Sibling Incest A Descriptive Study of Family Dynamics

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CHARLOTTE M. GILBERT, PhD,RN, CS From the University of South Florida, Tampa, Florida

This study investigates the characteristicsof families in which a member was identified as a victim of sibling incest. Four agencies in a southeastern city provided a convenience sample of 14 family case records from November 1986 through April 1988 for review. Sixteen children were identified as victims of sibling incest, including three boys and 13 girls between the ages of 2 and 10 years (mean = 6.75 years). Perpetrators included 1 girl and 14 boys between the ages of 13 and 17 years (mean = 15.06 years). The incestuous relationship had a major impact on families, especially the children. Many offenders and victims, in addition to experiencing emotional, school, and legal problems, were removed from their homes.

reported (Bank & Kahn, 1982; Loredo, 1982). Age differences between siblings may be 2 to 5 or more years (Bank & Kahn, 1982; Loredo, 1982; Russell, 1986). Victim reports differ with regard to the effects of sibling incest. Russell (1986) reported that some victims described the incestuous experience as bothersome and annoying or very serious. Sibling incest is considered less serious when the partners are in mutual agreement and when there is an absence of the following factors: power and control of one partner over another, a large disparity in age between partners, or use of force or sexually intrusive behavior (Finkelhor, 1979; Lieske, 1981; Russell, 1986). Family dynamics are considered crucial variables in sibling incest. which is likely to exist in families with the following characteristics: disorganization and family secrets (e.g., parents who have been sexually abused themselves as children or who are engaging in extramarital affairs); parents who are passive or preoccupied, or parents who pay little attention to sexual boundaries within the family (Justice & Justice, 1979; Smith & Israel, 1987; Thorman, 1983). This study described the dynamics of families in which there was an identified sibling incest victim. Several questions were entertained. First, what are the characteristics of families in which there is an identified sibling incest victim'! Second, did case record review produce information that differed from previous studies (Smith & Israel, 1987). Third. what are the implications for nursing practice and future research?

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138,000 cases of child sexual abuse occur each year in the United States (National Center on Child Abuse and Neglect, 1988). Although fatherdaughter incest is considered the most reported and studied form of child sexual abuse, a review of the literature by Finklehor ( 1987) indicated that a larger group of child sexual abuse perpetrators include relatives (e.g., uncles and brothers) or other persons known to the family and child. Sibling incest is believed to be the most widespread form of incest, although there is a paucity of information, including empirical data, regarding this particular form of sexual abuse (Bank & Kahn, 1982; Finkelhor, 1979; Fortenberry & Hill, 1986; Forward & Buck, 1978; Justice & Justice. 1979; Lieske, 1981; Loredo, 1982; Macfarlane et al., 1986; Miller & Mansfield, 1981; Ralphing, Carpenter, & Davis, 1967; Russell, 1986; Smith & Israel, 1987; Thorman, 1983). A review of the literature (Gilbert, 1989) produced one research study specific to sibling incest (Smith & Israel, 1987). Sibling incest can be defined as sexual interaction between persons having one or more parents in common; the incestuous relationship may occur between siblings of either sex, with brother-sister incest being the most common type T IS ESTIMATED THAT

Methods Procedure

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Reprint requests: Charlotte M . Gilbert, PhD. KN, CS. Assistant Professor, University of South Florida. College of Nursing, Tampa. FL 33612. Accepted for publication July 18. 1991

Data in this study were obtained from a convenience sample of 14 case records gathered from four agencies

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located in a southeastern city: two Departments of Family and Children Services. one child and adolescent inpatient unit at a public sector psychiatric hospital. and one rape crisis center. Each agency had experience with sexually victimized children and their families. including victims of sibling incest. Before conducting the research. a written proposal was submitted to state and local agency directors and their permission was secured both verbally and in writing. At the time of the actual case review, a signed consent form was obtained from each case worker. Two agencies allowed the researcher to review the case records; the remaining agencies directed case workers to complete the forms and return them to the researcher or review the case records in the presence of the researcher. Based on clinical practice and a review of the literature. questions were formulated to obtain data in the following areas: general family demographics. mother characteristics. father characteristics. child victim characteristics. and characteristics of the abuse perpetrator. Within the category of the mother’s characteristics, questions involved determining her historb with regard to childhood sexual abus,? and substance abuse, her physical or emotional presence in the family. and her attitudes toward sexuality. For example, maternal physical presence or absence in the family was determined according to whether or not the mother was dead: had abandoned the family: was hospitalized. incarcerated, separated or divorced and without child contact: or was employed at occupations that necessitated shift work. long hours, or geographical distance from family. Mother‘s emotional availability or unavailability included presence of substance abuse. mental illness, disinterest in parenting. lack of empathy or knowledge of a child’s emotional needs. or repeated pregnancies with minimum support. Questions pertaining to the father’s characteristics were similar to those for the mother. Characteristics of the child victim were determined through inquiry about incest occurrence. use of force or deception. relationship of victim to perpetrator, type of sexual behavior. person to whom child disclosed incest. whether or not child was believed. and the effects of abuse (e.g., physical o r emotional. school-related. or removal from home). Inquiry about perpetrator characteristics included his or her own history o f sexual or substance abuse. acknowledgement of sibling incest or sexual abuse of others. and effects after disclosure ( e . g . , school-related. legal. emotional. or removal from home).

