Childhood Sexual Abuse and The Development of Sexual Deviance

Child maltreatment has the potential to induce both paraphilic behaviors and sexual deviance. The presence of adversity in childhood is said to be associated with sexual deviance and sexual violence, implying that exposure to trauma early on can increase the likelihood of sexual and general self-regulation difficulties later in life. In this paper, I will discuss the relationship between childhood sexual abuse and the development of sexual deviance and paraphilic disorders across the lifespan of adult male sex offenders.

Paraphillic behaviors can include frotteurism, voyeurism, exhibitionism, rape, sadism, and pedophilia (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition [DSM-5], 2014), which can be viewed as expressions of disturbance in a common regulatory system. Aside from pedophilia and sadism, the latter disturbances can be better explained through Freud’s theory of Courtship Disorders (1990). This theory consists of four normal courtship phases:

Phase 1 - Location of a partner, locating an appraising a potential partner (voyeurism).

Phase 2 - Protractile interactions, non-verbal interactions such as looking at, smiling at, and talking to a potential partner (exhibitionism).

Phase 3 - Tactile interactions, physical contact is made (frotteurism).

Phase 4 - Copulatory interactions, sexual intercourse.

Paraphilic disorders such as voyeurism, exhibitionism, frotteurism, and preferential rape patterns can be seen as distortions in each courtship phase, respectively. Pedophilia is not included in the courtship phases as this disorder is characterized by having a preference in children as targets for the enactment of paraphilic behaviors. Sadism is also not included in the courtship phases as this includes the preference for pain and humiliation to fulfill sexual desires.

Both nature and nurture seem to have a relative impact on the development of sexual deviance and paraphilic behaviors across lifespan. With regard to nature, male sex hormones seem to be primarily responsible for the expression of sexual behaviors. The gonads and adrenals secrete male sex hormones called androgens, and testosterone has been found to be the most potent and abundant androgen in the male reproductive system. The performance of sexual behavior is determined by blood levels of the male sex hormone, testosterone. In addition to sexual performance, testosterone also assists in maintaining libido. Males with early onset of androgen secretion are likely to develop an early interest in sexuality and erotic fantasies, which speaks to the role testosterone plays in the expression of sexual behaviors. In addition to testosterone, there seems to be other biological components involved in deviant sexual behavior. The hypothalamic- pituitary- gonadal axis is said to be involved in the regulation and control of sexual drives. Previous research supports the hypothesis that dysfunction in the hypothalamic- pituitary- gonadal axis plays an important role in the etiology of paraphillias. Furthermore, it has been noted that genes also play a role in the etiology of paraphillias. Abnormal chromosome types such as mosaic and inversion chromosomal patterns have been linked with the development of sexually deviant behaviors. The latter abnormalities have been associated with various conditions including Klinefelter’s Syndrome and Huntington’s Disease, and individuals with these condition have been known to either engage in paraphilic behaviors or have comorbid paraphilic disorders. There has not been a direct link between a single chromosome or gene locus regarding the development of psychiatric conditions, but the information noted above suggest the existence of a genetic vulnerability or predisposition towards sexual deviancy.

There are multiple components that contribute the role nurture plays in the development of sexual deviance including environmental variables, childhood experiences, how the child was raised, social relationships, and surrounding culture. It seems that children may have a genetic vulnerability or predisposition towards sexual deviance and they are being exposed to sexually deviant behaviors in their environment, thus increasing the likelihood of adopting those behaviors. The latter notion can be explained by multiple theories including Bowblys’ Attachment Theory (1982), Eriksons’ Theory of Psychosocial Development (1959), Marshalls’ Vulnerability Model (2000), Skinners’ Operant Conditioning (1948), and Laws and O’Donohues’ Deficits in Developmental Tasks (2008). First, Attachment Theory explains the parent-child dynamic in relation to maladaptive behavioral patterns. Attachment style has been the focal point of the etiology of sexual offending. The latter can be subcategorized into three distinct styles including avoidant, ambivalent, and disorganized, with disorganized being the most frequently observed attachment style in children who have experienced abuse. Disorganized attachment is the result of children seeking protection from their caregiver in times of distress; even if/when the caregiver is abusive. The unstable nature of disorganized attachment styles has the potential to characterize the relationship between the child and their parent. For example, previous research has found that sex offenders’ relationship with their fathers have been characterized by rejection and neglect, while the relationship with their mothers seemed kind but lacked clear boundaries. The latter is indicative of a developmental hazard and these present as a result of parent-child relationships being exposed to abuse and/or neglect during the initial stage of Eriksons’ Psychosocial Development (1959), trust vs. mistrust. The developmental task of the trust vs. mistrust stage corresponds with the goal of achieving a sense of trust and security from perceived caregivers through affection and gratification needs, but if those needs are not being met, distorted cognitive schema, boundary violations, disorganized attachment patterns, and emotional dysregulation could potentially arise.

