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Journal of Child Sexual Abuse
ISSN: 1053-8712 (Print) 1547-0679 (Online) Journal homepage: https://www.tandfonline.com/loi/wcsa20
Child Sexual Abuse and the Moralization of Purity
Mattan D. Arden & Sharon Rabinovitz
To cite this article: Mattan D. Arden & Sharon Rabinovitz (2019): Child Sexual Abuse and the
Moralization of Purity, Journal of Child Sexual Abuse, DOI: 10.1080/10538712.2019.1694118
To link to this article: https://doi.org/10.1080/10538712.2019.1694118
Published online: 21 Nov 2019.
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Child Sexual Abuse and the Moralization of Purity
Mattan D. Arden and Sharon Rabinovitz
School of Criminology, University of Haifa, Haifa, Israel
ABSTRACT
Recent studies were able to associate disgust with the moral
domain of purity, as well as a heightened sensitivity to disgust
with sexual victimization. However, no empirical evidence has
yet to document the exact relation between sexual victimiza-
tion and its impact on the moralization of purity. Therefore, the
present study aimed to examine the relationship between
child sexual abuse (CSA) and the moral domain of purity, by
means of judgments toward three different types of disgust:
pathogen, sexual and moral. To test this, The Three Domains of
Disgust Scale (TDDS) was given to both CSA participants (n =
29) and to a non-sexually abused population (N-SAP; n = 31). .
Results have shown a statistically significant difference
between the CSA and N-SAP groups on the combined depen-
dent variables (i.e., pathogen, sexual and moral disgust).
However, only the sexual disgust domain, out of the other
two domains has been found to hold significance.
Furthermore, consistent with previous empirical findings, simi-
lar gender patterns of moral judgments have been found
between the two groups (i.e., CSA and N-SAP), though with a
statistical significance only in the sexual domain. Implications
of these findings are discussed.
ARTICLE HISTORY
Received 18 February 2019
Revised 15 October 2019
Accepted 9 November 2019
KEYWORDS
Child sexual abuse; purity;
moralization; disgust
In recent decades, the subject of childhood sexual victimization (CSV) or
child sexual abuse (CSA) has received widespread empirical research. The
academic literature covers a vast range of social, psychological and behavioral
domains and discusses a variety of the negative sequelae with regard to this
important topic. However, few empirical studies have explored the relation-
ship between CSA and the domains of morality or the domain of purity in
particular. The following study will attempt to address this gap in the current
literature and provide an initial integration between the two distinct fields of
study –Sexual victimization and moral psychology, specifically, the relation
between CSA and the moral domain of purity.
The aim of the current study is to propose a new perspective when dealing
with sexual victimization and its implications. Discerning that sexually
abused victims are more sensitive to the moral domain of purity could be
of theoretical and practical importance to the study of sexual victimization
CONTACT Mattan D. Arden mattanarden@gmail.com School of Criminology, University of Haifa, Mount
Carmel, Haifa 31905, Israel
JOURNAL OF CHILD SEXUAL ABUSE
https://doi.org/10.1080/10538712.2019.1694118
© 2019 Taylor & Francis
(SV). As a theoretical value, distinct sensitivity to purity could serve as a path
to explore different phenomena, such as differential gender exposure to
sexual abuse, differential exposure to re-victimization, and perhaps even
decision making of victims with risky sexual behaviors. As a practical
value, different moralization processes in the purity domain could serve as
a diagnostic tool for examining victims of sexual abuse for assistance and
treatment purposes, as well as a therapeutic tool for acknowledging the state
of awareness with regard to the importance of keeping the body and soul
from potential harm.
This manuscript will offer exposition of the current literature about moral
psychology and briefly expound the theory of moral foundations (Graham
et al., 2013), with specific emphasis on the domain of Purity. It will offer
a review of existing literature about the relation between SV and disgust, as
well as the relation between disgust and the moral domain of purity, as
a ground to recognize the correlation between SV and the purity domain.
Three Domains of Disgust (Tybur, Lieberman, & Griskevicius, 2009) will be
outlined to enable a rigorous examination of the appraisals of disgust, which
in turn, will allow a deeper understanding of the variance in the moralization
of purity. Lastly, the manuscript will attempt to cover two main variables that
may potentially influence the levels of disgust (i.e., gender and religious
affiliation) both in between-group and within-group and, thus, enabling
a more comprehensive outlook on the moralization processes.
Moral psychology and the domains of morality
For many decades, morality scholars were narrowly preoccupied with the
notion that moral judgments are primarily made through rational-cognitive
processes that constrained only to the issues of care (people are vulnerable
and often need protection) or justice (people have rights to certain resources
or kinds of treatment) (e.g., Kohlberg, 1969; Turiel, 1983). Hence, the pre-
vailing supposition was that an individual, in making a moral judgment, is
consciously applying priori principles, such as beliefs about equality or rights.
