title: A prospective examination of whether childhood sexual abuse predicts subsequent sexual offending.
abstract: OBJECTIVE
  Childhood sexual abuse has been assumed to increase the risk for sexual offending. However, despite methodological limitations of prior research, public policies and clinical practice have been based on this assumption.
  
  
  OBJECTIVE
  To empirically examine the commonly held belief that sexually abused children grow up to become sexual offenders and specialize in sex crimes.
  
  
  METHODS
  This prospective cohort study and archival records check included cases and control individuals originally from a metropolitan county in the Midwest. Children with substantiated cases of physical and sexual abuse and neglect (aged 0-11 years) were matched with children without such histories on the basis of age, sex, race/ethnicity, and approximate family social class (908 cases and 667 control individuals). Both groups were followed up into adulthood (mean age, 51 years). The court cases were from 1967 to 1971; the follow-up extended to 2013.
  
  
  METHODS
  Criminal history information was collected from federal and state law enforcement agency records at 3 points in time and from state sex offender registries.
  
  
  RESULTS
  Overall, individuals with histories of childhood abuse and neglect were at increased risk for being arrested for a sex crime compared with control individuals (adjusted odds ratio [AOR], 2.17; 95% CI, 1.38-3.40), controlling for age, sex, and race/ethnicity. Specifically, individuals with histories of physical abuse (AOR, 2.06; 95% CI, 1.02-4.16) and neglect (AOR, 2.21; 95% CI, 1.39-3.51) were at significantly increased risk for arrest for sex offenses, whereas for sexual abuse, the AOR (2.13; 95% CI, 0.83-5.47) did not reach significance. Physically abused and neglected males (not females) were at increased risk and physically abused males also had a higher mean number of sex crime arrests compared with control individuals. The results did not provide support for sex crime specialization.
  
  
  CONCLUSIONS
  The widespread belief that sexually abused children are uniquely at risk to become sex offenders was not supported by prospective empirical evidence. These new findings suggest that early intervention programs should target children with histories of physical abuse and neglect. They also indicate that existing policies and practices specifically directed at future risk for sex offending for sexually abused children may warrant reevaluation.
authors.affiliation: Department of Psychology, John Jay College of Criminal Justice, City University of New York, New York2Graduate Center, City University of New York, New York.
authors.forename: Cathy Spatz
authors.initials: CS
authors.lastname: Widom
authors.affiliation: Department of Psychology, John Jay College of Criminal Justice, City University of New York, New York2Graduate Center, City University of New York, New York.
authors.forename: Christina
authors.initials: C
authors.lastname: Massey
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002648:Child; D002649:Child Abuse / Q000706:statistics & numerical data; D002650:Child Abuse, Sexual / Q000706:statistics & numerical data*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D015146:Midwestern United States / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D012742:Sex Offenses / Q000706:statistics & numerical data