Abused Boys Prone to Psychiatric Ailments and Future Violence

Boys who are physically abused, often by their mothers, have a heightened risk of psychiatric illnesses, legal troubles, violent behavior, and doing prison time as adults, researchers here reported.

A random telephone survey of 197 men here found a history of childhood physical abuse to be significantly associated with depression (P=0.003), post-traumatic stress disorder (P<0.001), the number of lifetime sexual partners (P=0.035), legal troubles (P=0.002), and incarceration (P=0.007), investigators reported in the Oct. 18 issue of the Annals of Internal Medicine.

The findings highlight an understudied area and provide a snapshot of the cycle of abuse, wrote William C. Holmes, M.D., of the University of Pennsylvania here.

“Historically, we have focused much of our energy and resources on abuse of women and girls,” Dr. Holmes said. Evidence suggests that abuse among boys is high, but the subject is understudied, and male-focused “approaches to domestic violence are deficient.” Identifying patterns that may explain why men perpetrate violence could help break “the sequence of aggression,” he said

Mothers were more often the abusers, although the amount of time spent with each parent was not examined in this study, the researchers wrote.

Dr. Holmes and colleagues randomly called the participants who lived in Philadelphia neighborhoods with high rates of domestic violence against women and girls and high rates of HIV infection. The participants’ mean age was 34; 68% were non-white, 7% were homosexual or bisexual, 45% had a high school education or less, and 27% had an annual income of $20,000 or less.

The researchers also asked about the men’s living arrangements when they were growing up. The most common living arrangement was both parents under one roof simultaneously (110 participants), followed by living with the mother only (64), living with someone other than their parents (11), living with only their father (seven), and living with both parents serially (five).

Of the 197 men in the study, 100 reported a history of childhood physical abuse, such as being hit by a person or an object,

being pushed or grabbed, or being choked or scalded. Of these 100 men, 57 met the definition of severe physical childhood abuse.

Parents, especially mothers, were the most frequent abusers. For example, 50% of the men reported being pushed, grabbed, or shoved by their mother compared with 43% who said their father did it. Sixty-five percent said their mothers threw an object at them, compared with 24% who said their fathers threw something.

The participants’ education was also significantly associated with the childhood physical abuse (P=0.002). Parental bonding was not as significant (P=0.054), while age, race, and ethnicity did not play a role.

Tackling the issue of domestic violence, the authors noted that they were unable to learn whether men who had histories of childhood physical abuse, especially if the abuser had been a parent, were likely to harm their own partners, children, or both. This would have required the researchers to report the perpetrators, but disclosing this factor at the time of recruitment could have biased the results, they explained.

So instead Dr. Holmes and colleagues asked the participants about their lifestyle, including depression, sexual behavior, substance abuse, hostility, and run-ins with the law. Previous studies, they wrote, have shown these outcomes to be associated with domestic violence and other criminal behavior.

These factors, the researchers wrote, were substantially more common in men with childhood physical-abuse histories, “providing a circumstantial case that boys who are victims of domestic violence may be more likely to perpetrate domestic violence as adults.”

The authors also noted that these findings are based on an urban, low-income, predominantly minority group of people and that the results cannot be extended to other populations. However, the results illustrate some patterns that could help clinicians identify who is at risk, they said.

“Childhood physical abuse may be a marker for other conditions that are the primary explanatory variables for poor adult outcomes,” the research team concluded.

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