7. The Four Assumed Properties of CSA
Revisited
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Gender Equivalance
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Causality
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Pervasiveness and Intensity of Negative Effects or Correlates
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The gender differences found in current adjustment, retrospectively recalled
immediate reactions, current reflections, and self-reported effects demonstrate that the
experience of CSA is not comparable for men and women, at least among those who go on to
attend college.
The relation between CSA and adjustment problems was generally stronger
for women than men.
Two thirds of male CSA experiences, but less than a third of female
CSA experiences, were reported not to have been negative at the time. Three of every eight
male experiences, but only one of every 10 female experiences, were reported to have been
positive at the time. Patterns for current reflections about these events were similar.
The magnitude of gender differences in
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self-reported effects was virtually identical in the college samples in the
current review (r u= .22) and in the national samples (r u=
.23) examined by Rind and Tromovitch (1997) , which lends further
support to the relevance of the college data to the general population.
A number of researchers have commented on differences in male and female
reactions to CSA.
Schultz and Jones (1983) noted that men tended to see these sexual
experiences as an adventure and as curiosity-satisfying, whereas most women saw it as an
invasion of their body or a moral wrong. Fritz et al. (1981) made nearly identical
observations. West and Woodhouse (1993) , comparing their male sample with Nash and West's
(1985) female sample, observed that women's remembered reactions at the time were
"predominantly of fear, unpleasant confusion, and embarrassment . . . [while men's]
remembered reactions were mostly either indifference, tinged perhaps with slight anxiety,
or of positive pleasure, the latter being particularly evident in contacts with the
opposite sex" (p. 122). These gender differences in reactions to CSA experiences are
consistent with more general gender differences in response to sex among young persons.
For example, boys and girls report very different reactions to their first experience of
sexual intercourse ( Sorensen, 1973 ), with
girls predominantly reporting negative
reactions such as feeling afraid, guilty, or used, and boys predominantly reporting
positive reactions such as feeling excited, happy, and mature. These differences are
likely due to an interaction between biologically based gender differences and social
learning of traditional sex roles ( Fischer & Lazerson, 1984 ).
Researchers (e.g.,
Kinsey et al., 1948 ; Sorensen, 1973 ) have repeatedly reported that boys
are more
sexually active than girls, masturbate more frequently, and require less physical
stimulation for arousal. Social norms tend to encourage sexual expression in adolescent
boys but have traditionally emphasized romance and nurturance in girls ( Fischer &
Lazerson, 1984 ). Thus, it is unsurprising that men and women should show similar
differences in their reactions to CSA.
It is important to add that men and women may react differently to CSA
experiences because they tend to experience different kinds of CSA.
For example, Baker and
Duncan (1985) commented
that girls in their national survey in Great Britain may have found their CSA experiences
to be more damaging than boys did because they had more intrafamilial CSA and experienced
CSA at younger ages. [*]
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In the current review, college men and women also tended to have
different experiences; SA women experienced close family CSA more than twice as often as
SA men and experienced force about twice as often.
It is important to note that the separate meta-analyses of the four Gender ×
Consent combinations revealed a stronger association between CSA and adjustment problems
for women than for men when all levels of consent were considered, but not when unwanted
sex only was contrasted.
These findings suggest that some types of CSA (e.g., unwanted
experiences) are equivalent between the genders, but that other types (e.g., willing) may
not be.
The overall difference between male and female college students in the
CSA-adjustment relationship is not surprising, because men experienced coercion less
frequently than women. The CSA-adjustment results, however, reflect both the effects of
CSA and of confounding variables. For this reason, the self-reported reactions and effects
data are valuable as direct measures of impact.
These data point to gender nonequivalence
but must be qualified because of potential biases in recalling past events.
Nevertheless,
the two sets of analyses converge to suggest that when using current sociolegal
definitions for CSA, which include both unwanted and willing experiences, men and women
are not equivalent in their reactions and outcomes.
Two approaches were used to examine whether poorer adjustment for CSA students
compared with control students reflected the effects of CSA.
First, examination of the
interrelations among CSA, adjustment, and family environment revealed that weighted mean
effect sizes for CSA-adjustment, CSA-family environment, and family environment-adjustment
relations were r u= .09, .13, and .29, respectively.
The finding
that family environment was confounded with CSA and explained nine times more adjustment
variance than did CSA is consistent with the possibility that the CSA-adjustment relation
may not reflect genuine effects of CSA.
Second, analysis of studies that used statistical
control further supported the possibility that many or most CSA-symptom relations do not
reflect true effects of CSA, because most CSA-adjustment relations became nonsignificant
under statistical control.
Some researchers ( Briere, 1988 ; Briere & Elliott, 1993 ) have questioned
the validity of statistically controlling for family environment when examining
CSA-adjustment relations, arguing that such analyses may be invalid when
the control
variable (e.g., family environment) is unreliable, the sample size is small, the causal
relationship between the control and CSA variables is unknown, or the sample
underrepresents abuse severity. These concerns do not appear to be problematic in the
current review.
Whether measured by standard instruments or by author-written items,
family environment was reliably related to adjustment. Sample sizes were not small in the
studies using control ( M = 309, SD = 173). Regarding the direction of
causality, Ageton's (1988) national sample showed that family problems preceded, rather
than followed, CSA. Burnam et al. (1988) , using the same large community sample as Stein
et al. (1988) , found that SA persons tended to be symptomatic both before and after
experiencing CSA. These researchers noted that a third variable such as family or
community environment might have been responsible for both the CSA and the adjustment
problems.
Pope and Hudson (1995) detailed the potential role of third variables in
accounting for obtained CSA-adjustment associations
(e.g., genetic factors can both
predispose individuals to adjustment problems and make them vulnerable to CSA events).
