Sexual Health

6. Sexual abuse

6.5. Victims and long-lasting harm

Photo: G. H. Lunde

It varies how a victim is harmed and reacts to abuse. Several different factors play a role, such as when and where abuse happened, who committed the abuse, how often, for how long and in what settings. Some people are more robust and others more vulnerable. 

There is a lack of research on how PWID react on sexual abuse (15). There is also insufficient research on what kind of treatment and follow-up different PWID need. We do not currently know what is best for PWID, but the main goal is to help victims to have a good life and healthy sexual relations (15). Cognitive behavioural therapy and psyho-education can be beneficial to people with ID (15). There are few sources of best-practice in literature (3, 4, 15, 16). Preventive measures must be adapted to the person concerned, and the reasons for the action.

Video: Abuse of people with ID by pedagogy and sexologist Wenche Fjeld   (Video from online study Seksuell helse og seksualitetsundervisning Oslo Metropolitan UniversityVUNDS6100)

 

 

People, who are victims of sexual abuse can behave differently from before. Some changes can be short-lived, others can be long-lasting.  There is a huge variation in expression or ways in which someone who is violated will process harm of their personal space and react on it. Sometimes the victim search for a more human contact or search for isolation. It may happen that they become more promiscuous or withdraw from close contact with others. Some may find it difficult to concentrate.  Others will change behaviour and become more hyperactive, or more passive. Some develop aggressive traits, other become more self-destructive. Some will smile all the time, while others are always sad when interacting with other humans (13, 16). 

A reaction caused by experiencing trauma may decrease over time. However, for some, they can be permanent.  

Immediately after the abuse, symptoms of post-traumatic stress syndrome (PTSS) may arise. PTSS has four main elements: the resurrection of the trauma (shaped as intrusive memories, pictures, flashbacks); avoidance (trying to avoid everything that reminds them of the trauma); numbness and depression; hyperactivity (irritability, explosive anger, being alert all the time, concentration difficulty, difficulty in sleeping) (15).

Sexual abuse may have serious consequences for PWID. Some develop PTSS, others may need higher doses of medicine after the abuse (15). Three months after the incident, half of the victims will have the same symptoms. Those with permanent symptoms need therapy. About 20-44% of children abused have no symptoms or adaptation difficulties in adulthood. It is a complex issue where the harm done due to abuse depends on several factors.  

Harm after long-term abuse depends on many factors, such as (15): 

                □ Age at time of abuse

                □ The extent of time the abuse took place

                □ Earlier experiences

                □ General family relationships

                □ Who is the abuser, how many abusers

                □ Use of violence/ threats

                □ The nature of the abuse

                □ The scope of help and support in connection with the disclosure

                 

Common signs of long-term harm (15): 

                □ Strong sense of guilt and shame

                □ Negative self-image

                □ Fail to trust others

                □ Isolation

                □ Sexual problems

                □ Feeling like a pervert

                □ Afraid of losing your mind

                □ Strong need for control

                □ Problems to relate to your own gender

                □ Pains and aches 

                □ Psychosomatic symptoms

                □ Anxiety (phobia, breathing difficulty, nausea, fear of GPs/ dentist)

                □ Avoiding to be close to others

                □ Self-harming

                □ Depression

                □ Problems with food/ eating disorders

                □ Hallucinations

                □ Sleeping disorders

                □ Feelings of being dirty, nasty, broken

                □ Trivialising abuse

                □ Trouble defining your own limits 

                □ Self-destructive behaviour

                □ Suicidal tendencies

                □ Wishing to disappear

                □ A tendency to become a victim again

                □ Development of abusive and aggressive, conflict-prone behavioural pattern

                □ Posttraumatic stress syndrome (PTSS)

                □ Dissociative disorder

ACTIVITIES:

• Look at the list of common signs/behaviour after long-term harm and compare these signs to behaviour of PWID you know… Do you find some signs you think may be interpreted as part of the persons ID?*
• Discuss with colleagues/cooperation partners about your discovery* and find out what you can do to avoid wrong interpretation of signs on abuse.
• Consider what you can do to help your child/ a person with ID to feel fine after an abuse… see yourself in cooperation with other professionals that also provide support/treatments.