LONDON (Reuters Health) Aug 09 - Women who were physically or sexually abused as children have a substantially increased risk of revictimisation in adulthood, UK researchers report in the August 11th issue of The Lancet.

Past research has shown an increased risk of victimisation in adulthood for women who were physically and sexually abused as children. However, this research concentrated on sexual revictimisation and did not include data on other types of abuse or on the prevalence of revictimisation, Dr. Jeremy Coid from St. Bartholomew's Hospital, London, and colleagues note.

In a cross-sectional survey, Dr. Coid's group evaluated data collected on 1207 women attending general medical practices in east London. Women were asked about physical and sexual abuse in childhood and about domestic violence, rape, assault and other traumatic experiences in adulthood.

Dr. Coid and colleagues found that childhood abuse was independently associated with adult abuse and trauma. Women who had unwanted sexual intercourse when they were 16 years of age or younger had an increased risk of domestic violence as adults (adjusted odds ratio 3.54), as were those who had been severely beaten more than once (adjusted odd ratio 3.58).

In addition, women who had unwanted sexual intercourse as children had an increased risk of rape as adults (adjusted odds ratio 2.84), as were those who had been severely beaten (adjusted odds ratio 2.70). Women who had been beaten as children were also at increased risk for other traumatic events as adults (adjusted odds ratio 3.85).

"We have confirmed that experiences of abuse do not occur in isolation; women who had unwanted sexual intercourse in childhood were likely to experience other forms of unwanted sexual activity, and the occurrence of either of these increased their risk of physical abuse," Dr. Coid's group writes.

"We need to investigate therapeutic interventions for girls and young women who have experienced childhood abuse and are at risk of abuse in adulthood, as well as studies with women who have already experienced revictimisation," the researchers advise.

"The cycle of neglect with respect to the present state of research, education, and practice in the field of family violence helps perpetuate the cycle of violence that Coid and colleagues' research reveals," Dr. Richard D. Krugman of the University of Colorado School of Medicine in Denver and Dr. Felicia Cohn of the University of California in Irvine comment in a journal editorial.
"Ending both cycles will occur only when the topic of violence is included in the core activities...of academic institutes for health professionals. Government policymakers need not set up any more commissions to study the issue of family violence; rather, they must seek ways to stimulate the interest of the health professions in addressing this problem," Drs. Krugman and Cohn stress.
Lancet 2001;358:434,450-454.