Rind et al. controversy

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The Rind et al. controversy was a unique historical debate in scientific literature, public media, and the US government, regarding a 1998 peer reviewed paper on child sexual abuse (CSA) that conducted a meta-analysis of several samples of college students.[1] The paper was written by researchers Bruce Rind (PhD), Philip Tromovitch and Robert Bauserman, following a related 1997 meta-analysis by Rind and Tromovitch in the Journal of Sex Research.[2] The debate resulted in the unprecedented condemnation of the paper by the United States House of Representatives and concern in the social science research community over the chilling effect the resolution may have on publication of controversial research results.

The authors' stated goal was "...to address the question: In the population of persons with a history of CSA [child sexual abuse], does this experience cause intense psychological harm on a widespread basis for both genders?" Some of the authors' more controversial conclusions were that child sexual abuse does not necessarily cause intense, pervasive harm to the child;[3] that the reason the current view of child sexual abuse was not substantiated by their empirical scrutiny was because the construct of CSA was questionably valid; and that the psychological damage caused by the abusive encounters depends on whether the encounter was consensual or not.[1]

Rind et al. concluded with a statement that even though CSA may not result in harm, this does not mean it is not wrong or morally repugnant behavior and denied that their findings implied current moral and legal prohibitions against CSA should be changed.[1] Numerous age of consent reform organizations have quoted the paper in support of their efforts to lower or rescind age of consent laws, and defense attorneys have used the study to argue for minimizing harm in child sexual abuse cases.[4][5]

Findings in brief

Prior to publishing the 1998 Rind et al. meta-analysis that was based on college samples[1], Rind and Tromovitch published a meta-analysis based on national samples[2]. The 1998 manuscript replicated the overall, nationally representative findings regarding the association between experiencing one or more episodes categorized as CSA and later psychological adjustment.[6] The definition of CSA varied significantly between samples, most including victims as old as 17, and also included non-contact offenses (such as exhibitionism).[7] Both the national studies and the college studies showed only a small overall average association between CSA and impairment (the association between CSA and poorer psychological adjustment can be expressed as a percentage from 0% to 100% where 0% indicates there is no association and 100% indicates that CSA completely determines one's psychological adjustment; using this scale the overall association was less than 1.0%; separated by gender it was approximately 1/2 of 1% for males and 1% for females; correlation rs=.07 and .10, respectively).[8][9] Most social science research is designed so that on average, 1 out of 20 findings will be statistical outliers if the research is perfectly conducted. The 10 national samples contained 1 statistical outlier; the 54 college samples contained 3 statistical outliers, as expected in social science research; after removing these outliers, the findings across both male and female samples (both within the national samples and the college samples) were highly consistent (i.e., homogeneous), thus the small averages are not the result of mixing studies with markedly different findings.[10][11] Even when the researchers included the statistical outliers, the overall result was small.[12] In addition to the overall analyses, in the college study the researchers examined the 18 most studied, alleged symptoms of having experienced CSA (e.g., self-esteem problems, anxiety, depression, eating disorders, sexual problems, etc.). Fifteen out of eighteen of these data sets were homogeneous after outlier removal, and all 18 average associations were small both before and after outlier removal.[13]

The researchers conducted the college meta-analysis in part because the college studies provided data regarding causality which was lacking in the national studies.[14] The analyses of these data showed that CSA was unlikely to be the major causal variable, if it is a causal variable at all.[15] In studies that controlled for any confounding variables, less than 1 in 5 attempts to find a statistically significant finding between CSA and harm did so.[16] Poor family environments and other confounding variables were found to be 9-fold better explanations for the small associations that were found in the main analyses, suggesting that the causal association between CSA and harm is small at most, but perhaps zero in the typical case.[17]

In addition to the meta-analyses that compared people who experienced CSA with controls, the researchers also summarized the available data on peoples' reactions to the experiences that were labeled as CSA by researchers. They found that nearly one-third of females and two-thirds of males who had an experience that was labeled as CSA, reported that the experience was neutral or positive.[18]

