EFTA00159928.pdf

ASSOCIATION FOR Empirical Article PSYCHOLOGICAL SCIENCE Psycholopc.al Science I -I6 Long-Term Memory in Adults Exposed 0 The Authors) LOIS AnKle reuse guidelines to Childhood Violence: Remembering sigcpub.conliournailtpeimmans DOI- I0.1I77/216770260130742 wenvpsychologica6cience ocp/CPS Genital Contact Nearly 20 Years Later OSAGE Deborah Goldfarb', Gail. S. Goodman2, Rakel P. Larson3, Mitchell L. Eisen', and Jianjian Qins oen:Lament of Psychology, Florida International university: 'Department of Psychology, University of California, Davis. 'Department of Psychology, Pities College. 'Department of Psychology, California State University, Las Angeles; and ^Derailment of Psychology. California State University. Sacramento Abstract Recent changes in statutes of limitations for crimes against children permit accusations of decades-old child sexual abuse to be considered in court. These laws challenge scientists to address the accuracy of long-term memory of genital contact. To examine theoretical, clinical, and legal concerns about long-term memory accuracy, children who in the 1990s (Time 1) were 3 to 17 years old and experienced a documented child maltreatment medical examination that included genital touch were interviewed between 2012 and 2014 (Time 2), as adults, about the medical experience. Almost half of the adults reported the childhood genital contact. Child sexual abuse and greater depression in adulthood predicted greater memory accuracy. No participant falsely reported chargeable offenses that did not occur, even when such offenses had been falsely suggested in a childhood interview. Some participants erred with regard to specific and misleading questions implying less egregious acts. Ramifications for theory and application are discussed. Keywords maltreatment, longitudinal memory Received 3/31/1R; Revision accepted 8/2/18 There are some memories that time may never erase, Morrison, & Conway, 2014), as reflected in prosecutions but questions arise as to whether genital contact expe- of Penn State coach Jerry Sandusky, Michigan State ath- rienced in childhood is one of them. Recent research letic physician Larry Nassar, Bay Area child psychiatrist confirms the possibility of false memories of childhood William Ayres, former Speaker of the U.S. House of sexual encounters, including as intensified in vulner- Representatives Dennis Hasten, and in the U.S. Senate's able individuals by debated clinical techniques (Bot- Judiciary Committee hearings on the confirmation of toms, Shaver, & Goodman, 1996; Lilienfeld, 2015; Loftus, Judge (now Justice) Brett Kavanaugh. As few, if any, 1996). Yet clinical and memory theories should also published studies have analyzed the accuracy of adults' address the matter of enduring memories for genital memories for a verified abuse-related childhood event touch actually experienced in childhood. that includes concurrently documented genital contact, Currently, there is a pressing need for scientific stud- the question of how accurately adults remember such ies on this topic because in "historic" child sexual abuse experiences has gone largely unanswered (hut see cases (where prosecution occurs years after the alleged Alexander et al., 2005; Widom & Morris, 1997; Williams, assault), the accuracy of adults' memory for childhood 1994). To shed light on this issue, we analyzed adults' genital contact is paramount, with concerns about inac- memories for verified childhood genital contact after an curacies amplified when the adults have trauma histories 18-to-20-year delay. (Conway, 2013; Howe, 2013; Loftus, 1996; Otgaar, Muds, Corresponding Author Howe, & Merchkelback, 2017). Society is grappling with Gail S. Goodman, Department of Psychology, University of California, how to respond to such cases (D. A. Connolly, Chong, One Shields Ave.. Davis. CA 95616 Coburn, & Lutgens, 2015; Howe & Knott, 2015; Wells, E-mail. pasordnianerucdaviciedu 3534-013 Page 1 of 16 EFTA_00010280 EFTA00159928 2 Goldfarb et al. Long-Term Memory for Significant suggestions (Loftus, 1996; Rubin & Wenzel, 1996; Childhood Events Wickens, 1998; Wixted, 2004). There are legitimate con- cerns that delay can lead to increased guessing, schema- In general, memories fade over time for both children driven commission errors, and false memories (e.g., and adults (Hirst et al., 2015; La Rooy, Pipe, & Murray, Kleider, Pezdek, Goldinger, & Kirk, 2008). Although few 2007), making adults less sure of their childhood mem- studies of memory accuracy