Note: On 22 April 2005 Science published a Policy Forum:
Freyd, J.J., Putnam, F.W., Lyon, T.D., Becker-Blease, K. A., Cheit, R.E., Siegel, N.B., & Pezdek, K. (2005). The science of child sexual abuse. Science, 308, 501. [Full text.]
In the 19 August 2005 issue Science published 4 letters and a response by the authors regarding the 22 April policy forum. This page contains quotes from the letters and our complete response. For access to the complete letters please see the Science magazine web site.
The Problem of Child Sexual Abuse, Science, Vol 309, Issue 5738, 1182-1185 , 19 August 2005
1. Fink: "The Policy Forum "The science of child sexual abuse" by J. J. Freyd et al. (22 Apr., p. 501) provides an extremely important call to action to the scientific community". .....We have severely underestimated the effects of this problem on our children's health. It is time to recognize that the problem is not solely a product of the action of a few sick individuals; child sexual abuse is a preventable health problem that has been allowed to spread unabated due to scientific and social neglect."
Paul Fink, President, The Leadership Council on Child Abuse & Interpersonal Violence, and Past President, American Psychiatric Association, 191 Presidential Boulevard, Suite C-132, Bala Cynwyd, PA 19004, USA, E-mail: Pjayfink@aol.com
2. Read: "In the Policy Forum "The science of child sexual abuse" (22 Apr., p. 501), J. J. Freyd and colleagues succinctly summarized an enormous amount of research and rightly highlighted the depressing bias of those researchers who "emphasized false allegations rather than false denials." It is a sad fact of life that after decades of ignoring the issue altogether, research showing the alarming prevalence of child abuse has met with a kind of 'backlash.'"
John Read. Psychology Department, University of Auckland, Auckland 1020, New Zealand
3. Dawes: "In their Policy Forum "The science of child sexual abuse" (22 Apr., p. 501), J. J. Freyd et al. assert that '[s]urveys likely underestimate prevalence [of child sexual abuse] because of underreporting and memory failure' There is no way of making that inference."
Robyn M. Dawes,Department of Social and Decision Sciences, Carnegie Mellon University, Porter Hall 208, Pittsburgh, PA 15213-3890, USA.
4. Kihlstrom, McNally, Loftus, and H. Pope: "The notion that individuals can develop amnesia for seemingly unforgettable traumatic events, followed by 'recovery' of these memories months or years later, has been part of the folklore of psychiatry and clinical psychology for more than 100 years ....Genuinely traumatic events--those experienced at the time as overwhelmingly terrifying and life-threatening--are seldom, if ever, truly forgotten."
John F. Kihlstrom, Department of Psychology, University of California, Berkeley, Berkeley, CA 94720-1650, USA
Richard J. McNally, Department of Psychology, Harvard University, Cambridge, MA 02138, USA
Elizabeth F. Loftus, Department of Psychology and Social Behavior, University of California, Irvine, Irvine, CA 92697-7085, USA
Harrison G. Pope Jr., Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA 02478, USA
As Dawes indicates, one must take into account both false allegations and denials in determining the prevalence of sexual abuse. However, evidence indicates that false allegations occur at rates lower than nondisclosure rates. Prevalence is underestimated (in Dawes' notation, c < b) whenever the likelihood that reports of abuse are false [c/(a c)] is less than the likelihood that true abuse is not disclosed [b/(a b)]. Mechanisms of false allegations, such as suggestive therapy or interviewer bias, occur in a small minority of abuse reports: 2% of survey respondents claiming abuse report having recovered their memory with the help of a professional or others (2), and approximately 10% report that the abuse was disclosed to authorities, setting an upper bound on adult influences (3). On the other hand, most surveys of adults with "well-documented serious abuse or neglect" have found nondisclosure rates over 30% [(4), p. 270].
High rates of nondisclosure also speak to Kihlstrom and colleagues' assertion that sexual abuse is "seldom, if ever, truly forgotten." Although underreporting is attributable in part to abuse victims' reluctance to disclose, Williams' (5) difficulty in eliciting abuse reports despite extensive questioning of women with documented abuse histories led Loftus et al. (6) to acknowledge that "many children can forget about a sexually abusive experience from their past" (p. 1177). What Kihlstrom et al. call "folklore" is actually over 100 years of clinical and scientific evidence for the forgetting of trauma (7). Although the frequency and mechanisms of forgetting are not completely clear, the basic phenomenon is documented in dozens of empirical studies (8) and corroborated case studies (9).
Kihlstrom et al. argue that trauma victims typically remember their experiences "all too well." However, both intrusive recall and an "inability to recall an important aspect of the trauma" [(10), p. 428] are diagnostic of pathological posttraumatic conditions and may both reflect, in part, some common underlying disregulation of memory processes (8). Indeed, traumatized individuals exhibit a range of memory impairments (11). Research on executive control over recall of unwanted memories (12), and research on children's (13) and adults' (14) encoding and memory of trauma stimuli has provided preliminary support for models of repression and traumatic amnesia. The relations among the effects of trauma on encoding, retrieval inhibition, and memory functioning are worthy of future study.
In our Policy Forum, we recommended a series of international consensus panels on scientific and clinical practice issues related to CSA, expansion of the National Child Traumatic Stress Network, and the creation of a new Institute of Child Abuse and Interpersonal Violence within the NIH that would foster research on CSA and related conditions. Claims that traumatic amnesia rarely occurs, as well as legitimate disagreements over the prevalence and accurate recall of CSA, reinforce these recommendations. Denial and underestimation of the effects of CSA continue to be serious obstacles to ending a preventable public health problem.
Jennifer J. Freyd, Department of Psychology, University of Oregon, Eugene, OR 97403-1227, USA
Frank W. Putnam, Department of Pediatrics, Children's Hospital Medical Center, Cincinnati, OH 45229, USA
Thomas D. Lyon, University of Southern California Law School, Los Angeles, CA 90089, USA
Kathryn A. Becker-Blease, Department of Psychology, Washington State University, Vancouver, WA 98686, USA
Ross E. Cheit. Department of Political Science, Brown University, Providence, RI 02912, USA
Nancy B. Siegel, NBS Associates, Columbia, MD 21046, USA
Kathy Pezdek, Department of Psychology, Claremont Graduate University, Claremont, CA 91711, USA
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