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Problems in Studying Long-Range Effects 

Definition of Terms 
Child-adult contact 

Sampling Problems 
Lack of control groups 
Small number of cases 
Clinical and offender populations 
Combining age groups 
Combining socio-economic groups 

Measures of Consequences 

Three major methodological problems emerged from the review: definition of terms, sampling methods, and measures of consequences.

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Definition of Terms 

Terms describing sexual behavior are used differently by different researchers, and the same terms are often used to describe different behaviors. Specifically, major problems arise with the varying definitions of "incest," "child-adult contact," and "abuse."


The definition of incest in the studies reviewed range 

from the dictionary definition of incest (Webster's, 1978) as "sexual intercourse between persons too closely related to marry legally" (used by Kilpatrick, 1986), 

to a definition of incest which includes the behavior of sexual propositioning (used by Finkelhor, 1979), 

to a definition which includes relatives by marriage as well as by blood (Meiselman, 1978). 

Thus, definitions vary, both with respect to the behavior and the partner. 

A further elaboration of this confusion is seen in the Meiselman review. Of the 47 studies cited in that review, 

36 useed "blood relative" as the incest partner criterion, whereas 

11 used both "blood relative" and "relative by marriage." 

Of the 19 studies involving incest which are reviewed in this paper, partners are described as "parental," "paternal," "sibling," or "other."

In regard to incestuous sexual behaviors, 

22 studies cited by Meiselman used "intercourse" as the incest criterion, 

14 used "sexual contact," 

7 used "sexual approach," and 

4 defined incest as either "advances," "attempts at incest," "abnormal sexual interest," or "strong incestuous wishes." 

The studies reviewed in this paper used 




"attempted seduction," and 

vague, nonspecific terms such as 


"had relations," or 

"a wider range of comportments which mayor may not include intercourse." 

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 of incest are warranted.

Child-adult contact

Researchers focusing on "child-adult contacts" have also varied in their definitions of "adult" and "child." For example, some researchers referred to "parent-child relations," and some of these were so vague that the reader is unable to determine their definitions of child and adult. The majority did not specifically deal with this concern. Three researchers were concerned with the effect on children 

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of relating to older sexual partners and, therefore, stated clear definitions. 

Gagnon (1965) defined adult as a male at least 5 years older and post-pubertal while the female was prepubertal. A "child" was a female before age 13. 

Finkelhor (1979) used three categories: 

(a) a child 12 or under with an adult 18 or over; 

(b) a child 12 and under and another person under 18 but at least 5 years older than the child; 

(c) adolescents 13 to 16 and legally defined adults at least 10 or more years older than the adolescent. 

Kilpatrick (1986) studied children ages birth through 14 years and defined older partner as persons at least 5 years older than the child.

The concern here is the lack of specificity about ages studied. Researchers are again making generalizations about effects of behaviors which may be too varied for such conclusions. 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.


"Abuse" has been the catch-all term for almost any type of child-adult contact. However, other terms are used by researchers to refer to similar behaviors. 

Finkelhor (1979) referred to child-adult contact in all three of his categories as "victimization." This term is based, however, not on effects upon the child, but upon age discrepancy and community standards about what is an exploitative sexual relationship. 

Fritz, Stoll, and Wagner (1981) used the term "molested" in much the same way as Finkelhor used "victimized" and as Gagnon used "child-adult contact." "Molested children" were those who reported at least one sexual encounter with a post-pubertal individual before the child reached puberty. 

Kempe and Kempe (1978), in a review of child abuse, define "sexually exploited children" as those children and adolescents whom sexual abuse robs of "their developmentally determined control over their own bodies and of their own preference, with increasing maturity, for sexual partners on an equal basis" (p. 43). They thus see all "sexually exploited children" as harmed although no specific measure of harm was used.

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 

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scientific investigations. Both Freud and Kinsey were guilty of this. Finkelhor (1979) believes that Freud's conclusion that child seduction was mainly fantasy helped to rationalize two very negative developments in the study and treatment of sexually abused children. The first consisted of discounting the patient's reports of childhood sexual experiences, and the second consisted of blaming the victim.

Kinsey, Pomeroy, Martin, and Gebhard (1953), in spite of survey evidence that incest, sexual abuse, and child molesting were far more widespread than anyone had known, de-emphasized these findings. 
Another researcher, Finkelhor (1979), built his victimization theme around social norms, as previously discussed. 
Also, as Renshaw (1982) has observed:

An article on incest may alter its perspective from a legal to a moral or psychosocial frame of reference without explanatory transition, seemingly without an author's awareness of a switch, leaving assumptions or forced coitus and crime. (p. ix)

In researching the effects of childhood sexual experiences, this confusion between violations of the moral code and harm done is problematic. 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 in which it was assumed that harm was done without any scientifically obtained data were omitted from this review.

Sampling Problems

 Sampling problems which surfaced were the lack of control groups, small number of cases, use of clinical populations, combining age groups, and combining socio-economic groups.

Lack of control groups

Only 10 of the 34 studies reviewed here used control groups. Seven of these have been published since 1978 (see Table 1). Without the use of control or comparison groups, it is impossible to determine causal effects or isolate contributing factors. 

Small number of cases 

Of the studies listed in Table 1

7 based their findings upon fewer than 10 cases, 

15 used fewer than 50 cases, 

21 used fewer than 100 cases, and 

29 used fewer than 300 cases. 

Two studies used between 300-500 cases (Gagnon, 1965; Sedney & Brooks, 1984), and 

3 studies based their findings on over 500 cases (Fritz et al., 1981; Kilpatrick, 1986; Landis, 1956).

