Overview of Studies Overview of StudiesOf 35 nonclinical studies located, 16 were based on college samples. In most of these studies, the sample included students enrolled in specific under-graduate courses at one or a few schools (e.g., Fischer, 1991); one study was based on a national sampling of male undergraduates (Risin and Koss, 1987). These studies have some broad generalizability, at least in comparison to clinical studies, in that nearly half the population of the United States experiences some college-level education (U.S. Bureau of the Census, 1995). The remaning studies involved samples obtained with a wide variety of methods. National population samples included Baker and Duncan (1985) in Great Britain; Committee on Sexual Offences Against Children and Youths (1984) in Canada; and Finkelhor et al. (1989) and Laumann et al. (1994) in the United Stales. The Canadian study and the Finkelhor et al. (1989) study, however, only asked subjects about unwanted sexual contacts or contacts they considered abusive, thereby excluding experiences regarded as neutral, positive, or consensual. Two other reports were based on community samples from specific cities (Bagley, 1991, in Calgary, Canada; Stein et al., 1988, in Los Angeles); however, in both of these studies subjects were again asked only about contacts considered unwanted or abusive. Other sample sources included print advertisements (e.g., Nelson, 1986; Okami, 1991); personal contacts and referrals (e.g., Bernard, 1981; Sandfort, 1984); a mixture of various sources (e.g., Ingram, 1981); and computer bulletin board users (Davis, 1990). Such samples are clearly not generalizable, but they do provide information on the range of experiences, associated outcomes, and variables related to those outcomes. OutcomesOutcomes are discussed according to the types of measures used (self- reports, standardized measures, and clinical impressions). Findings from reviews of clinical studies are cited for comparison purposes. Variables found [Page 114] to play a moderating role in outcomes (i.e., increasing or decreasing the likelihood of specific reactions and outcomes) are also discussed. Finally, reactions and outcomes for males are compared to those of females drawn from the same samples. Results of college studies (nearly half the total) are reported first, followed by the results of nonclinical studies drawn from other sources. Table II provides a more comprehensive summary of findings from the college studies. College Study Results: Self-ReportCollege males' self-evaluations of their early sexual experiences with adults ranged from positive to negative, but were mainly neutral or positive. Nine college studies provided full breakdowns of positive, neutral or mixed, and negative assessment. For short-term reactions (those occurring at or around the time of the actual experience), positive assessments ranged from 6 to 68% of experiences. If Landis (1956) is set aside, the range was between 38% (Urquiza, 1988) and 68% (Schultz and Jones, 1983) of all experiences. Neutral or mixed ratings varied from 8% (O'Neill, 1990) to 33% (Landis, 1956) of all experiences. Negative ratings ranged from 8% (Schultz and Jones, 1983) to 46% (Landis, 1956). Some college studies did not include a detailed breakdown of reactions. For example, Haugaard and Emery (1989) found that 33% or their male respondents regarded their experience as "very positive" both then and now, but did not report a breakdown of positive or neutral responses; Risin and Koss (1987) found that between 26.1 and 55.6% of their subjects reported feeling "not at all victimized," depending on the most intimate sexual act which they experienced. Despite these incomplete reports, what emerges is a consistent picture of males reporting predominantly neutral or positive feelings about their early sexual experiences with older persons at the time they occurred, with negative reactions in the minority. This statement should not be interpreted as minimizing negative reactions, but rather as pointing out what may seem a surprisingly high percentage of positive or neutral self-evaluations. For males' self-reports of long-term reactions, i.e., current feelings about their experience(s), long-term negative feelings ranged from 9% (Schultz and Jones, 1983) to 47% (Urquiza, 1988). Two studies reported average ratings on 5-point positive-to-negative scales for long-term feelings (Finkelhor, 1979; Goldman and Goldman, 1988). Finkelhor (1979) reportes an average rating of 3.2 by males for experiences with acquaintances or friends at least 5 years older, almost exactly on the neutral midpoint; experiences with strangers were evaluated negatively, at an average rating of 4.0. Goldman and Goldman (1988) reported an average rating of 3.0 for experiences with persons 5 to 10 years older and 3.3 for experiences with those at least 10 years older, [Pages 115 & 116: Table II; Page 117] again almost exactly on the neutral midpoint. When current feelings are distinguished from feelings at the time of the experience, some studies indicate that perceptions shift toward neutral