Over the past 30 years, a large number of studies have investigated the effects of adult-minor sexual activity on children and adolescents. Sometimes their findings have been controversial and seemingly contradictory. To understand and interpret these findings, it is necessary to understand the different kinds of studies that have been conducted.
Research is conducted by studying people selected in various ways.
Probability samples include people who are most typical of the general population, but they usually involve retrospective studies which rely on possibly inaccurate memories of past events. While all other types of samples are less representative, clinical and criminal samples are generally considered by psychologists to be the least representative.
It is also helpful to realize that researchers often conduct reviews of the literature; that is, they examine a large number of previously conducted studies and attempt to synthesize their findings. They search for consistent patterns that will lead to more powerful and reliable conclusions than would be possible from a single study. The findings and bibliographies presented on this site are based on both single studies and literature reviews.
It is important to remember that most studies do not distinguish between willing sexual experimentation or ongoing sexual relationships, and unwanted advances, coerced interactions, or violent assault. They also mix non-contact behavior (such as viewing of pornography, exhibitionism, and verbal propositioning) with touching or kissing and genital contact. Studies vary in the proportions of these different kinds of incidents they include, so their results vary widely.
It is clear that some boys experience severe forms of sexual abuse, and exhibit serious symptoms as a result. Others who are harmed come from disadvantaged or dysfunctional family backgrounds (including other kinds of abuse), and researchers are uncertain about the extent to which their poor adjustment is due to sexual abuse in itself.2
Some studies have suggested that for boys, physical or emotional abuse may be more common and more damaging than sexual abuse.3 In fact, many studies of college and probability samples, and even some clinical studies, find the majority of boys are unharmed when sexual abuse is defined to include willing and non-contact activity.4 However, boys who seem willing, but in reality are uncertain or feel compelled to engage in sexual activity with an older person may be particularly harmed due to subsequent feelings that they could have prevented the abuse.
Researchers seem to agree that there is no set of reactions that is a single inevitable outcome of adult-minor sexual interaction. There is no particular syndrome or set of symptoms, such as multiple personality disorder or borderline personality disorder. Negative outcomes are associated with
Because findings depend strongly on whether clinical samples are used, the following bibliography is divided between those studies using such samples and those based on non-clinical samples.
This bibliography includes single studies and literature reviews based on clinical samples, or on a mixture of samples which included clinical samples.
Beitchman, J., Zucker, K., Hood, J., DaCosta, G., & Akman, D., "A Review of the Short-Term Effects of Child Sexual Abuse," Child Abuse and Neglect, vol. 15, 1991, pp. 537-556.
The authors reviewed the literature on the immediate impact CSA has on children. They note the frequent finding that CSA victims suffered from a wide range of serious social, psychological, and school problems, and the limitations of these findings due to the fact that the studies relied mostly on clinical samples and failed to use comparison groups or to control for other factors that may have caused the symptoms. They write that CSA victims tended to have prior histories of psychopathology or to come from disadvantaged or disturbed homes, so that it was difficult to attribute outcomes in these samples solely to sexual abuse. However, sexualized behavior seemed to be related to CSA.
Beitchman, J., Zucker, K., Hood, J., DaCosta, G., Akman, D., & Cassavia, E., "A Review of the Long-Term Effects of Child Sexual Abuse," Child Abuse and Neglect, vol. 16, 1992, pp. 101-118.
The authors reviewed 32 studies on the effects of CSA on later adult adjustment. They describe findings of sexual disturbances among CSA victims, and, as in their earlier study of short-term effects, note that the studies were based on clinical samples and did not control for pre-existing psychopathology and family disruption commonly found in such samples. However, they do note that frequent invasive sexual abuse was associated with trauma or harm. Data suggested that CSA impacted negatively on adjustment, mental health status, and other psychiatric symptoms, but results were not certain. Beitchman et al. conclude that the evidence does not support a link between CSA and any particular syndrome or set of symptoms, including multiple personality disorder or borderline personality disorder.
Constantine, L.L., "The effects of early sexual experiences: A review and synthesis of research," in Constantine, L.L. & Martinson, F.M. (eds.), Children and sex: New findings, new perspectives, Boston: Little, Brown & Co., 1981, pp. 217-244.
Constantine reviewed 30 studies examining short-term and long-term impact of childhood sexual experiences with peers, family members, and unrelated adults. Findings of these studies varied greatly, ranging from all children harmed to none harmed. Clinical and criminal studies tended to show more harm, although some still found the majority of children were unharmed. While research leaves little doubt that some children do initiate the contacts and many participate willingly, the child’s interest is different from the adult’s, and children may be particularly harmed when they appear to cooperate but are actually unwilling. Constantine concludes that there is no set of reactions that is a single inevitable outcome of adult-child sexual interaction. Negative outcomes are associated with violence or coercion, tense situations, sex-negative attitudes, sexual ignorance, and unsupportive or judgmental adult reactions.
