Response to Campbell's "The Reliability and Validity of Gardner's Indicators of Pedophilia"

Richard A. Gardner^*

My primary reaction to Campbell's article is that he painstakingly criticizes the criteria I use to ascertain whether an alleged perpetrator has pedophilic tendencies, but does not provide us with any meaningful and/or useful comments about how he would assess a situation in which such an accusation is made.  He spends over 31 pages of manuscript detailing what he considers the various weaknesses and defects in the criteria that I use and then tells us only that a better way to approach this problem is to use "interpersonal events."  If he is referring here to interpersonal observations among the accuser, the accused, and the alleged child victim, this is something that I do.  However, the reader could not know this if he was not familiar with my book (Gardner, 1992) because Campbell would have the reader believe that my total evaluation rests on criteria applicable to the alleged pedophile.  In actuality, I make every attempt to interview the accuser, the accused, and the alleged child victim and repeatedly state that any evaluation that does not include the assessment of all three parties is flawed.

Campbell does, however, give us more information about what he considers to be "interpersonal events," among which is "the extent to which the allegation corresponds to rumor formation and rumor dissemination."  To the best of my recollection, this is the first time I have ever heard of "rumor" being used as a criterion for making a medical diagnosis (which pedophilia is) or deciding whether someone committed a crime (which is what a pedophilic act is).  Campbell has justification when he claims that some of my criteria are somewhat subjective.  However, this substitute criterion is probably more subjective than all of my subjective criteria put together.  This is especially the case because we are currently living in a period in which mass hysteria prevails regarding decisions involving sex abuse (Gardner, 1991).  The use of Campbell's rumor criterion would add to the parade of those who have already been incarceratted.

Campbell tells us at the outset that my criteria have been misused by "self-styled validators" who "exploit the ambiguity of Gardner's indicators to serve their own biased agenda."  There will always be those who will exploit another person's work for their own ends.  Anyone who publishes runs the risk that he will have to "bear to hear the truth he's spoken, twisted by knaves to make a trap for fools." (to paraphrase Rudyard Kipling).  Many of the things I have done and said have been exploited by others; however, this has never been a reason me not to state honestly what I believe.  If I were to concern myself with such misinterpretation, I never would have published a word.  I believe, further, that Campbell himself is joining the line of validators with his own misinterpretations of what I have tried to do.

At this point, I will comment more specifically on Campbell's article, primarily in the order in which he makes his comments.  With regard to my present list of indicators (1992) and its no-longer-used predecessor, the Sex Abuse Legitimacy Scale (1987), Campbell properly quotes me:

... one should work 15 or 20 years on its development and pull together the findings of many groups of investigators.  On the other hand, there is an urgency in that people were being jailed then and we could not wait until 'all the data was (sic) in' before formulating an objective scale (1992, p. xxxiv).

Dr. Campbell's gratuitous insertion of "(sic)" after "data was" implies that I have erred in using the word "data" as a singular.  His insertion of a sic here is a reflection of his own ignorance of the proper use of the word data.  I am fully aware that "datum" is singular and "data" is plural; just as "medium" is singular and "media" is plural.  In recent years, because of widespread use of the word "data" to refer to a whole collection of individual bits of information, it is correct to use it as a collective singular, just as "media" is used as a collective singular.  Enough pedantry.

Campbell states:

Gardner advocates that clinicians summarize their findings in terms of how many separate criteria supposedly indicating pedophilia a particular suspect satisfies.

What he has unfortunately omitted is the important statement I make in my introduction:

The examiner must consider the quality and quantity of the criteria satisfied.  A man who has a large collection of child pornographic materials may not satisfy many other criteria, but the evidence for pedophilia is still very compelling when this criterion is satisfied.  The conclusion that the accused has indeed engaged in pedophilic behavior should not be based on these criteria alone, but on the broad picture and additional data obtained during the evaluation, especially data obtained from the accuser and the alleged victim(s).

As I will comment on further, Campbell's omission of this important consideration contributes to his making an extremely absurd statement (see below) about the use of these indicators.

