Mental health articles

sexual abuse might occur when potentiating factors outweigh protective factors The transactional portion of the model is perhaps the most critical, for it represents the juncture among risk factors. This juncture can only be described as a complex process by which factors come together and crystallize into some level of risk. Risk factors are protective or potentiating, enduring or transieht (Cicchetti & Rizley, 1981), and proximal or distal (Baldwin et al., 1990). While Cicchetti and Lynch (1993) suggest that abuse might occur when potentiating factors outweigh protective factors, such a simple summative procedure does not appear to adequately explain the relationship among risk factors. Certain researchers have instead found that risk factors have a compounding or synergistic effect. For example, Rutter (1979; Rutter et al., 1975) found that in a sample of 10-year-old children, those with only one risk factor did not have an appreciably greater chance of developing a psychiatric disorder. With two risk factors, however, children were at a fourfold increase, and with four risk factors children were at a IO-fold increase. Moore et al. (1989) also found a synergistic relationship between risk factors and a history of child sexual abuse. Only 6% of children with no risk factors were sexually abused; 9% of children with one risk factor, 26% of children with two risk factors, and 68% of children with three or more risk factors were abused. Other literature has found that protective factors work only in the presence of a potentiating factor. In other words, the effect of the protective factor is indirect, operating only in interaction with a potentiating factor (Rutter, 1987). Being dependent upon some type of interaction, the effect is not apparent in the absence of a risk factor. One such protective factor is good parenting. Parker and Parker (1991), for example, found that victims of child sexual abuse who were treated poorly by their parents had greater impairment than victims who experienced good treatment by their parents. In the nonabused control group, however, scores measuring adjustment did not differ between groups having poor and good parenting. Only when the risk factor of abuse was added to the protective factor of good parenting did the buffering influence of good parenting become apparent. O’Grady and Metz (1987) conclude of research on protection factors, “the general pattern of results suggests that multiple risk factors may combine complexly and potentiate each other, and protective factors.. .may powerfully buffer the adverse effects of risk and stress’’ (p. 17). In summary, while certain risk factors may independently contribute to increased risk of sexual abuse, they also complexly and synergistically combine at the level of the child to increase or decrease risk of sexual abuse. As discussed earlier, Cicchetti and Rizley (1981) suggest that abuse may occur when potentiating factors outweigh protective factors. Because risk factors are often time-dependent, the child’s risk of sexual abuse is dynamic, changing as the child’s circumstances change. While an early risk factor (e.g., loss of a parent early in the child’s life) may have an ongoing effect, it is likely that its effect decreases as distance is gained from the event. From this perspective, while cumulative factors are hypothesized to impinge upon risk of sexual abuse, more current risk factors are expected to have a greater effect than more historic risk factors. A simple formula of adding all potentiating factors and subtracting all protective factors, however, is probably not sufficient. This formula ignores the complex interactions that occur among risk factors, as well as the possible synergistic effect of multiple risk factors. To fully understand risk, then, requires a complex analysis of (a) the number of potentiating and protective factors, (b) the timing of the events, and (c) the nature of the risk (i.e., whether it is enduring or transient, and distal or proximal).

Tags: sexual abuse