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ETIOLOGY
Review: Assumed properties of sexual abuse in childhood are not
borne out in college student samples
Rind B, Tromovitch P, Bauserman R,
Data extraction
A meta- analytic examination of
assumed properties of child sexual
abuse using college samples.
Psychol Bull. 1998Jul;124:22-53.
Data were extracted on psychological adjustment (symptoms), sex of participants,
definition of CSA, reaction to CSA, selfrepotted effects, and family environment
Question
In college students with a history of
sexual abuse in childhood (CSA), what is
the effect of CSA on psychological adjustment in terms of causality, pervasiveness, intensity, and gender?
Data sources
5 databases were searched using the
terms adjustment, effect, college, undergraduate, sex abuse, child, and adult.
Study selection
Studies were selected if they included
samples of college students for whom
separate measures were available and
contained data on reactions to CSA or
self-reported effects of CSA, Studies
were also included in analyses of psychological correlates of CSA if they included a control group of students with
no CSA experiences, provided data on
> 1 of 18 psychological symptoms, and
provided sufficient data to calculate > 1
effect size.
Main results
59 studies met the inclusion criteria
and included 35 703 participants (62%
women), providing 54 stodentsamples for
calculating 54sample-level effect sizes and
214 symptom-level effect sizes. Effect-size
data for psychological adjustment were
based on 15 824 respondents. Meta-analysis of the sample-level effect sizes showed
that students with CSA were slightly less
well adjusted than control-group students
(mean weighted effect size 0.09, 95%
CI 0.08 to 0.11). At the symptom level,
the effect-size estimates ranged from 0.04
to 0.13 for the 18 psychological symptoms; all but 1 (locus of control) showed
that students with CSA were less well
adjusted than control-group students.
The effect sizes, however, were small,
which indicated a weak association between CSA and psychological adjustment
with symptoms being neither pervasive
nor intense. Self-reported reactions to
CSA that were recalled retrospectively
(data from 15 studies) differed between
colon
men and women: 72% of women's expe,|:. Giovann
riences were reported as negative coiiv?; GA, et a
pared with 33% of men's experiences,-^'; and col<
meta-analysis of self-reported effects fii Nurses'
CSA combining 4 effect sizes gave antm- <• Med. 19
biased effect-size estimate of 0,2 2 (CI O.jy s:.
to 0.28), showing that women reported I
more negative effects than men. Further;--. Question
meta-analysis was done based on Hf:. Is foiate
samples that examined the potential con- i •• supplem>
founding effects of family environment^ risk for c
For 59% of the symptoms examined, tfel. Design
statistically significant CSA adjustment: :Populat
association became nonsignificant after-: women
controlling for family environment, K '/with 14Setting
Conclusion
Among college students, an association*:. ..United!
exists between a history of sexual abuss:'- Parlicipi
in childhood and poorer psychological!:.: ,887561
adjustment, but the magnitude of Mt •55. years
association is small.
... j .: teriawei
:
Source of funding. No extmml funding. :••••. s.;.homa
si
For correspondence: Dr. B. Rind, Depaittmif:.familial
of Psychology, Temple University, Phikdei\Mi;%• W high
PA 19122, USA.
FAX2l5~204-5W;;.;?h .intake, i
Assessn
Abstract and Commentary also publisHedi;-;:
.;i*:vNursesi
Bvideiict-Based Mental Health. 1999 Feb.
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Commenidtv
Few topics in the psychological literature
generate as much controversy as CSA..
The meta-analytic review by Rind and
colleagues tackles one of the most contentious and crucial issues in this field: the
nature and strength of die relation between CSA and psychological adjustment.
The authors have done a comprehensive
meta-analysis using samples of college students. Their finding that college students
with a history of CSA were only slightly less
well adjusted than control-group students
with no history of CSA is encouraging information. Nevertheless, this conclusion cannot be generalised to all persons with a
history of CSA. Rind and colleagues highlight the similarities between sexually abused
persons in college and national samples.
College students, however, still represent a
relatively special spectrum of the population
in terms of sociodemographic characteris-
60
tics. Further, although 59 studies were
included in the overall review, each symptom was assessed only in about 20% of the
individual studies.
This meta-analysis has several strengths,
including the use of explicit criteria for
study selection, data extraction by 2 independent raters, and sophisticated assessment of the variability in sample-level
effect siz.es. However, the review did not
include an assessment of the methodological quality of the original studies. Such
aspects as design, sampling technique, and
response rate in the studies- are essential to
consider, otherwise studies of varying
quality are grouped together and given
equal weight (1). In addition, the issue of
CSA causing harm cannot be examined in
cross-sectional surveys; only longitudinal
studies can investigate the causal role of
CSA. Therefore, information about the
design of the individual studies is i
tant in interpreting the results.
Jaitty,
Although Rind and colleagues
j
that CSA "does not cause intense hann%:;:;:
a pervasive basis" in the college pop%:•'•[
tion, this conclusion is premature b#>fe.,:.:
the quality of the individual studies fe::::
not taken into account. The findin^%-:.this review suggest that CSA may n | ^ ^
associated with poor psychologici>l:|!||>::.
tioning generally in college
further research is necessary before $
tive conclusions can be drawn,
Harriet MacMilhih
Hamilton, Health Sciences Cor,
Hamilton,
Reference
1. Lewis G, Churchill U, Hertdpi
tematic reviews and
Med. 1997;27:3-7.
Evidence-Based Medicine
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Review: Assumed properties of sexual abuse in
childhood are not borne out in college student
samples
Evid Based Med 1999 4: 60
doi: 10.1136/ebm.1999.4.60
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