Polyvictimization

Any kind of victimization may invite continued anxiety and stress. Trauma shatters core assumptions about the world. A world that once shined brightly with hope may take on a frightening shadow of danger. Research findings into polyvictimization does not dismiss or devalue the hurt caused by single incident trauma, or repeated episodes of the same kind of victimization. Any trauma, in any kind or severity can ravage our minds, rob us of vitality, and leave us empty and vulnerable.

Trauma research has extensively explored the devastating impact of victimization on mental health. The vast volumes of findings have helped therapist, clergy, and medical professionals treat victims, help them regain stability, and return to some normalcy in their lives. However, not all trauma is the same. Therefore, not all treatment plans are appropriate for every traumatized victim. Up until the early 2000’s, most research into trauma was either focused on single incident trauma (stranger rape), or a single type of trauma occurring over a longer period of time (domestic violence). In 2007, David Finkelhor published research on those who experience multiple forms of victimization, and the heightened impact this has on their mental health. He referred to these victims as “poly-victims” (2007).

What is Polyvictimization?

Polyvictimization refers to individuals experiencing victimization across multiple domains. These may include sexual abuse, physical abuse, bullying, and exposure to family violence. Often polyvictimization begins in childhood, leading a life more susceptible to continued victimization. Finkelhor suggests that for some childhood victims, “victimization is more of a ‘condition’ than an ‘event'” (2007).

History of Polyvictimization

The impact of stress on mental wellbeing has been  focal point of psychological research almost as long as written history. Sigmund Freud, Alfred Adler, and William James all made the connection. I have written on the general adaptation syndrome, the diathesis stress model, and adaptive survival styles in recent months. All stem from observations that the body and mind react to extreme stress.

​A significant source of stress researched is from family environments. When those environments are toxic, they may severely impact a child’s ability to function in other relationships throughout their lives. John Bowlby and Mary Ainsworth significantly contributed to this line of research through their work on attachment theory and the concept of a secure base for healthy development.

As victim research entered the 1990’s new discoveries were being published. Researchers discovered the tendency for victimization clustering both among adults and children. This means that some individuals were more likely to be victimized multiple times. Other studies discovered a “conjunction between child abuse and witnessing domestic violence.” Associations were also found between intrafamily and extra family victimizations. Sexual abused children were more likely to be sexually abused as adolescents (2007).

Victimization Occurs in Clusters

The underlying story is victimization often occurs in clusters, not single incident events. The historical picture of a victimization focus on a single frightening, unpredictable event, occurring to a safe, untroubled person, overlooked a significant population of poly-victims. Perhaps, we blamed these repeated trauma survivors for their own demise.

During the 1990’s the literature began to evolve, painting “a much more complicated picture, showing many childhood victimizations, not as a single traumatizing event, but as a part of an on-going pattern of victimizations” (2007). In this environment, David Finkelhor began his research. The research into polyvictimization continues today. In my research of the topic I found a plethora of new research examining the impact of polyvictimization on young adults emerging from the horrors of repeated trauma in childhood. 

Impact of Polyvictimization

Research has found that “exposure to multiple forms of maltreatment, victimization, and trauma is associated with the worst mental health outcomes both in childhood and adulthood” (Cyr & Chamberland, 2014, p. 618).

In a 1998 study, the researchers found a graded relationship between the number of categories of childhood exposures to traumatic events and health risk behaviors. They found that “persons who had experienced four or more categories of childhood exposure, compared to those who had experienced none, had 4- to 12-fold increased health risks for alcoholism, drug abuse, depression, and suicide attempt; a 2- to 4-fold increase in smoking, poor self-rated health, more sexual intercourse partners, and sexually transmitted disease; and a 1.4- to 1.6-fold increase in physical inactivity and severe obesity.”

They also found a graded relationship between the number of categories of adverse childhood exposures and “the presence of adult diseases including ischemic heart disease, cancer, chronic lung disease, skeletal fractures, and liver disease. The seven categories of adverse childhood experiences were strongly interrelated and persons with multiple categories of childhood exposure were likely to have multiple health risk factors later in life” (Felitti, et al., 1998).

More Research on Polyvictimization Needed

A 2022 systematic review of available literature, concluded that the association between health outcomes and polyvictimization need further research. The study discovered plenty of literature associating polyvictimization with mental, behavioral and social health but limited research on the direct impact of polyvictimization on physical health. 