The researchers pointed out that a likely reason their findings were counter to expectations that CSA causes prevalent, intense harm, regardless of gender,[19][20] was at least in part due to the use of definitions of CSA that are of questionable scientific validity.[21] The authors then suggested that researchers label willing sexual encounters that were experienced positively as "adult-child sex" and that other experiences such as unwanted and negative experiences be labeled as "child sexual abuse" so that researchers would be more likely to achieve a valid understanding of the heterogeneous behaviors currently grouped under the CSA label.[22] The authors then closed their article pointing out that although scientists should use definitions that produce better scientific validity, this did not mean that "moral or legal definitions of or views on ... CSA should be abandoned or even altered."[23]

Controversy

The paper was first published by the American Psychological Association (APA) in July, 1998, in the widely-respected Psychological Bulletin, to little reaction. The first substantial and public reaction was a December criticism by the National Association for Research & Therapy of Homosexuality, an organization dedicated to the view that homosexuality is a mental illness that can be cured by psychotherapy. In March 1999 talk show host Laura Schlessinger criticized the study as "junk science" and stated that since its conclusions were contrary to conventional wisdom, its findings should never have been released, and she questioned the motives of the authors, asserting the purpose of the study was to allow the homosexual rape of children. Shortly thereafter, the North American Man/Boy Love Association posted an approving review of the study on their website, furthering the impression that the piece was an endorsement of pedophilia.[24]

In response, the APA declared in a press statement that child sexual abuse is harmful and wrong, and that the study was in no way an endorsement of pedophilia.[25] In an internal APA email, President of the APA Raymond D. Fowler stated that due to the controversy the article's methodology, analysis and process by which it had been approved for publication was reviewed and found to be sound.[26] In June 1999, Fowler announced in an open letter to Congress Representative Tom DeLay that there would be an independent review of the paper and stated that from a public policy perspective, some language used in the article is inflammatory and inconsistent with the position of the APA's stance on CSA. The APA also implemented a series of actions designed to prevent the study from ever being used in legal circumstances to defend pedophilia and stated an independent review would be undertaken of the scientific accuracy and validity of the report.[27]

In the following month the United States House of Representatives unanimously passed a resolution declaring sexual relations between children and adults are abusive and harmful, and condemned the study on the basis that it was being used by pro-pedophilia activists and organizations to promote and justify child sexual abuse.[28] The resolution was passed unanimously in the Senate and was greeted among psychologists with concern due to the perceived chilling effect it may have among researchers.[24] In September 1999 the American Association for the Advancement of Science (AAAS), upon a request by the APA to independently review the article, stated that it saw no reason to second-guess the peer review process that approved it initially and that it saw no evidence of improper methodology or questionable practices by the authors. The AAAS also expressed concern that the materials reviewed demonstrated a grave lack of understanding of the study on the part of the media and politicians and were also concerned about the misrepresentation of its findings.[29] The AAAS stated that the responsibility for discovering problems with the article lay in the initial reviewers, and declined to evaluate the article and concluded with a statement that the decision not to review the article was neither an endorsement, nor a criticism of it.

In August 2000 the APA drafted and adopted a position statement in response to the Rind et al. controversy which opposed any efforts to censor controversial or surprising research findings and asserting researchers must be free to investigate and report findings so long as the research has been conducted within appropriate ethical and research standards.[24]

Criticism and response

A series of 2001 papers published in the Journal of Child Sexual Abuse discussed and criticized the findings of Rind et al. Stephanie Dallam stated that after reviewing the evidence the paper was best described as "an advocacy article that inappropriately uses science in an attempt to legitimatize its findings."[30] Four other researchers also discussed alleged flaws in the methodology and generalizability of Rind's findings, and concluded the paper's results were scientifically invalid.[31][32] The criticisms were co-published in the 2001 book Misinformation concerning child sexual abuse and adult survivors.[33]

Sample bias accusation

Dallam et al. note that, by restricting their analysis to convenience samples of college students, Rind et al. introduced a systematic bias in favor of their conclusion by excluding victims so traumatized that they did not go on to attend college. In addition, Duncan (2000) found that child sexual abuse survivors were far more likely than non-abused individuals to drop out of college, especially after only one semester.[30]

Rind, Bauserman, and Tromovitch have responded to this criticism by emphasizing that "the representativeness of college samples is in fact irrelevant to the stated goals and conclusions of our study" since the purpose of their research was "to examine the validity of the clinical concept" of CSA. According to the commonly understood definition of the term, child sexual abuse is extremely and pervasively harmful, meaning that "in any population sampled - drug addicts, psychiatric patients, or college students - persons who have experienced CSA should show strong evidence of the assumed properties of CSA." The authors of the study note that because the college sample did not show pervasive harm, "the broad and unqualified claims about the properties of CSA are contradicted."[34]