Campbell then goes on to criticize both the validity as well as the inter-rater reliability of these criteria.  Although he quotes me as saying that these criteria are an initial offering," he criticizes me for not being able to provide studies in which the inter-rater reliability has been assessed.  We cannot have it both ways.  We cannot have initial offerings to serve as guidelines to evaluate people who are ready to be sent to jail and have criteria that, at the same time, have inter-rater reliability.  He has already quoted me as saying that this would take 15 to 20 years, and the accused cannot obviously wait so long.  As far as validity goes, as mentioned, whenever possible I have quoted studies on known pedophiles as my basis for claiming validity for some of the criteria.  Others, I openly state, have face value, and face value only, and hope that these too will be the subject of further studies. Now to the specific criteria:
  

Specific Criteria

1) History of Family Influences Conducive to the Development of Significant Psychopathology

There is significant scientific evidence that confirms a relationship between the development of psychopathology and a history of family dysfunction at the time of ones upbringing.  Because I consider pedophilia to be a psychiatric disorder (as does DSM-III-R), I consider this to be a reasonable criterion.  I recognize that there are many borderline situations in which even the most competent individuals might have difficulty deciding whether this criterion is satisfied.  It is for this reason that I suggest that the most blatant manifestations of family dysfunction be utilized, e.g., "history of violence, alcoholism, drug abuse, psychopathy, serious psychiatric disturbance, and suicide."  The presence of these can be more objectively determined than some of the more subjective types.

I am convinced that if Dr. Campbell were to make up a list of what he considers to be manifestations of family dysfunction and were to apply these criteria himself to groups of confessed pedophiles and a comparison group of those who have absolutely no evidence for such behavior, he would be able to substantiate the validity of this criterion.  On the basis of Dr. Campbell's subsequent discussion on this point, the reader could easily be led to believe that it is my position that the presence of any of the aforementioned factors contributory to family dysfunction automatically produces pedophilia.  This is absurd.
  

2) Longstanding History of Emotional Deprivation

I am in agreement that this criterion might be difficult to apply in certain cases.  I am in agreement, also, that it might be misinterpreted by those who are biased in either direction.  I have included references to studies which provide support for the inclusion of this criterion.
  

3) Intellectual Impairment

I recognize that some scientific studies provide support for this criterion and others do not.  I have openly admitted that this is one of the weaker criteria, which is certainly deserving of further study (as are all of them).  The fact that smart pedophiles might avoid being included in studies on this subject is not a reason for abandoning entirely such lines of study.  Every study has its potential flaws and most studies raise questions regarding the purity of the population studied.  These problems in setting up such studies do not warrant discrediting this criterion.  Every study in which we compare those who have been sexually abused and those who have not been sexually abused, those who are pedophiles and those who are not, runs the risk of "impure" groups.  This risk does not negate the value of such studies.  We can only hope that the evaluators have taken great pains to ensure that their groups areas pure as they can possibly select them.
  

4) Childhood History of Sex Abuse

Campbell states that "..  the limited data that appear to support this hypothesis are less than convincing."  I have provided my references and they are obviously more convincing to me than they are to Campbell.  Campbell's conclusion here is not surprising because he does not consider even one of my criteria to have any validity.  Actually, this is one of the more compelling criteria.  Campbell also states:

Moreover, this index implicitly assumes that sexual abuse is a homogeneous experience leading to essentially similar outcomes for all male children who endure it.

Once again, Campbell imputes to me the absurdity that if a person is sexually abused as a child, he automatically must become a pedophile.  All I am saying is that some people who have been sexually abused become pedophiles and some do not.  I am also saying that such abuse increases the likelihood that a person will become a pedophile and that if one compares known pedophiles to non-pedophiles, more pedophiles will have had that experience in childhood than non-pedophiles.

Throughout, Campbell brings up other false arguments in an attempt to discredit any validity to any of the criteria.  For example, here he also states that "when self-admitted pedophiles undergo treatment, therapy can persuade them that they were sexually abused as children when — in fact — they were not."  It may very well be the case that some incompetent and/or irresponsible therapists might convince known pedophiles to believe something that did not happen.  Such individuals might then lessen the purity of the group in which they are placed in a study on this issue.  It is not an argument, however, for claiming that the criterion is not a valid one.  He concludes: "... this index also offers little promise for validly discriminating between pedophiles and non-pedophiles."  I am in full disagreement with him on this point.  Campbell's caveats can help researchers purify their groups, but they should not serve to lead them to conclude that no such studies can be useful.
  

5) Longstanding History of Very Strong Sexual Urges

Campbell refers to this criterion as a "definitional nightmare" because of the difficulty in objectifying "very strong" and the inability to pinpoint any particular age of childhood as a cutoff point for satisfying this criterion.  Once again, Campbell omits important information.  I do state, "The age at which masturbation first began can provide important information in this regard."  Once again, Campbell uses difficulties in validating the criterion as an excuse for not only not using it now but not even trying to validate it in the future.
  

