The Sexual Abuse of Children

Volume I: Theory and Research

William T. O'Donohue, James H. Geer, William T. O'Donohue, James H. Geer

• Publisher: Routledge
• Year: 2014
• eBook ISBN: 9781317760306
• Topic: Psychology
• Subtopic: Clinical Psychology
• Index: Psychology

The sexual abuse of children is now seen as an enormous problem; first, because there is an increasing awareness that it is more prevalent than previously thought, and second, because it gives rise to so many complex questions. How is sexual abuse to be defined? What are the effects of abuse? How can the victim be helped? How can abuse be prevented? These two comprehensive volumes cover a wide spectrum of basic and applied issues. Expert contributors -- including physicians, attorneys, psychologists, philosophers, social workers, and engineers -- address such relevant topics as epidemiology, animal models, legal reforms, feminist scholarship, child pornography, medical assessment, and diverse models of psychotherapeutic intention.

I

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BASIC ISSUES

1

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Introduction

James H. Geer

Louisiana State University

William O’Donohue

Northern Illinois University

This two volume offering is designed to provide the interested professional with a comprehensive, up-to-date, and authoritative examination of many facets of child sexual abuse (CSA). As editors, it is our intention to provide a wide range of perspectives on this controversial but pressing topic. We have been fortunate to have been able to enlist the help of outstanding scholars. We believe that the chapters in this book represent a broad cut of the issues and problems that pertain to CSA.

We would not be so ill advised as to suggest that all or even most of the answers to the many complicated problems associated with CSA are contained within the following chapters. In fact, as is the case with good scholarship, we find that our contributors often identify more problems than are resolved. The lack of easy solutions is just one of the challenges that faces the professional who works in this field. Simply put, we do not have most of the answers. Answers are still missing on so many of the crucial issues that the professional must guard against feeling only frustration when confronting CSA. The other and brighter side is that we believe the content of the chapters shows that there is a substantial start on dealing with many associated problems. The chapter authors have provided their considerable expertise to help us understand what appear to be the most satisfactory extant responses to the many problems posed by CSA.

We believe that much of the uncertainty associated with this field arises from problems in accurately detecting CSA. If we had a perfect index of child abuse—if we could somehow detect without error every incidence of CSA—we would have the touchstone we need for evaluating proposed therapies, assessment instruments, and theories. Without this ability to detect child abuse errorlessly, a fundamental uncertainty enters the field.

The possibilities for error fall into two broad classes: (1) unreported cases, and (2) reported fictitious cases. By definition we will never know the extensiveness or the significance of undetected cases. We can only speculate regarding the percentage of all cases that we are detecting—90%, 60%, 30%?. Undetected cases never become grist for our clinical and theoretical mills and thus we are missing potentially important information. We will be perennially faced with the possibility that our theories, measures, and therapies would need to be revised in light of this set of cases. The certainty that we are not detecting all cases of CSA will likely always frustrate this field.

Dividing reported cases into the veridical and the fictitious although not completely intractable is, of course, a most difficult and inexact process. Dejong (Volume II, Chapter 3) indicates that there is no conclusive physiological evidence of sexual abuse in the vast majority of cases. CSA is usually a witnessless crime. Thus we are often left with a child’s word against an adult’s. Are children competent witnesses and testifiers in these situations? Although Bulkley (Volume I, Chapter 8) argues that children are generally as competent as adults, the literature on adult witnesses shows that even the testimony of adults is often problematical. Moreover, the literature regarding the validity of the self-report of children regarding sexual abuse is in its infancy and thus only tentative conclusions can be drawn. The possibility that a 3-year-old can be influenced by leading questions or can have trouble separating fact from fantasy must be admitted to have at least some plausibility.

Another complication must be acknowledged in attempting to distinguish true from false reports is that CSA may at times be overreported by perpetrators themselves. Do these individuals ever attempt to “please” their therapists or attorneys by exaggerating the number of abuse incidences or victims? This is not unknown regarding murderers and other criminals. Abel et al. (1987) found that after taking elaborate precautions, such as storing records overseas, telling subjects to withhold any specific facts that could be used by police to identify specific crimes, and obtaining a certificate that assured that no agency could compel investigators to reveal the identity of the subjects, pedophiles who target male children outside the home reported a mean of 150 victims (median 4.4). But did these investigators, inadvertently, in informing subjects about these elaborate precautions create strong demand characteristics that resulted in fictitious overreporting?

To decide if a case is veridical we need a touchstone—a standard that accurately distinguishes true reports from false or that tells us which of our proposed indexes are valid and which are not. However, the only touchstone would be to have direct and consistently veridical evidence of the abusive incident or incidents (e.g., direct observation by a third party who is known to be reliable) or some indirect evidence that conclusively indicates that abuse has occurred. We clearly and unfortunately do not have these indicators.

If we had this perfect indicator, questions of epidemiology could be efficiently and accurately answered. We could just activate the indicator. Or in a less direct manner, we could use conventional methods of gathering information (questionnaires, telephone contacts, interviews), and we would know the validity of our measurement strategies because we could compare the respondents’ answers with our perfect indicator. When we don’t have this indicator, how do we assess the accuracy of the responses? We can’t compare their responses with what actually happened, because we don’t know what actually happened and there is little likelihood of gathering this sort of conclusive independent evidence. We can tell if someone is underreporting or overreporting only by comparing their response with what actually happened. But this touchstone is not particularly useful because the event is obscured in the opaqueness of the past.

