Childhood Sexual Abuse

Letter from student Fall 1999

Prof. Harris,

I really enjoyed today's lecture on divorce. However, I am very intrigued

by your thoughts on abuse. I was extremely concerned when you mentioned

that not everyone who is abused as a child, is scarred for life. I do

believe that humans are resilient animals but I also feel that we have a

great capacity to be affected by people around us and especially traumas.

In the case of amnesia, I totally understand how it would not affect your

life. But, with abuse, I do not care how small it is, it affects your

personality, outlook on life, and your thoughts forever. One may be able

to deal with the abuse in an appropriate way but it doesn't mean they won't

still think about it. I have never been abused myself but my mother has

worked with abused children and I have known people who have been

abused...and I have found no matter how isolated or small the incident, it

affects peoples self-worth and sense of trust by violating someone in such

a violent way. I'd appreciate any thoughts you have in response to my

opinion...and also more detail on the scientific findings you mentioned in

class today.

thanks much,

Prof Harris' response, Fall 1999

Thanks for your comments! Imagine your reaction, keenly and sincerely felt, magnified by all the people who read the Psychological Bulletin article... perhaps you can see why this article created so much controversy, including a bill introduced in congress that passed both the House and the Senate in July of this year. (The resolution denounced the article and APA for publishing it.)

Here is the citation:

Rind, B., Tromovitch, Ph., & Bauserman, R. (1998). A meta-analytic examination of assumed properties of child sexual abuse using college students. Psychological Bulletin, 124: 22-53.

How to to find out about more about the controversy?

I first heard about it on the midnight TV show, Politically Incorrect, whichpicked it up from the radio show, Dr. Laura.  Since then the controversy has been featured in newsletters of the American Psychological Association and the Association for Psychological Science. (The  Feb 2000 issue of Lingua Franca also discusses this, p.12, but I found their account to not correctly reflect the content of the Rind et al article.)

To learn more about the controversy, check databases that specialize in popular media, such as Reader's Guide or Nexus.

Regarding the points you brought up:

But, with abuse, I do not care how small it is, it affects your personality, outlook on life, and your thoughts forever. One may be able to deal with the abuse in an appropriate way but it doesn't mean they won't still think about it.

Psychologists would probably agree that the abuse may affect your thoughts forever. How would we test the hypothesis that childhood sexual abuse (CSA) affects your personality or adult outcome measures such as years of education completed, psychiatric disorder, income, number of marriages, sexual dysfunction, criminal behavior...?

The method used is to administer personality scales and other measures of adult adjustment. To the extent that these tests adequately measure personality and adjustment, these tests do not find strong differences between individuals who self-report CSA and those who report no CSA.

One possible response is that the aspects of personality that are always affected by CSA are not the aspects of personality that are easily measured by the psychological scales that have been developed to date. But then the question is why not, since other these scales do a good job at being sensitive to other things, such as temperamental characteristics between adopted children and their biological parents.

Rind, Tromovitch and Bauserman found that many other factors predicted personality and adult adjustment, such as family conflict, parental strife, chaotic household, low income, parent with a psychiatric disorder, and so on.

These factors are correlated with CSA (just as they are with divorce)!  Once these factors are taken into account, CSA itself has no additional predictive validity.   So we can't attributed poor adult adjustment to CSA, because the factors which are correlated with CSA are sufficient to cause poor adult adjustment.  

This points to a reason why we believe that CSA causes poor adult adjustment.  We hear about an individual who had CSA and later committed suicide, or had a psychiatric disorder, or exhibited criminal behavior, or never finished high school (or whatver).  We think "Oh, that is because of CSA" --not, oh, that was because of chaotic childhood household, family conflict, parental strife, low income, parent with a psychiatric disorder...  Thus we record this correlation as evidence about CSA, not evidence about the relationship betwen these other risk factors and poor adult outcome.

Rind, Tromovitch and Bauserman examined measures beyond personality tests. They reviewed hundreds of studies that looked at academic performance, attitudes to interpersonality relationships, sexual adjustment in adulthood, self-esteem.... same outcome. CSA either did not predict adult behavior/adjustment or was a very weak predictor.

One thought I had while reading the Rind et al article is that many of their definitions of abuse were less extreme than intercourse (being touched/fondled or witnessing exhibitional behavior). However, factoring in "severity" of the abuse did not increase the ability of the CSA variable to predict adult personality or non-optimal outcomes. There was not a stronger effect of self-report of CSA on adult personality even analysis was restricted to what is considered the most extreme form of CSA, forced penetration.

I wondered if maybe a one-time episode of CSA might not be vary traumatic, but adult outcomes did not vary as a function of duration of the CSA over time.

Could it be that CSA victims are putting on a happy face, pretending to "look normal" to an interviewer or on a questionnaire? But in no other area of personality research do we find that a group is so talented at what psychologists call "faking good".

So, the CSA story remains a mystery. We have these gut reactions that CSA should have long term effects that can be measured in adulthood, but we can't find strong effects when we look at interview and questionnaire data.  The one resolution I see is if everything else in your life is going well, then you are robust to a one-time incident of CSA.  If you are subject to multiple-recurrent CSA, then we have no way to determining if the mutliple, recurrent CSA is the cause of negative outcomein adulthood because evertying else in your life would *not* be okay if CSA was allowed by the caregivers in your life to continue.  That is, could it ever happen that a child had a perfect childhood except for recurrent episodes of CSA?  No, because many other things than CSA are wrong with your life if (a) caregivers rae so distant that they don't know about the recurrent CSA or (b) caregivers allow CSA to continue. 

What about the idea that CSA could "change your outlook on life" ?

CSA could have the following effect: For a very specific situation that reminded the now-adult CSA victim of her own situation (I will assume female CSA victim for convenience), that person could react strongly in a way that a non-CSA victim wouldn't, e.g., say the CSA perpetrator had been an older teen who had been a baby sitter for a few times one summer. The now-adult victim may get a flash of anger and hurt whenever remembering that traumatic event, and for her own children, will never feel comfortable using babysitters, and may even hire a professional nanny or only use relatives for babysitting and never never use a neighborhood teen, and may even fly into a rage when her partner suggests such a thing.

That would be an example of CSA making a life-long difference. But insisting on special babysitting arrangments is not something that will show up on a personality tests or as an out-come measure.

Does the finding that CSA is "Not in all cases devestating" mean that CSA is okay?  Of course not.    But to believe, in the absence of evidence, that CSA is always devestating, is to have an impoverished view of human nature.  Humans are not so fragile and weak.  It takes more than a single negative event to break us.  How CSA may combinewith other risk factors in childhood to influence adult outcome needs to be studied, as does how to help CSA victims have optimal recovery.