Su bjec1.s A convenience sample of 14 case records of sibling incest was obtained from four agencies located in a southeastern metropolitan area. These cases constituted approximately 2% to 5 % of the child sexual abuse cases for participant agencies during the period of November 1986 through April

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1988 (personal communication, Department of Family and Children’s Services. 1988). Most of the information was obtained from the agency caseworker’s review of the client’s record. Victims. There were 13 girls and 3 boys between the ages of 2 and 10 years (mean = 6.75 years, SD = 2.44). Eleven subjects were white (68.7%). and five (31.2%) were African American. Perpetrators. There were 14 (93.3%) male perpetrators and 1 female perpetrator (6.6%) between the ages of 13 and 17 years (mean = 15.06 years, SD = 1.16). Ten perpetrators (66.6%) were white, and five perpetrators (33.3%) were African American.

Results Descriptive statistics were used to analyze data. Percentages may vary due to missing data.

Futnily Charucteristics Fourteen family case records were reviewed. Nine couples were married (64.28%). two (14.28%) had separated, one (7.14%) had divorced. and in two cases (14.28%), marital status was not known. Eight families (57.14%) were blended: the couples brought children from previous niarriages to the marriage, and there were also children produced by the current marriage. Ten families (64.28%)had incomes between $0.00 to $15,000.00. Twelve families (85.71%) had a household membership of five to seven members. The mean age of mothers ( n = 8) was 35.5 years (SD = 4.37), and the mean age of fathers (ti = 7) was 38.28 ( S D = 6.18). Victims. Sixteen children were identified as victims of sibling incest. They were young and predominantly female. More than half of the victims (68.75%. n = 1 1 ) were white. There were three cases of brother-brother sibling incest, and one case of sister-sister sibling incest. Most subjects disclosed the abuse to their mother (62.596, n = 10). Other persons to whom the children revealed their abuse included father (6.2%. ti = I ) , another relative (18.7%. n = 3), or another person (12.5%. ti = 2 ) . Victims of sexual abuse experienced a continuum of abuse behaviors including fondling (25.0%. 11 = 4). oral-genital behavior (18.7%. IZ = 3). vaginal intercourse (12.5%, I I = 2). rectal intercourse (6.2% ti = I ) , or some combination of sexual behaviors (37.5%. n = 6). Eight subjects (50.0%) were subjected to physical force by the perpetrator, and six (37.5%) were bribed by the perpetrator. Five victims ( 3 1 . 2 4 ) were sexually abused by persons other than the sibling perpetrator. More than 50% (tz = 9) of the victims remained within their own home after disclosure of sexual abuse. School problems were reported by four subjects (25.0%), and emotional problems were experienced by 8 subjects (50.0%). Of the ten subjects (62.5%) who received counseling. four (25.0%) received individual counseling, three

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(18.7%) received group therapy, and three ( 1 8.7%) received some combination of individual and family counseling. Perpetrators. There were IS sibling incest perpetrators, of whom one was female. All sibling perpetrators were older than their victims; the mean age of the perpetrators was 15.06 years (SD = 1.16years) and the mean age of the victims was 6.75 years (SD = 2.43 years). More than 50% of the offenders were stepsiblings. Six perpetrators (40.0%) acknowledged the sibling abuse, and 4 of the 15 perpetrators (26.6%) were known to have sexually abused others. Seven (46.6%) of 15 perpetrators were removed from their homes. Nine (60.0%) perpetrators received the following types of counseling: individual (33.3%,n = S),group(13.3%,n = 2),oracombinationof individual and family therapy (13.3%, n = 2).

