A Meta-Analytic Review of Findings from National Samples on Psychological Correlates of Child Sexual Abuse
Rind, Bruce, Tromovitch, Philip, The Journal of Sex Research
Child sexual abuse (CSA) has received considerable attention over the last two decades by the media, the lay public, mental health care professionals, the legislature, law enforcement personnel, and the judiciary. Much of this attention has concerned the possible psychological consequences of this experience, as is shown by the surge in recent scientific and popular publications (Pope & Hudson, 1995). Our purpose in the current research was to examine these possible consequences by reviewing an important body of literature that has not been systematically examined in previous literature reviews on the psychological correlates of CSA.
First, it is important to discuss definitions. Kilpatrick (1987) argued that, in scientific discussions, abuse (i.e., harm) is something to be established as a conclusion, not to be accepted as a premise. Although we are in agreement with this position, because the term child sexual abuse is used pervasively in the literature under consideration, we have retained this term as a matter of convenience. Based on the manner of use of this term in the studies to be reviewed, CSA is generally defined in the current article as a sexual interaction involving either physical contact or no contact (e.g., exhibitionism) between either a nonadult (i.e., child or adolescent) and someone significantly older (e.g., an older adolescent or an adult), or between two nonadults in which coercion is employed.
Empirical investigations into the psychological correlates of CSA began in earnest during the late 1970s and grew rapidly during the 1980s. Given the emerging literature on correlates, a number of researchers began conducting literature reviews (e.g., Beitchman, Zucker, Hood, DaCosta, & Akman, 1991; Beitchman et al., 1992; Black & DeBlassie, 1993; Briere & Elliot, 1994; Briere & Runtz, 1993; Browne & Finkelhor, 1986; Constantine, 1981; Glod, 1993; Jumper, 1995; Kendall-Tackett, Williams, & Finkelhor, 1993; Kilpatrick, 1987; Mendel, 1995; Neumann, Housekamp, Pollock, & Briere, 1996; Urquiza & Capra, 1990; Watkins & Bentovim, 1992). Among the literature reviews just cited, the authors typically have concluded that CSA is associated with a wide range of psychological problems, including anger, depression, anxiety, eating disorders, alcohol and drug abuse, low self-esteem, relationship difficulties, inappropriate sexual behavior, aggression, self-mutilation, suicide, dissociation, and posttraumatic stress disorder, among others. Additionally, the typical literature review has asserted or implied that (a) CSA causes these problems, (b) these problems occur pervasively throughout the population of persons who have experienced CSA, (c) these problems are generally intense (i.e., severe), and (d) the CSA experiences of boys and girls are equivalent in terms of pervasiveness and intensity of harm. Next we discuss these four fundamental claims in more detail.
Four Basic Conclusions or Implications about CSA
Causality. Conclusions or implications that CSA causes psychological problems have been indicated in the literature reviews by the consistent use of terms such as effects and impact and by a failure to qualify discussions of symptoms associated with CSA by considering alternative explanations for this association (e.g., Black & DeBlassie, 1993; Briere & Elliot, 1994; Browne & Finkelhor, 1986; Kendall-Tackett et al., 1993; Mendel, 1995; Watkins & Bentovim, 1992). Conclusions of causality have also appeared in several reviews in which the authors briefly discussed the methodological principle that correlation is not causation but then argued or implied that the evidence supports causality (e.g., Briere & Runtz, 1993; Glod, 1993; Urquiza & Capra, 1990). In only a minority of the reviews have the authors argued or acknowledged that causality cannot be inferred from the studies they reviewed because of problems such as the presence of confounding variables (e. …