Fergusson, D.M. & Mullen, P.E., Childhood sexual abuse: An evidence based perspective, Thousand Oaks, California: Sage Publications, 1999.
Fergusson & Mullen examined a review of 26 studies as well as 15 individual studies (12 using community samples) and concluded that children known to have been sexually abused show vulnerability to a wide range of emotional and behavior symptoms. They qualify this finding by writing that research may overestimate the impact of CSA due to biased sample selection and failure to control for confounding influences such as disturbed and disadvantageous family backgrounds which may contribute to the children’s problems. They find no evidence to support the belief that CSA is linked to specific types of dissociative disorders or a CSA-specific pattern of symptoms. In addition, they estimate that up to 40% of minors exposed to CSA may be symptom free. Whether or not symptoms occur seems to depend on the severity of the incident, the extent of family support and nurturance, and the child’s attitudes and coping skills.
Ingram, M., "Participating victims: A study of sexual offenses with boys," in Constantine, L.L. & Martinson, F.M. (eds.), Children and sex: New findings, new perspectives, Boston: Little, Brown & Co., 1981, pp. 177-187.
British child counselor Michael Ingram describes cases of man-boy sexual interaction that occurred with 74 prepubescent boys he saw in his practice. Two incidents involved traumatic sexual assault by a stranger, while the rest involved willing sex-play or affectionate interactions. Some of the boys seemed healthy and required no further counseling, while others seemed quite disturbed. Ingram examines reasons for the boys’ differing adjustment.
Kilpatrick, A., "Childhood Sexual Experiences: Problems and Issues in Studying Long-Range Effects," Journal of Sex Research, vol. 23, No. 2, 1987, pp.173-196.
Kilpatrick evaluated 34 studies of the long-range consequences of childhood sexual experiences, and narrowed them down to ten which did not suffer from major methodological problems. She found no evidence to support the hypothesis that childhood sexual experiences inevitably lead to particular long-term effects—negative, neutral, or positive. Harm was associated with childhood incest experiences, disadvantaged backgrounds, older age at cessation of molestation, stronger negative feelings, higher frequency, and longer duration.
Li, C.K., "Adult sexual experiences with children," in Li, C.K., West, D.J., & Woodhouse, T.P., Children’s sexual encounters with adults, London: Duckworth, pp. 139-316, 1990a.
Reviewing the literature, Li found that clinical studies find a majority of CSA victims experience a wide range of serious psychological symptoms, but probability sample studies find only a very small minority of children exhibit any harm. He writes that studies often do not make distinctions between unwanted sexual incidents and those willingly engaged in, so there is significant disagreement about psychological harm when no coercion occurs. He also addresses situations in which researchers resort to speculation, neglect confounding factors, examine the data selectively, or base their definitions or interpretations on their own moral values.
Ney, P., Fung, T., & Wickett, A.R., "The worst combinations of child abuse and neglect," Child Abuse and Neglect, v. 18, no. 9, 1994, pp. 705-714.
Ney et al. surveyed a combination clinical, criminal, and probability sample of 167 children and adolescents, asking them about physical abuse, physical neglect, emotional neglect, verbal abuse, and sexual abuse. They attempted to determine which combinations of different kinds of abuse were most related to negative outlooks for the future. Combinations involving physical or verbal abuse seemed most strongly correlated with negative outcomes.
Oellerich, T.D., "Child Sexual Abuse: Is the Routine Provision of Psychotherapy Warranted?"*, Issues In Child Abuse Accusations, vol. 11, no. 1, 2001.
Ohio University Social Work Professor Thomas Oellerich reviewed the literature on the effects of childhood or adolescent sexual activity with adults, and found that many popular beliefs were not supported. Many studies suffered from methodological problems, and those that didn’t found that children and adolescents showed a wide range of reactions to sexual abuse.
West, D.J., "Boys and Sexual Abuse: An English Opinion," Archives of Sexual Behavior, Dec. 1998.
British criminologist Donald J. West reviews evidence for gender differences in reactions to childhood sexual experience with adults. He discusses the potential for harm in such activity, but finds no support for the supposed link between sexual abuse in childhood and later abusive behavior as an adult.
This bibliography includes single studies and literature reviews based only on non-clinical samples; that is, on probability, college, or convenience samples.
