7. The Four Assumed Properties of CSA Revisited
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
self-reported effects was virtually identical in the college samples in the
current review (
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. 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
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]
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.