To illustrate further how this simple but refractory question of historical fact vitiates the field, let us suppose we are attempting to determine if some treatment for child sexual abusers is effective. We need to know if the offenders are committing acts of abuse during and after treatment. But how do we know this? Through arrest records? Client’s self-reports? Or the self-report of every child the client might have had contact with? Again, we are faced with a seemingly intractable problem—we cannot gain a satisfactory index of what we need to know—who has been abused.

As a final example, suppose we want to assess the validity of some assessment device such as the penile plethysmograph (Earls, Volume II, Chapter 7; Farrall, Volume II, Chapter 6). Assessing the validity of a test involves the comparison of the results of the test with a criterion measure. For example, if we want to know the predictive validity of arousal measurements, we need to know who is offending and who is not. Again, accurate measurement of this criterion is currently technically impossible. This gives rise to an interesting possibility: Problems with our therapies, assessment devices, and even theories might be due to problems with our criterion measurements—our touchstones—rather than due to limitations of our therapies, assessment devices, and theories. For example, some counterevidence to the validity of the plethysmograph might be that it classified someone as an offender while our criterion measure indicates is not. But this could simply be due to the criterion measure being in error rather than to problems with the plethysmograph. That is, we have difficulty knowing how good or bad the plethysmograph is, because we do not have a good index upon which accurate feedback can be supplied.

This is not to say that detection is completely intractable. Cases in which an accused adult confirms a child’s report seem clear. Also, clinical experience reveals that many more adults convincingly retract their initial allegations of innocence than children convincingly retract their allegations of having been abused. However, the point is that the identification of an essential element in our field of inquiry—incidents of sexual abuse—is much more allusive, indirect, and tentative than in many other fields. We often have direct evidence that our clients are schizophrenic, or alcoholic, or depressed. We come to be fairly confident in our claims that these are actual problems because we have direct observational evidence: they hallucinate, slur when they speak, or cry in our offices. Moreover, other individuals who we believe to be reliable reporters tell us of their similar observations. Finally, although all sorts of problems may be difficult to admit because of the stigma that may be associated with them, clients are much more likely to admit to problems with psychosis, alcohol, and depression, because these problems have so much less stigma associated with them than sexually abusing a child.

We point to these problems because we think that these can help explain some of the uncertainty associated with questions in this field. We believe that the problem of reliably detecting cases of CSA will not be resolved in the near future. Uncertainty is likely to continue to hamper our efforts at research and therapy. However, we hope that an explicit understanding of this problem can help in attempts to ameliorate it. We believe that understanding these concerns can aid in developing reasonable standards for evaluating responses to the many important questions in this field.

Until recently, CSA was unrecognized as an extensive problem. It has only been in the past 20 years or so that an awareness of its seriousness and surprising frequency has developed. In fact, as a result of increased awareness, there is now a concern that in some instances CSA may be mistakenly alleged. This risk, as well as the risk of undetected abuse, makes it imperative that professionals be as informed as possible on all aspects of CSA. We also wish to point out that views on CSA are undergoing dramatic revision in contemporary thinking. We are pleased to offer this compendium of topics and views with the confident expectation that professionals will find much of value in it.

We have chosen to organize the two volumes around specific themes. The first theme, which is represented primarily in the first volume, is an examination of the basic issues in CSA. The second volume focuses upon the more pragmatic matters that face practitioners, especially the therapist, when confronting CSA in their clinical endeavors. We believe that theory informs practice and vice versa. This makes us to some extent concerned with the somewhat arbitrary division found in the two volumes. We would hope that interested professionals, researchers, and practitioners alike, would find both volumes of value. In some instances we have placed contrasting positions in juxtaposition. We view this as serving the valuable function of facilitating informed judgments of choice among alternative conceptualizations or courses of action. By offering the two volumes, we hope to encourage practitioners to become acquainted with the basic issues and encourage researchers and scholars to become familiar with the real problems faced by practicing professionals.

Let us turn our attention first to the series of chapters on basic issues. Following this brief introductory chapter, O’Donohue discusses what is often at the root of controversy in any field of study. Namely, what are the definitional roots of the field of inquiry. Among our various chapters the careful reader will note that sometimes there are subtle yet significant definitional differences. The chapter does not resolve definitional concerns but importantly points them out. The second topic addressed in O’Donohue’s chapter is central to CSA. This is a consideration of ethical matters. O’Donohue argues that resolving a seemingly uncomplicated question—Is sexual contact with a child morally wrong?—is a difficult matter with important implications.

The next three chapters place CSA in the broad contexts seen from the perspectives of the historian, the anthropologist, and the animal researcher. These views oblige us to recognize the limitations that we place upon ourselves by failng to view CSA in its broadest context. Dr. Wasserman and Dr. Rosenfeld begin their chapter with a summary of historical information available on CSA. The authors then focus considerable attention upon the theorizing of Freud and how his views changed over time. Then the author’s explore more contemporary views of CSA. The chapter helps us to recognize the dramatic changes that have taken place in societies’ and theorists’ views of CSA.

Prof. Davenport examines child—adult sexual relations in the cross-cultural perspective. He points out that very little anthropological data are available. He notes the tie between CSA and the incest taboo. The incest taboo has been studied in some detail. This chapter provides us with a discussion of “gerontological marriage,” which, as he notes, does not readily f...

Table of contents

• Cover Page
• Half Title Page
• Title Page
• Copyright Page
• Table of Contents
• Preface
• I Basic Issues
• II Associated Aspects of Child Sexual Abuse
• Author Index
• Subject Index