have included delays as ories and more subject to suggestive influences (Loftus long as 20 years (Bahrick, Bahrick, & Wittlinger, 1975), & Pickrell, 1995). Yet memories of highly emotional it seems likely that, as the time between an event and (compared to neutral) events are often less susceptible a memory task increases, individual differences will be to forgetting (LaBar & Cabeza, 2006; Yonelinas & evident in the adoption of a conservative versus liberal Ritchey, 2016): Individuals who experienced traumatiz- response strategy, the latter of which could increase ing events, such as a natural disaster, an impending suggestibility (Singer & Wixted, 2006). airplane crash, or an injury necessitating an emergency room visit, recall the event years and sometimes even Individual Differences and Memory decades later (Bauer et al., 2016; Fivush, McDermott Sales, Goldberg, Bahrick, & Parker, 2004; McKinnon Individual differences in trauma history and psychopa- et al., 2015; Peterson, 2015; Van Abbema & Bauer, thology may affect the accuracy of long-term memory 2005). For example, adolescents and adults accurately for stressful life events. In this regard, maltreatment remember injuries and assaults experienced 6 to 13 history and posttraumatic stress disorder (PTSD) have years prior (Goodman et al., 2003; Greenhoot, McClo- been of much interest, especially to clinicians. Some skey, & Glisky, 2005). researchers find that maltreatment history and/or PTSD Young children's ability to remember details of a symptomology are associated with increased accuracy medical event decreases over an initial 3-month period of remembering abuse-related experiences (Alexander and becomes stable by 6 months (Ornstein et al., 2006). et al., 2005; Eisen, Goodman, Qin, Davis, & Crayton, However, for children old enough to remember a stress- 2007). For example, children with a history of sexual ful medical test, delays of months or years do not nec- abuse omit fewer details regarding a forensic anogenital essarily increase inaccuracies or suggestibility (Quas examination than children with no such history (Katz, et al., 1999). Even when encoding occurred in the sec- Schonfeld, Carter, Leventhal, & Cicchetti, 1995). Prior ond year of life, during what later is typically labeled a childhood sexual victimization, especially when associ- period of -childhood amnesia," a subset of older children ated with PTSD, may provide a knowledge structure and adults remember salient and distinctive emotional within which to encode abuse-related acts or increase events despite significant delays (McDermott Sales, the saliency (including trauma relevance) of such expe- Finish, Parker, & Bahrick, 2005; Peterson 2015; Usher & riences (Baker-Ward et al., 2015; Frankenhuis & Weerth, Neisser, 1993; Williams, 1994). Still, young age and long 2013). delays typically predict the waning accuracy and decreas- Another mental health problem of particular interest ing detail of long-term memory, including of child sexual is depression, which is associated with a child maltreat- abuse (Goodman et al., 2003), and predict adults' sus- ment history (Brown, Cohen, ohnson, & Smailes, 1999), ceptibility to false suggestion (Howe & Knott, 2015; Qin, increased overgeneral memory (Williams & Broadbent, Ogle, & Goodman, 2008). 1986), and increased rumination and recall of negative There are factors, however, that guard against false life events (e.g., S. L. Connolly & Alloy, 2018; Hertel & childhood recollections (e.g., Pezdek, Finger, & Hodge, El-Messidi, 2006; Matt, Vazquez, & Campbell, 1992). 1997). Relatively strong memories of negative, conse- Greater rumination of negative childhood experiences quential childhood experiences combined with age may keep such memories alive, leading to greater improvements in metacognitive abilities, such as accu- accuracy. rately realizing that one does not know an answer It has also been proposed, however, that individuals (Koriat, Goldsmith, & Pansky, 2000; Lyons & Ghetti, with trauma-related psychopathology, such as PTSD or 2010), may support the ability of many adults either to depression, are less conservative in responding and accurately report salient childhood events that occurred more likely to err in reporting events (Otgaar et al., decades prior or to use a conservative response strategy 2017; Windmann & KrUger, 1998). Coupled with a (e.g., saying, "I don't remember") if one has forgotten trauma history, PTSD and depression may thus be pre- or is unsure of what happened. There is