Researching Sexual Revictimisation: Associated Ethical and Methodological Issues,and Possible Solutions

This paper has been inspired by the processes of preparing for ethical scrutiny and seeking ethical approval for a series of studies examining causal mechanisms that might facilitate sexual revictimisation. The focus here is on just four of the issues that arose in the context of the first study: a web‐based survey. One of the aims of the survey is to test whether victims of child sexual abuse who experienced a period of psychogenic or dissociative amnesia demonstrate an exaggerated risk for adolescent/adult sexual assault during this amnesic phase. That is, cases where survivors report ‘suddenly remembering’ in adulthood that they were abused as children, but state that prior to this ‘remembering’ they had no prior knowledge of their abuse. The study design is considered to be the first ethical issue. To enhance the methodological robustness a strategy has been employed to reduce the erroneous inclusion of currently amnesic participants in the non‐abused comparison group. Secondly, consideration is given to the likely harms and benefits that might be incurred or bestowed upon the participants. Thirdly, problems of both re‐traumatisation and vicarious traumatisation in relation to the researcher are contemplated and juxtaposed against the possibility of the facilitation of post‐traumatic growth and a personal shift towards wisdom and generativity. Finally, the survey title was originally criticised as negating ‘fully’ informed consent and a defence is therefore offered that ultimately gained ethical approval. It is hoped that these deliberations and insights may prove useful to others in planning their own research and ethics proposals.     

Ethical Issues in Child Custody and Dependency Cases

Abstract

The emotional and psychological risks to children of high conflict divorce have led to the increased involvement of mental health professionals in child custody cases. Numerous service models (Greenberg & Gould, 2001; Johnston, 2000; Johnston & Roseby, 1997) have been developed to assist divorcing families in minimizing family conflict and supporting children'S needs. This underscores the need for judges and attorneys to understand the ethical and professional standards that underlie competent mental health practice in forensic cases. The practices of mental health professionals providing court-related services may have a substantial impact on the validity of their professional opinions, the effectiveness of services provided to children and families, and children'S development and adjustment. The authors suggest core ethical and clinical issues to be considered by all psychologists who work in the context of custody disputes. It is hoped that these professional practice suggestions will also be useful to attorneys and judicial officers in assessing the quality of mental health professionals' opinions.     

The Construct of Grooming in Child Sexual Abuse: Conceptual and Measurement Issues

There have been claims that some child molesters engage in a “seduction stage” prior to committing abuse. These behaviors, commonly known as “grooming,” are understood as methods child molesters use to gain access to and prepare future victims to be compliant with abuse. However, there is a lack of consensus regarding exactly what this process entails and how it is clearly distinguished from normal adult–child interactions. It is important to devise an accurate definition of grooming for scientific, clinical, and forensic purposes. We critically evaluate the various definitions and reveal problematic heterogeneity. Furthermore, there are no methods of known psychometrics to validly assess grooming. We review the empirical literature regarding the occurrence of grooming and propose future directions for research.     

Prevalence of Sexual Trauma History Using Behaviorally Specific Methods of Assessment in First Year College Students

There are several challenges associated with evaluating the prevalence of sexual trauma, including child sexual abuse and adult sexual assault. The aim of this study was to assess sexual trauma prevalence rates among first year college students (N = 954) using behaviorally specific questions and a more representative recruitment sample that did not rely on self-selection. Participants completed a list of sexual trauma questions, including general questions containing labels such as “rape” or “abuse” as well as behaviorally specific questions that describe specific behaviors that qualify as sexual trauma without labels. Results indicated that 6.7% of the sample reported at least one incident of child sexual abuse, with similar rates for men and women. Women were more likely to report a history of adult sexual assault, which was reported by 12.4% of the total sample. Participants were also more likely to endorse a history of sexual trauma when answering behaviorally specific rather than general “label” questions. Women survivors in particular were more likely than men to identify their experiences as abuse/assault (66.7% versus 21.1% for child sexual abuse), which may help explain prevalence differences between men and women in prior research. Men may be less likely than women to label their experiences as abuse and may be underidentified in sexual trauma research without the use of behaviorally specific questions. Overall, the results of this study suggest that the prevalence of sexual trauma is better assessed using behaviorally specific questions and that this is an important topic of study among both men and women.     

