Mini Review

Sexual Abuse in Adults with Intellectual Disability: A Mini Review

Geetesh Kumar Singh¹*, Pragya Mitra² and Shweta Narayan³

¹Department of Clinical Psychology, School of Criminology and Behavioral Sciences, Rashtriya Raksha University, India

²Department of Paediatric Oncology, Homi Bhabha Cancer Hospital-a Unit of Tata Memorial Center, India

³School of Behaviour Forensic, National Forensic Science University, India

Submission: June 01, 2023; Published: JJuly 05, 2023

*Corresponding author: Geetesh Kumar Singh, Department of Clinical Psychology, School of Criminology and Behavioral Sciences, Rashtriya Raksha University, India, Email: g_ksingh007@yahoo.com

How to cite this article: Geetesh K S, Pragya M, Shweta N. Sexual Abuse in Adults with Intellectual Disability: A Mini Review. Glob J Intellect Dev Disabil. 2023; 12(1): 555828. DOI:10.19080/GJIDD.2023.12.555828

Abstract

This mini review explores the susceptibility of adults with intellectual disability (ID) to sexual abuse because of their substantial intellectual and social impairments. Using pertinent keywords, searches in Medline, PubMed, and Google Scholar were done for the review. The review aims to shed light on the prevalence of sexual abuse among adults with ID, its effects on their functioning, early warning signs of abuse, prevention strategies, legal consideration and future directions for addressing this critical issue.

Keywords: Intellectual disability; Sexual abuse; Adults

Mini Review

Sexual abuse is considered any unwanted sexual activity in which offenders purposefully use force, threaten or prey on victims who lack the capacity to consent because of their young age, innocence or cognitive impairment [1]. While sexual abuse affects individuals across different demographics, adults with intellectual disability (ID) face a heightened risk. This vulnerability stems from the significant impairments in intellectual functioning and adaptive behavior that are commonly observed in individuals with ID, making them more susceptible to experiencing sexual abuse.

An electronic search was conducted in Medline, PubMed and Google Scholar using a combination of the keywords “sexual abuse, adult, intellectual disability” on 21 May 2023. The findings of various studies have revealed high rates of sexual abuse among adults with ID. According to a systematic review conducted by Hughes et al. [2] the prevalence of sexual abuse in this population ranged from 4% to 34% [3]. Tomsa et al. [4] found that males with ID are more susceptible to sexual abuse compared to females and the risk increases with the severity of disability. Factors such as limited intellectual understanding, communication deficit, dependence on caregivers, insufficient knowledge about sex and social isolation contribute to the increased vulnerability to sexual abuse among adults with ID [1,4]. Green & Davis et al. [5] found that adults with ID are typically less likely to report incidents of sexual abuse. This tendency largely stems from their restricted communication abilities and understanding, which can make the identification and reporting of abuse a challenging task for them.

Sexual abuse can result in profound and long-lasting physical, emotional and psychological consequences and victims often suffer from trauma, anxiety, depression, and diminished self-confidence [6]. Victims may exhibit a range of behavioural and psychological symptoms, including aggression, self-harm, post-traumatic stress disorder (PTSD), and signs of anxiety and depression [7]. Such abuse can have long-lasting effects on victims, affecting their general well-being, preventing them from forming and maintaining social connections, and limiting their autonomy [8].

Recognizing early warning signs of sexual abuse or abusive behaviours is crucial for prompt intervention. These signs may include (i) sudden or significant changes in demeanour, such as showing fear or becoming withdrawn around a specific individual, It is essential to identify early warning signs of sexual abuse or abusive behaviour among adults with ID for timely intervention. These signs may include (i) abrupt or marked shifts in behaviour, such as exhibiting fear or becoming reclusive around a particular person, place, situation or activity, (ii) bruising in the chest or genital area, (iii) ripped, stained or bloody undergarments, (iv) unexplained vaginal or anal bleeding, (v) unexplained sexually transmitted infections/diseases/pregnancy, (vi) proof of pornographic material being shown, (vii) new words for body parts or sexual activity [7,9].

Social and structural barriers, such as stigma, ignorance, and a lack of adequate support services, make it difficult to prevent and address sexual abuse of adults with ID [11]. Addressing sexual victimization and enhancing the quality of life of victims with ID requires holistic interventions, preventive measures, and training for professionals and caregivers [12]. Education about the components of healthy relationships, personal boundaries, and consent is therefore necessary (Dowling et al., 2017). Caretakers, healthcare providers, and law enforcement organizations must work together to ensure that victims receive the assistance they need and are kept safe and well.

Legal structures hold a significant role in managing cases of sexual abuse that involve adults with ID. In such circumstances, professionals and decision-makers often encounter ethical quandaries in maintaining a balance between the independence and safeguarding of individuals with ID. It is necessary to have explicit guidelines, enhanced laws, and policies that focus on the rights and safety of victims [13].

Continual research is crucial to better understand sexual abuse among adults with ID and find effective prevention and intervention strategies. Enhancing access to education, training, and support services for these individuals and promoting a multidisciplinary approach, community involvement and awareness are essential for fostering a safe and supportive environment for adults with ID [14].

Addressing sexual abuse in adults with ID is a pressing societal concern. Through recognizing prevalence, understanding impact, overcoming prevention and intervention barriers, we can build a society that respects the rights and well-being of adults with ID. Prioritizing research, policy changes and community engagement is paramount to combat sexual abuse effectively and create safer environments for adults with ID.

References

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