Abused boys may 'learn' that violence is an acceptable method of conflict resolution in the home

According to a study in the October 18 issue of the Annals of Internal Medicine, a history of childhood physical abuse may be common in men from urban settings, and these men with physical abuse histories may be more likely to commit domestic violence. The study found that the childhood abuse was primarily committed by parents, with mothers being the most frequent abusers.

"The results provide a circumstantial case that abused boys may 'learn' that violence is an acceptable method of conflict resolution in the home," said William C. Holmes, MD, MSCE, Assistant Professor of Medicine & Epidemiology at the University of Pennsylvania School of Medicine and lead author of the study. "Our findings suggest that, at the very least, this cycle-of-violence connection deserves confirmation in a larger study."

The study was conducted among a sample of 197 men aged 18 to 49, living in Philadelphia zip code areas with high incidence of domestic violence against women and girls. Utilizing a scale that is also used to identify domestic violence among girls and women, the researchers found that 51% of the men experienced at least one form of abuse that met the definition of childhood physical abuse. The mean age at the start of abuse was approximately eight years old; the mean age at the end of abuse was approximately 14 years old. Examples of abuse include being hit with an object or being kicked, bit, choked, burned, scalded, or punched. (Other studies have shown abuse prevalence of 28% in male college graduates and 51% in active duty soldiers in the United States Army.)

The study also found that approximately 75% of the identified abuse was carried out by parents, and of these cases, a considerably larger share was attributed to mothers than to fathers. (The relative amount of time that boys spent with mothers versus fathers--a possible explanation for the difference--was not examined in the study.) Others responsible for abuse included extended family members as well as non-family members.

"The findings point to a number of actions that can be taken," said Holmes, who is also an investigator at the Center for Health Equity Research and Promotion, Philadelphia VA Medical Center. "For example, screening for domestic violence and protecting those who screen positive should be as important in boys as it is in girls and women. Reducing the abuse of boys, as well as developing post-abuse interventions for boys who have been abused, will generate direct benefits for the boys and may help their future intimate partners and children."

The study did not directly examine whether boys who were abused were more likely to engage in domestic violence in their adult years because any positive responses to such questions had ethical and potentially legal ramifications. The researchers would have been required to inform respondents of possible reporting requirements before conducting the study, thereby potentially biasing the study sample or responses.

Instead, participants were asked about a combination of factors that, taken together, might indicate a tendency toward violence. Previous studies have shown these factors – depression, substance abuse, sexual risk, legal problems, and incarceration – to be associated with dating violence, domestic violence, and other criminal violent behavior.

Holmes has conducted prior research into the physical and sexual abuse of boys. The combination of those earlier findings and the new results point to childhood abuse as a substantial risk factor for many poor outcomes in adult males. Nevertheless, Holmes cited two major reasons for caution in drawing definitive conclusions from the current study. First, the participants of the current study were from a non-affluent, largely minority, and urban-based population. Findings must be confirmed in other populations. Second, variables related to physical abuse, but not the physical abuse itself, might actually explain links to adult domestic violence. These could include age, sex, or educational attainment of parents; alcohol or drug use in the home or neighborhood; or household size and composition.

"Historically, we have focused much of our energy and resources on abuse of women and girls," Holmes noted. "In contrast, boys' experiences with domestic violence are understudied and, as a result, male-focused policy approaches to domestic violence are deficient. The experiences of boys may play a crucial but currently unexplored role in men becoming perpetrators of domestic violence. By studying and identifying patterns of behavior that may lead men to become abusive, we may be able to make major strides toward breaking the sequence of aggression."