evaluations and away from either positive or negative evaluations. Condy et al. (1987), Fromuth and Burkhart (1987), and a'Neill (1990) all reported decreases in negative or positive evaluations or both and increases in neutral evaluations. In contrast, Urquiza (1988) reported an increase in both negative and neutral evaluations and a decrease only in positive evaluations. College Study Results: Standardized MeasuresStandard measures of adjustment or functioning used in college studies included measures of social functioning, such as the Texas Social Behavior Inventory (e.g., Haugaard and Emery, 1989); sexual behavior and adjustment, such as the Derogatis Sexual Functioning Inventory (e.g., Predieri, 1991); and clinical symptoms or problems, such as the Hopkins Symptom Checklist (e.g., Fromuth and Burkhart, 1988). In most cases, the researchers used subjects who did not report early sexual experiences with adults as controls to make comparisons with the abused group. Personality MeasuresSeveral researchers have used measures of personality and behavior characteristics not directly involving sexual or clinical problems. Fromuth and Burkhart (1988) used locus of control and the Rosenberg Self-Esteem Scale among their measures. Neither measure correlated with a history of abuse in male undergraduates. Haugaard and Emery (1989) used the Comrey Personality Scales and the Texas Social Behavior Inventory to compare control subjects with a broadly defined group of abused subjects, including those who rated their experiences as "very positive" at the time and in retrospect. The controls seemed slightly better adjusted in their same-sex relations in emotional stability, but no differences were found on most subscales from the two measures. When abuse groups were more narrowly defined so as to exclude the positive responders, more differences emerged and the magnitude of the differences increased. Predieri (1991) used the masculinity-femininity scale from the MMPI and found no differences between abused and control groups. Finally, Urquiza (1988) compared abused and non abused groups of males on the Tennessee Self-Concept Scale and a Self and Family History Questionnaire. There were no differences between groups on the TSCS, although the abused group reported more problems on the Self and Family History Questionnaire. In short, studies using varied personality measures with college- [Page 118] based samples have found no differences between abused and non-abused groups on most scales and subscales, but significant differences indicating better adjustment for non-abused subjects appear on a minority of measures. In addition, researchers typically failed to compare positive and negative responders separately with the control subjects. This leaves open the possibility that no differences exist for positive responders while significant differences exist for negative responders, and combining the two groups into a single "abuse" category obscures these differences. Haugaard and Emery's (1989) study supports this interpretation, with the exclusion of "positive responders" leading to increases in significant differences. Sexual AdjustmentFromuth and Burkhart (1987) found no differences between abused and non-abused males using Finkelhor's (1984) Sexual Self-Esteem Scale. Finkelhor (1984) analyzed data from his 1979 subjects on this scale and reported that the sexually abused group had lower sexual self-esteem. Finkelhor (1984) also noted that male subjects in his college study who had such early experiences were four times more likely than other males to be currently engaged in homosexual activities. However, the other studies cited here did not report on sexual orientation, so this finding is tentative. Predieri (1991) found no differences in sexual dysfunctions or other sexuality-related problems on either the Sexual Experiences Surveyor the Derogatis Sexual Functioning Inventory. Urquiza (1988) did find some differences on a Sexual Adjustment Questionnaire, with the abused group being less well adjusted. Fritz el al. (1981) used a questionnaire on sexual satisfaction, sex problems, and the subject's perceived need for sex therapy, and found that 10% of males in their abused group reported such problems, Unfortunately, similar data were not reported for the subjects with no such contacts, so no control group comparison was possible. Despite the fact that early sexual experiences that are presumed to be harmful could reasonably be expected to produce later sexual problems, the various studies were inconsistent in their results, with differences reported in some but not others. Even in those case where differences emerged, it is once again an open question as to whether this finding applies to all the abused subjects, or primarily or exclusively to those whose experiences were negative. Clinical MeasuresFromuth and Burkhart (1989) used the Symptoms Checklist (SCL-90) and the Deck Depression Inventory (DDI), and found no differences on [Page 119] the BDI. For the SCL-90, no differences were found for one of their two college samples, but some appeared for the second sample, indicating that the abused subjects were "slightly less well-adjusted" (p. 536). Once again, however, no attempt was made to separate positive versus negative responders. Hatfield (1987) also used the SCL-90 and found no group
