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1.

Objective

Psychological maltreatment (PM) is the most prevalent form of child abuse, and is the core component of most of what is considered as child maltreatment. The aim of this work was to explore differential adverse outcomes of the different types of PM in the mental health and functioning of children living in homes in which they are exposed to intimate partner violence (IPV).

Method

Participants were 168 children, aged between 4 and 17, whose mothers experienced IPV. They were assessed using different measures of psychopathology and functioning: Diagnostic Interview for Children and Adolescents-IV, Child Behavior Checklists and Child and Adolescent Functioning Assessment Scale. Furthermore, IPV was assessed with the Schedule for Assessment of Intimate Partner Violence Exposure in Children and the Index of Spouse Abuse. Statistical analyses were carried out with regression models adjusted by means of Generalized Estimating Equations.

Results

Spurning was the PM subtype with the greatest global effect on the children, as it was significantly associated with internalizing and externalizing problems. Denying emotional responsiveness specifically increased the risk of internalizing psychopathology and impairment in the emotional area. Terrorizing was not significantly associated with a greater number of negative outcomes in children's psychopathology or functioning in this population.

Implications

The results suggest the importance of taking PM types into account in order to fully understand the problems of children exposed to IPV at home, and for the design of effective treatment and prevention programs.  相似文献   

2.

Objective

This study assessed the co-occurrence of child maltreatment and intimate partner violence (IPV) and examined the association between them.

Method

The cross-sectional study recruited a population-based sample of 1,094 children aged 12-17 years in Hong Kong. Structured questionnaires were used to collect data from the children. The prevalence of occurrence of child abuse and neglect by parents and exposure to IPV in both the past year and lifetime was examined, and their correlates were assessed using univariate and multivariate logistic regression.

Results

The results show that 26% and 14.6% of child participants had been exposed to IPV physical assault, and 44.4% and 22.6% had been subjected to a parent's corporal punishment or to physical maltreatment from a parent in their lifetime and the year preceding the study, respectively. Among those families characterized by IPV, 54.4% and 46.5% were involved in child physical maltreatment over the child's lifetime and in the preceding year, respectively.

Conclusions

Multivariate logistic regression analyses revealed that children exposed to IPV were at higher risk of being victims of neglect, corporal punishment, and physical maltreatment or severe physical maltreatment by their parents than children who were not exposed to IPV, even when child and parent demographic factors were controlled for.

Practical implications

The higher risk of child physical maltreatment associated with IPV highlights the need for an integrated assessment to screen for the presence of multiple forms of family violence within the family, and for intervention to assess effective responses to both IPV and child maltreatment by child protective service workers and domestic violence agencies.  相似文献   

3.

Objective

This study investigated the long-term effects of exposure to intimate partner violence in the home on adolescent violence and drug use and gender differences in these relationships. Although the general relationship between exposure to IPV and negative outcomes for youth has been demonstrated in past research, gender differences in the effects of IPV on adolescents have been rarely assessed using longitudinal data.

Methods

Longitudinal data was obtained from 1,315 adolescents and their primary caregivers participating in the Project on Human Development in Chicago Neighborhoods (PHDCN). The sample was 51% female and ethnically diverse (45% Hispanic, 37% African-American, and 14% Caucasian). Two waves of data were assessed to examine the effects of exposure to IPV, reported by caregivers when their children were aged 12 and 15, on violence and drug use, reported by adolescents 3 years later. Multivariate statistical models were employed to control for a range of child, parent, family, and neighborhood risk factors.

Results

Exposure to IPV did not significantly predict subsequent violence among males or females in multivariate analyses. IPV exposure was significantly related to the frequency of drug use for females but did not predict drug use among males. This gender difference was not statistically significant, however, which suggests more similarities than differences in the relationship between exposure to IPV and subsequent violence and drug use.

