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Sexual vs. physical abuse

According to public opinion, sexual abuse seems to be much worse than every other type of abuse. In almost all Western countries we have much higher penalties against sexual abuse in comparison with physical violence.

Is this opinion justified by scientific results? It seems, not. Unfortunately, other types of abuse (psychological, verbal) and neglect are often ignored. But there is already a large number of studies which consider as sexual, as physical abuse. Not to consider the other types of abuse remain to be a failure, nonetheless, these studies already provide more information than "pure" sexual abuse studies. And this information is very interesting - it shows that the impact of physical and sexual abuse is comparable.

Correlation between sexual and physical abuse

This seems widely accepted, that's why only some examples: Brown & Anderson 1991 have found 9% sexual abuse, 10% physical abuse, but 3% (instead of 0.9%) for combined abuse. Richter-Appelt 1994 have found 25% sexual abuse, 26% physical abuse, but 12% (instead of 6.5%) combined abuse.

Highest impact for combined abuse

Combined (sexual and physical) abuse is not only more common, but has usually much more negative impact as may be expected by adding the effects of sexual and physical abuse alone. (cf. Richter-Appelt 1994)

High correlation of combined abuse with other abuse and neglect

An explanation of the greater impact of combined abuse may be third factors: emotional and verbal abuse, physical and emotional neglect have the same property - an association with above types of abuse, but an especially high association with combined abuse. (cf. Richter-Appelt 1994)

Qualitative comparison of the effects of sexual vs. physical abuse

The studies we have considered here we have found using various sources, especially Medline research with various keywords (sexual abuse, physical abuse, verbal abuse). This is yet only a raw overview, because for many of the Medline research results I have seen yet only the abstract. In any way, you have the possibility to follow the links and judge yourself, if the raw classification given here is justified.

Studies where sexual abuse causes less impact compared with physical abuse

Studies where physical and sexual abuse seem to be comparable

Without consideration of other maltreatment types, the influence of physical and sexual abuse on adjustment seems to be of the same order. That means, sexual abuse and physical abuse are mentioned in the almost the same way, or above are mentioned as significant. Usually other types of maltreatment are not considered in these studies.

Studies where sexual abuse is more important

Of special interest are, of course, studies which are not in agreement with our hypothesis. Until now, we have found 5 of them.

(Guzder 1996 compares two groups with high functional impairment.)

Studies where only physical abuse is considered

Discussion

Among the studies which mention as physical, as sexual abuse, we have found ten where physical abuse is more importand, vs. five where sexual abuse is more important. The studies usually consider different types of impact, only for dissociation (2:1). where is a conflict. To resolve this conflict, a comparison of quality seems sufficient. We have two studies with sample sizes N=1028 N=1377 where physical abuse seems more important vs. a single study with N=86 which has found sexual abuse more important. In this comparison, it seems reasonable to ignore the last.

Another study Toomey et al. 1993 with N=36 subjects without control group may be ignored too. After this, there are only two domains where sexual abuse seems more important than physical abuse: suicidality of women and prostitution.

Instead, there is evidence that in general, as well as in various special domains like alcoholism, drug abuse, adult sexual assault, school problems, dissociation, bulimia nervosa, anorexia nervosa, suicidality of men, panic disorders, depression, anxiety and somatisation, physical abuse has a greater association with negative impact.