29 de janeiro de 2018

Notes on “Childhood Sexual Experiences: Problems and Issues in Studying Long-Range Effects”.

Filed under: Saúde e bem-estar — Tags:, , — Yure @ 15:08

“Childhood Sexual Experiences: Problems and Issues in Studying Long-Range Effects” was written by Allie C. Kilpatrick. Below are some notes I made about that text. They are not quotations.

  1. Many of the findings in research about sexual relationships in childhood are useless due to methodology problems.
  2. Those problems may be rooted on poor definitions, sampling bias or wrong measuring.
  3. The author examined 34 studies about long-term effects of child sexual relationships and found out that only 10 had clear definitions, samples that could be generalized and correct measuring.
  4. Those 10 studies were in agreement that sexual relationships in childhood don’t follow outcome patterns (the child can react negatively, positively or indifferently to a sexual contact with another child or an adult).
  5. The definition problem: there’s no set of words that is “standard” for all researchers, which means that Bruce Rind and David Finkelhor employ the word “abuse” for different behaviors (for Rind, “abuse” should only be used for negative sexual contacts, but, for Finkelhor, a positive contact is also abuse, if the age disparity exceeds five years).
  6. Plus, the same word can be used to describe different things in a same work.
  7. “Incest”, in a work by Kilpatrick (intercourse between people related by blood), isn’t the same thing as “incest”, in a work by Meiselman (sexual contact between people of the same family, even if unrelated by blood, such as adopted children).
  8. That means that “incest” is used to designate different behaviors in different people, depending on the researcher.
  9. Depending on the study, a sexual invitation between family members count as incest, even if the person hasn’t approached a blood relative.
  10. Depending on the study, a non-penetrative act or even an attempt at seduction already count as incest.
  11. If you conclude that incest causes post-traumatic stress, but you also label as “incest” the mere presence of invitation, you are saying that inviting a relative to something sexual causes post-traumatic stress in that relative.
  12. It’s a wrong generalization.
  13. Other problematic words are “adult” and “child”.
  14. How young is a “child“?
  15. Some studies take the definition for granted and don’t explain what “child” means, in a way that “child” can be anyone under age 18.
  16. That makes the reader draw wrong conclusions.
  17. I can’t talk about “effects of sexual contact on children” without saying what is a sexual contact and what is a child.
  18. If I say that sexual contact harms children and I call anyone under age 18 a “child”, then I’m saying that sexual contact harms 17-year-olds.
  19. The point is that we can’t generalize with such broad definitions.
  20. All contacts between adults and children are called “abuse” by many researchers.
  21. The term “victimization” often has social roots and has nothing to do with the effects upon the child (if the child was treated well, enjoyed the contact, even in an emotional level, and would do that again, the child is still a “victim” according to this definition).
  22. Same goes with the term “molestation”.
  23. While there are researchers who reserve those terms only for negative contacts, a sharp line between what’s harmful and what is not may be absent.
  24. Harm can be objectively measured, but violation of social norms don’t always result in harm.
  25. If we conflate objecitivity and morality, our results will be harmed.
  26. Science is an attempt to understand the world as it is, while morals are a set of rules by which we choose to live.
  27. Mixing both can lead to mere validation of social standards, which is not science.
  28. The definitions used in science must not have moralistic foundation.
  29. Some definitions have different meanings depending on the context (legal, moral and psychosocial), but some authors make no context distinction.
  30. Is abuse “damage” (objective) or “violation of social norms” (subjective)?
  31. Assuming that violation of social norms causes harm is often incorrect (homosexuality was a violation of social norms).
  32. Who was the victim: the child or the morals?
  33. You can not presume that harm took place.
  34. Sampling problems: lack of control groups, generalization from small number of cases, use of clinical samples, combination of age groups and combination of socio-economic groups.
  35. Only 10 out of the 34 reviewed studies used control groups (a group of “normal” people to compare with the people who are being studied in order to know if they really differ and how).
  36. Without a control group, it’s impossible to establish causality and to isolate contributing variables.
  37. Out of the 34 studies, seven had a sample poll of less than 10 people.
  38. 70% of those studies used clinical or forensic samples, which are not representative of the general population.
  39. Adolescents and children respond differently to sexual contact.
  40. Age groups must be separated in those studies: a sexual contact is perceived differently depending on the tyke’s age.
  41. A low-income person had a sexual contact in childhood and develops poor adult functioning, but is that thanks to the sexual contact or thanks to poverty?
  42. The problem of measuring: when can an adult be considered “damaged”?
  43. Some researchers use the social status as harm measure (an adult is damaged if they didn’t have a family and was unemployed, for example).
  44. Others say that the adult is “damaged” if they developed “character disorder”, but no one can explain what that term even means.
  45. Another measuring problem is not specifying how much time has passed between the sexual contact and the interview with the researcher: it could be one year or a decade, which means that we don’t know how “long” is the “long-range” effect.
  46. If you don’t specify how much time has passed, you risk labelling a short-term effect (sometimes much more intense) as a long-range one.
  47. Another problem is employing terms such as “consequence” and “effect”, which imply causality.
  48. You better prove that causality.
  49. There are reports of damage caused by environment reaction to the act, which means that we should gauge how much damage, if any, was caused by the sexual contact itself and how much damage was caused by society’s reaction (interrogatory, medical exams, forced therapy, parent reaction, shaming and other factors that could cause secondary victimization).
  50. Of the 34 studies reviewed, 19 conclude that harm is the usual consequence.
