Research: Association or Causation

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Web Archive (within series)

Our page on family environment demonstrates that any relationship between adult-child sex and harm is unlikely to be causative. Our section on outcomes and poly-victimization shows that the purported relationship is unlikely to exist in the first place.

The 9 criteria outlined by Austin Bradford Hill in The Environment and Disease: Association or Causation? are used to determine whether causation can be assumed in medicine. This page will review the research on adult-child sex to see if these criteria have been met. Unfortunately, much research fails to disentangle adult-child sex from clearly abusive activity, so some quotations examine the construct of 'child sexual abuse' as a whole.

• Biological gradient: the demonstration of a biological gradient, in which more of the causative agent leads to a poorer outcome
  • Forouzan, Elham, and Gijseghem, Hubert Van (2005). "Psychosocial Adjustment and Psychopathology of Men Sexually Abused During Childhood," International Journal of Offender Therapy and Comparative Criminology, 49(6), 626-651

    "Certain studies conducted with clinical participants have revealed that frequency and duration of sexual contacts had a significant effect on the development of the participant (Freeman-Longo, 1986; Friedrich, Urquiza, & Beilke, 1986; Gerber, 1990; Mendel, 1995), whereas studies carried out with nonclinical participants reported no clear link between frequency and duration of contacts and the development or later aggravation of disorders of whatever nature among participants (Finkelhor, 1979; O’Neill, 1990; Sarbo, 1984; Urquiza & Capra, 1990)."

  • Rind, B., Tromovitch, P. & Bauserman, R. (1998). "A meta-analytic examination of assumed properties of child sexual abuse (CSA) using college samples," Psychological Bulletin, 124(1), 22-53

    "Multiple regression analyses showed that the intensity of the relationship between CSA and adjustment varied reliably as a function of gender, level of consent, and the interaction of these two factors. It is noteworthy that neither the level of contact nor the interaction between gender and level of contact was related to intensity. These latter results failed to provide support for the common belief that contact sex is more harmful than noncontact sex or that contact sex for girls is especially harmful. These conclusions, however, should be viewed cautiously because of the overlapping nature of the two levels of the contact variable (i.e., contact only versus contact and noncontact sex). This same caveat applies to consent because its two levels (unwanted versus willing and unwanted) were overlapping as well. [...] In separate moderator analyses, we examined how aspects of the CSA experience moderated self-reported reactions and effects, as well as symptoms. Although these results should be viewed cautiously because they were usually based on a small number of samples, we found that only force and incest moderated outcomes. The largest relation occurred between force and self-reported reactions or effects, but force was unrelated to symptoms. Incest moderated both symptoms and self-reported reactions and effects. Penetration, duration, and frequency did not moderate outcomes. The near-zero correlation between penetration and outcome is consistent with the multiple regression analysis finding that contact sex did not moderate adjustment. [...] This finding is consistent with Laumann et al.'s (1994) failure to find an association between their composite variable (consisting of penetration, number of older partners-abusers, relatedness of partner-abuser, frequency of contacts, age when having contacts, duration of contacts) and adjustment for SA respondents in their study of a U.S. national sample. "

  • Finkelhor, D. (1979). Sexually victimized children. New York: Free Press.

    "Unlike force, sexual activity and duration both are ambiguous in their implications. A longer relationship and one involving intercourse indicate greater intensity. Intensity may be more harmful, but it could also be an indicator in some cases of a positive, or at least. an ambivalent, bond. In contrast, presence of force would almost always signal something negative about the relationship. It is a concise symptom of a whole negative context - the reluctance of the child, the pressure exerted by the partner, the difference in power and control. The primary recollection of the child is of the coercion. That there was sex involved is perhaps less important than the fact that there was aggression." (pp. 104-105; as cited in Rind, 2001)

• Consistency: consistency of the findings across research sites and methodologies
  • Bauserman, Robert, and Rind, Bruce (1997). "Psychological Correlates of Male Child and Adolescent Sexual Experiences with Adults: A Review of the Nonclinical Literature," Archives of Sexual Behavior, 26(2), 105-141.

    "Clearly, by whatever measures of effects are used, the nonclinical research findings reviewed here differ consistently from clinically based studies of the correlates of early sexual experiences."

  • Forouzan, Elham, and Gijseghem, Hubert Van (2005). "Psychosocial Adjustment and Psychopathology of Men Sexually Abused During Childhood," International Journal of Offender Therapy and Comparative Criminology, 49(6), 626-651

    "Certain studies conducted with clinical participants have revealed that frequency and duration of sexual contacts had a significant effect on the development of the participant (Freeman-Longo, 1986; Friedrich, Urquiza, & Beilke, 1986; Gerber, 1990; Mendel, 1995), whereas studies carried out with nonclinical participants reported no clear link between frequency and duration of contacts and the development or later aggravation of disorders of whatever nature among participants (Finkelhor, 1979; O’Neill, 1990; Sarbo, 1984; Urquiza & Capra, 1990)."