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All but 2 studies published since 1981 have used over 100 cases. This is, hopefully, an indication of a trend away from small descriptive case studies toward larger studies with the potential for more sophisticated analytic procedures.

Clinical and offender populations   

Seventy percent of the studies reviewed utilized clinical or offender populations. An example of the problems involved in using samples from this type of population is found in Meiselman (1978). She found a higher incidence of sexual problems of all types among patients with father-daughter incestuous experiences than among patients without incestuous experiences. If a  woman seeks help because she has problems in social functioning, and she is then selected for study because she has a history of certain childhood sexual experiences, it is impossible to determine whether the problems in social and personal functioning are due to the childhood sexual experiences or to all the other things that may lead to the problem being treated. 

Another problem with this type of study is that it is not known how these cases differ from a nonclinical population. 
The same point could be made for using offender populations. Primarily, it may tend to create bias and limit the generalizability to other populations.

Combining age groups 

Another problem occurs when studies in which the ages of the samples vary are combined and general conclusions are draw. The studies reviewed included samples from ages 1 to 77. Also, the interval between when the childhood sexual experience occurred and when the effects were studied varied from a few years to 50 years. 

Of particular concern is the combining of data on effects in pre-pubertal children with post-pubertal children. Some researchers have found that effects are much more critical after puberty 

(Mann & Gaynor, 1980; Sedney & Brooks, 1984; Sloane & Karpinski, 1942). 

In marked contrast, Rasmussen (1934) and Bender and Blau (1937) found pre-pubertal experiences more critical. Studies which compare long-term effects on these two age groups could be quite beneficial and revealing. However, when generalizations are made across these groups, important data may be lost and findings may be misleading.

Combining socio-economic groups 

There were 13 studies in which primarily lower-class samples were used. Six used primarily middle-class samples, 4 used middle- to upper-class samples, and 1 used a lower- to middle-class sample. Nine studies did not give the socio-economic groups used (in most of the studies many classes were sampled). 

Combining the findings across the range of socioeconomic 

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groups may tend to obscure differences in long-range effects. 

Kilpatrick (1986) found that background variables which included socio-economic variables explained more variance in adult functioning than did the type of sexual experiences women had as children. Controlling for socio-economic class or using comparison groups would provide more definitive data on effects which could be attributed to childhood sexual experiences and not the socio-economic class of he subject.

Measures of Consequences 

The third problem encountered is the measures of consequences. 
For example, 

Bender and Grugett (1952) judged adult functioning in terms of whether the person married, had children, or held a job. As indicated in Table 1, the method they utilized to determine consequences was available follow-up information on social and psychiatric adjustment. How this information was collected and from whom was not stated. 

There is a vagueness of meaning in the terms "character disorder" and "neurosis" used by Lukianowicz (1972) in describing consequences. Behavioral indicators of the terms used could have provided a clearer understanding of consequences. 

Rasmussen (1934) questioned the role of sexual trauma as a decisive factor in causing mental disturbance and abnormalities of deportment in 8 of the 54 cases she studied. She stated that the role was doubtful because in most of them she found evidence of an independent constitutional predisposition to mental unbalance. 
However, it is not known what specific measures she used in coming to that conclusion. Nor is it possible to understand just what her conclusion meant. 

Chaneles ( 1967) admits that he could only "conjecture" about the long-range effects on sexual offense victims. 

The lack of specificity in these studies is problematic. 

In some studies there was also a lack of specific data regarding the length of time between the experience itself and the measures of the so-called long-range effect 

(e.g. Greenland, 1958; James & Meyerding, 1977; Justice & Justice, 1979; Medlicott, 1967). 

Other researchers were very specific regarding the time span between the experiences and the study. 

In the Bender and Grugett (1952) study, there were 11-16 years; 

in Brunold's (1964), there was a minimum of 15 years; 

in De Francis' (1969), the span was to 3 years; and 

in Vestergaard's (1960), the span was from 11-19 years. 

Immediate effects are sometimes quite different from long-range effects, and it is important to distinguish between the two.

More recently, most authors have been more specific regarding the measure of long-range effects. 

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Finkelhor (1981) used well-defined terms, data on specific behaviors, and a comparison group. Although he states that his study was not well equipped to grapple with the question of outcome, he did have three indicators of adult behavior which included 

the frequency of current heterosexual activity, 

frequency of current homosexual activity, and 

a scale designed to evaluate the level of respondents' sexual self-esteem. 

These indicators were used to measure consequences. 

Fritz et al. (1981) studied adult sexual adjustment. His terms were operationally defined, and behaviors were specified. He used both objective and subjective measures of adult sexuality.

Sedney and Brooks (1984) studied factors associated with a history of childhood sexual experiences. They looked at specific sexual behaviors and 18 adult symptoms such as depression, overweight, or trouble sleeping. 

Kilpatrick (1986) also used well-defined terms, data on specific sexual behaviors, and a comparison group. Her measures of consequences included five standardized scales which measured 

current adult functioning in the areas of self-esteem, 

family relationships, 


marital satisfaction, and 

sexual satisfaction. 

A related issue with respect to the use of terms like "consequences" and "effects" is that these terms imply causal relationships between childhood sexual experiences and adult functioning. 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 

 (Brunold. 1964; De Francis, 1969; Justice & Justice, 1979; Mann & Gaynor, 1980; Schultz. 1973; Summit & Kryso. 1978). 

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.

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