Summary
Background:
Violence against children is not uncommon and can have serious consequences. Childhood violence is related to problems with health and also to a number of other problems. One of these is an increased risk of exposure to new violence, a phenomenon called revictimization. Research suggests that a number of problems may persist, but there is still much we do not know about the development over time. There is a need for knowledge about the long-term outcomes for the children exposed to violence. In this study, we focused on revictimization, health, alcohol use and relational difficulties in young adults exposed to childhood violence.
This report is based on a study supported by the Ministry of Justice and Public Security and the Ministry of Health and Care services. The report presents findings from two sub-studies under the Violence Programme at The Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS) (Violence and revictimization and Violence and substance use). The framework of the Violence Programme is presented in the Norwegian government report “Preventing and combating violence in close relations. It’s a question of living” (Meld. St. 15, 2012-2013) and “Action plan against violence in close relations: A life without violence” (2014-2017). Many of the findings in this report have previously been published internationally in peer-reviewed scientific journals.
Method:
The study is a continuation of a prevalence study on violence and sexual assault, which NKVTS conducted in 2013. From the 6589 respondents in this study, we selected both persons exposed to violence in childhood and persons of the same sex and age who had not experienced violence in childhood. These were contacted firstly after 12-18 months and then again after 24-31 months. At the second assessment time, 1010 people participated (response rate: 82.6% of those who answered the phone). At the third assessment time, 681 people participated (response rate: 63.0% of those who answered the phone). Participants were 16-33 years old at the first assessment time, with an average age of 21 years. The study is approved by the Regional Committees for Medical and Health Research Ethics (REK).
Results:
This report builds on several scientific articles that have been previously published or are currently under peer review (see the attached list of publications, Appendix 4). We have supplemented this with other analyses that are important in a national context but which were not included in the articles. We reproduce here the main results taken from the four chapters of the report.
Revictimization (new violence):
- One in three of those who had experienced violence in childhood reported having been subjected to new violence after a period of 12–18 months. After three years (at the third assessment time), 39.4% of those who had experienced violence in childhood reported that they had been revictimized.
- Childhood violence was related to the risk of being exposed to all types of violence as an adult. The risk of new violence was not confined to the type of violence that occurred in childhood.
- The risk of new experiences of violence was related to having been exposed to several types of violence, both at the same time and throughout the life cycle, frequent alcohol intoxication, social marginalization and feelings of shame.
- Good social support was a protective factor against revictimization.
Health:
- Those who had experienced violence in childhood had a higher level of mental health problems in adulthood, both in terms of anxiety/depression symptoms and post-traumatic stress, than those who had not experienced violence in childhood.
- The more types of violence one had experienced in childhood, the higher the level of mental health problems in adulthood.
- Revictimization seemed to further exacerbate the mental health problems of those who had experienced violence in childhood.
- Suicide attempts and self-harming behaviours occurred more frequently in those exposed to violence in childhood compared with those not exposed. Among those who had experienced three different types of violence in childhood, over half reported that they had harmed themselves or attempted to take their own lives. In those who were revictimized, there was a particularly high incidence of attempted suicide and self-harming behaviours.
- There was also a clear relationship between exposure to violence in childhood and physical health problems.
Alcohol intoxication:
- In the case of sexual assault in adulthood, it was common that both the victim and the offender were intoxicated during the assault.
- Among those who had experienced sexual assault in the past year, there was no difference between victims of assault involving alcohol intoxication and victims of assault not involving alcohol intoxication in terms of health and functioning.
- Those exposed to violence in childhood were more frequently intoxicated at a young age than those not exposed, and the frequency of alcohol intoxication was related to later revictimization.
- It was more common among those who had experienced violence in childhood to report problematic drinking behaviour, such as experiencing one’s own alcohol use as damaging to social relationships, health or personal safety. For example, 21% of victims of violence reported that they felt that drinking is damaging to their health.
- Victims who had been revictimized, who had a dysfunctional social network and poorer social support, were at greater risk of developing problematic drinking behaviour.
Social relationships:
- Those who had experienced violence in childhood reported that they had poorer family cohesion while growing up and lower social support in adulthood. They experienced more loneliness, had more barriers to seeking social support, more often experienced being let down by others and were more likely to have been bullied compared to those who had not experienced violence in childhood.
- For victims of violence, two factors were particularly central to social relationships: experiencing that others distanced themselves after what had happened and worrying too much about what others thought of them after what had happened.
- Many of the victims of violence felt shame about what had happened. For example, 44% reported that they had worried about what others might think about them after what happened, and 48% reported that they had attempted to conceal some of what happened.
- Many of the victims had experienced bullying. Bullying was related to problems with health and psychosocial adjustment, and much of the effect was mediated by shame.
- A significant part of the relationship between shame and health problems can be explained by loneliness.
Conclusions
We found that children exposed to violence are not sufficiently protected against new violence in young adulthood. The more violence the victims have experienced, the higher was the risk of being subjected to new violence, the poorer were health outcomes and the more problems were found in social relationships. Those who had been revictimized reported more problems with health than those who experienced violence only in childhood and not in adulthood.
While many of the children exposed to violence are doing well, childhood violence is associated with increased vulnerability to negative development in a number of areas. This vulnerability lasts into adulthood. In addition to physical and mental health, this vulnerability also applies to social relationships and use of alcohol. Violence in childhood is related to problematic alcohol use, and some patterns of alcohol use increase the risk of new violence.
The results also suggest that violence in childhood can have a major impact on social relationships. Victims of violence feel more often let down by others, have lower social support and feel more lonely. Relationship problems increase the vulnerability of the victims. This means that they are less protected and more susceptible to new violence, alcohol problems and poor health. Shame related to experiencing violence seems to be of particular importance to later development in terms of health, revictimization and social relationships.
Although the childhood violence may belong to the past, these findings emphasize that the consequences can be complex and lasting. There is a need for prevention in many areas and at various levels to prevent negative development in children and adolescents who have experienced violence in childhood. There is also a need for more knowledge about how violence affects social relationships and on how societal changes are needed to reduce shame following violence.