Climat incestuel : proposition d’objectivation des critères de définition à partir de jeunes orientés en institut thérapeutique, éducatif et pédagogique (ITEP)

Abstract

IntroductionThe consequences of sexual violence have a negative impact on the child's subsequent development. Emotional incest is harmful to the child, even if there are no actual physical acts; its consequences are not as well known as those of incest, but are likely to be similar. Young people with severely disturbed behavior are referred to Therapeutic, Educational and Pedagogical Institutes (ITEP). We looked for a history of sexual abuse in these young people, including emotional incest. The aim of this study is to better define emotional incest (among other forms of sexual violence) and to propose criteria for its identification among the young people attending ITEPs. MethodThe sample consisted of 202 young people (mean age 17.1±2.0 years, 13–23; 87.1% men) in the two ITEPs of the department of Indre-et-Loire in the ‘Centre-Val de Loire’ Region (France). The elements suggesting emotional incest were defined from the literature (Racamier) and preparatory consensus meetings (a team of local child psychiatrists and doctors working with the Education Ministry), resulting in 12 criteria. The global questionnaire explored four other areas of the lives of young people: suspected violence and/or legally defined emotional incest; clinical symptoms suggesting sexual abuse; environmental causes; educational measures. The team of professionals considered the existence of emotional incest if two or more criteria were met. A multi-disciplinary team from the two ITEPs completed the items in the questionnaire from the files and their knowledge of the young people in their care. ResultsThe prevalence of proven sexual abuse was 5.94% (n=12) and of suspected abuse 16.49% (n=32); 49.01% (n=99) of the young people met at least one of emotional incest criteria and 33.17% (n=67) at least two. The latter had experienced more sexual abuse (actual and/or suspected) than the other adolescents. They had more sleep and mood disorders (which could suggest a depressive syndrome), history of suicide attempts, and inappropriate attitudes to sexuality (detected by their language, knowledge, disinhibition, gambling, risk-taking, excessive or deviant sexuality). Concerning the contextual factors (family dynamics, break-up of relationships, mental disorders in the parents, etc.), we show the importance of precarious socio-family backgrounds, the detention of a parent, and mental disorder of the mother. ConclusionEmotional incest is a form of sexual abuse, and this study provides objective criteria to identify it. While this exploratory study needs to be confirmed by other studies, it offers a way of seeking other causes of behavior disorders and non-verbalized suffering. In ITEPs, professionals must be attentive to the family dynamics of the young people in their care, particularly to dysfunctional relationships and sexual preoccupations. In education and early childhood sectors, it may be useful to strengthen prevention by looking more systematically for indications of emotional incest in the same way as other forms of abuse.