A relatively recent view of moral judgment, however, enabled a much
broader perspective to morality by highlighting how moral reasoning is
typically a post hoc rationalization for decisions that are made unconsciously
through rapid, emotion-driven and intuitive processes (Damasio, 1994;
Greene & Haidt, 2002; Haidt & Joseph, 2004). Expanding upon this finding
and taking a more evolutionary-anthropological approach to morality, the
inception of Moral Foundations Theory came to be (MFT; Haidt & Joseph,
2007). Through MFT, five core moral-related foundations have been able to
be identified, presumably presenting themselves in virtually all cultures of
society to varying degrees (Graham et al., 2013). The identified moral
domains that were proposed (in addition to the domains of Care/harm and
2M. D. ARDEN AND S. RABINOVITZ
Fairness/cheating) are Loyalty/betrayal, Authority/subversion and Purity/
degradation, all of which are apparently being emphasized or downplayed
as a product of cultural socialization, individual experience and differences in
biology (Haidt, 2012).
For the purposes of the current study, this paper will focus only on one out of
the five moral domains that were proposed in the literature –the domain of
Purity/degradation, which will be elucidated in accordance with the MFT.
According to the theory, the purity domain is rather unique, as it is the only
moral domain for which its evolutionary origin is not social related, but rather
individualistic and nutritive-related (Graham et al., 2013). According to
a thorough examination, what began as concerns over purity and contamination
of the physical form, subsequently extended to include concerns over the purity
of the individual’s character and social conduct, which in turn promoted beliefs
about the moral value of the purity of the mind and soul (Haidt & Joseph, 2004;
Rozin & Fallon, 1987). Therefore, this distinctive domain encompasses the view
that people ought to be, in their bodies and minds, clean, chaste, self- restrained
and spiritually pure and therefore should strive to live in a sacred, divine way.
Conversely, it is considered immoral to behave in a way that is self-polluting,
filthy, profane, carnal, hedonistic, unnatural, animal-like or ungodly (Horberg,
Oveis, Keltner, & Cohen, 2009).
Disgust, purity and their relation to sexual victimization
In the field of moral emotions, recent empirical studies have associated
disgust with the moralization of purity by conceptualizing disgust as
a moral emotion defined by appraisals of purity and contamination (Haidt,
2003; Rozin & Fallon, 1987). Lerner and Keltner (2000,2001) proposed
a model, The Appraisal-Tendency Framework, which presupposes that each
emotion is defined by a core appraisal and that emotion influences judg-
ments in domains that are thematically related to the eliciting appraisal. Fear,
for example, is an emotion that amplifies judgments with some degree of
uncertainty and uncontrollability, whereas disgust is an emotion that con-
tributes to moralization of purity violations and virtues. Given that thesis, by
using three studies with different methodologies, Horberg et al. (2009) have
found that an experience of disgust is associated with higher moral evalua-
tions of purity behaviors and that disgust is associated with judgments of
pure and impure behaviors but not with judgments of just or unjust, or
harmful or caregiving behaviors. They concluded that disgust seems to be
uniquely associated with purity concerns and not with concerns in the realms
of justice or harm/care.
In the study of victimology, disgust and mental contamination (or feelings of
dirtiness and the urge to wash in the absence of a physical contaminant) are
increasingly being associated with traumatic event exposure and posttraumatic
JOURNAL OF CHILD SEXUAL ABUSE 3
stress symptomatology (Badour, Feldner, Babson, Blumenthal, & Dutton, 2013).
Recent data suggests that a sense of disgust and mental contamination are
particularly relevant to sexual abuse experiences (Feldner, Frala, Badour, Leen-
Feldner, & Olatunji, 2010). Rachman (2004,2006)proposesthatsexualassault
may be particularly likely to lead to the belief that one has been contaminated by
the experience; feelings of disgust, contact with bodily products (e.g., saliva,
semen and blood) and perceptions of violation, degradation, immorality or
impurity during a sexual assault may all result in a perceived contamination.
To illustrate the sense of mental contamination, a certain study has demon-
strated that 70% of women reported having an urge to wash following a sexual
assault with more than one-quarter of these women continue to experience such
urges for up to a year post-assault (Fairbrother & Rachman, 2004). A relatively
recent study, which compared victims of sexual assault and physical assault, not
only reported that the intensity of disgust was rated higher by sexual assault
victims, but also that adolescents who reported exposure to both types of
assaults, rated the sexual assault as more disgusting than the physical one
(Badour et al., 2013).
Further indications for the association between purity/impurity and sexual
victimization can be seen in the recent study of Gray and Keeney (2015), who
found that participants overwhelmingly provided sexual examples when asked
to describe scenarios that depict impurity. Interestingly enough, the most
commonly provided scenarios included child molestation and rape. Similarly,
several studies have found that fictitious cases of consensual incest evoke strong
disgust reactions, even when participants are given supplementary information
suggesting that there was no chance of conception and that no emotional harm
would come from the incestuous encounter (Giner-Sorolla & Russell, 2009;
Haidt, Koller, & Dias, 1993; Paxton, Ungar, & Greene, 2011).
To explain this phenomenon of elevated disgust among victims of
a traumatic event (including sexual victimization), few studies have offered
a behavioral framework, specifically a conditioning model of disgust. Recent
studies (Badour & Feldner, 2016; Badour et al., 2013) support the idea that
while classical conditioning during a trauma is likely to lead to an increased
frequency and/or intensity of experienced disgust in response to trauma cues
in the environment (i.e., disgust-relevant reexperiencing), operant condition-
ing processes are likely to reinforce escape from and avoidance of, stimuli
capable of evoking a disgust response. These results remain validated even
after accounting for peritraumatic fear and posttraumatic anxiety experi-
enced in response to traumatic event cues (Badour et al., 2013).
