RELATIONSHIP BETWEEN SEXUAL ABUSE, GENDER, AND SEXUALLY INAPPROPRIATEBEHAVIORS IN SERIOUSLY MENTALLY-ILL YOUTHS

Objective: To examine gender differences in sexual abuse histories and in the development of inappropriate sexual behaviors in a sample of s eriously mentally ill youths. Method: A retrospective chart review was completed for all patients from 1987 through 1992 at a tertiary care public sector psychiatric hospital for youths (N = 499). Subjects were categorized by gender, sexual abuse status, and whether they had sexu ally reactive or victimizing behaviors. Results: Girls were more likel y to have been sexually abused, and their abuse histories were more se vere. Sexual behavior problems in girls were almost exclusively associ ated with sexual abuse, whereas 29% of boys with victimizing behaviors had no sexual abuse history. Among sexually abused youths, boys were more likely to display victimizing behaviors, whereas both genders dis played similar rates of sexually reactive behaviors. Of the 19 girls w ho displayed victimizing behaviors, 95% were chronically sexually abus ed and one third had also received a major injury due to physical abus e. Conclusions: Boys appear to have a lower threshold of abuse exposur e required to develop sexually inappropriate behaviors and are signifi cantly more likely to display victimizing behaviors. Conversely, victi mizing behaviors in girls may require a catastrophic maltreatment hist ory. These gender differences should be incorporated into treatment in terventions directed at sexual abuse victims.