differences. Finally, Urquiza (1988) used Briere's Trauma symptom Checklist (TSC-33) and found no overall differences between the abused and non-abused groups. Again, no group differences emerged on most scales, although the differences that did occur indicated better adjustment for non-abused subjects. In general, researchers using standardized measures with college samples consistently find few or no differences between abused and non-abused groups. Differences that do appear are typically present on one or a few scales or subscales out of many used. In addition, researchers have typically failed to compare control groups separately with those who report positive versus negative evaluations of their experiences. This problem can potentially both obscure the magnitude of symptoms for negative responders, and lead to exaggeration of differences or symptoms for positive responders. Noncollege Study Results: Self-ReportSelf-report findings in other nonclinical samples are similar to those in the college reports. Among national population samples, Baker and Dun- can (1985) found that 57% of males in their British sample felt their experience had no effect; 6% felt that it had improved their life; 33% felt it was harmful at the time, but had no lasting effect; and 4% felt they had suffered permanent harm. In the U. S., Laumann et al. (1994) found that 45% of their male subjects who were sexually touched by adults during childhood reported that the experience affected them. Nearly all these reports of effects were negative. This leaves 55% of the males who indicated no effects, suggesting that the majority did not feel negatively affected. In the Canadian national sample (Committee on Sexual Offences
Against Children and Youth, 1984), only 6.8% of abused males reported emotional
or psychological harm from the unwanted experience. [[Page 120] As seen in Table I, most other convenience samples indicate primarily neutral or positive self-evaluations. The main exception is Doll et al (1992), who used predominantly homosexual males recruited from sexually transmitted disease clinics. In this study, 58% felt the experience was negative when it occurred and 54% felt so in retrospect. However, a very high number of the experiences involved force (approximately 50%), which may account for the high rate of negative evaluations. In a unique self-report study, Sandfort (1984) reported on 25 boys aged 10-16 in the Netherlands who were engaged in ongoing sexual relationships with older males. Using the Self-Confrontation Method, in which subjects report on their emotional responses to experiences and also provide ratings of how they would like to feel, Sandfort found that 24 of the 25 boys reported predominantly positive emotions about the sexual contacts and all felt predominantly positive about the relationship as a whole. Although it is unclear to what population such findings can be generalized, Sandfort's study is unique in that it is the only study of children and adolescents in ongoing relationships in which the subjects had not experienced legal, clinical, or other interventions. Noncollege Study Results: Standardized MeasuresBernard (1981) reported that his subjects did not differ from
population norms on the ABV, a measure of personality standardized on the Dutch
population. Sandfort (1992) reported on a group of young male adults who had early, self-defined consensual experiences with adults. These subjects were just as well-adjusted on sexual measures, such as sexual satisfaction, as were those with no early sexual experiences with adults. In contrast, adjustment problems did appear for those who had early experiences self-defined as nonconsensual. In their U.S. national sample, Laumann et al. (1994) found differences between sexually touched and non-touched males on 6 of 11 items measuring sexual adjustment. For the data presented, however, the average effect size was small (r = .07). These findings are consistent with the results from the college studies, with few or no differences typically reported. In some studies, subjects were asked only about experiences they considered unwanted or abusive, thereby excluding experiences seen as neutral or positive. In these cases, more relationships do emerge between sexual abuse experiences and later symptoms. In community samples, both Stein et al. (1988) in the U.S. and Bagley (1991) in Canada reported that abuse history in males was associated with increased psychological symptoms and disorders. Finkelhor et al. (1989) found in their U.S. national sample that [Page 121] abuse experiences were associated with more marital disruption and lower religiosity (but not sexual satisfaction) among males. Effect sizes were small and Finkelhor et at. noted that these results must be regarded with caution because most victims reported no problems. Because these reports only examined