The three domains of disgust
Since the present study examines the moralization of purity via appraisals of
disgust, it is important to mention that the empirical literature has actually
4M. D. ARDEN AND S. RABINOVITZ
proposed that several categories of elicitors arouse different kinds of disgust (e.g.,
Marzillier & Davey, 2004; Rozin, Haidt, & McCauley, 1999), albeit, some were
proven to be less valid than others. A relatively recent measure of disgust has
shown quite decent results in terms of reliability and validity, that is The Three
Domains of Disgust (TDDS; Tybur et al., 2009). Tybur et al. (2009), who were
influenced by previous work (e.g., Haidt, McCauley, & Rozin, 1994;Rozin&
Fallon, 1987;Rozinetal.,1999), introduced a new measure of disgust sensitivity,
which offers three distinct types of disgust –pathogen, sexual and moral disgust.
The researchers claimed that the heterogeneity of disgust has important impli-
cations for research on an individual and emotional level, as well as for other
psychological indications, such as decision making and attitude formation in the
realms of sexuality and morality (Olatunji et al., 2012;Tyburetal.,2009). The
following parts will, thus, shortly elucidate the three distinct types of disgust.
According to the TDDS, pathogen disgust (also known as core disgust in
previous research) is mainly elicited by objects that are likely to contain
infectious agents, such as rotting foods and bodily fluids. The purpose of this
particular disgust reaction is, thus, to motivate an avoidance of such infec-
tious organisms. A recent study, however, argues that aside from infectious
agents, pathogen disgust could also be elicited by certain interpersonal
encounters, such as strange, immoral or unhealthy individuals, which may
lead to a perceived sense of desecration (Eickmeier, Hoffmann, & Banse,
2017). Therefore, although it has been found that pathogen disgust elicitors
may bear a minimal explicit association with conceptions of morality
(Horberg et al., 2009), this type of disgust may hold some relevance to the
current study.
Another type of disgust with a special relevance to the current study is
sexual disgust. Evidence for this type of disgust can be seen in the intrinsic
disgust reaction most people express when exposed to or hear about sexual
relationships that involve inbreeding or other incestuous relations with close
kin (Giner-Sorolla & Russell, 2009; Haidt, 2001). It has been proposed that
sexual disgust is an evolved solution to the adaptive problem of avoiding
biologically costly mates and risky sexual behaviors (Tybur et al., 2009). In
other words, sexual disgust is an evolutionary function to reduce suboptimal
mating behavior (Tybur, Lieberman, Kurzban, & DeScioli, 2013). Thus, the
TDDS is mainly examining sexual disgust by presenting sexual-related beha-
viors and situations that are not the most conventional, potentially risky
even. In that regard, this measure is certainly different from previous disgust
measures utilized in the victimization field, most often examining self-
disgust, body-disgust or peritraumatic disgust toward the perpetrator and
the experience itself.
Lastly, moral disgust (also known as socio-moral disgust) pertains to social
transgressions, primarily to non-normative or anti-social behaviors, such as
lying, cheating, stealing, harming others directly and/or impose diffuse costs
JOURNAL OF CHILD SEXUAL ABUSE 5
on one’s social group. It is important to mention, however, that moral disgust
and “moral injury”, which are often being associated with combat veterans who
suffer from post-traumatic stress disorder (PTSD), may seem to share
a conceptual commonality, though they are intrinsically different. While the
former pertains to a sense of disgust toward a variety of moral transgressions,
usually not as pernicious in their nature, the latter is most often associated with
very particular types of transgressions, which usually carry “adeepsenseof
transgression, including feelings of shame, grief, meaninglessness and remorse
from having violated core moral beliefs (Koenig, Youssef, & Pearce, 2019,p.2)”.
Core violations associated with moral injury usually include killing other people,
dismembering bodies, maltreating others, deserting comrades during battle or
failing to prevent the death of fellow soldiers (Koenig et al., 2019). Conversely,
moral disgust is more closely related to non-normative, though common-like
social-related violations. Moreover, perhaps an even more fundamental distinc-
tion between the two terms is the subject to which the disgust is directed to.
While moral disgust pertains to a sense of revulsion toward the transgressions of
others, moral injury pertains to a sense of revulsion toward oneself (self-loathing
if you will).
Potential variables that may influence disgust appraisals
Gender
When examining gender differences in terms of disgust reactions, prior
research has shown that females report higher levels of disgust in general
than males (Olatunji, Sawchuk, Arrindell, & Lohr, 2005), although consistent
evidence has found that the magnitude of the gender differences significantly
varied across the three domains of disgust. Specifically, the gender difference
was larger for sexual disgust, as compared with the pathogen and moral
disgust (Tybur et al., 2009). This finding is consistent with those of Olatunji
et al. (2012), who found that women’s greater disgust was more pronounced
in the sexual domain than in the pathogen and moral domains. According to
Olatunji et al. (2012), the enhanced gender differences in sexual disgust may
be accounted for by social learning factors, like being reinforced for sex-
appropriate behaviors.
