The puzzle of intrafamilial child sexual abuse: a meta-analysis comparing intrafamilial and extrafamilial offenders with child victims.

Intrafamilial child sexual abuse is a serious social and health problem, yet explanations of sexual offending against children that emphasize antisocial tendencies and atypical sexual interests do not adequately explain intrafamilial offending. In this meta-analysis, we tested other explanations of intrafamilial child sexual abuse by examining 78 independent samples that compared a total of 6605 intrafamilial offenders to a total of 10,573 extrafamilial offenders, in studies disseminated between 1978 and 2013 (Mdn=2000). Intrafamilial offenders were significantly lower on variables reflecting antisocial tendencies (e.g., criminal history, juvenile delinquency, impulsivity, substance use, and psychopathy) and atypical sexual interests (e.g., pedophilia, other paraphilias, and excessive sexual preoccupation). Contrary to other explanations that have been proposed, intrafamilial offenders scored lower on offense-supportive attitudes and beliefs, emotional congruence with children, and interpersonal deficits; intrafamilial offenders also did not differ from extrafamilial offenders on most indicators of psychopathology. Intrafamilial offenders were, however, more likely to have experienced sexual abuse, family abuse or neglect, and poor parent-child attachments. There were too few studies to examine family dynamics - spousal relationship quality, parent-child victim relationship, and family functioning more generally - even though these factors have been frequently mentioned in the clinical and theoretical literatures. Implications for theories of intrafamilial sexual offending, treatment, and future directions for research are discussed.