Understanding Research
Understanding research on childhood sexual abuse: an historical overview.
The dictionary defines research as "Original investigation, undertaken to gain knowledge and understanding."
Why it's important: Research on sexual abuse has mushroomed since the 1980s, and a large volume now exists on child sexual abuse (CSA), adult survivors, and sex offenders against children. You can find sexual abuse research across several disciplines, because it's at once a crime, a social problem, a mental and physical health issue, and a welfare issue.
The quantity of research around – largely in academic journals and books, but also in reports and other publications – can feel daunting, especially if it seems heavily academic or jargonistic. Yet research is really important, firstly because CSA is secretive and normally hidden from scrutiny; secondly because national policies, professional/public attitudes, and funding to support survivors are influenced by it. Good-quality research can establish facts, bring new insights and combat prejudice.
Need to be discriminating: But, because CSA as a whole is a controversial topic, its research can also be controversial. People and pressure groups may use (or indeed write) a particular study to "prove" their own views. Therefore it's important to be a bit discriminating when reading CSA research, and consider various perspectives. Does the study have clear aims and consult reputable sources? Do the researchers have a background of knowledge in this topic? Is this research likely to benefit abused people or abusers? Does it start from biased assumptions about class, gender, race or behaviour, or fail to "evidence" its own conclusions?
Outdated biases: Some past research for instance would now be widely challenged due to prejudiced assumptions about child and adult survivors. Victim-blaming studies suggested seductive children encouraged their own victimisation, e.g.: "These children undoubtedly do not deserve completely the cloak of innocence with which they have been endowed ... these children were distinguished as unusually charming and attractive ... thus we have frequently considered the possibility that the child might have been the actual seducer" (Bender L and Blau A. (1937) The reaction of children to sexual relations with adults, Am Jnl Orthopsych.7:4)
Prejudice also used to be common towards poor working class victims, for whom "incest" was complacently considered a cultural "way of life". For instance "The segment of the community in which these girls lived was notorious for its sexual laxity" (Sloane P and Karpinski E. (1942) Effects of incest on the participants, Am Jnl OrthoPsych.12:4) "One might hypothesise that (the fathers') incestuous activity was the expression of a type of sexual behaviour accepted by the subculture of their social groups ... everybody seems to be quite happy in this rather unusual household" (Lucianowicz N. (1972) Incest, paternal incest, 11: other types of incest. Brit Jnl Psych 120)
... Or too challenging to accept? Over the decades, some sexual abuse research findings have been considered unacceptable for other reasons: proving too unpalatable to society or to a particular profession. Understandably, few people wish to believe adults, particularly parents, carers or respectable educated people, can inflict severe or perverse abuses on children. Thus sexual abuse has kept appearing and disappearing from public and professional awareness, being forgotten and then remembered again across the generations:
"This has happened not because child sexual abuse is peripheral to major social interest, but because it is so central that as a society we choose to reject our knowledge of it, rather than to make the changes in our thinking, our institutions and our daily lives that sustained awareness of child sexual victimisation demands". (Olafson E et al. Modern history of child sexual abuse awareness: cycles of discovery and suppression. Child Abuse & Neglect 17:1.1993).
The most famous example of research findings considered unacceptable at the time was Sigmund Freud's The Aetiology of Hysteria (1896), in which he linked adult mental health disorders found in his patients to childhood sexual abuse trauma. But he renounced its findings barely a year later following his own re-thinking and some fierce professional criticism. The revised theory that children were usually fantasising incestuous sexual contact had lasting consequences for child and adult survivors of abuse.
Different definitions produce different results: research can also be disputed because it seems to produce inconsistent findings. The best-known examples are prevalence and incidence studies. These have been very important in revealing that CSA, once considered "a case in a million", is common right across societies. However, these studies have also produced confusingly varied findings. Differences arise because studies have varied in the questions they asked, in their definitions of CSA, and in interview methods used to enable people to discuss a difficult and private topic.
The modern re-discovery of
childhood sexual abuse
Research greatly increased when child sexual abuse once again became a topic for public debate in the late 1970s and early 1980s. Influences included the growing acknowledgment of physical violence against children and the contribution of C.Henry Kempe's research on the "battered child syndrome". This opened the way to considering symptoms of other violence against children.
The modern-day feminist movement which developed from the 1970s enabled women to speak out and campaign against previously "private" violence such as rape, domestic violence and sexual abuse. Committed professionals, self-help and user campaign movements, for instance the mental health user movement, also developed. More child-centred social philosophies, with new emphasis on listening to children and more open discussion of sex also played a role in bringing CSA to public attention.
New forms of sexual abuse acknowledged: Once professionals were able to listen open-mindedly to survivors' accounts of CSA, and once survivors could trust them to do so, gradually more information came to light. This included abuses which survivors had found very hard to speak about, or which had previously been dismissed.
