Title: The challenge of defining child sexual abuse
Author(s): Jeffrey J. Haugaard
Affiliation: Department of Human Development, Cornell University
Citation: Haugaard, J.J., “The challenge of defining child sexual abuse,” American Psychologist, vol. 55, no. 9, 2000, pp. 1036-1039.
Since the late 1970s, professionals from many fields, including psychology, medicine, social work, sociology, and anthropology, have focused on the causes and consequences of child sexual abuse. Psychologists, social workers, physicians, and nurses have tried to develop effective therapies for sexually abused children, for adults abused as children, and for children, adolescents, and adults who sexually abuse children. Professional organizations and been established and prevention, advocacy, and educational programs have been created.
Yet the most basic issue of defining child sexual abuse remains unresolved. Each word in the phrase “child sexual abuse” has been defined differently by different researchers, lawmakers, and clinicians, and there is no consensus about the definition of any of them.
Children are defined variously as those under 18, 17, or 16. Sex may or may not include bathing or sleeping with children, or appearing nude in front of them. Abuse can mean either a harmful act or a corrupt practice. In fact, there is no accepted scientific definition of abuse.
As a result, there has been a dramatic growth in the child sexual abuse literature without a definition of what is and what is not child sexual abuse. Definitional ambiguity complicates research, legal, and clinical work. Studies cannot be compared, and the creation of a useful body of knowledge is inhibited.
There are three obstacles to the development of unambiguous definitions. First, there are many different contexts and fields with different goals; for example, clinicians, prosecutors, and advocates all have different purposes in mind. Secondly, most characteristics used to determine whether sexual activity is abusive lie on a continuum, and it is difficult to determine where to draw the dividing line between abuse and non-abuse. Thirdly, the context of the behavior often determines whether it is abusive, and there are an endless number of possibilities for these contexts.
Initial research on the prevalence of sexual abuse had little previous work to guide it, and therefore used broad definitions. Anything the participant considered to be sexual that occurred within specified age ranges of the participants was classified as abuse. As laws, policies, and clinical efforts expanded, they may have been influenced by these broad definitions.
There have been three consequences of these broad definitions. One has been very high prevalence rates, which have raised public concerns and resulted in more services being provided for those who are abused. Another is the finding that severity of abuse varies widely. This may have had the effect of extending services to those who were abused less severely.
The third consequence is that the variation in severity has resulted in great difficulty in studying consequences. When broad definitions are used, most victims experience abuse of low severity. This fact can distort estimates of effects since mild forms obscure significant consequences experienced by the few who experience severe forms of abuse.
One way of resolving this dilemma is to create narrower definitions so that child sexual abuse is more homogeneous. This would result in the improved accuracy of assessing the consequences of abusive acts. Another solution is to use a narrow definition for research and a broader one for child protection and clinical contexts. A third approach is to maintain the current broad definition but create subgroups and study them separately.
All three of these approaches may be difficult. Suggestions to make definitions narrower may meet with resistance since the definition of abuse depends on individual and cultural values. A recent controversy illustrates how recommendations to allow the definition to vary in different contexts can meet with stiff opposition; when Rind et al. proposed a narrower scientific definition of sexual abuse, advocates and policymakers protested fiercely.
The creation of subgroups is complicated by the lack of a strategy for creating such subgroups. However, this difficulty could be resolved through statistical analysis. There is promising news in the recent decision of the National Center for Child Health and Human Development to engage in research to create a classification/definition system for all forms of child maltreatment.
Those in the field of child sexual abuse must recognize the difficulty of defining sexual abuse, and work methodically to overcome this difficulty, rather than continuing to accept the current situation.