6) Impulsivity

Campbell ignores my substantiation from the scientific literature and provides weak arguments like:

(P)edophiles may demonstrate impulsiveness as they sexually abuse children; but exhibit forethought and planning in other situations not associated with their pedophilia.

Of course, this is true.  Of course, some pedophiles may only exhibit their impulsivity in the situation when they are with children.  But this does not negate the validity of the criterion.  There will always be individuals who do not satisfy elements within a criterion.  Again, he brings up the argument about pedophiles who escape detection and therefore would not be included in any study.  Again, this does not preclude the validity of a discriminating criterion.  It only makes it harder to prove it.

Many of the studies I make reference to, e.g., those of Abel, Becker, Cunningham-Rathner, Mittelman, & Rouleau (1988) and Kinsey, Pomeroy, Martin, and Gebhard (1948) use known, self-confessed, and convicted pedophiles as their study group.  One might argue that some of these people really were not pedophiles and were just claiming they were so for some morbid reason and that anything they have to say might be suspect.  One can always find some fly in the ointment, some impure element in even the purest group.  But that should only make the evaluator wary, but should not bring about the automatic conclusion that the criterion being studied has no value or there is no point studying it at all.
  

7) Feelings of Inadequacy and Compensatory Narcissism

I recognize the difficulties in objectifying feelings of inadequacy.  The compensatory narcissism that derives from it is easier to assess.  I do not claim that this is one of the stronger criteria, but I have provided references to provide support for my concluding it.
  

8) Coercive-Dominating Behavior

There is very strong evidence in the scientific literature for this type of pedophile.  They are the individuals, often fathers, who dominate all members of their family, their wives and children, and sexual domination is just one example of their behavior.  The argument that I do not use objective criteria such as "assaultiveness as defined as two or more arrests, or one or more convictions" is not convincing.  Of course, one might try to provide further validation for this criterion by such studies.  But this argument would be used by Campbell to discount the criterion as having any validity.
  

9) Passivity and Impaired Self-Assertion

Campbell describes difficulties in objectively assessing these qualities.  There is no question that it may be difficult to assess these objectively in some individuals and there is no question that some people would fall into the borderline category with regard to whether they exhibit such qualities.  There is strong support in the scientific literature for the existence of this subtype of pedophiles.  These are the people who are fearful of asserting themselves with adult women and therefore gravitate toward children who more predictably comply with their sexual overtures.
  

10) History of Substance Abuse

Campbell's criticism that I do not provide objective cut-off points for defining substance abuse is the reason for discounting this criterion.  Of course there are borderline situations.  But there is also strong support in the scientific literature that there is a correlation between pedophilia and substance abuse as well as the fact that the pedophilic act is sometimes (if not often) perpetrated under the influence of these substances.  It is almost as if Campbell works on the assumption that if one cannot measure something — especially via the utilization of a pure scientific study — it does not exist.  I work under the assumption that if you cannot measure something, there are two possibilities: it might exist or it might not exist.  People who are on the verge of being sent to jail cannot wait until all the studies come in, until all the measurements are made.
  

11) Poor Judgment

I recognize that this is one of the more difficult criteria to objectively assess.  I recognize also that I am not able to provide studies to support this criterion.  However, it was included because of my repeated experience with pedophiles that they do such things as trust little children to keep secrets and will sometimes perpetrate pedophilic acts under such circumstances that disclosure is highly likely.  The fact that I provide little substantiation for this criterion subjects it to two possible conclusions with regard to its validity: that it is valid or that it is not valid.  Campbell automatically assumes that it is thereby not valid, and this criterion therefore should not be used.  He also uses this as a basis for his reasoning for discarding every single one of my criteria.
  

12) Impaired Sexual Interest in Age-Appropriate Women

Again, my ability to provide references to studies on this subject is completely discarded by Campbell with the argument that this may be hard to define in some individuals.  Every criterion will have its borderline subjects, yet it does not justify the conclusion that it does not exist in reality.
  

13) Presence of Other Sexual Deviations

Thus far, this is the first criterion for which Campbell has admitted the possibility it may be a valid one.  With this feeling he suggests further research to test empirically its discriminative power.  He ignores entirely the valuable studies by Abel et al. (1988) in which very strong evidence is provided for the validity of this criterion.  Campbell states:

Unlike the other indices previously discussed, this particular index is more conducive to reliable definition.  As a result, this index deserves research to empirically test its discriminative power ... Without validation to data [sic] to support it, however, this index only amounts to interesting speculation.

