Influence of family environment

Correlation is not cause. Third variables may be a common cause for CSA and impact. The variable we consider here is family environment. A broken home, or one containing physical abuse or emotional neglect, could predispose children or teenagers to counternormative behavior, such as using drugs or engaging in sexual activities that are classified as CSA. A broken home could also impair their adjustment.

Empirical research suggests that indeed an essential part of the correlation between sexual abuse and impact may be explained by this third variable - the family environment.

Results of the meta-analysis by Rind et.al. 1998

From our previous meta-analyses, we know that for college subjects CSA accounted for 0.81% of the adjustment variability. We conducted a series of meta-analyses to determine what percent of the variability in CSA was accounted for by family environment. The result was 1.69%. We next conducted a series of meta-analyses to determine what percent of the adjustment variability was accounted for by family environment. The result was 8.41%. In other words, these results show that family environment was substantially more important in terms of being able to account for adjustment variability than CSA was - by a factor of 10.

These results also show that CSA was indeed confounded with family environment - those who had CSA tended to come from poorer, more disorganized family settings. These findings together suggest that the statistically significant, but small relationship between CSA and adjustment may not be causal.

Thirteen of the college studies used statistical techniques to factor out, or hold statistically constant, family environment, when examining the relationship between CSA and adjustment (see Table 11). The 14 samples from these studies examined 83 CSA-adjustment relations. Before statistical control, 41% of these relations were statistically significant. After statistical control - that is, after removing the effects of family environment - only 17% were statistically significant. This represents a 59% reduction. Since CSA-adjustment relations within a given study tend to be correlated, we computed the percent reduction in statistical significance by using one overall result per study. Computed this way, the reduction in statistically significant results rose to 83%. These findings strongly support the possibility that many instances of statistically significant associations between CSA and adjustment are spurious. In particular, these findings argue against the popular assumption that CSA typically causes harm.

Note. N indicates the number of symptom measures whose relation to CSA status was examined (or was intended to be by the study authors) by using statistical control. "Before" indicates the number of relations significant before applying statistical control; "After" indicates the number of significant relations after applying statistical control. "Reduction" indicates the percent of significant relations that became nonsignificant after statistical control.
a Based on the percent of total significant relations that became nonsignificant after control. The unweighted percent reduction was 83%.

Other Research Results

Mullen et al 1993: "While elements in the individual's childhood which increased the risks of sexual abuse were also directly associated to higher rates of adult psychopathology, abuse emerged from logistic regression as a direct contributor to adult psychopathology. Severity of abuse reported was related to the degree of adult psychopathology. The overlap between the possible effects of sexual abuse and the effects of the matrix of disadvantage from which it so often emerges were, however, so considerable as to raise doubts about how often, in practice, it operates as an independent causal element. Further, many of those reporting childhood sexual abuse did not show a measurable long-term impairment of their mental health. Abuse correlated with an increased risk for a range of mental health problems, but in most cases its effects could only be understood in relationship to the context from which it emerged."

Plunkett et al. 1990 in a review also mentions that "attention must also be paid to potentially confounding demographic and family variables."

Ernst et al. 1993: "Childhood familial risk factors were more frequent for abuse cases than for controls."

A significant association with parental alcoholism was found by Yama et al. 1993. A substantially higher level of symptoms was revealed in women who had experienced both during childhood.

Goldberg et al.1999 studied pain and have found a correlation with sexual and physical abuse and family alcohol dependence. Logistic regression showed patients who were female, with an alcoholic parent, using non-narcotic drugs were more likely to have pain. They note that the problem of child abuse is broader than physical and sexual abuse.

Levitt & Pinnell 1995: Other variables such as family dynamics are involved; there may be only a few cases in which emotional harm results from sexual abuse as a single factor.

Hulsey et al. 1992 observe: "Abused subjects recalled families that were isolative, rigidly ruled in an authoritarian style, and unable to foster the development of autonomy in family members."

Fink et al. 1995 propose a "childhood trauma interview".

Studies who have controlled for family environment

Greenwald et al. 1990: psychological impact remains significant, no relation with sexual dysfunction.

Briere & Elliott 1993 discuss a study (Nash et al. 1993) where "sexual abuse history was associated with elevated Minnesota Multiphasic Personality Inventory and Rorschach scores in a sample of 105 women, but many of the reported differences disappeared when a Family Functioning Scale score was used as a covariate."