CSA
may be most likely to cause family dysfunction when it is incestuous; when it is
extrafamilial, however, then family dysfunction may contribute to CSA by making children
vulnerable to this experience ( Briere & Elliott, 1993 ). [*6]
[*6] It is important to note that, under certain circumstances, extrafamilial CSA may
be likely to affect adversely family functioning, as in cases where CSA episodes become
known to the family and to the police. In this situation, tension may arise in the family,
representing secondary consequences of the CSA (cf. Baurmann, 1983 ).
Most commonly,
however, CSA episodes do not come to the attention of the family or police; for example,
Laumann et al. (1994) , in their national probability sample, found that only 22% of their
SA respondents ever told anyone.
Additionally, it should be noted, because of its
salience, the revelation, or even fear of revelation, of CSA events may inflate a SA
person's perception of negative aspects of family environment, particularly in
retrospective measures.
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In clinical studies, which often include high proportions of patients with
incestuous CSA, causality is therefore more problematic. In the college samples, however,
close family CSA was the exception, not the rule. Only 16% of SA students had close family
CSA; the percentage of cases of paternal incest is even lower because the overall value
includes sibling incest. These considerations do not prove causal direction in the college
population but suggest that in most cases the direction is more likely to go from family
environment to CSA.
Finally, the college samples did not underrepresent abuse severity.
Compared with the general population, as indicated by studies based on national samples,
SA students experienced as much intercourse, close family CSA, and multiple episodes of
CSA; moreover, college students were just as likely to have experienced CSA as persons in
the general population.
Briere's arguments seem most appropriate for clinical samples with
large proportions of incest cases. In this situation, Briere's (1988 , p. 84) argument
that "abuse without family dysfunction may have little construct validity" may
be applicable; in the general population and in the college population, however, this
argument is less valid. These considerations support the validity of using statistical
control in the studies under review.
Aside from validity issues, however, the statistical control analyses do not
rule out causality for several reasons.
First, in a minority of cases, CSA-symptom
relations remained significant after statistical control. Second, when nonsignificance did
result from statistical control, low power rather than a zero effect may have been
responsible. Third, a small minority of students with a history of CSA did report
self-perceived lasting harm, implying genuine negative effects of CSA for these persons.
Fourth, for male participants, unwanted CSA was associated with greater symptomatology. If
unwanted CSA had been contrasted with willing CSA only, instead of a combination of
unwanted and willing CSA, then consent would likely have moderated CSA-symptom relations
more strongly. These results suggest that unwanted CSA does have negative effects,
although confounding variables must still be considered.
Despite these caveats, the
current results imply that the claim that CSA inevitably or usually produces harm is not
justified.
The finding that family environment is more important than CSA in accounting for
current adjustment in the college population is consistent with the results of several
recent studies using participants from noncollege populations (e.g., Eckenrode et al.,
1993 ; Ney et al., 1994 ).
Eckenrode et al. categorized children and adolescents obtained
from a large representative community sample in a small-sized city in New York state into
six groups: not abused, CSA, physical abuse, neglect, CSA and neglect, and physical abuse
and neglect.
They found that SA children and adolescents performed as well in school as
nonabused controls in all areas measured, including standardized test scores, school
performance, and behavior. Neglect and physical abuse, on the other hand, were associated
with poorer performance and more behavior problems.
Ney et al. (1994) separated their
mostly clinical sample of children and adolescents into categories of
CSA, physical abuse,
physical neglect, verbal abuse, emotional neglect, and combinations of these. They found
that the combination of abuse that correlated most strongly with adjustment problems was
physical abuse, physical neglect, and verbal abuse. In the top 10 worst combinations,
verbal abuse appeared seven times, physical neglect six times, physical abuse and
emotional neglect five times each, whereas CSA appeared only once.
The greater importance of nonsexual negative childhood experiences in explaining
later adjustment was clearly demonstrated in a study of a large, representative sample of
female college students throughout the United States.
Wisniewski (1990) used path analyses
to assess the relative contributions of CSA and family environment to current adjustment.
She concluded that the data did not support CSA
"as a specific explanation of current
emotional distress [but instead are] best interpreted as supportive of other factors such
as family violence . . . as having the greatest impact" (p. 258).
Other researchers
who used college samples and used statistical control reached similar conclusions
regarding the role of family violence, rather than CSA, in explaining current adjustment
problems (e.g., Higgins & McCabe, 1994 ; Pallotta, 1992 ).
One reason CSA may have
been overshadowed by other childhood experiences such as verbal and physical abuse in
explaining adjustment is that participants may have experienced the latter type of events
more frequently than CSA.
Nevertheless, the results from these studies highlight the
relatively greater importance of family environment compared with CSA in accounting for
adjustment problems - a point that has been ignored or underemphasized in much of the CSA
literature to date.
Pervasiveness and Intensity of Negative Effects or
Correlates
Self-reported effects from CSA revealed that lasting psychological
harm was uncommon among the SA college students. Perceived temporary harm, although more
common, was far from pervasive.
In short, the self-reported effects data do not support
the assumption of wide-scale psychological harm from CSA.
This conclusion is further
suggested by students' self-reported reactions. The finding that two thirds of SA men and
more than one fourth of SA women reported neutral or positive reactions is inconsistent
with the assumption of pervasive and intense harm.
It is not parsimonious to argue that
boys or girls who react neutrally or positively to CSA are likely to experience intense
psychological impairment. To argue that positive or neutral reactions are consistent with
intense harm, it seems logical to first demonstrate that negative reactions are consistent
with intense harm. However, the magnitude of the CSA-adjustment relation was small for
women, despite the reporting of negative reactions by a majority of SA women. This low
intensity finding for generally negative CSA experiences is inconsistent with an
expectation of intense harm from nonnegative CSA experiences.