Non-standardization of variables

Dallam et al. asserted that Rind et al. did not standardize their definition of child sexual abuse, leaving out certain studies that were appropriate, and including studies that were inappropriate. That is, they allege that Rind et al. uncritically combined data from studies of CSA with data from studies looking at other phenomena such as consensual peer experiences, sexual experiences that occurred during adulthood, and homosexual approaches during adolescence.

Rind, et al. have also responded to this criticism, asserting the appropriateness of including all five of the studies (Landis, 1956; Shultz and Jones, 1983; Sedney and Brooks, 1984; Grenwald, 1994; and Sarbo, 1985) specifically identified by Dallam as inappropriate to a study about child sexual abuse.

Dallam claims that the first three studies focused on all types of child sexual activity, not just child sexual abuse. Rind et al. reject this claim. In regard to the Landis study, Rind et al. note that it has been used by many other sex researchers (e.g., Finkelhor, Fishman, Fromuth & Burkhart, Sarbo, and others) as an example of an early study about child sexual abuse. In regard to the Shultz and Jones study, Rind et al. concede that the study "looked at all types of 'sexual acts' before age 12," but explained that the respondents in the study were all asked "if their experience was with a person over the age of 16," thus allowing Rind et al. to include only the relationships that were age-discrepant. In regard to the Sedney and Brooks study, Rind et al. admit that the study used a broad definition of child sexual abuse, but explain that the researchers themselves chose to use such a definition "because of the difficulty posed by a priori decisions about what type of sexual experiences are 'problems.'"

The last two studies, according to Dallam, were inappropriate because they included respondents who were over the age of 17.

Statistical errors

Dallam et al. also contend that Rind et al. miscoded or misreported significant amounts of the underlying study data, thereby skewing the results. Dallam et al. contend that Rind et al. incorrectly used "Pearson's r" instead of "Cohen's d" to calculate the effect size, which resulted in a failure to correct for base-rate differences of CSA in male and female samples, and which led to the finding that males were less harmed by CSA. After correcting for base-rate attenuation, Dallam et al. claimed to have arrived at identical effect sizes for male and female samples.[citation needed]

In responding to this criticism, Rind et al. report that they did indeed describe the contrast between the effect size estimates as "nonsignificant, z = 1.42, p > .10, two-tailed." However, they continue, "What [they] did report as significantly different was the contrast between male and female effect size estimates for the all-types-of-consent groups, where rus = .04 and .11, respectively. In "follow[ing] Dallam et al. (2001) [by] apply[ing] Becker's correction formula to these values, they become rcs = .06 and .12 for men and women, respectively. The contrast is still statistically significant (z = 2.68, p < .01. two-tailed), contrary to Dallam et al.'s (2001) claim."

Rind et al. claim that their own "handling of Pearson's r in the face of base-rate differences was methodologically proper and produced no important bias, if any at all." Furthermore, they contend that Dallam's criticisms "exhibited bias ... [by] selectively ignoring key clarifying quotes ... and citing them elsewhere in their critique to argue different points, and [by] ignoring or overlooking a key caveat by Becker (1986) regarding appropriate use of his correction formula."[citation needed]

Conceptual issues

Rind et al.'s model of "assumed properties of child sexual abuse," (that is, of universal and pervasive harm in all victims of CSA) has been criticized as a straw man assertion in that it is both simplistic and misleading.[5][35] The reactions of victims in their adult lives have been found to be extremely varied, ranging from severe to nearly unnoticeable, and many pathologies are not diagnosable in the strictly clinical sense Rind uses. Victims often have a flawed or distorted appraisal of their abuse, and fail to connect distressing and sometimes debilitating pathologies with their experiences. Further, these studies make no accounting for emotional support of the victim's family, clinical treatment of the victim prior to the study, or personal resiliency, which can easily account for less severe outcomes.[5]

