Title: Childhood Sexual Experiences: Problems and Issues in Studying Long-Range Effects
Author(s): Allie Kilpatrick
Affiliation: School of Social Work, University of Georgia
Citation: 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.
Existing studies of the long-range consequences of childhood sexual experiences are marred by problems which render many of their findings useless. A review of the literature reveals the methodological problems—of the definition of terms, sampling methods, and measures of consequences. In this review, scientific criteria are used to evaluate each of 34 studies which attempted to account for long-range effects of childhood sexual experiences. Ten studies were found which met the scientific criteria. The findings of these 10 studies do not support the three different hypotheses that childhood sexual experiences inevitably lead to either long-term harmful effects, neutral effects, or beneficial effects.
The author identified 34 studies conducted between 1934 and 1986 which examined long-term effects of childhood sexual experiences, including both incest and child-adult sexual contact outside of the family. She also examined a previous review of 47 studies.
Most studies suffered from methodological problems in one or more of the following three areas: definition of terms, selection of people to be studied, and measures of effects of sexual experiences. Of the 34 studies originally identified, 24 were eliminated from consideration due to their methodological problems. The remaining ten were reviewed to determine whether they supported any of the three hypotheses: childhood sexual experiences invariably result in harmful long-term effects, childhood sexual experiences invariably result in neutral long-term effects, or childhood sexual experiences invariably result in beneficial long-term effects.
In the most of the studies reviewed, definitions of “child,” “adult,” “child-adult contact,” “abuse,” and “incest” were vague, not given at all, or varied widely in terms of both behavior and the partner involved. For example, some studies defined sexual behavior to be intercourse, while others included “fondling,” “exposure,” or “attempted seduction.” Sometimes the specific behavior could not be determined because only vague terms such as “abnormal sexual interest” or “had relations” were used. The ages used to define adult and child varied or were not given.
The author writes:
The concern here is that researchers are making generalizations about behaviors which may be too varied for such general conclusions to be valid. It is necessary to determine that outcomes are consistent across types of behaviors and different partners before such generalizations are appropriate and more sweeping definitions…are warranted…What is needed is for researchers to discriminate between the ages of the children studied and then look at the effects with partners of different ages.
Words such as “abuse,” “victimization,” “molestation,” and “exploitation” are used by researchers as catch-all terms for any sexual contact between a child and someone older. As such, they are based not on effects upon the child, but on age differences or community standards. The terms assume harm without actually determining if harm has occurred:
The major issue here is whether the researcher has defined “abuse” as some type of harm (a consequence of sexual activity that can be quantitatively measured) or whether “abuse” is defined in relation to violation of social norms. When the two issues of scientific objectivity and maintenance of moral standards are not separated, problems arise. On the one hand, science is a pursuit to understand the world as it is. On the other hand, social norms are rules by which people choose to live. Failure to make a distinction between the two has caused many researchers to buttress existing social norms rather than to conduct scientific investigations…To assume that violations of social norms lead to harm for the child is not scientifically sound. The fundamental question concerning the definition of abuse, therefore, becomes, "What has been harmed -- the child or the moral code?" After the issues involved in defining sexual abuse are clarified, then, and only then, can the remaining problems involved in studying the long-range effects of childhood sexual experiences be resolved.
Studies which assumed harm without empirical support were eliminated from the review.
The validity of many studies was compromised by the sampling problems. First, to determine that childhood sexual experiences cause a certain effect, those who had childhood sexual experiences should be compared to those who did not; that is, a control group. Only 10 of the 34 studies used control groups. Secondly, an adequate number of people must be studied to make valid conclusions; 7 of the studies based its conclusions on less than 10 subjects.
Thirdly, studying only those who are receiving psychiatric care or those who have been identified by the criminal justice system biases the results of the study. When members of these groups are found to suffer from certain psychological problems, it cannot be determined whether these are due to the childhood sexual experience or to some other factor that caused them to be treated or incarcerated. It is not known whether people in the non-clinical population would react similarly. Thus, clinical and offender populations cannot be generalized to other groups of people. Only 10 of the studies did not use clinical or offender populations.