Conclusions

This study supports prior research indicating that exposure to IPV can negatively impact adolescent development, but it suggests that these effects may be more likely to influence some outcomes (e.g., drug use) than others (e.g., interpersonal violence). The findings also emphasize the need for additional research examining the overall impact of IPV on adolescent problem behaviors and gender differences in these relationships, including longitudinal studies and investigations that control for a range of other important predictors. A better understanding of these relationships can help inform intervention efforts aimed at ensuring that adolescents living in violent households receive timely and appropriate services to help prevent the occurrence of future problem behaviors.  相似文献   

4.

Objective

Young children involved with child welfare services are at high risk for behavior problems. This study aims to identify externalizing behavior paths that preschoolers in this high-risk population follow over a 6 year period, and the predictors of membership in normative and problematic pathways.

Methods

Using data from the National Study of Child and Adolescent Well-being (NSCAW), the sample included 246 4-year-olds who remained home after investigation. Latent class growth analysis (LCGA) was used to estimate the number, size, and shape of subgroups of preschoolers following distinct behavioral pathways. Early predictors of membership in the resulting groups were then examined.

Results

Four groups of preschool children following distinct behavior trajectories over 6 years were identified. Weighted results show that more than half (61%) of the children followed a low/normal problem behavior trajectory while just over one tenth (12%) were on a persistent high trajectory, remaining in the clinical range throughout the study. Improving (23%) and worsening (4%) problem behavior groups were also identified. Internalizing problems, attention problems, child ethnicity, and maltreatment type reported at age 4 predicted membership in the trajectory groups.

Conclusions

Internalizing behavior problems and maltreatment type may distinguish preschool children who are more likely to experience worsening or persistent problematic externalizing behaviors from those likely to follow a normal behavior trajectory.

Practice implications

Identifying early indicators of externalizing behavior problems and addressing them with evidence-based interventions to reduce negative behaviors may avert long-term negative outcomes.  相似文献   

5.

Objective

This study involves a reanalysis of data from a randomized controlled trial to examine whether child-parent psychotherapy (CPP), an empirically based treatment focusing on the parent-child relationship as the vehicle for child improvement, is efficacious for children who experienced multiple traumatic and stressful life events (TSEs).

Methods

Participants comprised 75 preschool-aged children and their mothers referred to treatment following the child's exposure to domestic violence. Dyads were randomly assigned to CPP or to a comparison group that received monthly case management plus referrals to community services and were assessed at intake, posttest, and 6-month follow-up. Treatment effectiveness was examined by level of child TSE risk exposure (<4 risks versus 4+ TSEs).

Results

For children in the 4+ risk group, those who received CPP showed significantly greater improvements in PTSD and depression symptoms, PTSD diagnosis, number of co-occurring diagnoses, and behavior problems compared to those in the comparison group. CPP children with <4 risks showed greater improvements in symptoms of PTSD than those in the comparison group. Mothers of children with 4+ TSEs in the CPP group showed greater reductions in symptoms of PTSD and depression than those randomized to the comparison condition. Analyses of 6-month follow-up data suggest improvements were maintained for the high risk group.

Conclusions

The data provide evidence that CPP is effective in improving outcomes for children who experienced four or more TSEs and had positive effects for their mothers as well.

Practice implications

Numerous studies show that exposure to childhood trauma and adversity has negative consequences for later physical and mental health, but few interventions have been specifically evaluated to determine their effectiveness for children who experienced multiple TSEs. The findings suggest that including the parent as an integral participant in the child's treatment may be particularly effective in the treatment of young children exposed to multiple risks.  相似文献   