Other explanations for the differential reactions within gender can be
found in the review work of Al-Shawaf, Lewis, and Buss (2017), delineating
various explanations via evolutionary-based theories. Generally, the authors
mention that there are at least four theoretically plausible, non-mutually-
exclusive factors driving the evolution of women’s heightened sexual disgust
relative to men: (a) greater minimum obligatory parental investment (the
parental investment hypothesis), (b) higher likelihood and greater costs of
contracting STIs (the sexually transmitted infections hypothesis), (c) defense
against rape and sexual coercion (the rape avoidance hypothesis) and (d) sex
6M. D. ARDEN AND S. RABINOVITZ
differences in reputational damage as a consequence of promiscuous or
deviant sexual behavior (the reputational damage hypothesis).
Religious affiliation
The concept of purity and conversely degradation, are certainly known to be
affected by religion or religious beliefs and, thus, their relation holds high
relevance to the current study. Interestingly enough, most religions have seen
a need to address the question of a “proper”way to live (a sacred way), or
a way with which one should ovoid lustful and carnal behaviors, most often,
through the manifestation of “improper”sexual demeanor. However, reli-
gions have differing codes of sexual morality, which regulate sexual activity
or assign normative values to certain sexually charged actions or ideas
(Cleveland, Craven, & Danfelser, 1979). Accordingly, each major religion
has developed a moral code covering issues of sexuality, morality, ethics etc.
These moral codes seek to regulate the situations that can give rise to
improper interests and to influence people’s impure activities and practices,
mainly sexual in nature (Cleveland et al., 1979). Citations with regard to the
varying conceptualizations of purity can be seen within many of the religious
texts, conveniently reviewed by the work of Graham and Haidt (2010) on the
relationship between religion and morality:
The Qur’an is replete with ordinances on how to purify oneself before
worship, forbidding prayer when intoxicated or unclean (4:43, 24:30); it also
forbids contact with menstruating women who have not been cleansed
(2:222) and restricts displays of female sexuality (24:31). The Hebrew Bible
describes God rewarding David “according to the cleanness of [his] hands”(2
Samuel 22:21), and the New Testament pays particularly close attention to
the purifications of Jesus and his followers (John 3:25, 11:55; Acts 15:9, 20:26,
21:26, 24:18). Hinduism describes the attainment of Brahman as becoming
free of impurities (Katha II 5.11, Upanishads; Müller, 1962) and posits
a division in the mind between “pure or impure; impure from the contact
with lust, pure when free from lust”(Maitriyana-Brahmana VI 34.6,
Upanishads; see also Bhagavad-Gita 5:11)”(Graham & Haidt, 2010, p. 144).
Therefore, it is quite clear that every religion affects its followers differ-
ently, with the potential to either augment or diminish one’s own perceptions
of pure and impure or moral and immoral behaviors. Unfortunately, it is
quite problematic to compare between the various religions with regard the
level of importance each gives to the conceptualization of purity, for each
religion adapted its own distinctive ideas and beliefs about what is right or
wrong; thus, making it virtually impossible to apply scientific or reasoned
arguments in the matter. At any case, when examining purity appraisals or
moralization processes, it is clear that keeping in mind religious affiliation is
of importance.
JOURNAL OF CHILD SEXUAL ABUSE 7
With this empirical background in mind, the present study aims to fill out
the blanks in the current literature and interconnect two intriguing fields of
study, which presumably up until now, have yet to be linked before –moral
psychology and sexual victimization. Specifically, as mentioned above, the
previous empirical literature indeed explored the relation between sexual
victimization and disgust, as well as the relation between disgust and the
moral domain of purity, albeit it has not made a sufficient use in the existing
empirical knowledge to directly examine the relationship between sexual
victimization and its impact on the moral domain of purity. Therefore, the
current study will attempt to address this gap in the literature by examining
the moralization processes of victims of CSA in the domain of purity.
To allow as many participants as possible to take place in the study, the
definition of Olafson (2011), which describe CSA as the use of a child
(18 years and under) for the purposes of sexual pleasure with or without
physical contact from another individual, whether known, unknown, older or
the same age, will be made in use in the present study. The research was
carried out by utilizing The Three Domains of Disgust Scale (Tybur et al.,
2009), which offers a wide range of statements that were designed to elicit
disgust in the three aforementioned domains (i.e., pathogen, sexual and
moral). This comprehensive scale enables a deeper examination of the
appraisals of disgust, which in turn, allows a better comprehension of the
variance in the moralization processes of purity.
Based on the empirical literature as discussed above, the hypothesis is that
victims of CSA will express higher concerns toward the moral domain of
purity, by expressing an overall higher sensitivity to disgust and to sexual
disgust, in particular, as compared with the non-sexually abused population
(N-SAP). Consistently, the expectation is to find that the N-SAP would
express lower concerns toward the domain of purity, by expressing an overall
lower sensitivity to disgust and to sexual disgust, in particular, as compared
with the CSA population (H1). Furthermore, in accordance with previous
research work (e.g., Olatunji et al., 2012; Tybur, Bryan, Magnan, & Hooper,
2011; Tybur et al., 2009), the expectation is to find similar gender patterns of
disgust both in the CSA group and in the N-SAP group, that is to say, the
gender difference would be the largest for sexual disgust (i.e., stronger
concerns among women), as compared with the pathogen and moral disgust
(i.e., no difference in concerns between genders) (H2).