Bernard, F., "Pedophilia: Psychological consequences for the child," in Constantine, L.L. & Martinson, F.M. (eds.), Children and sex: New findings, new perspectives, Boston: Little, Brown & Co., 1981, pp. 189-199.
This study conducted by Dutch clinical psychologist Frits Bernard examined the experiences of a convenience sample of 30 adults, mostly men, most of whom had un-coerced and positively experienced adolescent or childhood sexual experiences with adults.
Fromuth, M.E. & Burkhart, B.R., "Long-term psychological correlates of childhood sexual abuse in two samples of college men," Child Abuse & Neglect, vol. 13, 533-542, 1989.
Fromuth and Burkhart surveyed two samples of male college students about CSA experiences and administered several psychological adjustment assessments. Three-quarters of the incidents were boyhood sexual experiences with women. Their results suggested that in one sample, men who were sexually abused were slightly less well adjusted than the non-abused men, but in the other sample, there were no significant correlations between CSA history and adjustment difficulties. The authors try to account for this difference.
Haugaard, J.J. & Emery, R.E., "Methodological issues in child sexual abuse research," Child Abuse & Neglect, vol. 13, 1989, pp. 89-100.
Using a college sample, Haugaard & Emery studied how varying definitions of CSA impacted scientific findings regarding its consequences. When they defined CSA broadly as any sexual interaction that occurred before age 17 with someone at least five years older, CSA victims exhibited no statistically significant differences in adjustment from a comparison group. When CSA was defined more narrowly by excluding cases experienced positively and those involving only exhibitionism, CSA victims showed poorer adjustment in two areas. When CSA was defined even more narrowly so that it resembled clinical cases, CSA victims showed poorer adjustment in a larger number of areas. Additionally, when CSA was defined broadly, there were significant gender differences which disappeared when CSA was defined narrowly.
Meston, C.M., Heiman, J.R., & Trapnell, P.D., "The relation between early abuse and adult sexuality," Journal of Sex Research, vol. 36, No. 4, 1999, pp. 385-395.
The authors surveyed 1,032 university students to examine correlations between physical abuse, emotional abuse, neglect, and sexual abuse on the one hand, and sexual adjustment on the other hand. They found that CSA was related to all measures of sexual behavior for females and to none for males. They write that their findings suggest an independent relation between childhood sexual abuse and sexual behavior in females, and between emotional abuse and measures of body image and sexual adjustment in males.
Rind, B. & Tromovitch, P., "A Meta-Analytic Review of Findings from National Samples on Psychological Correlates of Child Sexual Abuse," Journal of Sex Research, vol. 34, No.3, 1997 pp. 237-255.
Rind & Tromovitch reviewed seven studies using national probability samples. They examined the pervasiveness and intensity of CSA-related harm, and addressed gender differences. They concluded that when CSA is accompanied by factors such as force or close familial ties, it has the potential to produce significant harm. However, in general, CSA is not associated with pervasive harm, and when harm occurs, it is not typically intense. Furthermore, a causal link between CSA and later psychological maladjustment could not safely be inferred because of confounding variables. Finally, CSA experiences for males and females are not equivalent.
Rind, B., Tromovitch, P., & Bauserman, R., "A meta-analytic examination of assumed properties of child sexual abuse using college samples," Psychological Bulletin, vol. 124, No. 1, 1998, pp. 22-53.
Rind et al. reviewed 59 studies based on college samples and found that students who experienced CSA were, on average, slightly less well adjusted than controls. However, this poorer adjustment could not be attributed to CSA because family environment (FE) was consistently confounded with CSA, FE explained considerably more adjustment variance than CSA, and CSA-adjustment relations generally became nonsignificant when studies controlled for FE. Self-reported reactions to and effects from CSA indicated that negative effects were neither pervasive nor typically intense, and that men reacted much less negatively than women.
West, D.J. & Woodhouse, T.P., "Sexual encounters between boys and adults," in Li, C.K., West, D.J., & Woodhouse, T.P., Children’s sexual encounters with adults, London: Duckworth, pp. 3-137, 1990.
West & Woodhouse provide an overview of the research on the prevalence and effects of boyhood sexual interaction with adults. They address the difficulty of interpreting results of studies due to definitional issues, reliance on clinical samples, and the existence of children’s emotional problems before the sexual interaction. They describe several factors that affect the consequences for children and the differences between boys’ and girls’ reactions. They then describe the results of their own studies using college, convenience, and probability samples. Incidents involved willing encounters with women and men, as well as unwanted advances from men.