220 Chapter 27
Resilience
How common is it for abused children to be resilient, that is, to develop
normally despite their adverse experiences? Even taking the relatively
conservative criterion of absence of significant problems, few abused
children are classified as resilient. If competencies are measured across a
range of domains, the proportion of resilient children drops still further,
to zero in many studies, although many develop normally in at least some
domains.
Intergenerational transmission
The proportion of abused children who become abusive parents varies
by study, averaging around 30%. While abusive upbringing clearly has a
powerful influence, the worst outcomes are by no means inevitable. Even
among girls brought up in children’s homes because of grossly inadequate
parenting, roughly half went on to provide adequate parenting for their
own children.
Effects of sexual abuse
As with all types of abuse, it can often be difficult to know how much
impairment has stemmed specifically from the sexual abuse, and how
much from the generally disorganised and disordered family background.
Although outcome studies on clinical samples are likely to miss individuals
who were resilient to abusive experiences, they serve to highlight the
damage done and typically show a variety of negative consequences that
often last for many years.
Emotionally, victims often feel guilt and responsibility for the abuse,
especially if they have come to enjoy the sexually arousing experiences.
They may experience a sense of powerlessness in response to their inability
to stop repeated invasions of their body. They may find it impossible
to trust others, especially older people of the perpetrator’s gender. The
trauma of the abuse may lead to sleeplessness, nightmares, loss of appetite,
other somatic complaints and self-destructive behaviour. Frank symptoms
of post-traumatic stress disorder may be present, with intrusive thoughts
relating to the actual abuse process and avoidance of any associated people
and places. Self-esteem is often very low with feelings of disgust, con-
tamination, dirtiness and worthlessness predominating. Helplessness and
hopelessness are frequent, often with an element of anger. The incidence
of depression is considerably raised.
Behaviourally, chronic disobedience, aggression, bullying and antisocial
acts are seen in both sexes following sexual abuse, but especially in boys.
Girls are more prone to self-cutting, burning themselves with cigarettes
and anorectic responses. A proportion of children show inappropriate
sexualised behaviour, including sexual contact or play with other adults or
children and seductive behaviour towards relative strangers, for example,
staff in residential establishments or in-patient units. There may be persis-
tent overt masturbation in public. As they grow up, a number are drawn
to prostitution. Boys who experienced homosexual abuse commonly show