Method
Participants
The sample consisted of 60 adults in total, including 29 with a positive history of
child sexual abuse (CSA) (i.e., as defined by Olafson, 2011) and 31 controls with
8M. D. ARDEN AND S. RABINOVITZ
no self-reported history of CSA orany experience of sexual victimization for that
matter (i.e., N-SAP). The participants in the CSA group were predominantly
females (82.8%) with a minority of males (17.2%), mostly comprised of Judeo-
Christian religion [Jewish (44.8%), Christian (34.5%)] and a minority of unspe-
cified religion (20.7%).The age range of the CSA group was 18–55 (median = -
25–35), with the vast majority being from the Middle-Class, on a political
spectrum of the Left (55.2%), Center (37.9%) and Right (6.9%) wing. The
participant’s relationship to the perpetrator included relative (58.6%), friends
(20.7%), acquaintances (10.3%) and strangers (10.3%). The control group (i.e.,
N-SAP) predominantly consisted of females (83.9%), with a minority of males
(16.1%), of Jewish (54.8%), Christian (25.8%) and Muslim (19.4%) religion. The
age range of this group was 18–55 (median = 18–25), with the vast majority
being from the Middle-Class, on a political spectrum of the Left (45.2%), Center
(38.7%) and Right (16.1%) wing.
In this study, three variables known to pertain to disgust or moral judg-
ments were controlled: SES, political orientation and gender (Haidt & Hersh,
2001; Haidt et al., 1993,1994). This allowed to ascertain whether disgust
relates to the moralization of the purity domain independently of these
identity-related sources of moral judgment. Furthermore, since the current
study examining victims of CSA, religion was also controlled. The partici-
pants in the CSA group were recruited from two large communities of sexual
abuse, the Israeli community, “The Association of Rape Crisis Centers in
Israel”(ARCCI) and the American domestic abuse community “Pandora’s
Project.”The participants of the control group were randomly collected from
a northern University in Israel. Both groups participated voluntarily.
Measures
The Three Domains of Disgust Scale (TDDS) is a well-established question-
naire by Tybur et al. (2009) and it consists of a 21-item self-report measure of
disgust responding in three domains: pathogen disgust (e.g., stepping on dog
poop), moral disgust (e.g., deceiving a friend) and sexual disgust (e.g.,
hearing two strangers having sex). Items are scored on a 7-point Likert-
type scale ranging from not at all disgusting (0) to extremely disgusting (6).
Existing investigations have supported the validity of the TDDS as a three-
factor measure; scores on the TDDS pathogen, sexual and moral factors found to
be sufficiently reliable (all Cronbach’s alphas above .80; Tybur et al., 2009).
Confirmatory factor analysis suggests that a three-factor structure fits the 21-
item measure well. Item composites possess good internal consistency and the
factors are weakly to moderately correlated (Tybur et al., 2009). Furthermore,
following studies utilizing the TDDS have shown that different domains of
disgust sensitivity have specific relationships with different outcomes, including
mate preferences, social values and political attitudes (e.g., DeBruine, Jones,
JOURNAL OF CHILD SEXUAL ABUSE 9
Tybur, Lieberman, & Griskevicius, 2010; Kurzban, Dukes, & Weeden, 2010;
Tybur et al., 2009). A concurrent validity study has shown that the TDDS is
similarly valid for both sexes, thus, suggesting that potential differences in the
meaning of TDDS constructs do not threaten the validity of inferences based on
the measure; all three factors demonstrated good internal consistency across
both sexes (α= .81, .86, and .87 for men; α= .81, .80, and .86 for women, for
pathogen, sexual, and moral disgust, respectively; Tybur et al., 2011).
Procedure
Inacourseoftwoandahalfmonths’, during a university-wide summer
vacation, contacts with communities of sexual victimization were made along
with a request to apply the TDDS questionnaire. After much discussion with
each community manager (i.e., site manager), an authorization was given to pass
an ad of the present study. The research ad mentioned that the study is
examiningthemoraldomainofpuritybycomparingvictimsofCSAto
a N-SAP. The idea was to leave the research description relatively plain, thinking
that a more detailed description could lead to some resistance or insincerity in
the giving answers. The participants of the CSA group were asked to enter a link
where the questionnaire could be answered online via “Google Forms.”For all
participants, the statements of the questionnaire appeared in an identical order
(the only difference being the language –English and Hebrew). The aim was to
gather an amount of CSA participants as close as possible to the estimated
gender ratio in the general population, which is considered to be 1:5 or 1 in 4
girls and 1 in 20 boys, who are exposed to a sexual abuse over the course of their
childhood (Finkelhor, Shattuck, Turner, & Hamby, 2014).
