This is a survey paper that was based in a “summer camp” within a low economic / high minority / disadvantaged cohort.
We studied 2292 children aged 5 to 13 years (mean [SD] age, 9.0 [2.0] years) who attended a summer camp research program designed for school-aged low-income children. Data were collected each year from July 1, 1986, to August 15, 2012…. Some children attended the camp for multiple years; the data from their first year of attendance were used in the current study. The study design specified recruitment of both maltreated children (n?=?1193) and nonmaltreated children (n?=?1099). A total of 1254 (54.7%) participants were boys. … The sample was 60.4% (n?=?1382) African American (73 [5.3%] Hispanic), 31.0% (n?=?711) white (261 [36.8%] Hispanic), and 8.6% (n?=?197) from other racial groups (6 [3.2%] Hispanic). The families of the children were low income, with 2180 (95.1%) of the families having a history of receiving public assistance. Single mothers headed 1442 (62.9%) of the families.
The first thing to note — after acknowleding that this is a group with a lot of trauma and disadvantage — is that most of the abuse is emotional and neglect: physical abuse is less common and sexual abuse (the numbers a percentages) is, unfortunately, not uncommon.
doi:10.1001/jamapsychiatry.2015.1792
Much more interesting, for me, is the pathway analysis. Family burden load aside, look at the pathways with the superscript a. These are the neglect pathways, and these are very highly significantly correlated with both internalizing conditions such as anxiety and externalizing conditions such as aggression. Sexual abuse is less highly correlated, and here things reverse: if you are sexually abused you are much less likely to be neurotic and far more likely to act out and be aggressive.
The authors produce two very good comments in the discussion.
Our results suggest that physical abuse, emotional abuse, and neglect are equivalent insults that affect broad psychiatric vulnerabilities. Our results also highlight an important problem—one that may explain mixed findings in the literature on child sexual abuse. Specifically, child sexual abuse is an infrequent event that is almost always accompanied by other types of CM. This pattern of rarity and lopsided co-occurrence has several consequences. First, it poses a statistical constraint that severely attenuates the correlation between sexual and nonsexual CM. For example, if nearly all people with a given disorder are men but very few men have that disorder, then sex will be nearly uncorrelated with the disorder (despite the fact that almost all cases are in men). This constraint explains why sexual CM and nonsexual CM are weakly correlated factors in our structural model: whereas 89% of cases of sexual CM are accompanied by nonsexual CM, only 9% of cases of nonsexual CM are accompanied by sexual CM.
Second, there is no practical way to understand the specific consequences of sexual CM because its correlates may be attributed to other forms of co-occurring CM. Statistically controlling for co-occurring CM removes what little covariation is left after the attenuation caused by unidirectional redundancy, further gutting the variance in the sexual abuse variable and producing unreliable parameter estimates. Alternatively, cases of “pure” sexual abuse (without co-occurring CM) are extremely rare and unrepresentative. This intractable issue may explain why research on sexual CM produces mixed results. The infrequency of sexual CM combined with its unidirectional redundancy with nonsexual CM attenuates their correlation and undermines efforts to identify the effects of sexual abuse, which are almost certainly detrimental. As such, previous meta-analyses of the literature on child sexual abuse7,8 may produce misleading results.
The paper is open access, read it. One hopes that it will inform family court practice and judges. I would not, however, hold my breath.
My impression, from other reading over the years, is that Sexual CM operates more as a specific trauma rather than disordering large swaths of the personality. It obviously crops up later in sexual relationship aspects, but it’s more like being afraid of water after nearly drowning than just being uncontrollably angry at the world.
On the general side (and the Christian take), Pride & Sloth come to mind. As one with Will practically sticking out of my ears, I really have little understanding for how some parents operate. But, at the same time, I understand I took responsibility for my own life long ago, and part of the fruit of the Spirit is self-control.