This is the best that I seem to be able to get from Campbell, namely, that a criterion might be an "interesting speculation."  But even so, at this point, he does not recommend its use subject to these future studies.
  

14) Psychosis

Here, Campbell gratuitously tells us that

... it is at least possible to empirically test Gardner's hypothesis in the future.  Nevertheless, his assumptions regarding the relationship between psychosis and pedophilia remain merely speculative without the availability of validation data.

My conclusion here is that Campbell suspects that there may be some validity to this criterion but would not recommend that it be used at this point because it cannot be validated by studies that measure these things.  Even those that Campbell suspects might have validity are to be discounted because we do not have numbers yet.
  

15) Immaturity and/or Regression

There are some pedophiles who are regressed individuals.  Some describe themselves as "We were just like two little kids playing together."  I am convinced they exist.  The fact that it may be hard to objectively define immaturity in some individuals, the fact that it may be difficult to provide objective criteria for regression, does not preclude the validity of this criterion.  Campbell would just have us not use it at this point.
  

16) Large Collection of Child Pornographic Materials

This is probably the most compelling criterion of all and the one that was first described by Kinsey as early as 1948.  The police and even the postman who delivers these materials know about it.  Campbell would have us discount it because of a police officer who interpreted this criterion to be satisfied by a father's taking a picture of his daughter in a bathing suit at the beach.  The fact that some zealot would misinterpret the criterion does not warrant its being discarded.  There will always be someone who will misinterpret and misuse.  If we are to go along with Campbell, he would leave us with absolutely no criteria at all because there will always be the possibility of misinterpretation.
  

17) Career Choice That Brings Him in Contact with Children

Campbell agrees that this criterion is more easily "conducive to reliable definition."  He states, "... any male who works with children endures a greater risk of encountering false allegations of sexual abuse."  That is true.  But that does not preclude the validity of this indicator.  The fact that some people gravitate to such fields who are not pedophiles also does not preclude the value of this indicator, as Campbell would suggest.
  

18) Recent Rejection by a Female Peer or Dysfunctional Heterosexual Relationship

Campbell States:

If many males experience rejection from adult females and never sexually abuse children, how can this index accurately identify pedophiles?

Campbell's question in no way obviates the value of this indicator.  There are some individuals who resort to pedophilia after repeated rejections by adult heterosexual females and there are certainly some who do not resort to pedophilia after such rejection.  And this is true of just about every criterion.  There are some people who were sexually abused as children who do not become pedophiles.  There are some who abuse substances who do not become pedophiles.  Each of the criteria is satisfied by some pedophiles and there are still others who satisfy the criterion who are not pedophiles.  When one puts all of them together, we have a highly reliable set of indicators.
  

19) Unconvincing Denial

I agree that this criterion may be more subjective than others and psychopathic types can fool most people.  I describe here the sense of impotent rage that a falsely accused person has.  Campbell then states:

More alarmingly, evaluators who attempt to use this index are acting as if they possess the discriminative power of polygraphs.

I find it amusing (but not inconsistent with his worship of numbers) that Campbell would use the polygraph as the example of an instrument that is famous for its "discriminative power."  Psychopaths are well known for their ability to pass polygraph tests as are people under the influence of drugs.  Courts know this well and are generally dubious about the introduction of polygraph results in evidence.  His subsequent discussion of polygraphs just extends further an irrelevant argument.
  

20) Use of Rationalizations and Cognitive Distortions That Justify Pedophilia

Here Campbell quotes some of the rationalizations that pedophiles commonly use to justify their behavior.  He concludes:

Basically, then, this index merely identifies the cognitive strategies used by known pedophiles to rationalize and minimize the consequences of their abusive behavior.

At that point his discussion ends.  The indicator is trivialized with the word "merely" and then offhandedly rejected.  The facts are that in our society pedophiles do rationalize their behavior in order to justify what is considered a crime and assuage their guilt over what is considered by many to be a sin.  There may be difficulty using this criterion but I have no doubt that, in some cases, it is a valid one, my inability to measure it notwithstanding.
  