After receiving a rather proportionate number of CSA participants (i.e., 24
females and 5 males) via the aforementioned online communities (i.e.,
ARCCI and “Pandora’s Project)”, random students from a northern
University in Israel asked if they would be willing to take part in the present
study and answer the printed version of the TDDS questionnaire. Much like
with the CSA participants, minimal (verbal) description of the study was
given, to avoid superfluous preconceptions that may affect the results. Most
of the questionnaires from the control group were collected individually
(“one by one approach”), inside the University library. Without any parti-
cular difficulty, a rather proportionate number of controls (i.e., 31; 26 females
and 5) to fill the TDDS questionnaire (printed version) was gathered.
Results
The main hypothesis was that participants of the CSA group would make
stronger judgments toward the moral domain of purity in terms of an overall
higher sensitivity to disgust elicitors as compared with the N-SAP participants,
10 M. D. ARDEN AND S. RABINOVITZ
particularly in the sexual domain. Multivariate Analysis Regression (i.e., one-
way MANCOVA) was used to test this hypothesis. A statistically significant
difference was found between the CSA and the N-SAP groups on the combined
dependent variables (i.e., pathogen, sexual and moral disgust), after controlling
for gender, SES, political orientation and religion, F(3,52) = 10.959, p<.001,
Wilks’Λ=.613,partialη2 = .387. However, unlike the prediction that the CSA
group would express an overall higher sensitivity to disgust as compared with
the N-SAP, only the domain of sexual disgust has been found to hold signifi-
cance [F(1,54) = 35.826, p< .001], as opposed to the pathogen disgust [F
(1,54) = 2.256, p= .139] and the moral disgust [F(1,54) = 2.006, p= .162].
Thus, it can be inferred that CSA participants hold significantly stronger moral
judgments toward the sexual domain (M = 4.02, SD = 1.15) as compared with
N-SAP (M = 2.63, SD = 0.74), but not toward the pathogen and moral domains.
To test the second hypothesis, that is, whether both CSA and N-SAP groups
wouldexpresssimilargenderpatternsofdisgust,aMultivariateAnalysis
Regression (i.e., two-way ANOVA) was conducted. As assumed, there were
similar gender patterns of moral judgments between the two groups (i.e., CSA
and N-SAP), with a statistically significant result only in the sexual domain [F
(1,56) = 28.565, p< .001]. For the other two domains (i.e., pathogen and moral),
there were no statistically significant results –pathogen [F(1,56) = 1.937, p= .170]
and moral [F(1,56) = 1.213, p=.275].Theseresultsaredemonstratingthatfemales
in general, are significantly more sensitive (or make stronger moral judgments)
toward the sexual domain (M = 3.55, SD = 1.06) as compared with males
(M = 2.09, SD = 1.05), but do not differ in their moral judgments in the pathogen
and moral domains.
Discussion
Previous empirical examinations were able to document a significant relation
between sexual victimization and disgust (e.g., Badour et al., 2013; Fairbrother &
Rachman, 2004), as well as a relation between disgust and the moral domain of
purity (viz., Horberg et al., 2009). The current study made use of these important
findings to examine the direct relationship between sexual victimization, speci-
fically, child sexual abuse and its correlational impact on the moralization of
purity. In fact, by utilizing the previous and well-established theoretical and
empirical correlations achieved so far and by applying methodological schema
that have yet to be of use on victims of sexual abuse (i.e., TDDS), a certain
novelty could be derived from the present study.
From the findings of the current study, it can be inferred that victims of
child sexual abuse hold stronger moral judgments (or express higher sensi-
tivity) toward the sexual domain of disgust as compared with a non-sexually
abused population, but do not differ in their moralization processes in the
pathogen and moral domains. This finding suggests that people who have
JOURNAL OF CHILD SEXUAL ABUSE 11
suffered from a sexual trauma in their youth are significantly more sensitive
to sex-related matters and, thus, perceive sexual purity as more important as
opposed to people who did not suffer from such trauma. This finding can
initially come across as an obvious one, given the nature of the trauma;
however, prior studies present a more confusing picture. For instance, it has
been found that victims of sexual abuse report a younger age of first inter-
course and that severe child sexual abuse is associated with greater number of
sexual partners among women (Luster & Small, 1997; Randolph & Mosack,
2006). Moreover, the relation between risky sexual behaviors and even
prostitution to a history of child sexual abuse is also known in the empirical
literature (e.g., Campbell, Ahrens, Sefl, & Clark, 2003; Homma, Wang,
Saewyc, & Kishor, 2012). Therefore, it is only natural to contemplate how
a person who holds a high sensitivity toward sexual-related aspects can, at the
same time, manifest certain licentiousness or promiscuity.
One plausible explanation to this baffling phenomenon could be offered
via prior empirical findings. Several studies, exploring the relationship
between body image and its implications, have shown that people who
have a history of CSA will express a large percentage of abnormalities in
their sexual function, along with distorted perceptions in their own body
image during their adult life (Littleton, Radecki Breitkopf, & Berenson, 2005;
Pulverman, Kilimnik, & Meston, 2018; Wekerle, Waechter, & Chung, 2011).
In fact, few studies examining the relationship between body image and risky
sexual behaviors among women, have shown that a poor body image is
a predictor of high-risk sexual behavior (e.g., Littleton et al., 2005; Miller,
Kelly, & Stephen, 2019). These findings, however, still do not account for the
inconsistent finding in the current study (i.e., relative increased concerns
toward the sexual domain of disgust, alongside expressions of risky sexual
behaviors as found in the empirical literature).
