An elaboration on causation and positive cases in child sexual abuse

Sbraga and O'Donohue (2003, this issue) argued that backward reasoning from current symptomatology to past child sexual abuse (CSA), often done by experts in court cases, is flawed in several important ways. Backward reasoning, or postdiction, is usually based on models that assume that CSA invariably causes symptoms and that it is always negatively experienced. They demonstrated the weaknesses in these assumptions. The present commentary expands on causation and positive reactions. Statistical research is reviewed that shows that causation cannot be safely inferred in the typical case. Prevalence of positive reactions is discussed. Case studies are presented to illuminate these issues. It is concluded that Sbraga and O'Donohue are correct in disputing postdiction in CSA and the models it is based on.