disagreement, dictors of increased correct memory of negative life however, about the contribution of forgetting to recol- events but also of greater error (e.g., susceptibility to lection error, as well as about the role that lack of misleading questions). The hypothesized memory confidence in one's memory plays in resisting false errors related to maltreatment may be driven by mental 3534-013 Page 2 of 16 EFIA_00010281 EFTA00159929 Remembering Genital Touch 3 health symptomology, perhaps resulting from trauma, Nearly 20 years later, between 2012 and 2014, 30 rather than by maltreatment itself (Eisen et al., 2007; participants were located and interviewed as adults Goodman et al., 2016). about their memories of the experience. On the basis Furthermore, gender differences in memory for emo- of aforementioned research, we predicted that partici- tional childhood events have been documented, with pants who were older at Time 1 and female would be males compared to females remembering fewer emo- more likely to report genital touch, but also that some tional childhood experiences (Davis, 1999). Such dif- of the youngest Time 1 participants (i.e., 4 years old) ferences may he particularly likely for an emotional would accurately remember such contact—an abuse- event that is sexual in nature, such that males may he related analogue for a legally chargeable act that did more reluctant than females to remember or disclose occur. We also examined accuracy in response to spe- sexual details (thereby increasing the extent of omis- cific and misleading questions, including questions that sion errors; Ullman & Filipas, 2005; Widom & Morris, could lead to memory errors with legal relevance. Given 1997). research showing that prior experience of sexual abuse in childhood may provide a framework for encoding and/or may increase the personal significance of genital Effects of Misleading Questioning in touch (Katz et al., 1995), we predicted that individuals Childhood on Adult Memory with (vs. without) a child sexual abuse history would be more likely to remember this documented event. As Increased memory error may occur after children are to the possible influence of psychopathology on mem- exposed to false suggestions in interviews (Ceci ory, it was predicted that higher levels of current PTSD Bruck, 1995); yet when memory is strong, misleading symptoms and greater depression would he associated questions can increase the accuracy of long-term mem- with more accurate memory of the anogenital exam, ory in children and adults (Peterson, Parsons, & Dean, including the genital contact, but also to greater error 2004; Putnam, Sungkhasettee, & Roediger, 2017; Quas in response to misleading questions. Finally, exposure et al., 2007). Moreover, memory rehearsal (e.g., via to a misleading interview in childhood was expected to repeated interviews or conversations with others be related to inaccuracy of memory in adulthood. regarding the event) may reinstate accurate memory but can also lead to error (Cordon, Pipe, Sayfan, Melinder, & Goodman, 2004; Ornstein et al., 2006; Method Peterson, 2015; Peterson, Pardy, Tizzrard-Drover, & Warren, 2005). However, the effects of prior misleading Participants interviews in childhood on the accuracy of adults' At Time 1 (1990s), when they experienced an anogeni- memory after an almost 20-year delay for an event tal examination as part of a forensic investigation of involving genital contact have not been previously maltreatment allegations, the 30 participants ranged in published. age from 4 to 17 years (M = 8.37 years, SD = 3.61; 20 females). They ranged in age from 23 to 36 years (M = 27.80 years, SD = 3.55) when interviewed at Time 2, The Present Study approximately 20 years later (M = 19.03 years, SD = .32, This project is part of a longitudinal study of memory range = 18 to 20), about their memories of the exami- in children exposed to violence. In 1994 (Time I), nation involving genital contact. Participants included because of suspicions of child maltreatment, authorities non-Hispanic Whites (13.3%), African Americans (80%), removed participants from their homes and placed and Latinos/as (6.7%). For analyses, ethnicity was coded them in a forensic hospital unit for evaluation (not for as African American = 1 and non-African American = illness), where participants experienced an anogenital 0 (M = .80, SD = .41). As adults, participants also tended exam by a physician as part of a 5-day child-maltreatment to be single (67%) and of low