Solving this supposed paradox may be a challenge, for this “two-faced”
behavior may be a result of several (perhaps contradicting) psychological
aspects. However, a certain study (Cash, 2004) exploring body image among
young women (without a history of SA/CSA) has shown, much like the afore-
mentioned studies, that women who have a high body dissatisfaction, are indeed
expressing a tendency to have profound issues with sexual function, as well as
a tendency for an avoidant behavior when it comes to sexual intercourse. The
study also suggests that due to the women’s low self-esteem, they cannot avoid
this sexual (and perhaps exploitive) relationships. Indeed, as can be seen, beyond
the fact that this study did not examine victims of SA or CSA, this particular
study addresses to body image as a key variable and not to the moral domain of
purity or sexual disgust (as the present study examined) and, as mentioned, the
study most probably only gives one possible explanation to an extremely
intricate and multi-faceted phenomenon. To better understand this complex
behavior, future research, examining the relationship between sex-related
12 M. D. ARDEN AND S. RABINOVITZ
appraisals and risky sexual behaviors, in general, as well as the relationship
between sexual victimization and sexual purity, in particular, can further illu-
minate this supposed paradox.
As for the perplexing finding with regard to the moralization toward the
moral disgust (i.e., no significant difference between CSA and N-SAP), a few
plausible explanations can be noted. Firstly, although it is true that victims of
sexual abuse are victims of a serious, immensely personal and deeply-
offensive crime, which usually involves complex and adverse health and
mental-related implications (Hall, 2010), research exploring sexual victimiza-
tion implications can provide some new insight into the apparent conun-
drum. For instance, several studies (e.g., Hall, 2010; McCauley & Casler,
2015) have shown that victims of sexual abuse, in general, and victims of
CSA, in particular, tend to take personal responsibility for the abuse. In fact,
when the sexual abuse is performed by an esteemed and trusted adult, it may
be hard or even impossible for the affected victims to view the perpetrator in
a negative light, thus, leaving them incapable of seeing what happened as not
their fault. Secondly, as noted, several studies (e.g., Berman, Assaf, Tarrasch,
& Joel, 2018; Ullman, Peter-Hagene, & Relyea, 2014), have consistently
shown that sexually abused victims are often characterized by self-blame
(i.e., it was my fault) and, thus, it is quite common for them to internalize
negative messages about themselves.
In fact, discussing self-blame within the framework of the attribution
theory might be more fruitful. According to the attribution theory (Janoff-
Bulman & Frieze, 1983) in the context of sexual victimization, the long-term
deleterious outcomes of CSA are thought to vary depending on whether
victims attribute the experience of the abuse to internal or external factors,
specifically, self-blame or perpetrator-blame, respectively (Okur, Pereda, Van
Der Knaap, & Bogaerts, 2018). Moreover, as compared with victims of other
traumatic experiences, such as combat stress and car accident, in victims of
sexual assault and in victims of CSA, in particular, trauma-related self-blame
is the highest, and its association with PTSD is the strongest (Berman et al.,
2018; Moor & Farchi, 2011).
These findings may provide a certain explanation for the undifferentiated
results between the two groups within the moral domain. In fact, it is
certainly plausible that victims of sexual assault and victims of CSA, in
particular, are inherently different from victims of other types of crimes
(e.g., victims of non-sexual violent crimes) in terms of typical responses to
transgressions and immoral behaviors. Unfortunately, there is not much
empirical data with regard to differential responses to different types of
victimization to make an adequate comparison, most probably because
individual’s domestic circumstances, personality and other individual differ-
ences clearly affect the severity of reaction toward victimization and, thus,
making it extremely difficult to predict which individual victim will suffer
JOURNAL OF CHILD SEXUAL ABUSE 13
which effects and to what extent (Gale & Coupe, 2005). Future studies,
comparing various types of victims, as well as examining their differential
responses and appraisals toward transgressions and immoral behaviors will
certainly help to shed some light on this puzzling finding. Given that self-
blame may certainly affect the results when examining victims of SA and
CSA (most likely within the moral domain), it is essential to account for this
important variable.
Another counter-intuitive finding derived from the current study is the
lack of differentiation between the two groups (CSA and N-SAP) within the
pathogen domain. As mentioned, during a traumatic event, sexual trauma, in
particular, individuals may be exposed to a wide array of disgust elicitors,
including tangible contaminants such as bodily fluids (e.g., blood, semen and
vomit; De Jong et al., 2010) and situations involving diseases (Haidt et al.,
1997; Rachman, 2004; Simpson et al., 2006), causing them to develop an
increased sensitization toward elements of disgust or contamination. The
finding of the present study, however, did not documented any significant
difference in the responses of the sexually abused victims as previously
suggested (e.g., Rachman, 2004,2006).