Discussion The results of this study should be used with caution. The sample size was small and convenient. Data were not complete for most of the categories related to family demographics, especially those of fathers and offenders. The accuracy of information gathered by caseworkers from case records was as accurate as the caseworker. In general, most families in this study were low income, relatively large, and known to public sector mental health providers or social service agencies. A comparison between this study and that of Smith and Israel ( 1987) reveals several differences. Smith and Israel studied 25 families who were referred for therapy because of sibling incest: 24 families were white and one family was Hispanic. The current study consisted of data obtained from case records on 14 families, in which nine families were white and five were African American. Smith and Israel (1987) reported family secrets to be a common dynamic in the families they studied (e.g., extramarital affairs and parents who had been sexually abused as children). Additional findings included parents who were noted to be physically or emotionally absent from their families. In the current study, most parents were physically present in the family and were considered emotionally present. For example, if parents were attentive to and supportive of their child’s emotional needs, caseworkers deemed the parents to be emotionally present. Although extramarital affairs or childhood parental sexual abuse was not routinely assessed by caseworkers, existence of extramarital affairs was appraised in seven cases, of which extramarital affairs were noted in four. Few parents were assessed for parental childhood sexual abuse. Of the five families known to have been assessed on this variable, only one mother was identified as having been sexually abused as a child. Disclosure of tncest Disclosure of sibling incest occurred in various ways. In several cases, mothers discovered the incestuous sibling

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activity. In one case, an incarcerated father remained in contact with his child through letters. Because the child could not read, the mother would read the father’s letter to the child. The father decided to answer the child’s question about what seemed to be a sexual abuse situation in written communication. knowing that the mother would have access to the letter. The mother, acting on the information in the letter, discovered and stopped the sexual abuse of their child. Another case involved a young child who had been removed from the family due to neglect. The foster family noticed that the child engaged in bestiality (sexual activity with animals). The foster family sought help for the child, whereupon the sibling incest in the family of origin became known. After discovery or disclosure of the incest, the children who were victimized were believed by their mothers. However, belief did not always constitute effective intervention, and disclosure was not always direct. For example, the mother of three young sibling incest victims worked 12-hour days and depended on her teenaged sons to care for their sisters in her absence. The mother repeatedly found the brothers engaging in intrusive sexual behaviors with the girls. Although she scolded, threatened, and used abusive measures (whipping) in her futile attempts to control the boys, the sexual abuse continued. It was only after the girls told their story to a teacher that the abuse became known to authorities. The sexual abuse recurred on several occasions and only ceased on removal of the girls from the family. Consequences of Sibling Incest Sibling incest had a major impact on the families, especially the victim and perpetrator. Both victims and abusers were at risk for removal from their homes, legal problems, school difficulties, and emotional problems. Several victims were reported to be experiencing emotional and schoolrelated problems. Several perpetrators were known to have sexually abused other children, and several perpetrators were either known to have been or were suspected of having been sexually abused as children. For example, a 16-year-old perpetrator, the only female offender in the study, had sexually molested her 10-year-old sister. The older sister had a history of incest: she had been sexually abused by a stepfather from her mother’s previous marriage, became pregnant, and delivered a child who remained with her. Intervention Because most case records were not available to the researcher and continuity of knowledge by ever changing caseworkers could not be assured, information related to counseling was limited to the number of subjects who received counseling and the type of counseling received. Ten victims and nine perpetrators received some form of counseling, the predominant forms of which were individual or a combination of individual and family therapy. It was surpris-

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ing that so few of the youths (three victims and two perpetrators) received group therapy. an intervention considered appropriate for schoolaged and teenaged youths (Gilbert, 1988b). It was also distressing to note the absence of programs for sexually abusing youth or for families. Impliccitions for Practice and Research

Considering the major impact that sibling incest was reported to have on families in this study. several practice and research implications are evident. A major implication for research on sibling incest would include study in any of the following areas: incidence. family dynamics, effects. and interventions. In general, detection of sibling incest has not been a priority among health care and social service agencies. Several caseworkers stated that they had inadvertently discovered the sibling incest after addressing other family problems. Personnel tended to be less knowledgeable about family dynamics in sibling incest. To engage in effective nursing practice with children and families. nurses must become more informed about the signs and symptoms of child sexual abuse. including sibling incest. Although the findings are not conclusive. families with the following characteristics may be at risk for sibling incest: parent-child incestuous families. parents who were sexually abused as children. and parents who are physically or emotionally absent (Gilbert, 1988a. 1989; Sgroi. 1983: Smith & Israel. 1987). Although the children involved in sibling incest in this study received some intervention. care was not family focused. A significant number of victims and perpetrators were removed from their homes. Noninvolved siblings received little attention. although these children often have questions and issues of their own. Information about fathers and sibling offenders was often lacking. Several caseworkers. in explaining the lack of information about these members. stated that "we just don't do much work with fathers or offenders."That position is unequivocal with family focused interventions. Few families received counseling. It is not known if issues such as normal child growth and development, and anticipatory guidance related to family roles and sexuality. were addressed in work (casework or counseling) with families.

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literature about mothers' behavior related to their children's disclosure. Certainly. the few cases in which the mothers discovered the sibling incest provided uncontestable proof, but that did not happen in most cases. Considering the importance of the mother's ability to believe the child victim, a larger study might address whether mothers are more likely to believe their children's disclosure of sexual abuse in cases of sibling incest versus paternal incest.

