The neglect and abuse of children and adolescents is a significant public health problem. A recent study published in JAMA Pediatrics indicated that over 15 per cent of children in 2013 to 2014 experienced maltreatment, with about 5 per cent experiencing a physical injury. Almost 5 per cent of girls aged 14–17 experienced sexual assault.
Along with Northeastern criminologist Gregory Zimmerman, I explored the outcomes of exposure to violence for adolescents. Regardless of the type of exposure (direct or indirect), adolescents exposed to violence were more likely to abuse substances, self-harm, and commit violent and property crime than those who had no exposure to violence. This echoes the results of several studies which all find that one of the most powerful predictors of violent behaviour is prior exposure to victimisation.
The key for the field of victimisation is to understand the developmental impact of exposure to violence in children and adolescents in an effort to establish effective violence prevention programmes. This begins with an understanding of the effects of abuse and neglect on the brains and bodies of young boys and girls. There is now a sizeable base of scientific evidence that being the subject of abuse and neglect can not only change cognition (the way someone perceives their surroundings) but their neurological and biological functioning as well. Importantly, the stress incurred from exposure to violence has significant impact on the function of the hypothalamic-pituitary adrenal axis (HPA axis). Chronic abuse or severe acute exposure to violence often affects the release of corticosteroids leading to a cortisol imbalance. Individuals with hyper- or hypocortisolism are extremely anxious (hypercortisolism) or fearless (hypocortisolism) both of which can lead victims to be hypervigilant or withdrawn from their current situation.
Victims often experience disregulation that occurs within the HPA axis leading to what can be perceived as hypervigilance and non-cooperativeness. These victims are especially vulnerable to the increased stress from assessment, interviews, and questioning. Approaching victims with care and patience in a safe environment is essential in victim recovery and ensuring cooperation with law enforcement. Follow-up with a physician may be needed for dealing with victims of chronic or severe acute stress from abuse and neglect.
Additionally, stress on the brain and HPA axis may result in tonic immobility (or the physiological state of freezing in response to trauma) and/or dissociation. Victims and offenders alike are often impacted by the violence they see or perpetrate resulting in a physiological state of emotionlessness and desensitisation which is little understood by victim service providers including police and victim advocates. This has significant implications for intervention and care. A victim who appears disinterested, forgetful, confused, or uncooperative might not be intentionally avoiding police or refusing care. Instead, they are potentially experiencing a physiological responses to stress that must be met with understanding and patience – not intensification. Added stress from an interview, assessment, or more aggressive law enforcement tactics could results in further damage to the individual and complete shutdown of the body.
Victims (and offenders) who try to avoid contact with police or service providers, or who provide incoherent or contradictory statements, might be experiencing tonic immobility or dissociation. Particularly, victims of sexual abuse might be perceived to be ‘making up’ stories and viewed with skepticism because they did not ‘fight off’ an attacker. This is likely due to an evolutionary response to freeze and/or dissociate during and after a victimisation experience. These victims must be given adequate time and medical assistance to ensure they are well enough to participate in recovery and investigative efforts.
Finally, genetic predispositions and susceptibility should be accounted for in prevention/intervention efforts. Largely, biological and genetic factors are ignored by service providers, but they do so to the detriment of victims. Certain genetic alleles and epigenetic processes influence the effectiveness of intervention efforts. In particular, genes related to serotonin (an inhibitory neurohormone) and dopamine (an excitatory neurohormone) and the methylation of promoter sites of these genes affect the outcomes of victim treatment. The effects of victimisation have been found to even degrade chromosomes as evidenced by shorter telomeres in those who have experienced adverse events early in life. These factors can be easily checked by DNA analysis that is readily available using today’s technology.
To the extent possible, and with consent of the victim, biological data can be collected for intervention efforts. This would include physiological factors such as heart rate, breathing patterns/oxygen usage, sleep patterns, and genetic/epigenetic markers. This type of data collection is non-invasive, quick, and, relatively, inexpensive. The information this would yield to victim service providers would be cost-saving and effective in the long-term and aid in continuing research efforts. These assessments could be built into already existing medical (e.g., rape kits) or investigation (e.g., DNA sample collection) procedures to reduce impacts on victims.
Victimology and victim policy often overlooks the essential physiological nature of human beings and the biological processes that are interrupted by abuse and neglect. To improve violence prevention, victim intervention, and victim care, scholars and service providers should be more knowledgeable of basic physiology and neuroscience and work closely with physicians and medical staff to provide the best possible care to victims of violence.
Chad Posick is an Assistant Professor of Criminal Justice and Criminology at Georgia Southern University. He co-authored The Criminal Brain and is an Associate Researcher at the Ochsner Institute for Injury Prevention and Research at Memorial University Medical Hospital in Savannah, GA. Chad received his doctorate in Criminology and Criminal Justice from Northeastern University in Boston, Massachusetts. There he completed his dissertation which examined the overlap between offending and victimisation in 30 countries.