Sexual violence is prevalent internationally with roughly 30-35% of girls and 10-27% of males experiencing sexual violence not less than as soon as of their lifetime (McLean, 2013; Krahe et al., 2015; WHO, 2013). Sexual violence can have important 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 spot in our understanding of the expertise of violence and abuse on this age group. This can be exacerbated by obstacles to disclosure, together with disgrace and guilt, perceptions of sexual violence being socially taboo, considerations 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, which means our understanding of the psychological well being impacts of such experiences on this age group is just not very nicely understood. In 2024, Fadeeva and colleagues demonstrated that older adults who had skilled violence prior to now 12 months had been extra prone to reside with a standard 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 (Cook dinner et al., 2011; Nobels et al., 2023), melancholy and nervousness (Cook dinner et al., 2013) and persistent sickness and/or incapacity (Nobels et a., 2023).
Nobels et al., (2024) aimed to contribute to this area by conducting the first qualitative examine to discover the self-perceived psychological well being affect of lifetime sexual victimisation in older victims.
Most analysis on sexual violence victimisation tends to concentrate on 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. Contributors 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 members 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 12 months previous to the examine.
Interviews passed off primarily on-line or over phone and adopted a structured matter information, which requested about seven key subjects: conceptualising sexual violence, experiences of sexual violence, perceived components contributing to victimisation, penalties of sexual violence, methods for coping and searching for assist, results on familial and peer relationships, transgenerational affect, and recommendations for prevention and help 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:
- Hurtful recollection – Contributors described damaging feelings when recalling sexual violence experiences, and lots of felt that the expertise remained consistently current within the background. Particular triggers included going to places the place the violence occurred, sexual activity, or information tales of comparable occasions.
- Many members 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 doable resulted in excessive misery. Hypervigilance led to feeling consistently on guard and alert to ones’ environment, notably when strolling or biking at evening.
- Contributors reported experiencing intense emotions of guilt and disgrace all through their lives, typically protecting their experiences of sexual violence a secret. This additionally impacted their sense of identification, resulting in emotions of disappointment in themselves, worthlessness, and low self-confidence.
- Affect on interpersonal relationships – Some members felt anger in the direction of their family members, notably in the event that they weren’t believed, resulting in emotional distance and mistrust. There was additionally a way of common mistrust, associated to the necessity to keep on guard. This typically led to loneliness and isolation.
- It was okay – Whereas many members described a spread of psychological well being impacts of their experiences, most reported no long-lasting affect of sexual violence, and didn’t affiliate one with the opposite. Contributors 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.
- Some members reported posttraumatic progress that emerged from their experiences, resembling pleasure for stopping the sexual violence, elevated empathy for others, and strengthened resilience. Different examples of optimistic impacts included being extra assertive, growing a stronger sense of self-worth, and being extra important or much less naïve.
Older adults didn’t are inclined to affiliate psychological well being difficulties with their expertise of sexual violence, reporting no long-lasting affect of the trauma.
Conclusions
This examine is the primary to qualitatively assess the affect 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 ceaselessly result in a disrupted sense of identification, and elevated mistrust towards others.
Older adults typically have problem articulating the direct affect of their experiences on their psychological well being or relationships, and this can be associated to avoidance associated coping methods, or a problem in seeing themselves as victims.
Many members discovered it tough 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 tough 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 might have been beforehand unable to do.
The authors are clear about their analysis goals, and use acceptable methodology, which is nicely described and justified, to deal with these. Given the delicate nature of the subject of the analysis, the authors took moral concerns under consideration, making certain that members had been comfy with the method and had help afterwards if wanted. In addition they used an acceptable and pragmatic strategy to recruitment, figuring out potential members who had been already participating in one in all two present 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 prone to entry or reply to different recruitment methods (e.g., social media ads). Lastly, the evaluation seems to be rigorous and findings are express, though there may very well be extra data 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 members, and didn’t focus on reflexivity or consideration of the affect or affect of the researcher on the analysis course of and findings. Moreover, the authors acknowledge that, as nearly all of interview members had been feminine, outcomes are restricted by way of their generalisability to male victims of sexual violence, and are usually not seemingly consultant given proof suggesting that almost one in three older males (aged 70 and above) had skilled sexual victimization of their lifetime (Nobels et al., 2021).
Nearly all of members on this examine had been feminine – what concerning the experiences of male older adults who’ve skilled sexual violence?
Implications for observe
This examine has a number of key takeaways for healthcare professionals:
- Whereas a minority of members 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 concentrate on and look out for indicators of probably unresolved and protracted trauma.
- Regardless of reporting signs in keeping with trauma and different psychological well being and interpersonal challenges, older adults who’ve skilled sexual violence might really feel disgrace, guilt and a common mistrust of others. Collectively, these might act as obstacles to searching for assist for these challenges. The authors suggest routine enquiry about sexual violence to establish those that might profit from therapeutic assist. In addition they suggest doing so in a delicate, trauma-informed method, to construct belief and create protected areas for disclosure.
- Additional, healthcare professionals ought to recognise and respect any boundaries asserted by this affected person group, which can mirror post-traumatic progress and be key to reaching belief.
- Healthcare professionals might 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 method. This may very well be paired with protocols for age-appropriate referral routes for help, and specialised coaching in sexual violence throughout the lifespan.
Moreover, the authors establish a number of avenues for additional analysis, together with:
- Understanding males’s experiences of sexual violence particularly. The authors recognised the limitation of their principally feminine pattern and recognized addressing this as a future avenue for analysis.
- Exploring the experiences of older adults with cognitive impairments or different vulnerabilities. Whereas this proof hole is probably not doable to deal with resulting from moral concerns, practically all members of the current examine had been group dwelling, so one potential avenue for additional analysis may very well be to research experiences of adults residing in care properties, who’re prone 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 probably unresolved and protracted trauma arising from earlier sexual violence victimisation.