6.
Young children are at significant risk of exposure to intimate partner violence (IPV), and vulnerable to exposure-related psychopathology, yet few studies investigate the effects of exposure to IPV on children under the age of 5 years. The current study investigated the role of maternal PTSD symptoms and parenting strategies in the relationship between mothers’ IPV experiences and psychopathology in their young children, ages 3–6 years in a community-based cohort of 308 mother-child dyads at high risk for family violence. Data were collected from 2011 to 2014. IPV history and maternal PTSD symptoms were assessed by self-report questionnaires. Children’s symptoms were assessed with a developmentally-sensitive psychiatric interview administered to mothers. Punitive/restrictive parenting was independently-coded from in-depth interviews with mothers about their disciplinary practices. Hypothesized direct and indirect pathways between physical and psychological IPV, maternal PTSD, maternal parenting style, and children’s internalizing and externalizing symptoms were examined with mediation models. Results indicated that neither physical nor psychological IPV experienced by mothers was directly associated with children’s symptoms. However, both types of victimization were associated with maternal PTSD symptoms. Examination of indirect pathways suggested that maternal PTSD symptoms mediated the relationship between mothers’ psychological and physical IPV experiences and children’s internalizing and externalizing symptoms and mothers’ restrictive/punitive parenting mediated the relationship between mothers’ psychological IPV and children’s externalizing symptoms. In addition, there was a path from maternal physical IPV to child externalizing symptoms through both maternal PTSD symptoms and restrictive/punitive parenting. Findings highlight the importance of supporting parents in recovering from the sequelae of their own traumatic experiences, as their ensuing mental health symptoms and parenting behaviors may have a significant impact on their children’s emotional health.  相似文献   

7.

Objective

Identify individual and environmental variables associated with caregiver stability and instability for children in diverse permanent placement types (i.e., reunification, adoption, and long-term foster care/guardianship with relatives or non-relatives), following 5 or more months in out-of-home care prior to age 4 due to substantiated maltreatment.

Methods

Participants were 285 children from the Southwestern site of Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). Caregiver instability was defined as a change in primary caregiver between ages 6 and 8 years. Classification and regression tree (CART) analysis was used to identify the strongest predictors of instability from multiple variables assessed at age 6 with caregiver and child reports within the domains of neighborhood/community characteristics, caregiving environment, caregiver characteristics, and child characteristics.

Results

One out of 7, or 14% of the 285 children experienced caregiver instability in their permanent placement between ages 6 and 8. The strongest predictor of stability was whether the child had been placed in adoptive care. However, for children who were not adopted, a number of contextual factors (e.g., father involvement, expressiveness within the family) and child characteristics (e.g., intellectual functioning, externalizing problem behaviors) predicted stability and instability of permanent placements.

Conclusions

Current findings suggest that a number of factors should be considered, in addition to placement type, if we are to understand what predicts caregiver stability and find stable permanent placements for children who have entered foster care. These factors include involvement of a father figure, family functioning, and child functioning.

Practice implications

Adoption was supported as a desired permanent placement in terms of stability, but results suggest that other placement types can also lead to stability. In fact, with attention to providing biological parents, relative, and non-relative caregivers with support and resources (e.g., emotional, financial, and optimizing father involvement or providing a stable adult figure) the likelihood that a child will have a stable caregiver may be increased.  相似文献   

8.

Objectives

To describe health-related problems across placement types (unrelated foster, kin foster, in-home with birth parent); to examine the association of placement and demographic/child welfare variables (child gender, age, race/ethnicity; caregiver language; type of maltreatment, and length of time receiving services from child welfare) with health-related problems.

Methods

This study utilized a retrospective medical chart review of children less than 6 years old (n = 449) seen at an outpatient child welfare pediatric clinic. Logistic regression modeling was used to estimate odds of having a weight, medical, or provisional developmental delay problem by placement and demographic/child welfare characteristics.

Results

Almost 13% of children in the sample were obese (≥95% age-gender specific percentile) and more than a quarter were overweight/obese (≥85%) while only 7% were underweight (≤5%). Most children (78%) had a physical health diagnosis and 25% were provisionally identified with a developmental delay. No differences between weight diagnoses, type of medical diagnoses, and provisional developmental delay by placement type were found, although children with 3 or more medical diagnoses were more likely to be with kin (p < .05). Children 2 years old or older were more likely to be overweight/obese than children under 2 years old (p < .05) and Hispanic children were more likely to be overweight/obese than non-Hispanic children (p < .01). Length of stay in child welfare was positively related with a medical diagnosis or provisional developmental delay (p < .01).