socioeconomic status investigation. As the anogenital exam was part of the (57% reported making less than $20,000 per year). Half standardized forensic medical procedure for the hospi- of the Time 2 participants (n = 15) were interviewed tal unit, virtually all children received such an exam, (with open-ended, specific, and misleading questions) and it followed a set format, including the doctor about the anogenital exam at Time 1, whereas the other administering both visual and manual inspection and half had not been interviewed about the exam at Time penetration of the genital and rectal areas to enable 1 (see Eisen, Qin, Goodman, & Davis, 2002, for details). swabbing for venereal disease. Researchers were pres- A central hypothesis of the present study concerned ent during the anogenital exam and documented what memory in adults with Time 1 histories of child sexual occurred, including all genital and anal contact. abuse compared to those with no Time 1 history of that 3534-013 Page 3 of 16 EFIA_00010282 EFTA00159930 4 Goldfarb et at type of maltreatment. Thus, children classified as child phone, email, and/or letter) to participants, inviting sexual abuse victims were those whose Under the Rain- them to take part in the research. bow (UTR) cases were determined to be "indicated" for Once participants were reached, trained female child sexual abuse by the Department of Child and researchers "blind" to Time 1 measures, including to Family Services (DCFS) after extensive investigations memory performance and maltreatment history, con- by local law enforcement, child-welfare authorities, and firmed participants' identity (i.e., name, birthdate, race, UTR specialized staff (i.e., medical, mental health, and gender, and city in which the participant grew up). social work professionals). DCFS records were also Participants were told that the study's purpose was to checked for past indicated sexual abuse. For the present interview children who had grown up in Chicago in research, if the child had an indicated case of sexual the 1990s. After consent was obtained and confidential- abuse at or prior to Time 1 (even if he or she had ity ensured, participants answered a series of demo- experienced ocher forms of maltreatment, such as graphic and background questions, which allowed for neglect, which was common, or physical abuse), the rapport building before the memory portion of the child was considered a sexual abuse victim = 19). If interview commenced. the child had no known sexual abuse case (current or For the memory interview, participants were cued to past at Time 1), the child was not considered a sexual the target event by our saying that we wanted to ask abuse victim (n = 11), although the child might have about the time they stayed at a hospital unit, the UTR suffered founded physical or psychological abuse or program, in the 1990s as a child or adolescent, and that neglect, or had no founded child abuse case (e.g., 4 "there were a lot of other children" there. Of note, neglect, 3 nonabused controls). As discussed below, participants were never informed of the purpose of Time 1 maltreatment status was unknown for 3 partici- their stay at the hospital, including that they were at pants. For the present study, child sexual abuse status the UTR as children as part of a forensic evaluation was coded as child sexual abuse history = 1 and no investigating maltreatment allegations. Participants such history = 0 (M = .70, SD = .47).' At Time 2, 5 par- were first asked a free-recall question concerning their ticipants reported having experienced sexual assault as general experience at the UTR program ("Please tell me an adult and 25 reported no such experiences. There everything you remember about being there"). They was no significant difference in Time 2 report of adult were then prompted to provide any additional informa- sexual assault between those who had experienced tion they could remember ("Is there anything else you child sexual abuse as of Time 1(19%) and those who remember about it? Even the smallest details are of had not (10%), Fisher's Exact Test, p = 0.285, ns. interest to us."). Time 2 participants Os = 30) were not significantly Participants were then asked to recall everything different from Time 1 participants who did not take part they could remember about the medical exam at the in the Time 2 interview (n = 183) in terms of age, gen- UTR, the one where "small white patches Jelectrode der, ethnicity, and memory accuracy at Time 1 for either