experiences seen as unwanted or abusive by the respondents, they provide no information on how experiences with adults defined as neutral, positive, or voluntary might relate to observed symptoms. Noncollege Study Results: Clinical ImpressionsSeveral noncollege studies relied on clinical impressions or diagnoses (e.g., Ingram, 1981). Included were some collections of case reports that provided detailed descriptions of long-term sexual relationships, the younger person's perceptions, and current adjustment (Money and Weinrich, 1983; Tindall, 1978). Ingram (1981) reported on a group of boys, ages 6 to 14 at the time of their experiences, who had been involved in sexual contacts with older males. Although some were referred specifically for counseling because of their sexual contacts, in other cases the contacts were discovered accidentally or during counseling for other concerns. After reviewing the types of experiences the boys had, their home life, and their relationships with the men, Ingram concluded that there was no evidence from his study that any of the boys were worse off as a result of the experience. Money and Weinrich (1983) reported on two males who as boys had become sexually involved with men. The men had voluntarily referred themselves for counseling and therapy. Both boys regarded the relationships positively, saw their older partners as close friends, set limits on the sexual interaction, and were currently pursuing heterosexual relationships. Tindall (1978) reported in detail on nine case histories of boys whose sexual experiences with older men had been discovered by Tindall in his work as a school psychologist (none had been referred for sexual reasons). These cases were those with the most complete follow-up data out of a larger pool of 200. In some cases follow-up data extended into the subjects' 40s. All developed heterosexual adult patterns of behavior, displayed successful adjustment in other areas such as education and careers, and in several cases maintained friendships with the men with whom they had been involved. Tindall concluded that "in sexual relationships between males beyond puberty where force is not involved many have no deleterious effects" (p. 381). These case reports and clinical impressions involved, in some cases, follow-up information that extended for years or even decades after the sexual contacts stopped occurring. The findings indicate that long-term sexual contacts with older persons can be seen as positive by the younger participants and are not clearly associated with adult impairments or dysfunction. [Page 122] Moderators of OutcomesA wide range of responses by boys to sexual contacts with adults has been documented, from very negative to very positive. The next logical step is to attempt to account for this range, identifying moderator variables that may serve to increase or decrease the likelihood of specific outcomes. In non-clinical studies, researchers have identified a number of variables related to the sexual contact which play a role in how boys respond to their sexual contacts with adults. Reviews of the clinical literature also indicate the importance of moderator variables, often consistent with nonclinical findings. For each variable, findings from nonclinical literature are discussed first, followed where possible by relevant findings from clinical reviews. Force Versus Willingness The presence or absence of force, and subjects' evaluations of their willingness or consent in the sexual contact, have been examined in numerous nonclinical studies. These studies are consistent: When physical force or threats of harm are present, responses of boys to the sexual contact are typically negative. This finding is true for both college studies
and noncollege studies (Doll et al., 1992; Okami, 1991). In those studies in which the most positive cases of sexual
contacts with adults were reported, these contacts without exception were
reported with no mention of threat or force (Bernard, 1981; Money and Weinrich,
1983; Sandfort, 1984; Tindall, 1978). The boys studied by Sandfort (1984)
reported that current sexual contacts took place primarily as a result of mutual
initiative with the adult or on the boys' own initiative (although the first
contacts in the relationship typically took place as a result of the adults'
initiative). The issue of force leads to the larger issue of assent or consent. In the studies reviewed, a number of subjects defined themselves as willing or consenting participants in their sexual contacts with adults. This self-defined consent seems to refer to a willingness to participate, and does not necessarily indicate the level of sexual knowledge or awareness of possible [Page 123] consequences needed to meet the more stringent criteria of informed consent. Self-defined consent, like absence of force, is in all studies associated with positive outcomes or evaluations. Condy et al. (1987) found that subjects who reported that
they initialed the sexual contact with an older female, or who agreed to the
females' advances, identified their experiences as predominantly positive.