Conclusions

Results argue for careful assessment of weight, medical, and developmental problems in children active to child welfare, whether residing in their home of origin, with kin, or with unrelated foster parents. The increasing problem of obesity among young children in child welfare warrants further investigation and intervention.

Practice implications

The comprehensive health examination and enhanced health maintenance schedule for children in foster care should be extended to children who remain at home with child welfare services as child welfare involvement rather than placement is related to health-related problems.  相似文献   

9.

Objectives

To present a detailed confession from a perpetrator of Shaken Baby syndrome.

Methods

Case study.

Results

We present a confession of Shaken Baby syndrome describing how the perpetrator severely injured a 3 year old with repeated bursts of acceleration-deceleration (shaking). The child sustained retinal and intracranial hemorrhage. Details of the confession and circumstances by which it was obtained lead us to believe its accuracy.

Conclusions

Accurate perpetrator confessions offer useful windows into realities and pathophysiology of abusive head trauma.  相似文献   

10.

Objective

To examine whether depressed mood and anger mediate the effects of sexual abuse and family conflict/violence on self-injurious behavior and substance use.

Methods

A cross-sectional national survey was conducted including 9,085 16-19 year old students attending all high schools in Iceland in 2004. Participants reported frequency of sexual abuse, family conflict/violence, self-injurious behavior, substance use, depressed mood, and anger.

Results

Sexual abuse and family conflict/violence had direct effects on self-injurious behavior and substance use among both genders, when controlling for age, family structure, parental education, anger, and depressed mood. More importantly, the indirect effects of sexual abuse and family conflict/violence on self-injurious behavior among both males and females were twice as strong through depressed mood as through anger, while the indirect effects of sexual abuse and family conflict/violence on substance use were only significant through anger.

Conclusions

These results indicate that in cases of sexual abuse and family conflict/violence, substance use is similar to externalizing behavior, where anger seems to be a key mediating variable, opposed to internalizing behavior such as self-injurious behavior, where depressed mood is a more critical mediator.

Practice implications

Practical implications highlight the importance of focusing on a range of emotions, including depressed mood and anger, when working with stressed adolescents in prevention and treatment programs for self-injurious behavior and substance use.  相似文献   

11.

Purpose

Although researchers have concluded that child maltreatment has a negative effect on children's learning and academic achievement, not all children are negatively affected by maltreatment, and some children seem to succeed academically despite being maltreated. Drawing on risk and resilience theory, we examined a broad range of potential risk, promotive, and protective factors within children and their environments along with characteristics of the maltreatment to account for variability in test scores.

Methods

A national longitudinal probability sample of 702 maltreated school-aged children, ages 6-10, and their caregivers was used to predict reading and math scores among maltreated children over three years.

Results

We found that chronic maltreatment, poorer daily living skills, and lower intelligence explained a substantial proportion of the variance in maltreated children's math scores (39%), whereas type of maltreatment, poorer daily living skills and lower intelligence explained a substantial proportion of the variance in reading scores (54%) over time. Contrary to our prediction, having a behavior problem seemed to protect chronically maltreated children from poorer performance in math over time.

Conclusions

To increase academic achievement among maltreated children, it is imperative that we prevent chronic maltreatment and help children increase their competency on daily living skills.  相似文献   

12.

Objective

This study examined the relative risk of placement disruption for 3-10 year-old children placed in out-of-home care based on the biological relatedness of the placement caregiver and child disability status: no disability, a non-behavioral disability only, a behavioral disability only, or both a non-behavioral and behavioral disability.

Methods

Data were used from the baseline and 36 month follow-up of the National Survey of Child and Adolescent Well-Being, a national probability study of children investigated for child abuse and neglect in the United States. Disability status was derived using several different nationally-normed measures of language development, daily-living skills, social skills, and behavioral problems.

