainly is not uniquely powerful in generating
later sexually abusive behavior. In fact, the links with physical abuse or
neglect may be stronger, as are the links with other factors (e.g. family
factors, history of pre-existing behavior or conduct problems, etc.), and this
is true both for abused children followed prospectively for sexual behavior
problems, and in prospective studies for adult sex crimes outcomes.
</SPAN></FONT></DIV>
<DIV><FONT face=Arial color=#0000ff size=2><SPAN
class=856420918-22102001></SPAN></FONT> </DIV>
<DIV><FONT face=Arial color=#0000ff size=2><SPAN
class=856420918-22102001></SPAN></FONT> </DIV>
<DIV><FONT face=Arial color=#0000ff size=2><SPAN class=856420918-22102001><FONT
face=Arial size=2>Mark Chaffin, Ph.D.</FONT> <BR><FONT face=Arial size=2>Center
on Child Abuse and Neglect</FONT> <BR><FONT face=Arial size=2>University of
Oklahoma Health Sciences Center</FONT> <BR><FONT face=Arial size=2>P.O. Box
26901; CHO 3406</FONT> <BR><FONT face=Arial size=2>Oklahoma City, OK
73190</FONT> <BR><FONT face=Arial size=2>(405) 271-8858; fax 271-2931</FONT>
<BR><FONT face=Arial size=2>mark-chaffin@ouhsc.edu</FONT> </DIV>
<DIV> </SPAN></FONT></DIV>
<DIV><FONT face=Arial color=#0000ff size=2><SPAN
class=856420918-22102001> </SPAN></FONT></DIV></BODY></HTML>
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From: Charles Gene Lyle 266-4317 <LYLE@a1.rcdp.gov>
To: Child Maltreatment Researchers <CHILD-MALTREATMENT-RESEARCH-L@cornell.edu>
Subject: Primary vs Secondary Prevention
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Robert Caldwell in his posting re: Parents Anonymous and the
definitions of prevention provides technical definitions of both
Primary and Secondary prevention, and, in a more limited fashion,
Tertiary prevention. His posting caused me to give some thought to why
his definitions (I realize they are not actually "his" but are
apparently those accepted in the field. If a citation could be
provided, I think that would be helpful) seem to differ from those
cited by Karen Wade in her earlier posting.
I think I understand what some of the confusion may be around this
issue. From my perspective as a researcher and evaluator involved for
many years in child maltreatment services, I think practitioners do
not distinguish between primary, secondary, and tertiary prevention in
the ways the definitions might require. I think "primary" is
interpreted as "first things first" which is to intervene with those
families where maltreatment has actually occurred. Obviously one of
the desired outcomes of this intervention would be to prevent
maltreatment from happening again. In my agency this is basically what
we do by law. Secondary prevention, I think, is often seen as what you
do to assist families who are "at risk" of maltreating their children
but where actual maltreatment is not known to have occurred. Tertiary
prevention is more like the "community education" or "parent
education" process involving families where actual or at-risk
maltreatment is not at issue. It is the most "distant" from actual
case work. In other words, what one might call the lay or practical
perception of these levels of prevention is the inverse of the
technical definitions.
I also have a bit of a problem with the implication that "treatment"
and "prevention" are distinct. They are not when it comes to families
where maltreatment has actually occurred. The process of intervening
in maltreatment includes both, i.e., assure the safety of the child,
make a determination, and work toward preventing future occurrences.
Finally, another minor quibble: insofar as Parents Anonymous may do
public education they can be said to do Primary prevention, using the
technical definitions.
I bring up this matter not to damn the definitions Dr. Caldwell
provides but to show how this confusion can arise. I would be curious
to see what others have to say about this.
Gene Lyle
RCCHSD
Office of Research & Evaluation
lyle@a1.rcdp.gov or lylex002@tc.umn.edu