Assertions of bias

Rind, Bauserman and Tromovitch stated that research findings can be skewed by an investigator’s personal biases, and in Rind et al. claimed that "[r]eviewers who are convinced that CSA is a major cause of adult psychopathology may fall prey to confirmation bias by noting and describing study findings indicating harmful effects but ignoring or paying less attention to findings indicating nonnegative outcomes". They defended their deliberate choice of non-legal and non-clinical samples, accordingly avoiding individuals who received psychological treatment or were engaged in legal proceedings as a way of correcting this bias through the use of a sample of college students.[36]

Stephanie Dallam and Anne Salter have pointed out that Rind and Bauserman have had associations with age of consent reform organizations. In the years before the paper was written, both Rind and Bauserman had published articles in Paidika, a defunct journal whose purpose was "Through publication of scholarly studies, thoroughly documented and carefully reasoned, we intend to demonstrate that paedophilia has been, and remains, a legitimate and productive part of the totality of human experience."[37] In addition, shortly after the paper's publication, Rind and Bauserman were keynote speakers at a pedophile advocacy conference occurring in the Netherlands.[38]

Usage outside of scholarly discussions

Despite the author's comments that the paper should not be used to change moral or legal prohibitions on sex with children, it caught attention and was used by advocates for pedophilia.[4][5] The paper was posted on numerous advocacy websites such as International Pedophile and Child Emancipation (IPCE), the Male Homosexual Attraction to Minors information center (MHAMIC) and North American Man/Boy Love Association (NAMBLA), and has been used to argue that the age of consent should be lowered or abolished.[39]

It has also been used in several court cases by child sexual offenders as a defense. In State of Arizona v. Steward (1999), a man convicted of molesting 5 different children attempted to use the study to achieve leniency in his sentence by arguing the children were not harmed.[39] In another case, a defense expert argued that the victims of a Catholic priest were not harmed, citing Rind's study.[40]

Subsequent research and legacy

Numerous studies and work in the field of psychology from long both before and after Rind et al.'s publication have supported the stance that children cannot consent to sexual activity and are harmed by it.[5][41] The Rind study continues to be trumpeted by various pro-pedophilia groups and individuals, but its usage in legal action to defend such individuals has gradually waned since its congressional condemnation.[5]

In the behavioral sciences, modern works may make passing reference to the study, but largely ignore its more controversial conclusions.[42] A study published in the Scientific Review of Mental Health Practice published attempted to replicate the Rind study, correcting for methodological and statistical problems identified by Dallam and others. It supported some of the Rind findings, both with respect to the percentage of variance in later psychological outcomes accounted for by sexual abuse and in relation to the finding that there was a gender difference in the experience of child sexual abuse, such that females reported more negative effects. However it also acknowledged the limitations of the findings (college student sample, self-report data), and did not endorse Rind's recommendation to abandon the use of the term 'child sexual abuse' in cases of apparent consent in favor of the term 'adult-child sex'. In their conclusion, the authors address the objection that Rind's work and their own would give support to those who deny that child sexual abuse can cause harm: 'The authors of the current research would hesitate to support such a general statement. Instead, our results, and the results of the Rind et al. meta-analysis, can be interpreted as providing a hopeful and positive message to therapists, parents, and children. Child sexual abuse does not necessarily lead to long-term harm.' [43]

There has been greater emphasis in subsequent work on the range of responses that are possible from victims. For example, a few studies make reference to the paper's findings about "consensual" encounters, but approach it from the opposite direction (i.e. that the use of force causes more intense negative outcomes).[44] Heather Ulrich, author of the Scientific Review of Mental Health Practice study that replicated Rind's meta-analysis, later drew on the findings to study the reasons for the variability in outcomes of CSA victims, such as attributional style (individual’s causal explanations for why the abuse occurred), family environment, and social support.[45]