Second, Marshalls’ Vulnerability Model (2000) proposes the idea that insecure attachment styles create vulnerability (low self-esteem, poor coping skills, poor relationship styles) in children, resulting in the presentation of inappropriate juvenile sexual behaviors. The inappropriate sexual behaviors can be viewed as the individual’s way of coping with sex; this limited coping ability may induce impulsive and antisocial ways to meet his own needs. The inappropriate sexual behaviors are said to increase through conditioning processes experienced through interactions with the environment. Behavior is voluntary and goal directed, and it is controlled by its consequences such as rewards and punishments. The law of effect states that the positive outcome should increase the likelihood of the individual engaging in that behavior. For example, an individual who engages in inappropriate sexual behaviors such as frottage will eventually have an orgasm, and that orgasm represents a positive reinforcer that causes an increase in that behavior.

Third, unsuccessful completion of Developmental Tasks can influence the development of paraphilic behaviors. There are four developmental tasks including shifting to a more covert expression of sexual activities in childhood as the child grows older and become more aware of parental and cultural norms, developing internal inhibitors to control sexual urges while experiencing a shift from parental vigilance and influence to peer influence and opportunities in early adolescence, learning to develop trusting and intimate relationships with peers in middle-late adolescence, and learning to communicate effectively with an intimate partner in adulthood. It has been hypothesized that if the child is actively experiencing sexual abuse in the home, the following is likely to occur: the child is learning overt instead of covert expression of sexual activities as it is being modeled by the abuser; the child is unable to develop internal inhibitors because modeled behaviors presented by the abuser reflect a decreased need to hide sexual urges; developing trust in intimate relationships will be hindered due to the development of insecure attachment rooted in childhood; communicating effectively with an intimate partner in adulthood will be difficult to accomplish given the development of poor relationship styles through the process of insecure attachment.

Sexual deviance is a lifelong trait and the expression continues throughout the course of lifespan.

The development of sexually deviant behaviors seems to rapidly increase across childhood through early adulthood, and gradually declines through middle and late adulthood. Testosterone levels have been known to peak during early adulthood and then decline during the remaining stages of development. The expression or performance of sexually deviant behavior decreases with age due to the decrease in blood levels of testosterone. The decline in male sexual behavior has been described as gradual because older men do not experience sudden cessation of gonadal function and hormone secretion like women do during menopause. There seems to be a relationship between the reductions in the male hypothalamic- pituitary- gonadal axis function and aging. Aging has been known to induce changes in sexual performance in men. Age related changes in sexual performance include difficulty getting and maintaining an erection, as well as requiring more direct stimulation to induce and maintain the erection. However, research notes that individuals in the old-old (75-84) and oldest-old stage of development (85+) are still engaging in sexual activity, which speaks to the notion that it is possible for sexual behaviors and urges to persist throughout late adulthood.

Overall, child maltreatment has the potential to cause distortions in both developmental and mental health processes, as well as the development of sexually deviant behaviors. Those distortions are capable of inducing the presentation of various mental illnesses, overt expression of inappropriate sexual behaviors (paraphilia), and serious criminal offenses. Behaviors exhibited by sexual offenders are often learned through direct experience, modeling, or observational learning. The latter is reinforced through rewards and punishments in the individual’s environment. If the trauma is left untreated, the offender is likely to re-offend and the cycle of violence is likely to persist. Research states that children who experience trauma at home are likely to experience violence in their community, with their peers, and in their personal relationships. Moreover, the Cycle of Violence theory implies that individuals who were abused during childhood are at a higher risk of internalizing and repeating that learned behavioral pattern as an adult.