Information Processing of Sexual Abuse in Elders

Methodology: The Study

The study was a retrospective record review of 284 cases of documented elder sexual abuse. Experts with direct clinical, administrative, investigative, or legal experience with older adult sexual assault victims were invited to join a working group to determine essential forensic markers unique to older adult victims of sexual abuse. The experts each contributed cases between the years 2000-2004 from their own files and completed the Comprehensive Sexual Assault Assessment Tool (CSAAT) (Burgess & Fawcett, 1996) to record data on their cases and specific variables relative to behaviors previously noted in distressed elders (Burgess, Hanrahan & Baker, 2005).

Elder sexual abuse, for this study, included cases of persons age 60 and older involving a physical sexual relationship without the elder's informed consent and including sexual assaults by strangers. A physical sexual relationship refers not only to intercourse but to other forms of intimate sexual contact such as touching the genital area or breasts when not associated with a defined nursing care plan. This is an arbitrary definition but is similar to the Benbow and Haddad (1993) study.

Names were redacted and a coded number given to each case. IRB approval was secured from the Boston College Institution Review Board.

The CSAAT-E (E represents elder) included a method for measuring the patterns of post-traumatic stress symptomatology. An instrument was sought that was easy to use and sensitive to psychological changes over time. The SPAN scale is a four-item self-rated scale used in PTSD diagnosis and named for the four assessment items: Startle, Physiological upset, Anger, and Numbness. The scale has correlated significantly with other accepted instruments of post-traumatic stress with a diagnostic accuracy of 88% (Meltzer-Brody, Churchill, & Davidson, 1999) and was developed from the Davidson Trauma Scale (DTS) which is a valid 17-item self-rating scale sensitive to measuring the effects of treatment (Davidson et al., 1997). Meltzer-Brody et al., the authors of SPAN, believed a much shorter version of the DTS was possible as the DTS demonstrated a high level of item intercorrelation with a Cronbach's alpha coefficient of 0.90.

The limitations of the study include:

1. The instrument used to collect the data; the CSAAT, had not been specifically designed for use with elderly sexual assault victims
   
   

2. The sample was not nationally representative
   
   

3. The case files were derived from various sources
   
   

4. A convenience sampling method was used

J Foren Nurs. 2006;2(3):113-120. © 2006 International Association of Forensic Nurses