Subjects who reported being forced identified their experiences as negative. Findings from the clinical literature are consistent with the nonclinical literature on the impact of force. In their reviews, both Mendel (1995) and Urquiza and Capra (1990) reported that the presence of force or threats is typically associated with increased symptoms. It is noteworthy that in many clinical samples, which might be expected to include the most disturbed individuals, force continues to emerge as a major predictor of outcome. Relationship to the Older PersonThe most consistent finding in terms of the relationship between
the boy and the adult is that contacts involving relatives are associated with
more negative outcomes. Clinical and nonclinical research again seem reasonably consistent: incestuous relationships are associated with more negative outcomes. Reviews focused on males (Mendel, 1995; Urquiza and Capra, 1990) and on females only or both males and females (Beitchman et al., 1991; Browne and Finkel- hor, 1986) reported this conclusion. [Page 124] Sex of Older PersonSurprisingly, a number of studies failed to examine boys' experiences with men separately from boys' experiences with women. One possible reason for this failure is that the adults have been commonly assumed to be male. This assumption is fairly accurate for the experiences of girls; in the studies in Table I, the proportion of older males involved in girls' experiences ranged from 90 lo 100%. However, experiences reported by boys involve older females far more often than those of girls. From Table I, the proportion of older females reported as partners (in those studies including experiences with both older males and older females) ranged from 40% (Goldman and Goldman, 1988) to 75% (Fromuth and Burkhart, 1987). Because negative attitudes toward homosexual behavior persist in our society, and such attitudes could be expected to influence a boy's reaction to a sexual contact with a man, the sex of the older partner may be an important variable. In a few studies, experiences with older males versus older females were studied separately. Experiences with older females were consistently rated in a more positive fashion than experiences with older males (Finkelhor, 1979; Fischer, 1991; O'Neill, 1990; Predieri, 1991). This difference is unsurprising in view of the continuing stigmatization of homosexual behavior. However, not all experiences with older females are regarded positively, and nut all experiences with older males are regarded negatively. Condy el al. (1987) found that 25% of their male respondents had a negative immediate reaction to their experiences with older females, and 16% felt the experience had a negative long-term effect. Also, many of the studies describing the most positive examples of adult-nonadult sexual relationships included man-boy relationships only (Money and Weinrich, 1983; Sandfort, 1984; Tindall, 1978). In short, both heterosexual and homosexual contacts with adults involve the full range of responses, from negative to positive. Type of Sexual ActivityFor this variable, an interesting pattern emerges: In a number of studies, fondling and/or penetration as the most intimate sexual behavior seem to be associated with more negative outcomes. Contacts involving oral sex as the most intimate behavior seem more positive. Risin and Koss (1987) noted higher levels of negative emotions
(such as guilt and anger) for both fondling and penetration as the most intimate
activity, compared to oral sex. However, high levels of positive emotions were
also associated with penetration, which the authors suggested could be due to
subjects reacting positively to penetrating an older partner. [Page 125] that males who were symptomatic on the various measures of adjustment were more often those with fondling as the most intimate contact. Type of sexual activity might be confounded with other
variables, such as willingness or force. For example, Risin and Koss ( 1987)
reported that contacts with fondling as the most intimate behavior involved more
force and less initiation by the boy himself. Another possible confound is the failure to distinguish between boys' experiences of penetrating their partner versus being penetrated (e.g., Risin and Koss, 1987). Being the recipient or oral sex, or penetrating an older female partner, may be associated with more sexual pleasure and more positive emotional reactions than being orally or anally penetrated. Duration/Repetition of Sexual ContactsMost nonclinical researchers reporting on these variables found no relationship (e.g., Finkelhor, 1979; O'Neill, 1990; Sarbo, 1984). However, Urquiza (1988) reported that repetition was associated with more symptomatology. This variable could be confounded with others, such as consent and force. For example, voluntary relationships might involve repeated contacts over an extended period but so might involuntary experiences characterized by force or by unwilling acquiescence to the adult's demands. This situation could be especially true in the case of incestuous contacts. Reviews of clinical literature do not clarify the possible impact of duration and repetition; Urquiza and Capra (1990) found no clear relationship of duration to impact. Age Difference / Age of Older PersonThese variables do not seem clearly related to outcomes, at
