Child Sexual Abuse Policy Recommendations Published in Science

David Spiegel, Stanford, California, USA

For the first time, the journal Science (April 22, 2005, Vol. 308, p. 501) published major policy recommendations regarding child sexual abuse.

The lead authors of “The Science of Child Sexual Abuse” are ISTSS members Jennifer Freyd and Frank Putnam. Freyd and Putnam and five colleagues who together represent the fields of medicine, law, political science, psychiatry and psychology, summarize the research and make recommendations for new policy.

Publication of this policy article in the nation’s leading general science journal is a tremendous opportunity to shed light on an important and neglected problem. It is especially important because science is most needed where passion overshadows reason, and the authors of this Science article have applied the tools of science to this highly contentious area that is of great importance for health and public policy.

The Science article explains that child sexual abuse is a serious public health problem. It summarizes the body of research on child sexual abuse, which shows:

• At least 20 percent of women and 5 percent to 10 percent of men have experienced child sexual abuse worldwide.
• Underreporting (including memory failure) often leads to underestimation of the extent of abuse.
• Child sexual abuse is associated with serious mental and physical health problems, substance abuse, victimization and criminality in adulthood.
• Though official reports of child sex abuse have declined somewhat in the U.S. during the past 10 years, nearly 90 percent of sexual abuse cases are never reported to authorities.
• Most child sexual abuse is committed by family members and individuals close to the child, which increases the likelihood of delayed disclosure and possible memory failure, while increasing the potential for unsupportive reactions by caregivers and lack of intervention.
• Abuse reports often are doubted for a variety of reasons, despite evidence that when adults recall abuse, the truth of their memories is not correlated with the time in which they regained awareness of a past incident.
• Cognitive and neurobiological mechanisms that may underlie the forgetting of abuse have been identified.

The Science article notes that currently the research is not well known by policy makers, and gaps in knowledge are not well articulated. In addition, the problem of false allegations often receives more attention than the related problems of real sexual abuse and false denials. Most critically, there is very little U.S. federal research funding for this serious public health problem.

The authors call for a major research and educational initiative on abuse in childhood, including expansion of the National Child Traumatic Stress Network and the creation of a new Institute on Child Abuse and Interpersonal Violence at the U.S. National Institutes of Health (NIH). The growing evidence that childhood abuse predisposes to both mental and physical disorders is carefully cited. The article makes it clear that violence against children is not only repugnant, but is disturbingly frequent and damaging far beyond its immediate visible effects.

The Science article has attracted quite a bit of attention, including discussion on National Public Radio’s respected “Talk of the Nation: Science Friday” (May 13, 2005). On that show, Jennifer Freyd emphasized a sobering point made in the Science article (and attributed to an analysis by Frank Putnam): While we spend $2 on research for every $100 spent in costs for cancer, we spend only a nickel on research for every $100 in costs for child maltreatment. The authors are eager to see their recommendations lead to change.

Authors of “The Science of Child Sexual Abuse,” published in Science are Jennifer Freyd, University of Oregon; Frank Putnam, Cincinnati Children’s Hospital Medical Center; Thomas Lyon, University of Southern California Law School; Kathryn Becker-Blease, University of New Hampshire; Ross Cheit, Brown University; Nancy Siegel of NBS Associates, Maryland; and Kathy Pezdek, Claremont Graduate University.

References
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; http://dynamic.uoregon.edu/~jjf/articles/science05.htm.

“The Science of Sexual Abuse,” NPR’s Talk of the Nation: Science Friday, New York, N.Y., May 13, 2005. http://www.sciencefriday.com/pages/2005/May/hour1_051305.html.

David Spiegel, MD, is Willson Professor, School of Medicine, Associate Chair of Psychiatry & Behavioral Sciences, and Medical Director, Center for Integrative Medicine, Stanford University School of Medicine.