Psychological well being impacts of sexual violence in older adults: a qualitative examine

Sexual violence is prevalent the world over with roughly 30-35% of ladies and 10-27% of males experiencing sexual violence a minimum of as soon as of their lifetime (McLean, 2013; Krahe et al., 2015; WHO, 2013). Sexual violence can have vital impacts on each bodily and psychological well being (e.g., Jina & Thomas, 2013; Stein & Barrett-Connor, 2000; Tarzia et al., 2017; 2018). Nevertheless, the expertise of sexual violence is under-researched in older adults, with most proof specializing in kids, adolescents and adults of working age.

One instance of sexual violence traditionally being ignored in older adults is the exclusion of older adults within the Crime Survey for England and Wales, the supply of official violence statistics in England and Wales (Workplace for Nationwide Statistics, 2021), resulting in a niche in our understanding of the expertise of violence and abuse on this age group. This can be exacerbated by boundaries to disclosure, together with disgrace and guilt, perceptions of sexual violence being socially taboo, issues about being believed, beliefs that they don’t match the perceived sufferer stereotype, and denial (Donne et al., 2018; Goldblatt et al., 2022; Orchowski et al., 2022; Pijlman et al., 2023; Ullman & Relyea 2016).

Collectively, because of this our understanding of the psychological well being impacts of such experiences on this age group is just not very properly understood. In 2024, Fadeeva and colleagues demonstrated that older adults who had skilled violence previously yr had been extra more likely to dwell with a typical psychological dysfunction than older adults who had not skilled violence (26.4% versus 10.2%), demonstrating the hyperlink between violence and psychological well being points on this age group (Fadeeva et al., 2024; see Carlisle 2024 for an outline). Different quantitative research have equally discovered associations between sexual violence in older adults and PTSD (Prepare dinner et al., 2011; Nobels et al., 2023), melancholy and nervousness (Prepare dinner et al., 2013) and power sickness and/or incapacity (Nobels et a., 2023).

Nobels et al., (2024) aimed to contribute to this subject by conducting the first qualitative examine to discover the self-perceived psychological well being influence of lifetime sexual victimisation in older victims.

Most analysis on sexual violence victimisation tends to deal with younger individuals or individuals of working age. We don’t but know what the impacts of sexual victimisation are for older adults.

Strategies

Fifteen older adults (outlined as these aged 70 years or older) who had skilled sexual victimisation sooner or later of their lives had been invited to participate in in-depth interviews. Interviews ranged from 15-111 minutes. Individuals had been predominantly feminine (n=12), heterosexual (n=14), and community-dwelling (n=14), with a imply age of 77 (SD 3.9 years, vary 71-85 years). Fourteen contributors had skilled sexual harassment, twelve had experi­enced sexual abuse, and 9 had skilled (tried) rape throughout their lifetime. Two had encountered some type of sexual violence within the yr previous to the examine.

Interviews passed off primarily on-line or over phone and adopted a structured matter information, which requested about seven key matters: conceptualising sexual violence, experiences of sexual violence, perceived elements contributing to victimisation, penalties of sexual violence, methods for coping and searching for assist, results on familial and peer relationships, transgenerational influence, and solutions for prevention and assist providers following sexual victimisation.

Interviews had been audio recorded and analysed utilizing thematic evaluation in line with Braun and Clarke (2006), utilizing a mixture of deductive and inductive coding.

Outcomes

Evaluation resulted in six key themes:

1. Hurtful recollection – Individuals described detrimental feelings when recalling sexual violence experiences, and lots of felt that the expertise remained continually current within the background. Particular triggers included going to areas the place the violence occurred, sexual activity, or information tales of comparable occasions.
2. Many contributors skilled nervousness within the type of both avoidance or hypervigilance. Avoidance manifested within the type of avoiding particular locations, conditions and folks, in addition to particular ideas or conversations and when not attainable resulted in excessive misery. Hypervigilance led to feeling continually on guard and alert to ones’ environment, significantly when strolling or biking at evening.
3. Individuals reported experiencing intense emotions of guilt and disgrace all through their lives, typically preserving their experiences of sexual violence a secret. This additionally impacted their sense of id, resulting in emotions of disappointment in themselves, worthlessness, and low self-confidence.
4. Influence on interpersonal relationships – Some contributors felt anger in direction of their family members, significantly in the event that they weren’t believed, resulting in emotional distance and mistrust. There was additionally a way of normal mistrust, associated to the necessity to keep on guard. This generally led to loneliness and isolation.
5. It was okay – Whereas many contributors described a variety of psychological well being impacts of their experiences, most reported no long-lasting influence of sexual violence, and didn’t affiliate one with the opposite. Individuals didn’t appear to recognise these contradictions, which can be a real absence of long-lasting psychological well being impacts, a coping mechanism, or acceptance.
6. Some contributors reported posttraumatic progress that emerged from their experiences, resembling satisfaction for stopping the sexual violence, elevated empathy for others, and strengthened resilience. Different examples of constructive impacts included being extra assertive, creating a stronger sense of self-worth, and being extra vital or much less naïve.