See also

Footnotes

  1. ^ a b c d Rind, B (1998). "A Meta-Analytic Examination of Assumed Properties of Child Sexual Abuse Using College Samples". Psychological Bulletin. 124 (1): 22–53. doi:10.1037/0033-2909.124.1.22. PMID 9670820. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
  2. ^ a b Rind, B (1997). "A meta-analytic review of findings from national samples on psychological correlates of child sexual abuse". Journal of Sex Research. 34 (3): 237–255. doi:10.1080/00224499709551891. JSTOR 3813384. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
  3. ^ Rind B (2007). "National Samples, Sexual Abuse in Childhood, and Adjustment in Adulthood: A Commentary on Najman, Dunne, Purdie, Boyle, and Coxeter (2005)". Archives of Sexual Behavior. 36 (1): 101–106. doi:10.1007/s10508-006-9058-y. PMID 17139555. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
  4. ^ a b Spiegel, J (2003). Sexual Abuse of Males: The Sam Model of Theory and Practice. Routledge. pp. 3, 9. ISBN 1560324031.
  5. ^ a b c d e f Ondersma SJ; et al. (2001). "Sex with children is abuse: Comment on Rind, Tromovitch, and Bauserman (1998)" (pdf). Psychol Bull. 127 (6): 707–14. doi:10.1037/0033-2909.127.6.707. PMID 11726067. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)
  6. ^ Rind et al. 1998, p. 42
  7. ^ Rind et al. 1998, p. 29
  8. ^ Rind et al. 1998, pp. 31, 33, Table 4
  9. ^ Rind & Tromovitch 1997, p. 248, Table 6
  10. ^ Rind et al. 1998, pp. 31, 33, Table 4
  11. ^ Rind & Tromovitch 1997, see pp. 248-249
  12. ^ Rind et al. 1998, p. 31
  13. ^ Rind et al. 1998, p. 32 Table 3
  14. ^ Rind et al. 1998, pp. 25, 42
  15. ^ Rind et al. 1998, pp. 39-40, Table 12
  16. ^ Rind et al. 1998, p. 40
  17. ^ Rind et al. 1998, pp. 30-40
  18. ^ Rind et al. 1998, p. 36, Table 7
  19. ^ Rind & Tromovitch 1997, pp. 238-239
  20. ^ Rind et al. 1998, see also pp. 23-26
  21. ^ Rind et al. 1998, p. 46
  22. ^ Rind et al. 1998, pp. 46-47
  23. ^ Rind et al. 1998, p. 47
  24. ^ a b c Lilienfeld, SO (2002). "When Worlds Collide: Social Science, Politics and the Rind et al. (1998) Child Abuse Meta-Analysis" (PDF). The American Psychologist. 57 (3): 177–187. PMID 11905116. Archived from the original (pdf) on 2003-04-29.
  25. ^ Martin, S (1999-07-01). "APA defends stance against the sexual abuse of children". APA Monitor. 30 (7).
  26. ^ Fowler, RD (1999). "RE: APA statements". Child Maltreatment Researchers (Mailing List).
  27. ^ Folwer, RD (1999-06-09). "The Honorable Tom DeLay". American Psychological Association.
  28. ^ United States Congress (1999). "Whereas no segment of our society is more critical to the future of human survival than our children" (PDF). 106th Congress, Resolution 107.
  29. ^ Rind, B (2000). "Condemnation of a scientific article: A chronology and refutation of the attacks and a discussion of threats to the integrity of science". Sexuality and Culture. 4 (2): 1–62. doi:10.1007/s12119-000-1025-5. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
  30. ^ a b Dallam, SJ (2001). "Science or Propaganda? An Examination of Rind, Tromovitch and Bauserman". Journal of Child Sexual Abuse. 9 (3/4). Haworth Press: 109–134. doi:10.1300/J070v09n03_06.
    • Co-published as a book chapter in Dallam SJ (2001). "Science or Propaganda? An Examination of Rind, Tromovitch and Bauserman". In Whitfield CL; Silberg JL; Fink PJ (ed.). Misinformation concerning child sexual abuse and adult survivors. Routledge. pp. 109–134. ISBN 0789019019. {{cite book}}: External link in |chapterurl= (help); Unknown parameter |chapterurl= ignored (|chapter-url= suggested) (help)CS1 maint: multiple names: editors list (link)
  31. ^ Tice, PP (2000). "The real controversy about child sexual abuse research: Contradictory findings and critical issues not addressed by Rind, Tromovitch, and Bauserman in their 1998 outcomes meta-analysis". Journal of Child Sexual Abuse. 9 (3–4). Haworth Press: 157–82. doi:10.1300/J070v09n03_08. PMID 17521995. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
