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Problems and Pitfalls: Child Sexual Abuse Accommodation Syndrome and False Memory

By: Dr. Michael J. Perrotti, Ph.D.
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Schmidt (1983; 1992) published two articles describing Child Sexual Abuse Accommodation Syndrome (CSAAS). In his first article he asserted that CAAS consisted of five main components 1) Secrecy 2) Helplessness 3) Entrapment and Accommodation 4) Delayed Unconvincing Disclosure 5) Retraction. In his second article, Schmidt (1982) described what he saw as abuses of the CSAAS. He was particularly concerned that the CAAS was being misused in court to "diagnose" whether or not abuse has occurred. This writer frequently sees "experts" for the prosecution equating CSAAS with a defendant alleged to have committed child sexual abuse. In particular, delayed disclosure is equated with validity of child sexual abuse claims.

While the syndrome has received high rates of attention in legal settings, including two highly critical reviews, the entirety of its issues have not been expanded upon. (Coden, Bruell, Ceci + Shwan, 2005; Coden, Bruell, Wright, Ceci, 2008). Bento (2012) went so far as to state CAAS should be considered as an example of "junk science" and should not be used in legal settings. Juries are misled by only a part of the true picture of CAAS being presented. Schmidt (1983) introduced CSAAS by claiming that accusers feel secondary trauma when their disclosure is viewed by significant individuals in their lives as a lie. Hunt asserts that secrecy creates fear in the child and the false promise of safety. In the secondary category of helplessness, Schmidt related that children are required to be obedient and appropriate with any adult entrusted with their care. His assertion is that perpetrators are often known to their victims. Thus, children are helpless against allegedly trustworthy adults. In entrapment and accommodation, Hunt represents that children hold themselves at fault for painful sexual events and that the child feels obligated to perpetrators. Schmidt argues that most ongoing sexual abuse is never disclosed and if family conflict triggers disclosure it is usually after years of continuing sexual abuse. This completely neglects to note that cumulative traumatic events in the form of PTSD result in acute anxiety impairing daily functioning. Schmidt notes that even when a child discloses child sexual abuse, he or she is likely to recant due to family dynamics such as seeing the family disrupted.

Ten years later, Schmidt (1993) published a response to what he described as distortion and misuse of CSAAS in the Courts. (Drohan and Bento, 2002) notes that Schmidt attested that CSAAS posed a threat to defense arguments that legitimate victims would fight back and that there are false complaints of sexual abuse.

As with any "syndrome" used to support child sexual abuse complaints in the courts, there are problems with experimental design. Lordn, Buuck, Wright and Ceci (2008) argued against research used in support of CSAAS. They questioned the representations of samples of children in forensic interviews, reliability of memory recall data and questionable abuse status. Evidence based interview protocols that lack leading questions yield high rates of disclosure (85%) lending support to the notion that denial is not common in substantiated abuse cases. (London et al, 2008). These same authors note that misinformation may stem from false disclosure elicited by highly suggestive interviewing techniques. Drohan and Bento (2012) note that Brodley and Wood (1996) noted disclosures of sexual abuse in 234 sexual abuse cases in CPS and observed recantation in only 4% of cases. Of the 4%, only 1/2 who recanted did so in response to pressure from a caretaker.

The term "CSAAS syndrome" noted by (O'Dohne and Bento 2012) is an imprecise term. They acknowledge that there is no clinical methodology to assess typical "valid" claims from those that are invalid. Schmidt (1992) himself notes that the intent of CSAAS used in court testimony is not to prove but to refute his thesis which produced endorsement of delayed or incomplete disclosure. Drohan and Bento (2012) note that Schmidt failed to provide empirical evidence that there is an aggregate to be treated as a group. There is no operational definition of what is meant by a "delay" in reporting.

Schmidt does not specify if CSAAS appears to apply to all children who are sexually abused. To boys? Girls? What age range? None of the variables are specified by Schmidt.

Long-Term Memory in Adults Remembering Sexual Abuse 20 Years Later

Goldfarb et al (2019) state that recent research confirms the possibility of false memories of childhood sexual encounters (Badanz, Slaver & Goodman, 1990; Liddonfield, 2015; Loftus, 1996). Goldfarb et al (2019) state that memories of highly emotional events are less susceptible to forgetting. However, one must take into account that memories are a constructive process. Individuals make source errors, viz, erroneously recalling characteristics of another situation. Imagination inflation refers to a finding that imagining an event which never happened can increase confidence that it actually occurred. Goldfarb et al (2019) note that there is disagreement about the extent of forgetting and errors in recall of information. There is also the phenomenon of suggestibility, especially with children, and the effect of suggestion and leading and suggestive investigative interviews on memory. "Recovered" memories from sessions with therapists are yet another source of memory contamination. Singer and Wixtel (2006) note that as the time between an event and a memory increases, individual differences will be evident in an individual adopting a conservative as opposed to liberal response strategy, which may in turn increase suggestibility. Memories also decay over time and are reconstructed and subject to distortion.

Contribution of PTSD and Depression to Errors in Reporting Events

Some investigators report that maltreatment history and/or PTSD symptomology are associated with increased accuracy of recall of abuse (Alexander et al 2005; Eisen, Goodman, Gin, Davis, & Crayton, 2007). However, it has also been proposed that individuals with trauma-related psychopathology such as PTSD or depression are more likely to err in reporting events (Otgaar et al 2017, Windmann & Kruger, 1998).

