Syndrome-Related Risk Factors for Sexual Abuse: The Example of Prader–Willi Syndrome

• Published in: Archives of sexual behavior Vol. 50; no. 5; pp. 2259 - 2266
• Main Authors: Benarroch, Fortu, Srebnik-Moshe, Naama, Hirsch, Harry J., Genstil, Larry, Derei, Dvorit, Shay, Anna, Gross-Tsur, Varda
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.07.2021; Springer Nature B.V
• Subjects: Adults; Assisted living facilities; Behavioral Science and Psychology; Caregivers; Child sexual abuse; Clinical Case Report Series; Food; Genetic disorders; Genetics; Intellectual disabilities; Medicine; Pain; Psychology; Public Health; Risk factors; Sex crimes; Sexual abuse; Sexual Behavior; Social Sciences; Israel; Food-seeking behavior; Sexual abuse; Prader–Willi syndrome; Intellectual disabilities; Sociosexuality education
• ISSN: 0004-0002; 1573-2800
• DOI: 10.1007/s10508-021-01934-9

Many genetic disorders associated with intellectual disability are characterized by unique behavioral phenotypes which may have serious psychological consequences such as increasing the risk for sexual abuse (SA). Prader–Willi Syndrome (PWS), a severe neurogenetic syndrome with uncontrollable hyperphagia and high threshold for pain, is an excellent example of this issue. The absence of reports on SA in PWS highlights the lack of awareness to the topic. Our aim was to report on SA in individuals with PWS, describe its unique characteristics, and offer recommendations for its prevention. Caregivers of all individuals with genetically confirmed PWS living in the only two residential facilities designated for PWS in Israel were interviewed for a history of sexual behavior and abuse, and medical data were collected from their files. SA was reported in a quarter of the sample. In most of the cases (78%), food reward was used by the perpetrators to attract their victims. Age at SA ranged from 11 to 29 years. Most of the individuals did not disclose the event and some continued to initiate inappropriate sexual activity to obtain food. Characteristics unique to PWS, such as food-seeking behaviors and high threshold for pain, likely contribute to the risk for SA. These findings suggest that syndrome-specific programs for SA prevention should be considered for individuals with any genetic syndrome with behavioral problems that may increase SA risk.