Results

Around 1 in 4 children placed in out-of-home care experienced a disruption. Placement with kin decreased the likelihood of disruption for a majority of children, and children with different types of disabilities were no more or less likely to disrupt in kinship care compared to children with no disability. Older children with a behavioral disability only or both a non-behavioral and behavioral disability were more likely to disrupt compared to younger regardless of placement.

Conclusion

The study findings suggest that maltreated children placed with kin will be afforded the same stability provided to children without a disability.  相似文献   

13.
14.
15.
16.

Objectives

The present investigation reports on the development and initial validation of a new analog task, the Parent-Child Aggression Acceptability Movie Task (P-CAAM), intended to assess respondents’ acceptance of parent-child aggression, including both physical discipline and physical abuse.

Methods

Two independent samples were utilized to develop and evaluate the P-CAAM: an undergraduate sample to initially pilot the task and a separate sample of normative parents for additional assessment of validity. Scores from the P-CAAM were compared to related measures, including measures of self-reported disciplinary attitudes, child abuse potential, harsh parenting style, and use and escalation of physical discipline practices on another analog parenting task.

Results

Across the studies, the P-CAAM demonstrated acceptable internal consistency and construct validity, evidencing mild to moderate associations with both self-report and analog measures. Participants demonstrating increased acceptance of physical discipline and physical abuse on the P-CAAM analog task also reported greater approval of physical discipline, greater use of and escalation of physical discipline, harsher parenting styles, and higher child abuse potential on two separate measures.

Conclusions

The P-CAAM analog appears to offer a promising alternative and/or supplement to conventional self-report measures, assessing attitudes regarding the acceptability of parent-child aggression in a way that is less likely to be influenced by social desirability. Suggestions for future evaluations with alternative samples, as well as possible implications of the data for disciplinary reactions are discussed.

Practice implications

The development of alternatives to self-report measurement may lead to clarification of theoretical models of abuse in ways that lead to improvements in intervention programming; analogs may also provide a useful means to assess intervention programming outcomes.  相似文献   

17.

Objectives

Previous research suggests that women's early sexual victimization experiences may influence their parenting behaviors and increase the vulnerability of their children to being sexually victimized. The current study considered whether mother's sexual victimization experiences, in childhood and after age 14, were associated with the sexual victimization experiences reported by their adolescent daughters, and if so, whether these effects were mediated via parenting behaviors.

Methods

The proposed model was examined using a community sample of 913 mothers and their college-bound daughters, recruited by telephone at the time of the daughter's high school graduation. Daughters reported on their experiences of adolescent sexual victimization and perceptions of mothers’ parenting in four domains: connectedness, communication effectiveness, monitoring, and approval of sex. Mothers provided self-reports of their lifetime experiences of sexual victimization.

Results

Consistent with hypotheses, mothers’ victimization was positively associated with their daughters’ victimization. The effect of mothers’ childhood sexual abuse was direct, whereas the effect of mothers’ victimization after age 14 was mediated via daughters’ perceptions of mothers’ monitoring and greater approval of adolescent sexual activity. Comparison of the prevalence of specific victimization experiences indicated that mothers were more likely to report forcible rape over their lifetimes; however, daughters were more likely to report unwanted contact and incapacitated rape.

Conclusions

Findings suggest that even in a highly functional community sample, mothers’ sexual victimization experiences are significantly associated with aspects of their parenting behavior and with their daughters’ own experiences of adolescent sexual victimization.  相似文献   

18.

Objective

The aim of this study was to describe how sexually abused children experience the legal process, a process that includes being questioned by the police during the preliminary investigation and by lawyers and the prosecutor in the courtroom, and meeting other professionals from various agencies.

