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Letters
June 16, 1999

Interpretation of Research on Sexual Abuse of Boys

Author Affiliations
 

Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor

JAMA. 1999;281(23):2185. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-23-jac90005

To the Editor: In their review of the North American literature on sexual abuse of boys, Drs Holmes and Slap1 conclude with a call to improve and standardize study designs. Although the authors recognize the importance of contextual factors in its etiology, they fail to explicitly note that preexisting psychological susceptibility could account for the psychosocial disorders observed in persons reporting a history of childhood sexual abuse. The sense is that reported negative psychosocial events are a consequence of childhood sexual abuse (note the frequent use of "sequelae"). This is an inherent bias of retrospective inquiries. In this case, respondents usually are interviewed downstream, which can obscure causal factors that may be considerably upstream. Reluctant as we may be to investigate questions of psychological susceptibility (perhaps because it blames the victim), scientific rigor requires its consideration. Absence of suspicion can easily result in suspicion of absence.

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