Dr. Kaplan and Colleagues Reply

To the Editor: Yifrah Kaminer, M.D., raises some important considerations in child abuse research. We plan, in future analyses, to examine the impact of some of the variables named by Dr. Kaminer, including age at abuse onset, frequency of abuse, and verbal abuse (an aspect of emotional abuse). Unfortunately, with regard to abuse severity, there does not exist sufficient variability in severity ratings in our study group for its impact on psychopathology to be measured statistically. Finally, we realize that our definition of sexual abuse, which we used to exclude certain cases of sexual abuse, is conservative. However, this definition was selected because it is commonly used by researchers studying sexual abuse and could be reliably assessed by using social services records. We appreciate Dr. Kaminer’s insightful comments and interest in our research.