  51. The study by Sloane and Karpinsky has sampling problems (only five cases were studied, all incest, all from clinical, low-income population), which render it’s findings questionable (it concluded, from just five samples, that incest leads to serious problems in the girl).
  52. Only a handful of researchers used the definition of incest found in the dictionary.
  53. If you choose the cases that you will study and generalize the findings, your research is invalid: you can not generalize information obtained by hand-picked samples (the correct procedure would be getting as many random samples from the general population as possible or drop attempts at generalization).
  54. We can’t always prove that harm was directly caused by the contact.
  55. A study is specially bad if it doesn’t include the minor’s opinon on the act.
  56. A study that concludes that you “can only conjecture about” something… ended in an empty conclusion.
  57. Clinical population is problematic because it’s like going to a hospital to see how many patients are ill: of course you will get a number close to 100%.
  58. However, we can’t generalize that and conclude that 100% of the world population is ill.
  59. Furthermore, people who didn’t suffer with the sexual contact don’t seek help for sequelae, meaning that a study using clinical samples closes itself to positive cases.
  60. Gross’ study used only 4 samples and had no control group.
  61. If we only take in consideration the serious studies that focus on negative outcomes, we can conclude that:
    1. Childhood incest, in low-income families, in which the adult was prosecuted, is associated with harm.
    2. Incest can predispose a person to some kinds of problems.
    3. At least in the forensic population (that is, in the cases reported to the police), children of low-income parents are more likely to suffer even if the experience was not incestuous.
    4. The more times the person has the sexual contact, the more it’s repeated, the longer each session lasts, the higher the frequency, the more negative feelings (shame and pain) are stronger than the positive (adventure and pleasure), then the higher is the chance of maladjustment.
  62. But that implies that an unreported, non-incestuous act that causes more pleasure than distress won’t cause harm (not to mention that this conclusion doesn’t say much about higher-income families).
  63. Of the 34 reviewed studies, 14 had conclusions that focused on neutral outcomes.
  64. Some conclusions seem to be pulled from thin air.
  65. Research mistakes aren’t exclusive to studies that seek to prove that sexual contact in childhood brings damage; there are also research mistakes in studies that conclude that those contacts make no difference.
  66. Some studies have no conclusive evidence.
  67. Even studies that are done with no control group and use clinical samples can conclude that sexual experiences in childhood make zero difference for the child.
  68. Landis’ study, done with college samples (which have higher generalization factor), with people of medium and upper-class, with control group, concluded that most of the 500 individuals who had sexual contacts in childhood or adolescence had no permanent damage and were perfectly normal.
  69. Some studies concluded that there’s no psychological damage without asking for personality details in the interview.
  70. Gagnon concluded that, out of the 333 women that he interviewed, only 5% had adjustment problems in adult life, but his findings can not be generalized to lower-income families.
  71. Some places tolerate incest, due to cultural reasons.
  72. A person may experience incest differently depending on their sexual orientation.
  73. Another study by Kilpatrick concluded that only harmful or forced contacts cause damage to the minor.
  74. It seems like studies with clear definitions and control group are more likely to conclude that neutral outcomes exist.
  75. If we only take in consideration the serious studies about neutral outcomes, we can conclude that:
    1. Middle-class college students who had childhood sexual experiences with adults don’t usually feel negative impacts from those contacts.
    2. It’s also unlikely that middle-class girls who have sexual contact with adults would grow up maladjusted.
    3. Sexual experiences between siblings have little impact in their adult sexual adjustment, when it comes to middle-class families.
    4. Those percentages are even smaller if the child receiving the act is a boy.
    5. Women who had sexual experiences in childhood do not differ from women who didn’t have those experiences, but just as long as the act was not forced or harmful.
  76. With that, we can not conclude that childhood sexual experiences will always result in negative or neutral outcomes.
  77. Kilpatrick found only one study about beneficial effects of early sexual experiences, but the study had sampling problems and no control group.
  78. The ten studies that passed in the “Kilpatrick test” show that the fact of a person feeling harmed by a sexual experience doesn’t depend only on the presence of sex, but also on third variables (such as pain, force and shame).
  79. If you eliminate those variables, you eliminate the potential damage.
  80. There’s no necessary causality between early sexual experience and trauma.
  81. An ideal study about sexual experiences in childhood must have:
    1. Control for variables, such as income, age, sex and race.
    2. Separation between the effect caused by the contact and the effect caused by society’s reaction to the contact.
    3. Separation between the effect caused by the contact and the effect caused by family dynamic.
    4. Control groups.
    5. Samples from general population, rather than clinical or forensic samples.
    6. Sophisticated analytical procedures.
    7. Statistical control.
  82. There should be a line distinguishing “sexual offense” (violation of social morals) and “sexual abuse” (harmful act).
  83. If you are going to talk about incest, define incest.
  84. Who was the sexual partner, what kind of sexual act was done and what was the child’s age?
  85. Define “normal adult” before saying that an adult was “harmed”.
  86. You should pay attention to the conditions surrounding the act and how the minor felt when the act took place.
  87. Did the minor have any problems with the adult’s prosecution (if it happens)?
  88. It’s important to note not only the sexual variables, but how the social variables surrounding the act interact with each other as well.
  89. If you are going to study long-range effects of any supposedly harmful behavior, do it right; this is not a game, nor a joke.
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