patches) and wires were placed on your chest to mea- the exam generally or the genital contact specifically, sure your heart beat." Note that for this part of the Time ts(15-30) < 11.871. The Time 2 sample, however, con- 2 interview, like the initial free-recall question, no cues tained more child sexual abuse victims than the original were given to inform participants that they had received sample, t(27) > 13.311, p = .001. The sample size was an anogenital exam. Two free-recall questions were based on prior research, including effect sizes, on long- asked: "Please tell me everything you remember about term memory for emotional events (Peterson, 2015; the doctor examination in as much detail as passible" Talarico & Rubin, 2003). and "Is there anything else you remember about it?" One open-ended question (e.g., "What parts of your body did the doctor examiner) and 25 closed-ended Measures and procedure questions about the examination followed. Closed- The longitudinal study was approved by the university's ended questions consisted of 16 specific (e.g., "Did the institutional review board and carried out in accordance doctor have you bend over?") and nine misleading with the provisions of the World Medical Association questions that presumed false information (e.g., "When Declaration of Helsinki. At Time 1, consent for follow- the doctor gave you the shot/inoculation, was it in your up had been obtained. At Time 2, researchers located upper arm, upper thigh, or in your buttocks?" though the participants' current physical or postal address, participants did not receive an inoculation) designed email address, and/or phone number by extensively to assess memory accuracy and suggestibility, respec- searching available databases, including Google, tively. Inaccurate responses for nine of the specific and LexisNexis, and TLO, and social network sites, such as seven of the misleading questions were commission Facehook and MySpace. Contacts were made (via errors (e.g., choosing an option when asked, "Did the 3534-013 Page 4 of 16 EFIA_00010283 EFTA00159931 Remembering Genital Touch 5 nurse wash off your whole body at the start of that All participants were debriefed at the end of the medical exam or was it during it?" when in fact the interview (e.g., told that it was normal not to remember children's bodies were not washed then), and inaccu- everything from the UTR, asked how they were doing). rate responses for seven of the specific and two of the As many participants did not remember portions of the misleading questions were omission errors (e.g., agree- event in question or the UTR at all, special attention ment to "I know it is hard to remember back all that was paid to assure the participants that some questions time, but there wasn't a chair in the room, was there?" might not have applied to them and that we asked the when in fact there always was a chair in the exam same questions regardless of an individual's specific room). As both commission and omission errors to experience. At debriefing, participants were given infor- misleading questions index suggestibility, they were mation on support hotlines they could contact. combined as incorrect responses. A subset of the After completion of the interviews, research assis- closed-ended questions (n = 7) asked about forensically tants (RAs) blind to hypotheses transcribed and de- relevant details that might well he related to an inves- identified the interviews (removing any identifying tigation of inappropriate or abusive behavior on the information not relevant to the accuracy of the medical part of the doctor or nurse (e.g. "Did the doctor take examination). Of central interest was memory for the your clothes off at the start of the exam?" when, in fact, documented genital contact (i.e., vaginal or penile the doctor did not). touch). Interview responses across free-recall, open- Two of these seven forensically relevant questions ended, and closed-ended questions were coded on a concerned memory of the genital contact that actually checklist for report of genital contact, false denial of did occur during the anogenital exam ("Did the doctor genital contact (omission errors), and "don't examine your genitals fprivate pans) during that exami- know"/"don't remember" responses. Participants' nation?"; if participants responded "yes," they were answers to the Time 2 specific questions were scored asked, "Did the doctor examine both your genital and as proportion correct, commission errors, omission rectal areas or