Conceptualization of the Complex Outcomes of Sexual Abuse: A Signal Detection Analysis

Abstract

Eighty-five New Zealand based practitioners experienced in treating adults with a history of child sexual abuse participated in an online judgment study of child sexual abuse outcomes using signal detection theory methodology. Participants' level of sensitivity was assessed independent of their degree of response bias when discriminating (a) known child sexual abuse outcomes from behaviors thought to be unrelated to child sexual abuse and (b) direct child sexual abuse effects from subsequent coping strategies. Results demonstrated good sensitivity (accuracy) when identifying child sexual abuse effects from noneffects. When asked to discriminate direct child sexual abuse effects from ways of coping with distress, practitioners' accuracy was reduced, revealing a tendency to identify all effects as coping. Although treatment approaches highlight the pivotal role of identifying coping strategies, practitioners did not perceive maladaptive coping as a distinct clinical feature. Complex abuse cases may benefit from replacing maladaptive coping strategies (e.g., self-harm) with constructive coping (e.g., social support) in order to deliver efficacious practice.

Keywords:

• sexual abuse
• coping behavior
• clinical judgment
• signal detection theory

Acknowledgments

We would like to thank very sincerely the research team of Rāranga Whatumanawa for their support and the ACC-registered counselors who gave so freely of their time and knowledge.

Notes

¹Of note, not all studies support a higher frequency of same-sex sexual relations in samples of females and males who experienced childhood adversity, including sexual abuse. No causal relationships are implied.

Additional information

Notes on contributors

Pia Pechtel

Pia Pechtel, PhD, is faculty in the Center for Depression, Anxiety, and Stress Research at McLean Hospital, Harvard Medical School in Belmont, Massachusetts.

Ian M. Evans

Ian M. Evans, PhD, is faculty in the School of Psychology, Massey University, in Palmerston North, New Zealand.

John V. Podd

John V. Podd, PhD, is faculy in the School of Psychology, Massey University, in Palmerston North, New Zealand.