21) Resistance to Taking a Lie Detector Test

Campbell claims that this index is prejudicial against an accused party who refuses to take the test because such refusal is often justified considering the unreliability of the instrument.  Campbell definitely has a point here.  However, this does not totally preclude the value of this criterion because 1) there are pedophiles who refuse to take the test for the reason that they fear it will disclose their pedophilia and 2) there are falsely accused people who are eager to take the test even though they recognize its fallibility.  The existence of such people justifies the inclusion of this criterion.  Difficulties in using this criterion make it one of the weaker criteria but do not warrant its being excluded (which is basically what Campbell suggests).
  

22) Lack of Cooperation in the Evaluative Examination

Campbell discredits this criterion by quoting some incompetent and/or zealot who applied it in an absurd fashion.  Specifically, this evaluator concluded that the accused satisfied this criterion because of one missed appointment, even though the appointment was missed because of a misunderstanding of its purpose.  I cannot imagine myself dropping a criterion because some zealot will misinterpret it.  Campbell would have me do so.
  

23) Duplicity Unrelated to the Sex-Abuse Denial and Psychopathic Tendencies

Campbell States:

Gardner indicates that pedophiles generally exhibit a long-term history of deception that extends beyond their pedophilia.  Nevertheless, he does not specify what kinds of deceptions pedophiles supposedly demonstrate; and as a result, his assertion creates more questions than answers.

Campbell is correct that I do not specify the various kinds of deceptions pedophiles use, beyond the living lie designed to cover up their pedophilia.  However, on this basis, he discounts the value of the criterion.  What he ignores is that the criterion focuses on deceptions the evaluator observes in the course of the evaluation.  It does not concern itself with other kinds of deceptions.  Campbell goes on to make the amazing statement:

Gardner seems to suggest that the Psychopathic Deviate scale of the MMPI discriminates between pedophiles and non-pedophiles.

There is absolutely no statement of mine which could suggest even remotely that this is my opinion.  If that were the case, I would have used it as a criterion.  The scale does discriminate between psychopaths and non-psychopaths and that is all I am saying here.  This is an excellent example of Campbell's use of reductio ad absurdum reasoning to discredit my criteria.

Campbell then goes on to knock down this straw man (which he has set up in the first place) by quoting studies that indicate no psychological test or combination thereof can differentiate between sexual deviates and non-deviates.  I am in one hundred percent agreement with him on that point.  In fact, none of the 24 of my criteria for the accused, 30 for the alleged child victim, and 24 for the accuser (the last two of which Campbell makes absolutely no mention of in his paper) rely on any formal psychological test.  Campbell's subsequent discussion regarding identifying psychopathic behavior and devious behavior and the fact that different examiners would come to different conclusions indicates that he has totally missed the point of this criterion.  It is specifically focused on the evaluator's own observations of duplicity within the context of the evaluation.
  

24) Excessively Moralistic Attitudes

Campbell refers to this criteria as "another interesting theoretical speculation."  I suspect that when Campbell uses the word interesting he believes that there may be some validity in this criterion and that I may, at some deep down level, have a point.  However, he quickly raises his old argument of the difficulties in objectifying this criterion, the problems of inter-rater reliability and the dangers of one's own values interfering with assessing it.  He then switches to a diatribe against psychoanalysis.  Although I am in agreement with most of his criticisms here, I fail to see what all this has to do with my criteria.  It derives from my use of one psychoanalytic term, reaction formation, a mechanism that is generally recognized by people who have absolutely no commitment to psychoanalysis either as a theory or as a treatment.

In his discussion statement, Campbell states:

The incremental validity of any set of indicators requires that each indicator index stand independent of the other indices.  Unless the condition of index independence is met, satisfying one index can spuriously lead to satisfying other related indices (Wolfner, Faust, & Dawes, 1993).  As a result, simply summing all the indices satisfied for an indicator set can result in very misleading outcomes.

For example, consider the following ten indices from Gardner's "Indicators": family of origin pathology, intellectual impairment, strong sexual urges, impulsivity, coercive-dominating behavior, history of substance abuse, poor judgment, immaturity and/or regression, lack of cooperation, and psychopathic tendencies.

Campbell has selected the indicators that I myself consider to be among the weakest.  He would then lead the reader to believe that an individual who satisfies these ten criteria would be judged a pedophile by me.  At the outset, I make a clear statement about the evaluator considering not only the quantity of indicators satisfied but their quality.