Assertion of pursuits
Sophie Carlisle – No conflicts of curiosity.
Edited by
Laura Hemming.
Hyperlinks
Major paper
Anne Nobels, Mona Biebuyck, Ines Keygnaert. (2025). ‘Did it depart scars? It did, then and now’–older adults’ perceived psychological well being affect upon sexual victimization throughout their lifetime. Ageing & Psychological Well being, 1-11.
Different references
Aakvaag, H. F., Thoresen, S., Wentzel-Larsen, T., Dyb, G., Røysamb, E., & Olff, M. (2016). Damaged and responsible because it occurred: A inhabitants examine of trauma-related disgrace and guilt after violence and sexual abuse. Journal of affective problems, 204, 16-23.
Carlisle S. Violence in opposition to older individuals is strongly related to poor psychological well being #16DaysOfActivism2024. The Psychological Elf, 10 Dec 2024.
Cook dinner, J. M., Pilver, C., Dinnen, S., Schnurr, P. P., & Hoff, R. (2013). Prevalence of bodily and sexual assault and psychological well being problems in older girls: Findings from a nationally consultant sample. The American Journal of Geriatric Psychiatry, 21(9), 877-886.
Donne, M. D., DeLuca, J., Pleskach, P., Bromson, C., Mosley, M. P., Perez, E. T., … & Frye, V. (2018). Limitations to and facilitators of help-seeking conduct amongst males who expertise sexual violence. American journal of males’s well being, 12(2), 189-201.
Fadeeva, A., Hashemi, L., Cooper, C., Stewart, R., & McManus, S. (2024). Violence in opposition to older individuals and associations with psychological well being: A nationwide likelihood pattern survey of the overall inhabitants in England. Journal of affective problems, 363, 1-7.
Goldblatt, H., Band-Winterstein, T., Lev, S., & Harel, D. (2022). “Who would sexually assault an 80-year-old girl?”: Limitations to exploring and exposing sexual assault in opposition to girls in late life. Journal of interpersonal violence, 37(5-6), 2751-2775.
Jina, R., & Thomas, L. S. (2013). Well being penalties of sexual violence in opposition to girls. Greatest observe & analysis Medical obstetrics & gynaecology, 27(1), 15-26.
Krahé, B., Berger, A., Vanwesenbeeck, I., Bianchi, G., Chliaoutakis, J., Fernández-Fuertes, A. A., … & Zygadło, A. (2015). Prevalence and correlates of younger individuals’s sexual aggression perpetration and victimisation in 10 European nations: a multi-level evaluation. Tradition, well being & sexuality, 17(6), 682-699.
McLean, I. A. (2013). The male sufferer of sexual assault. Greatest Apply & Analysis Medical Obstetrics & Gynaecology, 27(1), 39-46.
Nobels A, Cismaru-Inescu A, Nisen L, Hahaut B, Beaulieu M, Lemmens G, Adam S, Schapansky E, Vandeviver C & Keygnaert I. (2021). Sexual violence in older adults: A Belgian prevalence examine. BMC Geriatrics, 21(1), 601. https://doi.org/10.1186/s12877-021-02485-3
Nobels, A., Meersman, C., Lemmens, G., & Keygnaert, I. (2023). “Simply one thing that occurred?”: Psychological well being affect of disclosure and framing of sexual violence in older victims. Worldwide journal of geriatric psychiatry, 38(12), e6036.
Orchowski, L. M., Grocott, L., Bogen, Ok. W., Ilegbusi, A., Amstadter, A. B., & Nugent, N. R. (2022). Limitations to reporting sexual violence: A qualitative evaluation of# WhyIDidntReport. Violence in opposition to girls, 28(14), 3530-3553.
Pijlman, V., Eichelsheim, V., Pemberton, A., & de Waardt, M. (2023). “Typically it appears simpler to push it away”: A examine into the obstacles to help-seeking for victims of sexual violence. Journal of Interpersonal Violence, 38(11-12), 7530-7555.
Stein, M. B., & Barrett-Connor, E. (2000). Sexual assault and bodily well being: Findings from a population-based examine of older adults. Biopsychosocial Science and Medication, 62(6), 838-843.
Tarzia, L., Maxwell, S., Valpied, J., Novy, Ok., Quake, R., & Hegarty, Ok. (2017). Sexual violence related to poor psychological well being in girls attending Australian common practices. Australian and New Zealand journal of public well being, 41(5), 518-523.
Tarzia, L., Thuraisingam, S., Novy, Ok., Valpied, J., Quake, R., & Hegarty, Ok. (2018). Exploring the relationships between sexual violence, psychological well being and perpetrator identification: a cross-sectional Australian major care examine. BMC public well being, 18(1), 1410.
Tarzia, L. (2021). “It went to the very coronary heart of who I used to be as a lady”: The invisible impacts of intimate associate sexual violence. Qualitative well being analysis, 31(2), 287-297.
Ullman, S. E., & Relyea, M. (2016). Social help, coping, and posttraumatic stress signs in feminine sexual assault survivors: A longitudinal evaluation. Journal of traumatic stress, 29(6), 500-506.
World Well being Group. (2013). World and regional estimates of violence in opposition to girls: Prevalence and well being results of intimate associate violence and non-partner sexual violence. Retrieved from http://www.who.int/reproductivehealth/publications/violence/9789241564625/en/
Yon, Y., Ramiro-Gonzalez, M., Mikton, C. R., Huber, M., & Sethi, D. (2019). The prevalence of elder abuse in institutional settings: a scientific overview and meta-analysis. European journal of public well being, 29(1), 58-67.
