Behavioral Problems In a Nationally Representative Sample of Sexually Abused Boys: The Moderating Influence of Family and Peer Context

BACKGROUND/PURPOSE: Over the past 20 years a growing body of literature has documented the enduring behavioral and emotional consequences associated with being sexually abused. Longitudinal studies increasingly demonstrate that these problems persist, re-emerge and evolve throughout a child's developmental life course. The complex risk and resilience processes involved when sexual abuse in children occurs presents a considerable challenge to researchers hoping to gain an accurate understanding of the impact of sexual abuse. And when gender is considered, it further muddies the waters. Despite being common, sexual abuse victimization in males remains largely under-reported, under-treated, and under-recognized by researchers, practitioners and the public. Male victims are significantly less likely to disclose sexual abuse; less likely to seek help; less likely to be believed upon disclosure; and more likely than their female counterparts to be blamed and perceived negatively when they do disclose sexual abuse. What impact does sexual abuse have on a boy's behavioral outcomes? What accounts for the variation in these outcomes? Do differing characteristics of the abuse play a role? What influence do family and peer context have on these outcomes? This study addresses many of the methodological limitations and ambiguity present in the prior research on sexually abused boys by elucidating some of the mechanisms that lead to positive and negative behavioral outcomes in a nationally-representative, longitudinal, multi-informant sample of sexually abused boys involved in the child welfare system (N=171).

METHOD: The current study uses data from the National Survey of Child and Adolescent Wellbeing (NSCAW) to examine the influence of cumulative family risk, social skills and peer rejection on long term internalizing and externalizing behavioral problems. Data were collected from youth, caregivers and caseworkers across four waves (baseline; 1½, 3 & 5 yr follow up). Behavioral problems were measured using the Child Behavior Checklist; social skills was measured using the Social Skills Rating System; and peer rejection was measured using the Peer Loneliness & Social Dissatisfaction Questionnaire.

RESULTS: Overall, sexually abused boys in this sample are relatively resilient – with behavioral problems averaging in the normal range across all three waves; approximately 1/5th scored above the clinical threshold. Regression analyses indicated that cumulative family risk confers greater risk for internalizing and externalizing problems over time while social skills had a buffering effect. Cumulative family risk moderated the relationship between severity and increased Wave 3 internalizing and externalizing problems. Peer rejection had a more prominent role in influencing internalizing outcomes. Specifically, peer rejection moderated the co-occurring abuse-internalizing problems relationship and the perpetrator-internalizing problems relationship. Social skills moderated the relationship between severity and behavioral problems. The most consistent pattern of findings for the moderating role of social skills was in the severity-internalizing problems relationship.

CONCLUSIONS/IMPLICATIONS: The findings are consistent with growing body of research underscoring the complex longitudinal relations between internalizing and externalizing problems across development. Future studies should pay closer attention to within group variation across socio-demographic and abuse characteristics and continue to disentangle the underlying mechanisms that contribute to adaptive and maladaptive outcomes for sexually abused boys.