by Michael D. Anestis, M.S.
The other night, Joye and I took part in one of our regular "Law and Order: SVU" marathons. We enjoy shows that involve solving crimes and we enjoy marathons of television shows, so combining the two leaves us almost powerless to change the channel. Generally speaking, this is a completely enjoyable experience for both of us; however, the various versions of "Law and Order" have a habit of filling scripts with information on mental health that is completely inaccurate. At times, this means using the wrong name for a psychological phenomenon or disorder (e.g., mistakenly saying "sociopath" instead of "psychopath" or saying "ADD" instead of "ADHD primarily inattentive type"). Other times, this means depicting forms of therapy as front line treatments that, in reality, are based on absolutely no evidence. One particular episode we watched during this most recent marathon committed what I believe to be their most problematic form of error: perpetuating a harmful myth.
B.D.Wong's character - a psychiatrist who helps the police and the district attorney's office understand psychological variables at play in a given case - repeatedly claimed that individuals who themselves had been victims of childhood sexual abuse (CSA) were at an increased risk of becoming sexual abusers. Why is this a harmful statement? Because despite widespread belief to the contrary, the evidence does not support such a link. At most, the results are ambiguous, but the most compelling data in fact points towards a completely different conclusion. In a 1996 study, Cathy Widom presented compelling data that indicated victims of child abuse were less likely than victims of physical abuse or neglect and no more likely than controls (individuals with no history of any form of abuse victimization) to commit sex crimes. In other words, whereas physical abuse and neglect appeared to increase the risk of later sex crimes, being a victim of CSA left individuals no more likely to commit such an offense than an individual who had never been a victim of CSA.
This is not to say that abuse in general and sexual abuse can not lead to dangerous outcomes. CSA has been linked to a variety of mental illnesses, including PTSD, depression, and substance abuse (Beitchman, Zucker, Hood, DaCosta, & Akman, 1991; Black & DeBlassie, 1993; Jumper, 1995), although, to some degree, these links have been shown to be mediated by other variables. When all abuse categories are combined into one, abuse victims do have a higher rate of later sex crime offenses, but there is absolutely no utility in combining forms of abuse into a single category when we have clear data demonstrating different behavioral trajectories for different forms of abuse.
So how can we explain the existence of the widely held belief that victims of CSA are more likely to sexually abuse others despite evidence to the contrary? For one thing, researchers make little effort to publicize their findings to the general public and the media makes similarly little effort to report on such findings. This leaves people to draw their own conclusions based, for the most part, on anecdotal evidence. They remember a notable case when a victim of CSA was also an abuser and they generalize this particular instance to the larger phenomenon. Alternatively, they do hear about research, but the conclusions from a particular study are not appropriate given the limitations of the data.
Clarifying this topic entirely is well beyond the scope of a single article, but I would like to present a sampling of research findings in an effort to help further debunk this myth. In a study published in late 2008, Kevin Beaver demonstrated that genes and a history of CSA can interact to predict violent delinquency in males. Beaver found that, for men, a history of CSA predicted a greater level of violent delinquency and that this relationship was amplified when a male victim of CSA also had a genetic risk. For females, neither a history of CSA, a genetic risk, nor an interaction of the two predicted violent delinquency. Importantly, violent delinquency is not the same as sexually abusing others. Unlike Beaver, Ducci and colleagues (2008) did find an interaction between genetic risk and CSA victimization in the prediction of antisocial personality disorder symptoms for females.
In one study that runs counter to these findings, Dudeck, Spitzer, Stopsack, Freyberger, and Barnow (2007) looked at a sample of 51 inpatients in a maximum security forensic hospital in Germany. They found that sex offenders in this group were more likely than non-sex offenders to have a history of CSA. These findings, however, consisted of a comparison 19 sex offenders to 32 non-sex offenders - a sample size much too small for this type of analysis. Christopher, Lutz-Zois, and Reinhardt (2007) reported similar findings, with a group of 61 female sex offenders reported greater frequency and duration of CSA than a group of 81 non-sex offenders.
The absence of a control group of non-criminals distorts these findings, however, and distracts readers from the more important question - whether victims of CSA in general are more likely to commit sex crimes than non-victims in general. In other words, comparing two types of criminals to one another does little to help us understand the impact of CSA in non-criminal populations. Given that the vast majority of victims of CSA do not commit crimes, these findings seem far removed from the core of the issue. What the research seems to be telling us is that, in the general population, victims of CSA are no more likely than non-victims to commit sex crimes but that, within criminal populations, sex offenders have a higher rate of CSA than do non-sex offenders. This does not mean that all sex offenders were sexually abused as children and it certainly does not mean that being a victim of CSA causes an individual to be more likely to commit a sex crime.
Writers for television shows, be it Law and Order: SVU or any other program, certainly can not be expected to be current on all psychological research. Just as they frequently step beyond the bounds of reality in medical dramas, a certain amount of inaccuracy is to be expected with respect to mental health topics. A little inaccuracy, while not ideal to a psychology nerd such as myself, is unlikely to cause much harm and, after all, these shows obviously bring a lot of people a substantial amount of enjoyment. That being said, writers can certainly be held responsible for consulting with psychologists who are current on research in an effort to fact check their claims and ensure that they are not spreading misinformation that, in and of itself, serves as an obstacle between those who need help and those able to provide effective care. Victims of CSA have enough to obstacles to deal with. They do not need the added burden of harmful misconceptions.Mike Anestis is a doctoral candidate in the clinical psychology department at Florida State University.