A fourth sampling problem with much of the research involves combining different age groups or socioeconomic status. Prepubescent children may react to sexual experiences differently from those who have reached puberty, so that findings may be misleading when generalizations are made across these groups. Controlling for socioeconomic status is essential since there is evidence that it may have more effect on later adult functioning than the sexual experience does.
Older studies were vague regarding their measures of effects and the length of time between the sexual contact and the time that the effects were measured. Although most recent studies had rectified these problems, determining that these outcome measures were caused by the sexual experience was still problematic:
Such causal inferences are usually inappropriate given the retrospective and/or correlational nature of many of the studies. For example, there have been many reports that the social system's handling of incidents regarding sexual abuse of children caused as much or more harm as the sexual experience itself. Effects or consequences attributed to the sexual experience itself may have actually been caused by the way the experience was handled by the social system, or, for that matter, by any number of other factors. Extreme caution must be exercised in claiming causal relationships.
Nineteen of the 34 studies claimed childhood sexual experiences primarily lead to long-term harm. Only two of these studies were free of the methodological problems described above; three more suffered from only one or two problems: the lack of control group and/or exclusive use of clinical or offender populations. The results of these five studies could be summarized as follows:
With this tentative evidence, it could not be concluded unequivocally that childhood sexual experiences inevitably lead to long-term harmful effects.
Fourteen of the 34 studies in the review found neutral effects. Only 5 of them were relatively free of methodological problems. Their findings could be summarized as follows:
These findings did not support the hypothesis that childhood sexual experiences inevitably lead to long-term neutral effects.
One study suggested beneficial long-term effects of child-adult sexual interaction. It was a descriptive and biographical study of 30 pedophile cases. It lacked a control group, involved a small number of cases, combined age groups, and used an unrepresentative convenience sample. Therefore, the study was excluded from the review. It could not lead to the conclusion that childhood sexual experiences inevitably lead to long-term beneficial effects.
The author concludes with the following summary and recommendations:
The findings of the ten studies which met many of the criteria used in the analysis demonstrate the fact that many variables enter into the relationship between childhood sexual experiences and long-range effects. There is no simple linear cause and effect relationship. All but one of the 10 studies were retrospective in nature. As in all retrospective studies that relate early experiences to the current state of the individual, it is not possible to trace the current condition in a direct causal line from the previous condition. There exists a need for longitudinal studies which could determine the intervening variables between these two points.
As my analysis indicates, there is also a need for
- controls for variables such as socioeconomic groups, age at time of sexual experiences, sex, and race;
- evidence of effects of society's interventions such as court procedures or removal from home;
- evidence of influence of family environment on long-range effects;
- control groups consisting of nonclinical, non-offender populations;
- general population samples;
- more sophisticated analytical procedures; and
- the use of statistical controls.
On the basis of this review and analysis, the following recommendations for future research are made.
- Researchers need to adopt a clear nomenclature of distinction between a "sexual offense" and "sexual abuse." An offense is the act of breaking a law or violating a social norm. An abuse is a mistreatment or injury that is perceived by the recipient.
- When referring to incest, researchers must be very clear about which definition of incest is being used. If the dictionary definition…were consistently used, much confusion would be avoided.
- Some studies indicate that psychological harm is greater for children who have sexual experiences with relatives. Researchers must be careful to be very specific as to who the partner was, the type of sexual behavior that occurred, and if the child was pre-pubertal or post-pubertal. Only in this way may implications for later functioning be clearly delineated.
- Much more attention must be paid to sampling issues.
- Careful consideration should be given to measures of adult functioning. Previously used measures (such as marriage, parenthood, having a job, being a solid member of the community, etc.) are not sufficient. More specific, empirical data are needed.
- Conditions under which the sexual behavior took place and reactions to the sexual behavior are also important variables which need to be considered by researchers.
- Developmental studies are needed which take intervening variables into consideration.
- Analyses of data on the long-range consequences of childhood sexual experiences are needed which include not only the relationship of variables such as partner, type of behavior, conditions and reactions to the measures of later functioning, but also the relationship of the interactions of these variables to the measures of later functioning. Controls for socio-economic and other background variables must also be included.
The study of long-range consequences of any type of behavior that may cause harm to a person or interfere with optimum social functioning is a serious endeavor. Researchers must be clear about what it is they are studying and diligent in their pursuit of scientific objectivity.