    • Co-published as a book chapter in Tice, PP (2001). "The real controversy about child sexual abuse research: Contradictory findings and critical issues not addressed by Rind, Tromovitch, and Bauserman in their 1998 outcomes meta-analysis". In Whitfield CL; Silberg JL; Fink PJ (ed.). Misinformation concerning child sexual abuse and adult survivors. Routledge. pp. 157–182. ISBN 0789019019. {{cite book}}: External link in |chapterurl= (help); Unknown parameter |chapterurl= ignored (|chapter-url= suggested) (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)CS1 maint: multiple names: editors list (link)
  32. ^ Whittenburg, JA (2000). "A critical appraisal of the 1998 meta-analytic review of child sexual abuse outcomes reported by Rind, Tromovitch, and Bauserman". Journal of Child Sexual Abuse. 9 (3–4). Haworth Press: 135–55. doi:10.1300/J070v09n03_07. PMID 17521994. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
    • Co-published as a book chapter in Whittenburg, JA (2001). "A critical appraisal of the 1998 meta-analytic review of child sexual abuse outcomes reported by Rind, Tromovitch, and Bauserman". In Whitfield CL; Silberg JL; Fink PJ (ed.). Misinformation concerning child sexual abuse and adult survivors. Routledge. pp. 135–156. ISBN 0789019019. {{cite book}}: External link in |chapterurl= (help); Unknown parameter |chapterurl= ignored (|chapter-url= suggested) (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)CS1 maint: multiple names: editors list (link)
  33. ^ Whitfield, CL (2001). Misinformation concerning child sexual abuse and adult survivors. Routledge. ISBN 0789019019. {{cite book}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
  34. ^ Rind, B (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 (6): 734–58. doi:10.1037/0033-2909.127.6.734. PMID 11726069. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
  35. ^ McNally, RJ (2003). "Progress and controversy in the study of posttraumatic stress disorder" (pdf). Annual Review of Psychology. 54: 229–252. doi:10.1146/annurev.psych.54.101601.145112. PMID 12172002.
  36. ^ Rind, B (2001). "The condemned meta-analysis on child sexual abuse; Good science and long-overdue skepticism". Skeptical Inquirer: 68–72. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
  37. ^ Paidika: The Journal of Paedophilia. 1 (1): 3. 1987. {{cite journal}}: Missing or empty |title= (help)
  38. ^ Salter, A (2003). Predators: pedophiles, rapists, and other sex offenders: who they are, how they operate, and how we can protect ourselves and our children. New York: Basic Books. p. 64. ISBN 0-465-07172-4.
  39. ^ a b Dallam, SJ (2001). "The effects of child sexual abuse: Comment on Rind, Tromovitch, and Bauserman (1998)". Psychological bulletin. 127 (6): 715–33. doi:10.1037/0033-2909.127.6.715. ISSN 0033-2909. PMID 11726068. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
  40. ^ Watson v. Roman Catholic Church of the Diocese of Phoenix (Superior Court of the State of Arizona, Maricopa County 1999-08-17).
  41. ^ Holmes, WC (1999). "Sexual abuse of boys: definition, prevalence, correlates, sequelae, and management". Journal of the American Medical Association. 280 (21): 1855–62. doi:10.1001/jama.280.21.1855. PMID 10376568. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
  42. ^ Wood, Samuel H.; Wood, Ellen Meiksins; Boyd, Denise (2008). The world of psychology. Boston, Mass.: Pearson/Allyn and Bacon. ISBN 0-205-49941-4.
  43. ^ Ulrich, Heather (2005-06). "Child Sexual Abuse: A Replication of the Meta-analytic Examination of Child Sexual Abuse by Rind, Tromovitch, and Bauserman (1998)". The Scientific Review of Mental Health Practice. 4 (2). {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  44. ^ Senn, TE; Carey, MP; Vanable, PA; Coury-Doniger, P; Urban, M (2007). "Characteristics of Sexual Abuse in Childhood and Adolescence Influence Sexual Risk Behavior in Adulthood". Arch Sex Behav. 36 (5): 637–45. doi:10.1007/s10508-006-9109-4. PMC 2042031. PMID 17192833. {{cite journal}}: Unknown parameter |month= ignored (help)
  45. ^ Ulrich, Heather (June 9, 2007). "Examining the variability in the long term adjustment of child sexual abuse victims". University of Montana. Retrieved 14 July 2011.
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