just the genital area?" as a follow-up); errors, and 'don't know"/'don't remember" replies. this permitted us to examine omission errors of acts Responses to Time 2 misleading questions were coded that were potentially chargeable legally. Two of the as proportion correct, incorrect, and "don't know"/'don't seven abuse-related questions concerned acts that did remember" responses. To analyze the accuracy of par- not occur and that (as with genital touch) could also, ticipants' overall reporting, including monitoring of on their own, potentially lead to legal charges ("Did their lack of report, particularly after such a long delay, the doctor or nurse hit you during that medical exam?" a genital report variable was created to capture not only "At the end, did the doctor kiss you?"). This allowed us participants' rates of correct and incorrect responding to examine potentially chargeable commission errors. but also their "don't know" responses (-1 = incorrect At the end, participants were asked one final question recall, 0 = don't know, 1 = correct recall). ("Do you remember anything else about your doctor exam that day?"). Questions were roughly balanced for correct yes and no answers. Results Participants also completed a battery of psychopa- Descriptive and correlational analyses thology measures (all with strong psychometric proper- ties and appropriate for age and race/ethnicity). Of note Information on key variables is presented in Tables 1 here, at Time 2 they completed the 40-item Trauma and 2. For the variable indexing discussion of the hos- Symptom Checklist (TSC; Elliot & Briere, 1992) and the pital visit, mean imputation replaced missing data for 49-item Posttraumatic Diagnostic Scale (PDS; Foa, 4 people. All significant effects are reported. Cashman, Jaycox, & Perry, 1997). For our sample, rel- evant means and standard deviations on these measures Report of genital contact. As can be seen in Table 1, were: TSC total score, M = 23.92, SD = 14.08; TSC across the entire Time 2 memory interview (collapsing depression, M = 6.17, SD = 3.91; PTSD avoidance, At = across free-recall, open-ended, and closed-ended ques- .70, SD = .67; and PTSD arousal, M = .82, SD = .83. To tions), a slight majority of the participants (57%) failed to assess how frequently participants had discussed their report the documented genital touch (e.g., said they did memory of the UTR program, Time 2 participants were not remember what parts of their bodies were exam- also asked, "How frequently have you discussed your ined), including 2 participants who denied that such stay at Mt. Sinai Hospital with others?" Participants touch had occurred (e.g., said the doctor examined their responded using a 5-point scale (1 = never, 6 = very upper bodies but not their private areas). However, 13 frequently), = 1.58, SD = .88.2 (43%) of the participants correctly reported it. For the 3534-013 Page 5 of 16 EFIA_00010284 EFTA00159932 6 Goldfarb el al. Table 1. Percent of Adults Who at Timc 2 Reported Timc 1 Genital Contact, Denied Genital Contact, or Said "Don't Know," Analyzed by Time 1 Age Group and Gender Agc gmup at Time 1 Gender AJ 3-5 years 6-10 years 11-15 years Mak Female Type of genital contact report' (n=7) = 15) (n=8) = 10) (n= 20) (N=30) Reported genital contact 28.6% 40.0% 62.5% 20.0% 55.0% 43.3% Incorrect denial of genital contact 14.3% 6.7% 0% 20.0% 0% 6.7% -Don't know" across all question types 57.1% 53.5% 37.5% 60.0% 45.0% 50.0% 'Collapsed across free-recall, open.ended, and elosed-ended questions. subset of respondents who were asked specifically about Time 2, r = .40, p = .027. No participant who was over the anal touch (n = 11), omission errors were more frequent age of II when the genital touch occurred falsely denied for anal (55%) compared with vaginaVpenile (7%) con- it. Of those who remembered Time 1 genital contact, 1 tact, 1(10) = —3.46,p = .006. adult was only 4 years old (53 months) at the time. Four additional participants were of this age at Time 1, 3 of Lost memory. Five out of 30 (17%) participants did not whotn said "don't know' at Time 2 and 1 of whom incor- remember, or at least did not disclose, being at the UTR rectly denied genital touch had occurred. None of the 30 hospital unit at all (i.e., evincing a "lost memory"). For panic-4)3ms wa.s younger than 4 years old at Time 1.3 the overall sample, having a lost memory of the UTR was not significantly correlated with age (r = —.05; p = .808) Correlations controllingfor child age. Partial correla- but was