Academic journal article
By Buzi, Ruth S.; Tortolero, Susan R.; Roberts, Robert E.; Ross, Michael W.; Markham, Christine M.; Fleschler, Melissa
Journal of School Health , Vol. 73, No. 5
Tortolero, Susan R.
Roberts, Robert E.
Ross, Michael W.
Markham, Christine M.
An estimated 7% to 53% of American women, and 3% to 37% of American men, have been victims of a coercive sexual experience during childhood or adolescence. (1) Estimates of prevalence vary greatly, depending on the sample and definition of abuse used in the study. A coercive sexual experience during childhood and adolescence has been associated with a broad spectrum of poor mental health outcomes and linked to depression, (2) suicidal ideation or attempts, (3) antisocial behavior, (4) sexual risk behaviors, (5-7) and alcohol and other substance use. (8)
Some studies found gender differences in the patterns of psychological symptoms as a result of a coercive sexual experience. For example, a study of 370 males and 2,681 females in the Adolescent Health Survey found that female adolescents with a history of sexual abuse more likely than male adolescents to engage in internalizing behaviors such as suicidal ideation and behavior, depression, and disordered eating. (9) Male adolescents with a history of sexual abuse faced higher risk than females for poor school performance, delinquent activities, sexual risk-taking behavior, and frequent and extreme use of alcohol and marijuana.
Similarly, in the Netherlands, 745 students in secondary schools who reported a history of sexual abuse were compared on a variety of emotional and behavioral problems to a matched control group who did not report such a history. (10) No differences occurred between females and males with regard to an increase in emotional problems such as loneliness, anxiety, low self-esteem, and depression as a result of a sexual abuse experience. However, differences occurred with regard to behavioral problems. The experience of sexual abuse led to more consequences for boys than for girls regarding use of alcohol, aggressive/ criminal behavior, use of drugs, and amount of truancy.
The greater tendency of females to report mainly internalizing symptoms is not a consistent finding. For example, the Vermont Youth Risk Behavior Survey of 7,884 sexually active students in eighth- through 12th-grade in 79 public schools found that females forced or pressured to have sex demonstrated externalizing behaviors. (11) They were almost twice as likely to get into physical fights in the past year, report more years of sexual activity, and not use a condom at last sexual intercourse. Males with a history of sexual abuse exhibited internalizing behaviors such as bulimia and suicide. They were more than three times as likely to report having vomited or using laxatives, and twice as likely to consider suicide as nonabused males.
Little research exists regarding gender differences in psychological outcomes as a result of a sexual abuse experience. (12) Therefore, researchers recognize that more research should focus on gender-specific effects associated with sexual abuse. (13) Moreover, existing research focused predominantly on females or used clinical samples. (14) One setting where studies of high-risk behaviors are lacking is dropout prevention/recovery schools. (15-17) Nationwide, alternative high schools serve approximately 280,000 students expelled from their regular high school for problems such as excessive tardiness, truancy, and failing classes. (15) Findings from several studies have suggested that adolescents who attend these schools constitute a high-risk group. (15-17) Since these students engage in high-risk behaviors, it would be important to examine whether these behaviors relate to a history of sexual abuse. Increasing understanding of factors associated with high-risk behaviors can assist efforts to predict and prevent mental health problems for this population. Also, understanding gender-specific patterns of risk behavior suggest important implications for screening adolescents for a history of forced or pressured sex. This study sought to determine the prevalence of forced sexual experience in a sample of female and male adolescents who attend alternative schools, and to examine possible gender differences in the prevalence of select internalizing and externalizing problems for males and females who report a history of forced sexual experience. …