Because of the limited literature, and a lack of general agreement on the definition of polyvictimization (how many different types of exposure and which types of adverse events to include). This large systematic study was unable to make any conclusion on whether or how much later life physical health was associated to polyvictimization as a child.  They explain, “it may be that physical and general health outcomes are there but not regularly assessed, or it may be that the mental, behavioral, and social health outcomes serve as mechanisms for more long term health outcomes” (Lee, et al., 2022, p. 8).

​Other studies found that polyvictimization is associated to considerably more sever developmental outcomes, beyond just mental and physical health but also psychopathological and psychosomatic symptoms. In particular, one study found a significant association between polyvictimization in childhood with later victimization or perpetration of violence in adulthood (Song, et al., 2022, p. 6,011).

Cause of Polyvictimization

There is no single cause for polyvictimization. Several factors typically interact, creating more vulnerability to violence. Those suffering from early victimization are at greater risk for subsequent victimization. Children abused at home tend to be chronically targeted at school. Consequently, early victimization often leads to later life victimization. Finkelhor suggests that “multiple victimization s may be a sign that children are poorly supervised or socially isolated and unprotected targets, have poor social interaction skills or a variety of pre-existing psychological problems” (2007).

Sadly, exposure to domestic violence at home, or experiencing violence directly as a child, interferes with normal development, creating greater vulnerability to violence in other environments. Some predators specifically look for vulnerable children. Particularly disturbing is the attraction to abusive personality types by some survivors of childhood violence.

A Few Final Thoughts

Violence against the most vulnerable in our society is a sobering subject. Professional providing treatment may need to delve a little deeper into personal histories to gain a fuller picture. Extended family members and service providers should be more attentive to possible signs of abuse. Teachers and schools must be vigilant to provide protection against bullying and further abuse from teachers and staff. Polyvictimization is a societal problem and requires large scale complex solutions. The next time we turn our heads because a child is obnoxious, loud, or extremely shy, perhaps, we take a deeper more compassionate look.

References:

Cyr, K., Clément, M., & Chamberland, C. (2014). Lifetime Prevalence of Multiple Victimizations and Its Impact on Children’s Mental Health. Journal of Interpersonal Violence, 29(4), 616-634. DOI: 10.1177/0886260513505220

Emery, C., Yang, H., Kim, O., & Ko, Y. (2019). A Multiplicative Approach to Polyvictimization: A Study of Intimate Partner Violence Types as Risk Factors for Child Polyvictimization in South Korea. International Journal of Environmental Research and Public Health, 16(5). DOI: 10.3390/ijerph16050783

Felitti, Vincent J.; Anda, Robert F.; Nordenberg, Dale,; Williamson, David F.; Spitz, Alison M. ; Edwards, Valerie; Koss, Mary P.; Marks, James S. (1998). Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine, Volume 14, Issue 4, Pages 245-258. DOI: 10.1016/S0749-3797(98)00017-8

Finkelhor, David ; Ormrod, Richard K.; Turner, Heather A.  (2007). Poly-victimization: A neglected component in child victimization, Child Abuse & Neglect, Volume 31, Issue 1, 2007, Pages 7-26, DOI: 10.1016/j.chiabu.2006.06.008

Lee, N., Pigott, T., Watson, A., Reuben, K., O’Hara, K., Massetti, G., Fang, X., & Self-Brown, S. (2022). Childhood Polyvictimization and Associated Health Outcomes: A Systematic Scoping Review. “Trauma, Violence, & Abuse”, OnlineFirst, 1. DOI: 10.1177/15248380211073847

Morlat, P., Lei, C., Tse, S., & Guerra, C. (2022). Polyvictimization and Depressive Symptomatology in Adolescents: Evaluation of the Role of School Social Climate. Children & Schools, 44(3), 163-171. DOI: 10.1093/cs/cdac009

Pane Seifert, H., Tunno, A., Briggs, E., Hill, S., Grasso, D., Adams, Z., & Ford, J. (2022). Polyvictimization and Psychosocial Outcomes Among Trauma-Exposed, Clinic-Referred Youth Involved in the Juvenile Justice System. Child Maltreatment, 27(4), 626-636. DOI: 10.1177/10775595211025096

Sabina, C., & Straus, M. (2008). Polyvictimization by Dating Partners and Mental Health Among U.S. College Students. Violence and Victims, 23(6), 667-682. DOI: 10.1891/0886-6708.23.6.667

Song, A., Yoon, Y., & Cho, Y. (2022). The Association Between Polyvictimization in Childhood and Intimate Partner Violence and Child Abuse in Adulthood. Journal of Interpersonal Violence: Concerned with the Study and Treatment of Victims and Perpetrators of Physical and Sexual Violence, 37(9-10), 6009-6033. DOI: 10.1177/08862605211073088

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