Older adults didn’t are likely to affiliate psychological well being difficulties with their expertise of sexual violence, reporting no long-lasting influence of the trauma.

Conclusions

This examine is the primary to qualitatively assess the influence of sexual violence on psychological well being in older adults. The authors concluded that:

many older victims report psychological well being challenges, together with anxiety-related signs, profound emotions of guilt and disgrace, which continuously result in a disrupted sense of id, and elevated mistrust towards oth­ers.

Older adults generally have issue articulating the direct influence of their experiences on their psychological well being or relationships, and this can be associated to avoidance associated coping methods, or an issue in seeing themselves as victims.

Many contributors discovered it troublesome to speak about their experiences, which can be reflective of the time these adults grew up in, the place sexuality was seen as taboo, sufferer blaming was widespread, and males had been inspired to be robust and “man up”.

Older adults discovered it troublesome to speak about their experiences of sexual violence which can be reflective of the time these adults grew up in, the place sexuality was seen as taboo and sufferer blaming was widespread.

Strengths and limitations

This is a crucial examine, addressing a transparent hole within the proof by shedding mild on the experiences of an often-overlooked group. In doing so, this paper provides this subset of sexual violence victims a voice, one thing that many could have been beforehand unable to do.

The authors are clear about their analysis goals, and use applicable methodology, which is properly described and justified, to deal with these. Given the delicate nature of the subject of the analysis, the authors took moral issues into consideration, guaranteeing that contributors had been comfy with the method and had assist afterwards if wanted. Additionally they used an applicable and pragmatic strategy to recruitment, figuring out potential contributors who had been already collaborating in certainly one of two current research on sexual violence in older adults. This strategy was delicate and unobtrusive, and a great way to establish those that could also be much less more likely to entry or reply to different recruitment methods (e.g., social media commercials). Lastly, the evaluation seems to be rigorous and findings are express, though there might be extra info supplied on the evaluation course of resembling how the chosen quotes had been chosen.

Nevertheless, the authors didn’t appear to think about the connection between the researcher and contributors, and didn’t focus on reflexivity or consideration of the affect or influence of the researcher on the analysis course of and findings. Moreover, the authors acknowledge that, as the vast majority of interview contributors had been feminine, outcomes are restricted by way of their generalisability to male victims of sexual violence, and are usually not probably consultant given proof suggesting that just about one in three older males (aged 70 and above) had skilled sexual victimization of their lifetime (Nobels et al., 2021).

Nearly all of contributors on this examine had been feminine – what concerning the experiences of male older adults who’ve skilled sexual violence?

Implications for follow

This examine has a number of key takeaways for healthcare professionals:

1. Whereas a minority of contributors had skilled sexual violence in older grownup age, most mentioned psychological well being and interpersonal challenges of their previous experiences that continued over time into older age. Subsequently, healthcare professionals want to pay attention to and look out for indicators of doubtless unresolved and chronic trauma.

2. Regardless of reporting signs in line with trauma and different psychological well being and interpersonal challenges, older adults who’ve skilled sexual violence could really feel disgrace, guilt and a normal mistrust of others. Collectively, these could act as boundaries to searching for assist for these challenges. The authors advocate routine enquiry about sexual violence to establish those that could profit from therapeutic assist. Additionally they advocate doing so in a delicate, trauma-informed means, to construct belief and create secure areas for disclosure.

3. Additional, healthcare professionals ought to recognise and respect any boundaries asserted by this affected person group, which can replicate post-traumatic progress and be key to attaining belief.

4. Healthcare professionals could profit from the event of specialized screening instruments for trauma in older adults to facilitate the identification of sexual violence victims in a structured and delicate means. This might be paired with protocols for age-appropriate referral routes for assist, and specialised coaching in sexual violence throughout the lifespan.

Moreover, the authors establish a number of avenues for additional analysis, together with:

1. Understanding males’s experiences of sexual violence particularly. The authors recognised the limitation of their largely feminine pattern and recognized addressing this as a future avenue for analysis.

2. Exploring the experiences of older adults with cognitive impairments or different vulnerabilities. Whereas this proof hole is probably not attainable to deal with because of moral issues, almost all contributors of the current examine had been neighborhood dwelling, so one potential avenue for additional analysis might be to analyze experiences of adults residing in care properties, who’re more likely to be frailer and will have completely different experiences or impacts, and usually tend to expertise violence (Yon et al., 2019).

Healthcare professionals working with older adults ought to look out for indicators of doubtless unresolved and chronic trauma arising from earlier sexual violence victimisation.

Assertion of pursuits

Sophie Carlisle – No conflicts of curiosity.

Edited by

Laura Hemming.

Hyperlinks

Main paper

Anne Nobels, Mona Biebuyck, Ines Keygnaert. (2025). ‘Did it depart scars? It did, then and now’–older adults’ perceived psychological well being influence upon sexual victimization throughout their lifetime. Getting old & Psychological Well being, 1-11.

Different references

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