I would suggest, in contrast, that one consider these eight indicators: 1) Childhood History of Sex Abuse, 2) Longstanding History of Strong Sexual Urges, 3) History of Substance Abuse, 4) Impaired Sexual Interest in Age-Appropriate Women, 5) Presence of Other Sexual Deviations, 6) Large Collection of Child Pornographic Materials, 7) Career Choice That Brings Him in Contact with Children, and 8) Use of Rationalizations and Cognitive Distortions That Justify Pedophilia.  If I were to see a person who satisfies these eight indicators and only these eight, I would come to the conclusion that there was a high likelihood that the individual has pedophilic tendencies.  However, even then, I would compare these findings with those from the evaluations of the accuser and the alleged child victim.  By ignoring my introductory statement about considering both the quantity and quality of the indicators, and leading the reader to believe that I consider them all equally valid, Campbell can come up with this absurd scenario of what a pedophile might look like.

And now to my most important criticism of Campbell's paper, namely, his failure to come up with a useful and/or meaningful alternative way of discriminating between those people who have sexually abused and those who have not. In Campbell's opinion, this is how it is to be done:

False allegations of sexual abuse can be considered unsubstantiated rumors which acquire an unwarranted status of facts via socially constructed realities (Campbell, 1992c).  Mental health professionals can assist courts in these cases by examining the history of the allegations, and assessing the extent to which they correspond to rumor formation and rumor dissemination (Campbell, 1992d).

I am in full agreement with Campbell that one of the things the evaluator must do is trace in detail the history of the allegation.  In many places in my book I mention this point and consider it as important as evaluating all three parties to the allegation — the accuser, the accused, and the alleged child victim.  In addition, Campbell suggests that we compare the extent to which the allegation corresponds to rumor formation and rumor dissemination.  This is an amazing statement for a person to make, a person who, up to this point, is so beholden to objectivity, statistical analysis, statistical validity, and inter-relater reliability.

Campbell goes on:

Instead of resorting to the speculation and conjecture that frequently characterize examinations preoccupies with what transpires within suspects, evaluating the interpersonal transactions surrounding allegations of sexual abuse addresses what transpires between people.

Campbell would have the reader believe that my total evaluation is confined to some kind of introspective evaluation of the pedophile.  He fails to inform the reader that I evaluate the other two parties, both individually and together in joint interview.  In fact, whenever possible, I make it a proviso of my evaluation that I see all persons in all possible combinations.

Campbell then follows with another surprising statement:

Because interpersonal events between people are more observable than what occurs within them, this latter endeavor enjoys greater objectivity.

Campbell has much more faith in the objectivity of third party observers than I.  Take the situation in which ten people are observers to an interpersonal event, let us say, an argument between a man and a woman.  The likelihood of there being significant agreement on what has transpired is not likely to be very great if the interchange is a heated one and if it engenders emotions in the observers.  And this often happens in cases in which one is evaluating for sex abuse.  Somehow he believes that these observations are more valid and reliable than individual observations.
  

Conclusions

There is much more I could say about Campbell's article.  When Hollida Wakefield initially sent me this article, I felt that it would be a total waste of my time to respond to it because, if completely successful, I would just be getting back to point zero after all my efforts.  At this point, however, my preparing this response has served a useful function, namely, it has provided even more confirmation for me that my criteria are useful ones, especially because Campbell was not able to provide a meaningful substitute.

My final question to the reader is this: If you had a party who was being accused of pedophilia and who might very well go to jail, would you refer the accused, the accuser, and the alleged victim to someone who would conduct the kind of evaluation I describe in my book (of which the list of pedophile indicators is only one segment) or refer them to someone who would use Campbell's criteria?

References

Abel, G. G., Becker, J. V., Cunningham-Rathner, J., Mittelman, M. S., & Rouleau, J. L. (1988). Multiple paraphilic diagnoses among offenders. Bulletin of the American Academy of Psychiatry and the Law, 16(2), 153-168.

Gardner, R. A. (1987). The Parental Alienation Syndrome and the Differentiation Between Fabricated and Genuine Child Sex Abuse (). Cresskill, NJ: Creative Therapeutics.

Gardner, R. A. (1991). Sex Abuse Hysteria: Salem Witch Trials Revisited (). Cresskill, NJ: Creative Therapeutics.

Gardner, R. A. (1992). True and False Accusations of Child Sex Abuse (). Cresskill, NJ: Creative Therapeutics.

Kinsey, A. C., Pomeroy, W. B., Martin, C. E., & Gebhard, P. (1948). Sexual Behavior in the Human Male (). Philadelphia: W.B. Saunders Co.