This finding is perhaps the result of the current measure (TDDS), specifically
targeting (in several of the questions) pathogen-related disgust, an appraisal that
wasnotefficientlyoraccuratelyexaminedbeforeonthesexuallyabusedcommu-
nity. In fact, studies exploring the relationship between sexual victimization and
pathogen disgust have mainly focused on the mental contamination of the self
(e.g., Badour & Feldner, 2013) or concentrated on the peritraumatic disgust-related
appraisals toward the assailant (Feldner et al., 2010) and less so on the relative,
post-traumatic, pathogenic aspects perceived in others. In other words, previous
research tended to focus more on clinical, individual-oriented aspects and less so
on social-related aspects with regard to disgust,ingeneral,andpathogendisgust,in
particular. Therefore, future studies, examining sexual victimization, may consider
to incorporate social-related aspects of disgust (preferably, various types of disgust
as suggested; sexual, pathogen and moral disgust) and assess the potential implica-
tionsoftheseaspectsonthevictimswithin their social and interactional systems.
As for the more well-known, previously investigated finding, it can be seen
that gender patterns of moral judgments in both groups (i.e., CSA and
N-SAP) were rather similar. The only significant difference, however, was
in the sexual domain, while in the other two domains (i.e., pathogen and
moral) there was no significant difference between genders. This finding
suggests that women in general hold higher sensitivity to sexuality and,
thus, perceive sexual purity as more important than men, while moralizing
in the pathogen and moral domains do not differ between genders. This
finding is consistent with those of Olatunji et al. (2012), who found that
women’s greater disgust was more pronounced in the sexual domain than in
the pathogen and moral domains. It appears that when it comes to judgments
14 M. D. ARDEN AND S. RABINOVITZ
toward the moral and pathogen-related issues, men and women have similar
concerns, regardless of sexual trauma. However, when it comes to issues of
sexuality and purity-related virtues, women possess significantly more con-
cern or sensitivity than men. This finding is also supporting the more
evolutional-related explanations, suggested in the work of Al-Shawaf et al.
(2017), delineating several factors that driving the evolution of women’s
toward heightened sexual disgust compared to men (e.g., defense against
rape and sexual coercion, or sex differences in reputational damage).
Limitations
There are several limitations within the current study. Firstly, with regard to the
factors or variables potentially affecting the results, the current study, as men-
tioned, did not address to body-image as a potential factor affecting moraliza-
tion processes, a factor with special importance when examining victims of SA
or CSA. As discussed, body image can potentially affect the results within the
moral domain, due to the tendency of people with low body-image to perceive
self-responsibility instead of perceiving perpetrator-responsibility. Although the
current study did account for various types of sexual victimization (i.e., the
sexual crime performed by relatives, friends, acquaintances or strangers), it did
not account for the relative severity of the sexual abuse or the specific char-
acteristics of the experience (i.e., with/without contact, with/without ejaculation,
theamountoftimetheexperienceoftheabusetookplaceetc.).Accountingfor
these variables may be of particular relevance within the pathogen domain, for it
is certainly possible that there is a subgroup of CSA that was relatively more
sensitive to pathogenic disgust, given the nature of the abusive experience.
With regard to the sampling, although the current study did account for
religion in the analysis, religiosity (i.e., the relative level of a religious belief) and
ethnicity were not accounted for. In fact, the samples (especially the CSA
group) were mostly comprised of participants from a Judeo-Christian religion,
thus, limiting the religious representation. Future studies should certainly
attempt to account for these variables, for each of them may potentially affect
the results. Another important limitation worth mentioning is the possibility
that some of the participants from the N-SAP group were, in fact, belonging to
the CSA group, but were afraid to disclose this information. Although, self-
disclosure or social desirability bias is an inevitable issue when examining
participants via self-reported scales, perhaps a more genuine results will be
given via a different approach (e.g., comfortable, non-judgmental environment,
less direct approach etc.). Lastly, although the current study did account for the
relative ratio between CSA and N-SAP in the general population, the number of
participants (i.e., 60) is, indeed, relatively small, thus, should be taken with
caution when generalizing to the population.
JOURNAL OF CHILD SEXUAL ABUSE 15
Future studies should also test the moralization of purity by alternative, more
experimental methods, other than a structured, scale-like questionnaire. For
instance, A recent study devised a useful and effective tool for priming disgust
and for measuring individual differences in disgust sensitivity by means of
visual elicitors (e.g., Culpepper, Havlíček, Leongómez, & Roberts, 2018).
Furthermore, perhaps another possible measure worth exploring would be
a qualitative analysis of subjective attitudes toward purity violations and virtues.
All of which can provide a more in-depth examination and comprehension of
the relationship between sexual victimization and the moralization of purity.
Acknowledgments
Special gratitude to Avital Mentovich PhD., researcher in the field of procedural justice, for
providing inspiration to pursue the field of moral psychology and for broadening the
theoretical perspectives and instilling critical thinking.
Disclosure of interest
Authors declare that they have no conflicts to report.
Ethical standards and informed consent
All procedures followed were in accordance with the ethical standards of the responsible
committee on human experimentation [institutional and national] and with the Helsinki
Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for
being included in the study.
Notes on contributors
Mattan D. Arden, MA, a graduate student at the School of Criminology of University of
Haifa, Israel.
Sharon Rabinovitz, PhD., head of the graduate program in Crime and Addiction Studies at
the School of Criminology of University of Haifa, and the director of The Unit for Excellence
in Research & Study of Addiction (ERSA), The Center for Rehabilitation Research, University
of Haifa, Israel
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