significantly correlated with gender, even with tions, statistically controlling for Time 1 age, assessed age partialed (r = —.44, p = .016): Males (40%) were more whether other potential theorized predictors (e.g., gender, likely than females (5%) to express having no knowledge depression, PTSD symptoms) related to long-term mem- of ever being at the UTR program. Not recalling the UTR ory of the anogenital examination (Table 3). Consistent was also significantly related to higher total TSC scores, with the lost-memory findings, males (vs. females) were r = —.37, p = .048 (with age partialed; with gender par- significantly less likely to report genital contact and more tialed, r = .28, us). likely to omit information. Males also had lower shop-term memory (STM) scores at Time 1, but Time 1 STM (Al = Child age. Being older at Time 1 was associated with a 43.87, SD = 7.47) was not significantly correlated with greater likelihood of accurately reporting genital contact at memory performance. The Titne 1 memory-interview Table 2. Proportion of Correct, Incorrect, and "Don't Know" Responses to the Time 2 Memory Closed-Ended Questions About the Anogcnital Examination Agc group at Time 1 Gender Al 3-5 years 6-10 years 11-15 years Male Female Question type (n=7) (n= 15) (n = 8) (n= 10) (n = 20) (N=30) Specific questions Correct .17 (.20) .34 (.29) .33 (.30) .22 (.23) .33 (30) .30 (.28) Commission .05 (.08) .05 (.05) .06 (.07) .05 (.07) .06 (.06) .05 (.06) Omission .04 (.09) .03 (.08) .03 (.05) .08 (.11) .02 (.03) .04 (.07) 'Don't know' .73 (.37) .58 (.36) .58 (.39) .65 (.39) .60 (.36) .61 (.36) Misleading questions Correct .15 (.28) .17 (.19) .12 (.13) .14 (.24) .16 (.17) .16 (.20) Incorrect .23 (.22) .17 (.20) .24 (.28) .23 (.24) .19 (.22) .20 (.22) 'Don't know' .62 (.37) .65 (.34) .64 (.36) .63 (.40) .65 (.32) .64 (.34) Note: Means are accompanied by standand deviations in parentheses. misleading questions incorrect = commission + omission errors. 3534-013 Page 6 of 16 EFIA_00010285 EFTA00159933  Table 3. Partial Correlations of Key Variables Controlling for Participant Age at Time I Variable 1 2 3 4 5 6 7 8 9 10 11 12 13 14 IS 16 I" 10 I. Gender 1.00 2. Ethnicity 0.09 1.00 3. Time I STM 0.4r -cum 1.00 4. Time I Memory Interview 0.21 0.08 —0.04 1.00 5. CSA status" 0.09 0.10 0.15 —0.04 1.00 6. Time 2 Genital Contact Report 0.38' 0.05 0.001 0.05 0.48* 1.00 7. Time 2 Npo. tic Correct" 0.14 0.09 0.32 0.13 0.27 0.25 1.00 8. Time 2 Npo. tic Comm,' 0.04 0.33 0.22 0.16 0.23 0.38o 0.70" 1.00 9. Time 2 NI.. tic Omissions -O.3T 0.15 -0.15 0.19 -0.28 -0.13 0.4P 0.52" 1.0D 10. Time 2 specific DK4 —0.03 —0.15 —0.25 -0.16 -0.19 -0.23 -0.96" -0.8P• -0.61" 1.00 It, how 2 MI. Conrecri 0.06 0.15 0.10 -0.001 0.21 0.33 0.72" 0.59* 0.40* -0.73" 1.00 12. Time 2 MI. Incorrect -0.10 0.20 0.13 0.03 0.05 -0.02 0.62" 0.71" 0.46" -0.69" 0.34 1.00 13. Time 2 ML l)K 0.03 —0.22 —0.14 -0.02 -0.16 -0.17 -0.82" -0.79" -0.52" 0.87" -0.79" -.84" 1.00 14. Time 2 Total TSC 0.29 0.02 0.17 0.08 0.32 0.11 0.34 0.09 -0.11 -0.25 0.09 0.03 -0.07 1.00 15. TSC-Depression 0.17 0.10 0.07 -0.01 0.27 0.17 0.500 0.22 -0.13 -0.39. 0.26 0.26 -0.32 0.79" 1.0D 16. PTSD Avoid Severity -0.04 0.09 0.08 0.09 0.6r 0.09 0.13 0.26 -0.14 -0.12 0.07 0.12 -0.12 0.39 0.31 1.00 17. PTSD Arousal Severity 0.21 -0.19 -0.03 0.09 0.62" 0.26 0.08 0.02 -0.25 -0.01 -0.08 -0.13 0.14 0.73" 0.44o 0.64" 1.00 18. Discussing Hospital VLsitf 0.21 —0.09 0.15 -0.06 0.13 0.27 0.360 0.25 -0.14 0.29 0.31 0.27 —0.35 0.16 0.30 —0.12 —0.09 1.00 Nitre: N.30. except child sexual abuse (CSA) status, AN'. 27, and PTSD variables, N= 25. 5Th = short-teem memory; Comm = commission; DK = 'Don't Know"; ML = misleading. = male, I = female. = non-African American, I = African AMC/ILIA. s0 = not CSA, I = CSA. 'CI inconett recall of genital contact, 0 = don', know, I = correct recall of genital contact. `Tune 2 memory variables are all proportion scores (dosed-ended queitions). (Imputed values. 71, < .05. "p < .01. EFTA00159934 8 Goldfarb et al. Table 4. Age, Gender, Time 2 Depression, and Time 1 Child Sexual Abuse (CSA) Status Predicting Time 2 Memory for the Anogenital Exam Genital contact correct Proportion specific correct Proportion specific omission Model b SE p b SE I r b SE p Model 1 Age .06 .03 .33 1.781 .02 .02 .28 1.40 <.001 .004 .02 0.09 Gender .33 .24 .25 1.36 .03 .13 .04 0.21 -.08 .03 -.48 -2.60• R2 = .20 R2 = .08 R2 = .22 g2, 24) = 3.081 1(2, 24) = 1.09 FT2, 24) = 3.46• Model 2 Depression .01 .03 .08 0.40 .04 .01 .52 2.92" -.001 .004 -.07 -0.36 AR' = .006 Are = .25 AR2 = .004 1(3, 23) = 2.03 1(3,23) = 3.80* ki3, 23) = 2.26 Model 3 CSA .59 .25 .47 2.38' .09 .12 .15 .72 .04 -.27 -1.27 AR! = .16 AR/ = .02 AR2 = .05 114, 22) = 3.26• 1(4, 22) = 2.92° 1(4, 22) = 2.15 Now: Depression = '1SC depression suhscale score; GSA: 0 = not CSA, t = GSA; Genital contact collect: -1 = incorrect recall of genital contact, 0 = dont know, t = collect recall of genital contact, a = 27. 