Conclusions Child and adolescent psychiatric/mental health nurses are in a unique position to engage in strategies that promote healthy families. Public education programs that would include anticipatory guidance related to sexuality and family roles. boundaries, and relationships, and prevention programs that would include specific content related to sibling relationships could be developed. Interventions that promote health must also be advocated by child and adolescent mental health nurses for children and families who have experienced sibling incest. For example, both victim and abuser deserve legal advocacy to explore options other than removal from their home. If families can demonstrate behaviors indicating healthier family functioning (i.e., acknowledgement of abuse, compliance with therapy, parental availability and supervision of children, and behavioral monitoring of the abuser, especially when he or she is in the presence of the victim or other children). then risk to the victim for subsequent abuse is reduced as is the need to remove the victim or abuser from the home. In addition to interventions currently available, group therapy for children and youth deserves further consideration as an appropriate treatment modality. In this study, although several abusing youths were removed from their homes to youth detention centers, it is not known whether they received any mental health treatment. Certainly, groups for adolescent sexual offenders in such facilities could constitute initial steps to recovery, reunification with the family, and prevention of further abuse. Little research exists on the problem of sibling incest. Sibling incest, however, is an area in which nursing can make a contribution, from its own perspective, to the science of nursing and to the field of childhood sexual victimization.

Summary

References

Although sibling incest is believed to occur frequently, there is a paucity of information about it. The findings of this study indicated that sibling incest has a major impact on families, especially those members involved in the incestuous relationship. Therefore. the problem of sibling incest merits the attention of nurse researchers. For example, in the current study. mothers were reported to believe their children's reports of sexual abuse. This is an intriguing finding because it is contrary to reports in the

Bank. S . P . . & Kahn, M.D. (1982). The siblinR bond. New York: Basic Books. Finkelhor. D. ( 1987). The sexual abuse of children: Current research reviewed. Psyhicrrric. Anrmls. 4, 233-241. Finkelhor. D. ( 1979). Sexually victimized children. New York: Free Press. Fortenberry. J.D.. Rr Hill. R.F. (1986). Sister-sister incest as a manifestation of rnultigenerational sexual abuse. Jortmol ofAdolescvnt Cure. 7.202-204. Forward. S.. & Buck, C. (1978). Berra,w/ of innocence. New York: Penguin Books. Gilbert. C.M. (1988a). Psychosomatic symptoms: Implications lor child cexual abuse. Issues in Menml Heulrh Nursing. 9. 399-408.

SIBLING INCEST Gilbert, C.M. (1988b). Sexual abuse and group therapy. Journal of Psychosocial Nursing and Mental Health Services, 26,(5), 19-23, Gilbert, C.M. (1989). Sibling incest. Journal of Child and Adolescent Psychiatric and Mental Health Nursing, 2(2), 70-73. Justice, B., & Justice, R. (1979). The broken taboo. New York Human Sciences Press. Lieske, A.M. (1981). Incest: An overview. Perspectives in Psychiatric Care, 2 , 5 9 4 3 . Loredo. C.M. (1982). Sibling incest. In S. M. Sgroi (Ed.). Handbook of clinical intervention in child sexual abuse (pp. 177-189). Lexington. MA: D.C. Heath & Co. MacFarlane, K., Waterman, J.. Conerly, S., Damon, L., Durfee. M, & Long, S. (1986). Sexual abuse of young children. New York: Guilford Press. Miller, V., & Mansfield, E. (1981). Family therapy for the multiple incest

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family. Journal of Psychosocial Nursing and Mental Health Services, 4 , 29-32. National Center on Child Abuse and Neglect (1988). Studypndings: Study of national incidence and prevalence of child abuse and neglect (DHSS Publication No. He 23.1210: In 212 88-16506). Washington, DC: U.S. Department of Health and Human Services. Ralphing, D.L., Carpenter, B.L.. &Davis, A. (1967). Incest: A geneological study. Archives of General Psychiatry, 16, 505-5 11. Russell, D.E.H. (1986). The secret trauma. New York: Basic Books. Sgroi, S.M. (Ed.). (1982). Handbookofclinicalintervention in childsexual abuse. Lexington, MA: D.C. Heath. Smith, H.. &Israel, E. (1987). Sibling incest: A study of the dynamics of 25 cases. ChildAbuse &Neglect, 11. 101-108. Thorman, G. (1983). Incestuous families. Springfield, IL: Charles C. Thomas.

Sibling incest: a descriptive study of family dynamics.

This study investigates the characteristics of families in which a member was identified as a victim of sibling incest. Four agencies in a southeaster...
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