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Home » Child Sexual Abuse

Psychiatric Times. Vol. 25 No. 14
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FORENSIC PSYCHIATRY 

Forensic Issues in Child Sexual Abuse Allegations

By Charles L. Scott, MD | December 1, 2008
Dr Scott is professor of clinical psychiatry, chief of the Division of Psychiatry and the Law, and director of Forensic Psychiatry Residency at the University of California, Davis. He reports no conflicts of interest concerning the subject matter of this article.

In This Special Report:
Forensic Issues in Child Sexual Abuse Allegations, by Charles L. Scott, MD
Dangerously Paranoid?, by Suzanne Yang, MD
Insanity Defense Evaluations, by James L. Knoll, IV, MD and Phillip J. Resnick, MD
Evaluating Capacity to Make a Will, by Sthephen Noffsinger, MD

Of the nearly 3.6 million children who were the subjects of a Child Protective Services investigation in 2006, maltreatment was substantiated or indicated in 28%. Nearly 9% of these substan­tiated/indicated cases were related to sexual abuse allegations.1 When sexual abuse is alleged, children may face investigative interviews, family disruptions, a change in their school environment, mental health counseling, and even trial court testimony. This article reviews factors that affect the reliability of children’s statements and provides guidelines for evaluators to help minimize the risk of their contaminating a child’s report of sexual abuse.

Reliability of child sexual abuse allegations
Factors to consider when evaluating the reliability of sexual abuse allegations include an assessment of the child’s memory and suggestibility. Reporting a memory requires a person to perceive the event, retain the memory, and retrieve the memory when asked to do so.

(MORE: Child Abuse—or Cultural Norm?—in a Developing Nation)

Memory can be divided into 3 categories: recognition memory, recall memory, and reconstructed memory. In general, recognition memory is the least complex form of memory: one need only recognize a single stimulus that he or she has had. Children as young as 3 years are fairly reliable at memory tasks that involve basic recognition of objects they have seen. By age 6 years, children can recognize a familiar face nearly as well as an adult.2

In contrast, recall memory requires the reconstruction of what the child saw or experienced without the benefit of a prop or prompt. In this situation, a child who is interviewed may fail to report all or part of an event he experienced. This is known as an error of omission and is more commonly observed when preschoolers are interviewed than when older children are.

An error of commission is the endorsement of having experienced something that did not actually occur. It can result from deliberate lying, confusion between different memories that are similar, and difficulty in distinguishing real from imagined events.3,4

Reconstruction memory involves the process of extracting a memory that is not spontaneously volunteered through questioning or other types of prompts, such as pictures or videotapes. An original memory trace can be altered by the suggestions of other people who interact with the child, through inappropriate investigative interviews, or from therapy provided by clinicians who do not appreciate the influence of suggestibility on childhood memories.

Ceci and Bruck5 defined suggestibility as the “degree to which children’s encoding, storage, retrieval, and reporting of events can be influenced by a range of social and psychological factors.” One of the most famous cases involved alleged child abuse at the McMartin Pre­school in Manhattan Beach, Calif. Seven defendants were charged with over 300 counts of abuse that involved more than 100 children. Many of the allegations were extremely bizarre and highly unlikely. After 7 years and at a cost of $15 million, none of the accused were found guilty.6

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