least for boys. [Page 126] Age of Boy at Time of ExperienceAlthough it could be argued that experiences in adolescence are more likely to involve consent and hence less likely to have negative consequences, results on this variable have been inconsistent and inconclusive as well. For college-based studies, Condyet al. (1987), Fromuth
and Burkhart (1987), and Goldman and Goldman (1988) found no significant
relationship between age at time of the experience and immediate (short-term)
reaction. Previous reviews have reached inconsistent conclusions about the
effects of age at the time of the experience as well. In reviews focused on
effects on males, Urquiza and Capra (1990) argued that there was no conclusive
relationship, but Watkins and Bentovim (1992) concluded that impact was greater
at younger ages. Once again, the effects of age may be confounded with other variables such as consent. For example, younger children may be less able than adolescents to avoid or resist unwanted sexual contacts; as a result, research based on college or community samples may indicate that younger aec is associated with worse reactions and outcomes. Secondary ConsequencesSecondary consequences include reactions of others, such as parents and peers, to the sexual contacts. Feelings of guilt and shame regarding the sexual contacts, which are based on perceived violation of one's own and others' norms, are also addressed here. Emotional responses of guilt were related to outcomes, with
greater guilt associated with more negative responses, Haugaard and Emery (1989)
and Okami (1991) both reported guilt feelings to be associated with negative
evaluations of experiences. [Page 127] unwanted experience in a community sample, noted that feelings
of guilt and shame were common. The role of socialization in these reactions may be very
important. Clearly, feelings of guilt and shame and concerns about negative reactions from others are associated with negative responses to early sexual contacts with adults. These responses, however, are not inherent in the sexual contact per se but rather stem from social taboos and condemnation (cf. Constantine, 1981). To the extent that boys receive more positive messages regarding sexuality, they are less likely to experience these negative emotions and to react negatively to sexual contacts. Comparison or Males' and Females' ResponsesA number of the nonclinical studies reviewed included both male and female subjects and in all cases, as part of the inclusion criteria, reported at least some results separately. Consequently, responses of males and females drawn from the same populations can be compared directly on a number of measures. Self-ReportA clear, consistent, and large difference emerges in the college studies between male and female self-evaluations of their early sexual experiences with adults. Most female respondents rates their experiences as having been negative both at the time and in retrospect. In contrast, male respondents report predominantly neutral or positive ratings of their experiences. This difference is so consistent that, without a single exception, females rated their experiences more negatively than males did in every study that included both sexes. Immediate reactions for females ranged from 66% negative (Finkelhor, 1979) to 82% negative (O'Neill, 1990). Retrospective [Page 128] Evaluations were also consistently more negative than those of the males. Fischer (1991) reported that only 7% of females claimed no
stress then or now from their experience, versus 21% of males; 4% of the females
in Haugaard and Emery's (1989) study, versus 33% of the males, rated the
experience as very positive both then and now; and 69% of females in O'Neill's
(1990) study rated the experience as negative in retrospect, versus 44% of
males. Table II reveals similar differences in studies reporting results in a variety of other formats as well. Noncollege samples revealed similar differences.
Thus, male-female differences consistently appear across many types of nonclinical samples. In short, nonclinical research indicates that females are far more likely than males to evaluate their early sexual experiences with adults as negative, and are more likely to experience problems, especially sexual ones, associated with their experiences. These differences are consistent across a wide variety of sample types (college, national, and convenience). |