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Sex abuse surveys don't harm participants
Abused subjects aren't more likely to be angered
Anew study adds to the growing body of evidence that surveying people about past trauma doesn't put them at increased risk for harm.
The study, published in the May-June 2007 issue of the Journal of Sex and Marital Therapy, takes on what could be an IRB's most worrisome trauma survey subject — childhood sexual abuse.
Co-author Bill N. Kinder, PhD, a psychology professor at the University of South Florida, Tampa, FL, says that the study, along with a previous study on the same subject, showed that college students who reported having been abused sexually as children were not more likely than other students to show signs of anxiety, depression, or anger after being surveyed about abuse.
He says these findings should help IRBs feel more confident that sexuality research won't put sexual abuse victims at greater than minimal risk, and that such studies can be expedited, rather than requiring a full board review.
Measuring 'State,' 'trait'
Kinder notes that when he first began doing these type of studies, his own IRB required them to have full board review. His research has focused on survivors who have adapted well, in order to help account for what causes their resilience in the face of abuse.
"Anytime the words 'sexual abuse' came up, it had to go to the IRB," he says. "If we were asking about that, they were worried that it would be above minimum risk. My argument was that it should not be full board but expedited. Each time I would go in, I would argue that there's nothing in the literature that suggested more risk."
When he served on the IRB himself, he wrestled with the question.
"It's a tough issue," he says. "There were no data out there."
Finally Kinder says, he decided to confront the question head-on. His team surveyed 207 women, measuring "state and trait" levels of anxiety, anger and depression. The subject's "state" would measure how they were feeling at the time they took the survey; "trait" was a measure of their general inclinations.
Then, the women were exposed to a battery of sexually-charged surveys. One specifically screened for childhood sexual abuse, while the other surveys asked them about their orgasm frequency, use of condoms, and genital self-image.
The additional surveys were employed only to expose the subjects to sexually explicit content, and that data was not analyzed.
Afterward, the researchers again measured the women's levels of anxiety, anger and depression.
"The researchers found no significant differences between pre- and post-testing on the measures of state anxiety, depression, anger, and curiosity, as well as no significant differences when compared to the non-abused participants," the authors wrote.
Kinder says the more recent study expanded the survey to include males, a group he says has not been studied as extensively in sexual abuse research.
"Females are much more likely to be abused, although lots of people have pointed out that there's probably more abuse going on with men than we know about," he says. "Also, women, if they were abused, are much more likely to go into treatment (where much of the sexual abuse research is conducted)."
Kinder says the second study was conducted in exactly the same way as the first, except that the participants included 125 male and 125 female university students.
They were subjected to the same questionnaires and state-and-trait measurements.
In the second study, 32 percent of participants reported having a sexual abuse history, with 17 percent of them classed as severely abused.
Kinder says no significant differences were found between pre- and post-testing for anxiety, anger and depression among the non-abused, abused and severely abused subjects.
Males were not found to suffer any greater effects than females.
As part of their debriefing, all of the subjects were given a contact sheet they could use to seek help if they were upset by the test.
"We listed 15 places locally in Tampa that you could go if you have a problem, including the counseling center on campus and our training clinic in clinical psychology on campus," Kinder says. "It included mental health centers, crisis hotlines, that sort of thing."
The study's authors do note that they did not attempt to assess whether these resources were tapped by the participants afterward. And Kinder says the question of whether such studies cause long-term problems in participants hasn't been definitively answered.
"My hunch is if there's no real short-term effects, then there are no long-term effects, but nobody's looked at that," he says. "It's tough to look at, particularly in the group we're looking at — adult survivors — because they're basically college students. Finding them a year from now might be tough."
Kinder says the results from his studies have helped convince his own IRB to allow more recent studies to be expedited. He's heard from other researchers who hope to use his data to convince their IRBs to make similar decisions.
Kinder says the collection of studies pointing to little or no risk from asking these types of questions may finally convince more IRBs to consider them minimal risk surveys.
"I would tell IRBs, 'look at the data.' We've published several studies, and there are lots of other researchers across the country who are publishing these studies," he says. "And if you look at them, usually somewhere in there it's going to say there were no adverse reactions reported."
Kinder says IRBs may still find it necessary to require full board review for new questionnaires that might ask much more intrusive or potentially upsetting questions.
"Although I can't imagine something more intrusive than asking about sexual abuse or what your orgasms are like," he notes. "If somebody were to come up with a scale like that, it would be important I think to go before a full board. But then again, it's a Catch 22 — I have to convince you that there's no data out there to say these people are going to be at no risk, other than just to say that's the fact."
He says researchers would have to provide the usual extra protections for vulnerable populations being surveyed, such as children or prisoners.
And all surveys of this type, he says, must include contacts for subjects who may need counseling or some other help after the fact.
"That's absolutely vital," he says. "Whether it's expedited or full board, not just for sex research, for any kind of research that may cause any kind of discomfort to people. You have to provide them with some sort of referral source. It would be even more important with people who are at risk, such as patients."