UCD Professor's study of the psychological adjustment of adult survivors of institutional abuse included in the Ryan Report

Tue, 10 November 09 15:12

Professor Carr's 200 page study presents the results of interviews conducted in 2005 and 2006 with 247 adult survivors of institutional abuse in religiously affiliated reformatories or industrial schools. Survivors had spent an average of about 10 years living in institutions. More than 90% had experienced institutional physical and emotional child abuse and about half, institutional child sexual abuse.

About four fifths of participants at some point in their life had had a psychological disorder including anxiety, mood, substance use and personality disorders. The overall rates of psychological disorders among survivors of institutional abuse, for most disorders, were more than double those found in normal community populations in Europe and North America. All participants had experienced one or more significant life problems with mental health problems, unemployment and substance use being the most common. More than four fifths of participants had an insecure adult attachment style, indicative of having problems making and maintaining satisfying intimate relationships.

Participants with multiple co-morbid psychological disorders had experienced more institutional abuse and showed poorer adult psychological adjustment than those with fewer disorders. The most poorly adjusted were those who entered institutions through the courts and reported institutional sexual abuse, in addition to prior physical abuse within their families. The psychological processes of traumatization and re-enactment of abuse on self and others were associated with multiple difficulties in adult life and a history of institutional, but not family-based child abuse. Having spent more time living within a family context in childhood and using positive coping strategies such as planning, developing skills and developing a social support network in adulthood were associated with a good quality of life.

Professor Carr made four key recommendations: (1) that legislation, policies, practices and procedures be regularly reviewed and revised to maximize protection of children and adolescents in institutional care in Ireland from all forms of abuse and neglect; (2) that evidence-based psychological treatment continue to be made available to adult survivors of institutional abuse; (3) that staff at centres which provide psychological treatment for adult survivors of institutional abuse have regular continuing professional education and training to keep them abreast of developments in the field of evidence-based treatment of survivors of childhood trauma; and (4) that research be conducted to evaluate the effectiveness of psychological treatment for adult survivors of institutional abuse.