What is not addressed by those who propose that trauma (PTSD) results in vivid images of abuse and greater accuracy of memory is the phenomenon of dissociation which co-exists with PTSD. Individuals in dissociative states are detached from their surroundings and report out of body experiences. There is a disconnect of awareness, consciousness, and orientation to the environment. Goldfarb et al (2019) reports that memory errors may be driven by mental health symptomatology resulting from trauma, rather than by maltreatment itself (Eisen, 2007; Goodman et al, 2016).

Gender differences in memory for emotional childhood events have been documented, with males recalling fewer emotional childhood experiences (Daniels, 1999) compared to females (Goldfarb et al, 2019) reports that such differences may be more likely for an emotional event that is sexual in nature. As a consequence, males may be more reluctant than females to remember and disclose sexual details thus increasing commission errors (Vlman and Filipas, 2005); (Widsom and Morris, 1997).

Effects of Repeated Interviews

Memory rehearsal via repeated interviews and conversations with others regarding an event may reinstate memory but can also lead to erroneous memories (Gordon et al 2004; O, et al 2006) (Peter and Sara 2015; Peterson, Pardy, Tizzard-Drover and Warren 2005).

(Goldfarb et al 2019) reports that children who had been exposed to violence were recovered from their homes and placed in a forensic hospital and had an anogenital examination as part of the standardized forensic medical procedure, recalled the examination 29 years later. However 30 of the subjects did not recall being at the hospital at all exhibiting a "lost memory". They also reported that depression is associated with comparatively accurate memory of negative childhood occurrences at least at 20 years later. Adult males were found to recall less than adult females (Denis, 1999) including childhood sexual abuse. Males were reported as more likely to exhibit a "lost memory" for being at the hospital, were less likely to report genital contact and were more likely to make omission errors in answering specific questions. It was also found that specific and misleading questions did not count as memory reports after 20 years. "False memory" was not able to be investigated.

Limitations

(Goldfarb's 2019) study has limited statistical power due to a small sample size (n = 30).

Court Limitation on Long-Accepted Child Abuse Theory

The New Jersey Supreme Court (August 2018) agreed with a lower court that until aspects of the CAAS theory are well-defined and scientifically proven, that expert testimony about these aspects should not be introduced as evidence. The Supreme Court noted a number of shortcomings about the concepts of CAAS including labeling the theory as a syndrome, defining the five behaviors with precision and defining how the behaviors related to each other. Chief Justice Stuart Rabner wrote "based on the record before the Court, we conclude that the CSAAS (the Syndrome) does not satisfy a basic standard of admissibility - reliability - because it is not generally accepted by the scientific community".

Conclusion

There are many problems with reliability and validity of the concepts of CSAAS. Unfortunately it has been misused and misrepresented by some prosecutors and prosecution experts and has been represented as being "associated" with the validity of claims of accusers. However, this assessment is problematic. This is at the expense of defendants. The courts are in the forefront of adversarial conflict and are entitled to evidence based research examining all sides of issues rather than "junk science". Our justice system and a defendant's presumption of innocence and civil rights under due process deserves no less.

Celik, Tahiroglu, and Avci (2008) relate that false allegations may occur because of memory distortions or contamination. The phenomenon of imagination inflation occurs when an individual commits a source error, viz, is erroneous in identifying the situation and circumstances of what they are recalling. The individual then embellishes and adds on to the erroneous source and attendant memory and believes that it is true. Celik, et al (2008) also note that recurrent and close-ended questions may result in recantations and/or false allegations, especially those made to the police and the Courts. The authors also note that all evaluations of psychosexual factors may be more valuable than examining any physical findings or psychiatric symptoms or disorders in children who have disclosed sexual abuse. In their research, they discovered that recanting cases must be followed for at least one year with multidisciplinary facilities such as social services, legal procedures, and child psychiatrists. They note that additionally recounting disclosure rates mostly focus on forensic samples rather than general population. Recanting disclosure rates, they note, are still a controversial issue. They recommend that further studies should evaluate recantation rates in high risk populations as follow up.

This examiner has frequently encountered forensic interview techniques that do not adhere to the Gold Standard NICHD interview protocols articulated by Michael Lamb, PhD. close ended interview techniques such as, "Where did he touch you?", "What else did he do to you?", are suggestive, tainted and the research reveals high rates of errors in information given. Moreover, children are very suggestive. Many individuals are acquiescent to authority and tell law enforcement what they think they want to hear. Another source of error is repetitive interviews. Information becomes increasingly distorted as accusers are interviewed by parents, investigators, law enforcement, etc. Celik et al (2008) also notes that experts need to be aware of children who may show a tendency to recant due to their psychosexual backgrounds.



Dr. Perrotti received his PhD in Clinical Psychology from Alliant University in San Diego, CA. He is a licensed psychologist in California and Pennsylvania. Dr. Perrotti is a member of the National Register of Health Service Provider in psychology and the National Academy of Neuropsychology. He was an Assistant Professor of Psychiatry and Behavioral Sciences at the Keck School of Medicine, USC from 2005-2006. Dr. Perrotti is the author of numerous publications in forensic psychology and assessment, traumatic brain injury in college, professional sports and military populations, and child trauma and complex PTSD.

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