Cognitions and Distress in Caregivers after Their Child's Sexual Abuse Disclosure

The impact of child sexual abuse on children is well documented, but few studies have examined the impact of a child's sexual abuse disclosure on maternal caregivers. The studies that have been conducted suggest that parental response postdisclosure is variable. The present study examined the association between maternal attributions and abuse-specific cognitions with depression and trauma symptoms postdisclosure. Participants included 68 nonoffending maternal caregivers of children between the ages of 3 and 17 years who experienced child sexual abuse. Findings indicated that caregivers' abuse-specific cognitions were the best predictor of self-reported symptoms of depression after controlling for general negative attributions. These findings suggest that in order to reduce caregivers' distress and to enhance their support of their children, it is important to assess and treat caregivers' abuse-specific cognitions.

     

What Poole and Wolfe (2009) Actually Said: A Comment on Everson and Faller (2012)

Everson and Faller's (2012) article on the significance of sexualized behavior in child sexual abuse assessments critiques a chapter by Poole and Wolfe (2009), but their objections assumed conclusions and practice implications that were not contained in that chapter. In this comment, I reiterate the value of educating adults about normative sexual and nonsexual behavior that could be misconstrued as symptoms of sexual abuse in some children, review key points from the chapter, and point out that Everson and Faller's critique supports the chapter's take-home messages (i.e., the importance of gathering information from multiple sources and the need to test alternative hypotheses for concerning behavior, consider the overall context of individual cases, and obtain independent verification of evidence).     

The prevalence and nature of child sexual abuse: evidence from a female university sample in the UK

It is well established that child sexual abuse is a considerable international problem, yet evidence regarding its prevalence in the United Kingdom is extremely sparse, with the most comprehensive study conducted over a decade ago. The aim of this study is to establish a current estimate of the prevalence and nature of child sexual abuse in the United Kingdom, using a sample of female university students. Of the 213 female undergraduate students who completed questionnaires, 28 were sexually abused, giving a prevalence rate of 13.14%. Information was also obtained regarding the nature of the abuse. These results show that a substantial proportion of female students in the United Kingdom, who appear to be coping with tertiary education, have been sexually abused in childhood. The implications regarding the benefits of prevalence rates to health practitioners are discussed. Copyright © 2001 John Wiley & Sons, Ltd.     

Childhood Sexual Abuse and Brain Development: A Discussion of Associated Structural Changes and Negative Psychological Outcomes

The effects of traumatic exposure have been researched for many years and studies have shown that the parts of the brain affected by sexually traumatic experiences in childhood are also linked to many physical and psychological problems, such as depression, posttraumatic stress disorder, somatic complaints and suicide. Neuroimaging studies have provided a breadth of evidence that childhood sexual abuse is related to structural changes in the brain. Taken together, childhood sexual abuse affects brain development, leading to differences in brain anatomy and functioning that have lifelong consequences for mental health. Several limitations of neuroimaging research on childhood sexual abuse are discussed, including a lack of refined and sensitive neuroimaging measures and problems interpreting results of structural imaged subjects with associated psychiatric conditions. Future, large‐scale studies are warranted to examine the type and severity of the sexual abuse and how each of the levels of childhood sexual abuse contributes to structural and functional changes. Furthermore, future studies are needed to control for comorbid psychiatric conditions in order to disentangle the effects of childhood sexual abuse from psychiatric conditions that damage brain development. © 2018 John Wiley & Sons, Ltd.

‘Childhood sexual abuse affects brain development, leading to differences in brain anatomy and functioning that have lifelong consequences for mental health’

Key Practitioner Messages

• Childhood sexual abuse is linked to observable structural changes in the brain.
• These structural changes in the brain are associated with a myriad number of negative psychological effects.
• Research is limited in elucidating the role of childhood sexual abuse on brain development, as the bulk of the research has focused only broadly on child maltreatment.

     

Evaluating Therapeutic Intervention with Sexually Abused Children

The progress of sexually abused children attending community-based treatment programmes run by selected voluntary agencies was evaluated on several different dimensions. By the end of the treatment programmes, improvement was apparent in the children's scores on the Children's Depression Inventory and self-esteem scores and in behaviour (CBCL) reports from parents. Young people over the age of 11 years reported for themselves improvements in the CBCL total problem and internalizing scores, but no improvement in the externalizing scores. The reasons why many therapists had difficulty providing all the necessary information were explored in interviews with senior managers and suggestions are made for improving the ways in which abused children's progress through treatment can be evaluated. © 1997 John Wiley & Sons, Ltd.     