Some examples were the abuse of boys as well as girls; abuse by women as well as men, by middle and upper class perpetrators; sadistic multi-perpetrator abuse by organised groups; abuse by respected authority figures such as clergy, lawyers or teachers. It's likely that society's knowledge will go on increasing, creating a need for further research. Present-day examples include internet child pornography, international child-trafficking for sexual exploitation, and rape of children in war.
New understandings of trauma: Mental health and neurobiological research are now tackling increasingly complex work on the long-term post-traumatic impacts of childhood sexual and physical assault on brain and body, on memory and other aspects, including effects on the central nervous system. Research on dissociation after trauma is another growth area and research insights in both these fields continue to develop.
Connections with post-traumatic stress and traumatic memory in other situations (e.g. concentration camp experiences) have been explored: an early and influential contribution to this was Judith Herman's Trauma and Recovery (1991), which compared effects of combat on male war veterans with effects of CSA on women. Some of the more complex ground-breaking research, though, actually has its roots in the work of much earlier writers who were once out of favour. For instance Ellert Nijenhuis's work on how dissociation can affect both mental and physical functions develops the insights of Pierre Janet in the 19th century.
Backlash also influential: By the early 1990s, the growing numbers of adults now identifying a history of CSA, including people from professional middle class families, led in turn to some accused parents and other accused adults founding "false memory" societies in the USA, Britain and Western Europe. Their contention that many memories of abuse were false and had been encouraged by dubious therapeutic practices produced both published papers by their own supporters, and more general growth in research on trauma and memory, stimulated by this fierce public and media controversy.
Also contributing to a "backlash", some controversial official actions to protect abused children in a few highly-publicised cases were heavily criticised. This brought more cautious approaches to intervening in families, it brought "professionalisation" of child protection, and considerable growth in guidelines and procedures for social work, police, health and education. That in turn influenced the research topics which became a priority for child protection research – more emphasis on professional agencies' work, less on informal or community networks for protecting children.
Why are some research topics more popular, and easier to get published?
Some topics have generated huge amounts of published research, some very little. Why?
For instance you can find plenty on psychological effects of CSA; investigative interviewing of children; trauma and memory; professional interventions in "high-risk" families; incidence and prevalence of CSA; sex offender risk assessments, treatments and typologies; personal safety teaching in schools.
Other topics, such as abuse of males, physical effects of CSA, primary prevention of CSA, voluntary sector-led therapies, abuse in wealthier families, and studies of the views and experiences of survivors themselves, have been much less extensive. (Even now, survivors' voices are more often found in novels, plays, poems and campaign literature than in academic research.) In some of the above, this situation is now changing.
Among many reasons for differences in popularity are:
- Traditionally CSA was seen to be the concern of a few professions who were considered to have special expertise. In particular, psychiatry; children & families social work; and the criminology of sex offending.
- Adult survivors in the past were often stigmatised or seen as mentally ill, not appropriate subjects for studies which voiced their own views and experiences.
- Topics to which policymakers and key services seek urgent answers, for which they have responsibility, and which attract public and media concern (e.g. intervening in families, or protecting against known sex offenders) will always attract more research resources and routine data collection. Since hard-pressed frontline services must respond to crisis, research into prevention tends to take lower priority.
- Controversies (like recovered memory) themselves generate research. Another example is child witness testimony in criminal cases. Controversy reflects social values – e.g. if children's truthfulness was not widely questioned in society, there would be less research on assessing the accuracy of their testimony.
- Some agencies have far greater resources and access to research funds and prestigious research publications. ("Evidence based practice" is still heavily weighted towards "peer reviewed" journals.) For instance research into pharmaceutical medications or cognitive-behavioural therapies has been well supported. Small-scale statutory projects, voluntary organisations and survivor support groups have had particular problems in getting their support and therapies for survivors evaluated, and the results published in these journals.
Now though, welcome opportunities in some funding schemes are belatedly opening up for the voluntary sector to collaborate in research with universities and in partnership with statutory agencies, and thus to influence strongly the research agenda. The Scottish Government is keen to encourage these developments.
Do adult survivors share these priorities?
But do trends in the popularity of research literature on sexual abuse reflect the main concerns of adult survivors themselves? That's a very interesting question for debate. Many people might answer "no".
For instance, survivors are usually much less concerned about the exact incidence or prevalence of CSA in the population than in gaining help for the numerous survivors who already exist with little or no support.
Often other serious concerns include
- Keeping all children safer through primary prevention;
- Stigmatisation of adult survivors;
- Long-term physical ill-health problems;
- Disabling effects of abuse on being able to pursue a career or study, and whether benefits systems take account of these;
- More effective ways to charge and convict sex offenders;
- Ways in which services (e.g. legal and court systems, mental health or primary care) behave towards sexually abused people, and how well they are trained.
It is hoped that closer, respectful dialogue between survivors and key professional and academic groups (some of whom will of course, be survivors themselves) will raise the priority of research topics which adult survivors themselves see as important. This website itself can be one means of achieving that.
