Prevalence of Sexual Abuse in Adults with Intellectual Disability: Systematic Review and Meta-Analysis.

Raluca Tomsa,Noelia Flores,Belén Gutiérrez-Bermejo,Daniel Cojocaru,Smaranda Gutu,Cristina Jenaro

doi:10.3390/ijerph18041980

Abstract

This study presents the results of a systematic review on the prevalence of sexual abuse experienced in adulthood by individuals with intellectual disability. An electronic and manual search of academic journals was performed on four databases via EBSCO Host: Academic Search Complete, PsycINFO, Medline, CINAHL Full-Text. In addition, PubMed, ProQuest, and Web of Science (core collection) were searched. After an initial selection of 1037 documents, 25 articles remained for quantitative synthesis. The combined prevalence of sexual abuse in adults with intellectual disability was 32.9% (95% CI: 22.7–43.0) and sensitivity analysis revealed that the prevalence was not outweighed by a single study. Overall, the United Kingdom had the highest prevalence (r = 34.1%), and the USA had the lowest (r = 15.2%). The overall prevalence in females was lower (r = 31.8%) than that in males (r = 39.9%). Subgroup analyses revealed that prevalence of sexual abuse was higher in institutionalized individuals. The most prevalent profile of abuser is of a peer with intellectual disability. Prevalence increases from mild to severe levels of intellectual disability and decreases in profound levels. It is also more prevalent when the informant is the individual with intellectual disability than when someone else reports abuse. In sum, one in three adults with intellectual disability suffers sexual abuse in adulthood. Special attention should be paid for early detection and intervention in high risk situations.

Highlights

The Convention on the Rights of Persons with Disabilities from the United Nations (UN-CRDP) states in article 16.1 that “States Parties shall take all appropriate ( . . . )measures to protect persons with disabilities ( . . . ) from all forms of exploitation, violence and abuse, including their gender-based aspects” [1]
The whole sample was comprised of 3434 abused adults with intellectual disability
A total of 23 studies (76.6%) were performed in a clinical context, meaning that all participants were identified as victims with intellectual disability or alleged victims of sexual abuse, or the participants came from reported incidents of sexual abuse, or were attending an intervention program

Summary

Introduction

The Convention on the Rights of Persons with Disabilities from the United Nations (UN-CRDP) states in article 16.1 that “States Parties shall take all appropriate ( . . . )measures to protect persons with disabilities ( . . . ) from all forms of exploitation, violence and abuse, including their gender-based aspects” [1]. Intellectual disability includes different conditions classifiable according to the International Classification of Diseases ICD-11 [3] as disorders of intellectual development (6A00). These disorders are a group of etiologically diverse conditions originating during the developmental period characterized by significantly below average intellectual functioning and adaptive behavior. A similar definition is included in the Diagnostic and Statistical Manual of Mental Disorders, DSM-5 manual [4] where the condition is called intellectual disability. According to the International Classification of Functioning, Disability and Health (ICF), this condition is related to limitations in general mental functions, required to understand and constructively integrate the various mental functions including all cognitive functions and their development over the life span [5].

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