Youth Services Law

Child Sexual Abuse Accommodation Syndrome is Not A Diagnosis

An article about a convicted child molester whose victim has recanted her testimony caught my eye last week.  It wasn't the victim's change of heart that interested me.  As a former prosecutor, I am familiar with that phenomenon.  Sometimes witnesses think the sentence was too harsh, or they think that they have moved on and recant as a way of extending forgiveness.  And sometimes they really did lie in the original trial.  I don't know enough about this particular case to have an opinion on what really happened.  But I have serious questions about this testimony, presented by the prosecution to challenge the recanting victim:

The prosecution made its case by presenting testimony from a psychologist who theorized that Julie suffered from "child sex abuse accommodation syndrome," one of whose key symptoms is denial. In short, the theory was that her recantation as an adult was a form of denial that she had been sexually abused or that her father did it. Under the theory, her new statement also represented an effort by her to restore a family relationship.

The problem is that CSAAS is not a diagnosis.  No one can "suffer from" it.  If the expert actually testified as the article describes, then he or she was woefully, even inexcusably, uninformed.

CSAAS made its appearance in a 1983 article by Dr. Roland Summit, who was attempting to explain why children do not react to abuse in the ways that adults expect them to.  The legal profession,  not understanding the underlying science, quickly transformed CSAAS into a tool to diagnose victims.  Dr. Summit wrote a later article, protesting that lawyers had taken CSAAS far beyond its intended purpose.  "It should be understood that the CSAAS is a clinical opinion, not a scientific instrument." 

Mental health professionals who know their field know that CSAAS is not a diagnosis.  It is, at best, a description of how many children react to abuse.  Most states (and I think the best-informed ones) allow CSAAS evidence "only  to explain certain behavior of an alleged victim of child sexual abuse."  

Recent research, however, indicates that even that use of CSAAS is not well-founded.  Stephen Ceci, the nation's leading expert on the reliability of children's memories, and other prominent experts, a few years ago reviewed the research about how children disclose abuse.  They concluded that, of the five characteristics of CSAAS, only one, delayed disclosure, has empirical support.

Any expert who uses CSAAS as a diagnostic tool simply does not know current mental health literature, and should not pass muster as an expert witness.

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