The Dialectic of Chaos and Control in the Experience of Therapists Who Work With Sexually Abused Children

The aim of this study is to contribute to the understanding the interaction between the emotionally destructive intensity of the trauma and forces that foster growth in therapists who treat sexually abused children. Data were collected through in-depth semistructured interviews with 14 experienced social workers. Content analysis reveals two emotional poles. At one pole, the dominant experiences are anxiety, turmoil, and intrusion that disrupted the order in the interviewee’s secure world. At the opposing pole, the dominant experiences are positive, such as hope and faith. These formed the basis of empowering meaning construction that engendered a sense of control, enabling the therapists to trust the value of intervention with sexually abused children. The discussion uses a dialectical perspective to examine how interaction between these two poles enhances our understanding of the emotional and existential threats inherent in working with children who have experienced sexual abuse and on the potential for positive change.     

Evaluation of a Sexual Abuse Prevention Workshop in a Multicultural,Impoverished Urban Area

Participants in the ESPACE sexual abuse prevention workshop were in grades 1 through 4 and attended three Montreal, Canada, public schools in low socioeconomic areas. The sample was culturally diverse, with half born outside of Canada. An evaluation was conducted to explore the effects associated with participating in the workshop and the effects of booster sessions conducted two years later. Outcomes included knowledge gained, the ability to offer behavioral responses to abusive situations, peer victimization, sense of safety, empathy, self-efficacy, and support. Results revealed that participants in this sample obtained low scores on measures of sexual abuse knowledge and that short booster sessions that elicit children's recall of the learned material might produce greater improvements.     

Domestic Violence and Intergenerational Rates of Child Sexual Abuse: A Case Record Analysis

Using case review at a shelter for battered women and their children, this exploratory study investigated the association between physical abuse, exposure to domestic violence and intergenerational occurrence of child sexual abuse. The charts of 570 children were reviewed in an attempt to explore the relationship between the children's experiences with sexual abuse and their nonoffending parent's own history of having been sexually abused. Results indicated that a significant percentage of nonoffending parents who reported a history of child sexual abuse also had children who were sexually abused. Additionally, we found that most (93%) of the children studied had been exposed to domestic violence, and while the base rate of sexual abuse was relatively low (11%), the rate of physical abuse of the children was substantial (41%). Logistic regression results indicated that children of sexually abused nonoffending parents may be at heightened risk for sexual abuse. Implications for treatment and intervention are discussed.     

Service Patterns of Adult Survivors of Childhood Versus Adult Sexual Assault/Abuse

This analysis compared the characteristics and service patterns of adult survivors of childhood sexual assault/abuse and adult survivors of adult sexual assault/abuse. Utilizing data from sexual assault crisis centers serving survivors in a Midwestern state over a six year period and controlling for revictimization, we describe and compare the demographic characteristics, referral sources, and service patterns of the two groups. Results indicate that paths into service differ for the two groups. Furthermore, adult survivors of childhood sexual assault/abuse obtain significantly more hours of service and service contacts on average than adult survivors of adult sexual assault/abuse. Implications for policy and practice are discussed.     

Disability Simulations: Logical,Methodological and Ethical Issues

This paper examines issues of theory, methods and ethics in the use of disability simulations. Much of the educational, rehabilitation and counseling literature encourages teachers and counselors to use simulations to reduce prejudice toward persons with disabilities. However, the disability simulation literature reveals that: (a) there is typically a failure to consider the relationship between social/behavioral science theory and simulation design; (b) there are methodological weaknesses in most of the studies that render them virtually worthless to evaluate attitude change; and (c) there is little discussion of ethical concerns in disability simulations. A research agenda is proposed that focuses on logical, methodological and ethical issues in disability simulations. It is argued that simulations can be effective if: (a) certain ethical precautions are taken; (b) activities are well designed and evaluated; and (c) the simulation exercises are closely linked to social/behavioral science theory.     

The Real Controversy About Child Sexual Abuse Research: Contradictory Findings and Critical Issues Not Addressed by Rind,Tromovitch, and Bauserman in Their 1998 Outcomes Meta-Analysis

SUMMARY

This article presents a review of all types of child sexual abuse research ignored by Rind, Tromovitch, and Bauserman in their 1998 meta-analytic study. Eight major findings are addressed. Altogether, these findings demonstrate the narrow focus of the Rind et al. meta-analysis. By restricting a supposedly broad meta-analysis to only some of the research and population in question, the conclusions Rind et al. drew regarding this complex topic (primarily, that adult-child sex is not necessarily harmful to children) are invalid.