• Temporality: the demonstration of the appropriate temporal sequence, so that the causative agent occurs prior to the outcome
  • Rind, B., Tromovitch, P., & Bauserman, R. (2001). "The validity and appropriateness of methods, analyses, and conclusions in Rind et al. (1998): A rebuttal of victimological critique from Ondersma et al. (2001) and Dallam et al. (2001)," Psychological Bulletin, 127, 734-758.

    "Finkelhor et al.'s (1990) national sample findings are also relevant to this issue. They conducted a series of analyses that indicated that "unhappy family life is a true risk factor [for CSA] and not simply a distorted perception that a victim develops as a result of having been abused" (p. 24)."

• Strength: the demonstration of a strong association between the causative agent and the outcome
  • See Research: Prevalence of Harm and Negative Outcomes

• Specificity: the demonstration of specificity of the causative agent in terms of the outcomes it produces
  • See Research: Methodological flaws and syndrome construction

• Plausibility: the demonstration of a biologic rationale, such that it makes sense that the causative agent causes the outcome
  • The most popular proposed mechanism for the relationship between adult-child sex and its supposed non-sexual symptoms cannot reasonably be applied to fully consensual activity in the context of an accepting society. See "The traumatic impact of child sexual abuse: A conceptualization" in Research: Secondary Harm

• Analogy: evidence from analogous conditions
  • Childhood peer sexual activity is analogous to adult-child sexual activity. See the studies on mental health at Research: Youth sexuality

• Coherence: coherence of the findings, such that the causation argument is in agreement with what we already know

• Experimental evidence

Common flaws in research

Vaillancourt-Morel, M. et al., (2016). "Emotional and Sexual Correlates of Child Sexual Abuse as a Function of Self-Definition Status," Child Maltreatment, June 29, 2016.

• "Among individuals defined as having been sexually abused based on legal criteria, some will self-report having been abused and some will not. Yet, the empirical correlates of self-definition status are not well studied. Different definitions of abuse may lead to varying prevalence rates and contradictory findings regarding psychological outcomes. The present study examined whether, among legally defined sexual abuse survivors, identifying oneself as having experienced childhood sexual abuse (CSA) was associated with more severe abuse, negative emotional reactions toward the abuse, and current sexual reactions. A convenience sample of 1,021 French-speaking Canadians completed self-report questionnaires online. The prevalence of legally defined CSA was 21.3% in women and 19.6% in men, as compared to 7.1% in women and 3.8% in men for self-defined CSA. Among legally defined sexual abuse survivors, those who identified themselves as CSA survivors had been abused more frequently, were more likely to report a male aggressor, and more often described abuse by a parental figure than those who did not self-identify as abused. Further, self-defined CSA was associated with more negative postabuse reactions and sexual avoidance, whereas those not identifying as sexually abused were more likely to report sexual compulsion."

Excerpt Graphic Library

The EGL on Harm has some relevant information. Just right click/save and reproduce by uploading in short-form media to bypass character limits.

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  Basic Rind Paradox infographic
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  Summarized Rind findings
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  Rind and Tromovitch (2000) on Iatrogenic Harm
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  Research pointing to no intrinsic harm profiled in The Guardian
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  What victimologists say about youth perception + admissions of iatrogenic harm
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  Self-perception: Importance
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  Some reading on secondary harm and perception/situational variables
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  More secondary harms
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  Intrinsic vs secondary harm
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  Daly's 2021 repetition of Rind (1998), finds that self-perception is far more important that abuse status
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  Lahtinen Report: Most common reason for not reporting - event not serious enough
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  Stander et al. showing low perception of actual abuse among nominally "abused" Naval Recruits.
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  Bender. Sexologist's observations in 1969
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  College outcomes: Benefits of college samples
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  LGBT outcome/perception data (links to papers in this release)
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  Arreola 2009 - Psych outcomes for LGBT "CSA" identical to no sex
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  Simpler way of expressing Lesbian outcomes (ref to modern feminism)
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  Further distillation of Rind's Kinsey analysis
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  Finnish Victimization Survey
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  Finer analysis of Finnish Victimization Survey (Rind)
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  General reading on intrinsic harm
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  Oellerich on the self-fulfilling prophecy of iatrogenic harm
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  Oellerich comments further on iatrogenic harm
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  CSA harm was known to be confounded even before Rind
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  No "typical" CSA reaction or "syndrome"
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  Rind on methodological issues/limitations of victimology
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  The Lanning (1992) report - full of hysterical conjecture, nevertheless describes the "most common" forms of offender and victim in banal terms that are applicable to most relationships (in order to prepare investigators to pathologize banality)
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  Percy Foundation review of Chloe Taylor: "Foucault, Feminism, & Sex Crimes"
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  2022 debate response
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  Illinois state investigation finds a "pedophile" was his victims' "best friend"