Revictimisation in a sample of 2,759 victims of child sexual abuse: a 44 year follow-up study

Background Child Sexual Abuse (CSA) is recognised as a significant problem within today's society. The literature has established that individuals who have been sexually abused as children may be at an increased risk for revictimisation throughout their life. The primary aim of this study was to examine the relationship between CSA and subsequent revictimisation. This investigation included determining if the severity of the CSA affected the rate of revictimisation, if the age of the child during the initial sexual abusive experience affected the rate of revictimisation, and to determine if there is a mediating role between CSA and mental illness. Method The study utilised a prospective design. The forensic medical records of sexually abused children were obtained from the Office of Forensic Medicine (OFM), a state-wide forensic medical service, on children who had been medically confirmed to have experienced sexual abuse (n=2,759) between the years 1964 and 1995. These records were linked to the Victorian Police Law Enforcement Assistance Program (LEAP) and the public mental health database (RAPID) for a follow-up period of 44 years. The victims were compared to similarly aged peers obtained randomly from the Australian Electoral Commission (n=2,677). Results The individuals from the CSA cohort were more likely (OR = 1.4, 95% CI, 1.26-1.56) to have had contact with the Victorian Police, more likely (OR = 1.14, 95% CI, 1.02-1.27) to be revictimised and more likely (OR = 5.3, 95% CI, 3.79-7.41) to be sexual revictimised than the individuals from the general population. The CSA victims were divided into pre-pubertal (<12 yrs.) or post-pubertal (>12 yrs.) categories. The pre-pubertal group had significantly more contact (618, 39.7%) with the Victorian Police than did the post-pubertal group (382, 31.8%) and were significantly more likely to be revictimised in the form of sexual assault and violence. When examining by gender, the males were more likely to be revictimised if they were initially sexually abused post-pubertal (OR = 1.45, 95% CI 1.02-2.07) while the females were more likely (OR = 1.6, 95% CI 1.35-1.92) to be revictimised if they were sexually abused pre-pubertal. No significant difference was observed between the level of severity of the initial abuse and the rate of revictimisation. Almost one quarter (23%) of the CSA victims had had contact with the public mental system during the course of their lifetime compared to 7.7 percent from the general population, revealing that victims of CSA were over 3.5 times more likely to have mental health issues. These mental health issues were observed to have an influence on increasing the level of vulnerability to revictimisation. Rates of alcohol and drug use and self-harm and suicide were all higher within the CSA victim population. Conclusions This study confirmed many of the established relationships already seen between CSA and revictimisation. Mental illness was revealed to be a moderating variable for sexual revictimisation; the victim’s age at the time of the initial sexual abuse played a significant role in the level of vulnerability of revictimisation; and, surprisingly, the level of the severity of the abuse did not have a significant association with the rate of revictimisation. Overall, CSA was shown to play a substantial role in an individual's vulnerability for being subsequently victimised; however, the question remains whether the relationship between CSA and revictimisation is necessarily causal.