1p<.10. sp < .05. "p < .01. variable (i.e., having had a Time 1 memory interview) was in each of the sets of regressions, unless indicated oth- not significantly related to gender, ethnicity/race, or Time erwise, Time 1 age and gender were tested in the first 2 memory performance. model, depression was added in the second model, and Regarding psychopathology, total TSC scores were child sexual abuse status was added in the third model not significantly correlated with the memory variables (Table 4).. shown in Table 3. Contrary to our predictions, Time 2 depression was not significantly related to report of Genital contact. In the regression analyses of genital genital contact, but consistent with prediction, greater contact memory, the first model was not significant, p = depression was significantly correlated with greater .065, although there was a trend for those who were memory accuracy as assessed by specific questions older at Tame 1 to be more likely in adulthood to remem- (correct and "don't know" responses). The PTSD avoid- ber the childhood genital contact (p = .088), as would he ance and anxiety scores were not significantly associ- expected. Gender was not a significant predictor. When ated with memory performance and were not unique depression was added, the model was also not signifi- predictors in preliminary regression analyses; thus, they cant. However, in the final model, with child sexual abuse were maintained for control purposes only, as needed. status included, the model was significant: Having been a Having engaged in more discussion of the hospital visit child victim of sexual abuse at Time 1 was a significant was associated with increases in the proportion of cor- predictor in adulthood of accurately reporting of child- rect answers to specific questions at Time 2. Because hood genital touch experienced during the UTR medical ethnicity, STM, total TSC score, and experience of a exam. Time 1 memory interview were not significant predic- Because frequency of discussion about the hospital tors of memory in correlational and preliminary regres- visit was expected to affect memory, we conducted the sion analyses, they are not considered further. regression analysis above but with the hospital-visit discussion (imputed) variable added in the third model, Unique predictors of memory nearly and then with child sexual abuse status added in the last model. The model for frequency of discussion was 20 years later not significant, R2 = .32, F(4, 22) = 2.58, p = .065, R=A = The regression models discussed below tested the .11. However, the model that included child sexual unique predictors of long-term memory of the medical abuse status was significant, R2 = .467, F(5, 21) = 3.66, examination. The first set of analyses concerned mem- p = .016, R2A = .15; child sexual abuse remained a sig- ory of genital contact. The second set concerned the nificant predictor of adulthood memory of childhood adults' accuracy in response to closed-ended questions genital contact even after controlling for frequency of about the anogenital examination generally. Throughout, discussions: child sexual abuse status, b= .56, SE= .23, 3534-013 Page 8 of 16 EFIA_00010287 EFTA00159935 Remembering Genital Touch 9 13 = .45, 1(21) = 2.39, p = .026. In two sets of regressions, contact that actually occurred (Skeem, Douglas, & when the PTSD variables were separately entered in Lilienfeld, 2009). There is a pressing clinical, societal, second models followed by entering depression in the and scientific need to know whether individuals who third models, the second models were not significant, have experienced childhood trauma can accurately ps 2 .078, but in the third models, child sexual abuse remember genital contact decades later and to identify status remained a significant predictor, bs 2 .72, SEs 2 factors that promote accurate reporting of childhood .32, ps 2 is 2 2.24, ps 5 .038 (ns = 22). events (e.g., Goodman, Goldfarb, Quas, & Lyon, 2017). A main goal of this study was to examine the accu- Closed-ended questions. We were also interested in racy of ad