Method

Face-to-face in-depth interviews were conducted with 10 children—9 girls and 1 boy between 9 and 15 years old—who had experienced child sexual abuse (CSA). The interviews were semi structured and carried out and analyzed by interpretative phenomenological analysis (IPA). The aim of IPA is to explore the participants’ views of the world and to adopt as far as possible an “insider perspective.” IPA draws on a tradition of phenomenology and symbolic interactionism in attempting to understand how people make sense of their experiences.

Results

Five major themes emerged through the analysis: not being believed, making CSA visible, need for support, sanctions for offenders, and lack of respect for the child's integrity. Almost all the children had a feeling of not being believed. They described feelings ranging from anxiety to dread and even terror when they had to describe the CSA they had experienced. Even though the importance of support for such children is already well understood, the children stated that the support they were given was not sufficient. The children said that they wanted support from a single professional who was well informed about both the legal process and CSA. When the children were asked to reflect on sanctions against the abusers, they said that it was important that the perpetrator got treatment/therapy but they also said that imprisonment was desirable. Financial compensation was not as important to them; the damage had been done and money could not compensate for that damage. The children also said that both the lawyers and the media had treated them with disrespect.

Conclusions

It is valuable for children who have been exposed to CSA to learn that they can take part in the legal process as equal partners with the other participants, and it is evident that the quality of psychological care and support needs to be improved. The children want to be participants in the legal process rather than passive objects of that process.  相似文献   

19.

Objectives

Over 4.5 million children each year are exposed to intimate partner violence (IPV). Furthermore, IPV rarely occurs without other forms of violence and aggression in the home. IPV is associated with mental health and parenting problems in mothers, and children experience a wide variety of short-term social adjustment and emotional difficulties, including behavioral problems. The current study investigated the influence of IPV exposure on children's aggressive behavior, and tested if this relation was mediated by poor maternal mental health, and, in turn, by maternal warmth and child maltreatment, and moderated by children's age and gender. Study findings highlight the indirect consequences of IPV in the home on children's aggressive behavior.

Methods

Secondary data analysis using structural equation modeling (SEM) was conducted with the National Survey of Child and Adolescent Well-Being (NSCAW). Children were between the ages of 3–8 (n = 1,161). Mothers reported past year frequency of phsycial assualt by their partner, frequency of child psychological and physical abuse, maternal mental health, and children's aggressive behavior problems. Maternal warmth was measured by observation.

Results

IPV was significantly related to poor maternal mental health. Poor maternal mental health was associated with more child aggressive behavior, lower maternal warmth, and more frequent child physical and psychological abuse. Psychological abuse and low maternal warmth were directly related to more aggressive behavior while IPV exposure and physical abuse were not directly associated with aggressive behavior. Neither age nor gender moderated the modeled paths.

Conclusions

Expanding knowledge about child outcomes is especially critical for children who were involved in investigations of child maltreatment by child protective services (CPS) in order to identify relevant risk factors that can lead to interventions. The results identified maternal mental health as an important variable in mediating the relationship between IPV exposure and aggressive behavior. One implication is for multicomponent family interventions that could be tailored toward helping the mother cope with such mental health issues while also addressing deficits in children's social behavior development.  相似文献   

20.

Objective

This study aimed to investigate child physical abuse (CPA) while taking into account the more rigorous definitions of CPA in the Chinese societies. The prevalence of CPA and CPA-related PTSD were estimated, together with the examination of peri-traumatic subjective reactions and their impacts on PTSD.

Methods

In a Taiwanese sample of 1966 4th to 8th graders, the Chinese version of UCLA PTSD Reaction Index for DSM-IV (Steinberg, Brymer, Decker, & Pynoos, 2004) was used to investigate the lifetime exposure to CPA. A sub-sample of 236 traumatized CPA victims was examined with respect to related PTSD symptoms.

Results

Thirty-four percent of the children had been exposed to CPA. The estimated current prevalence of full and partial PTSD was 13.6% and 16.9%, respectively.

Conclusions

The current CPA prevalence was found to be higher than the Western countries, but lower than the previous findings in other East Asian societies. The full PTSD prevalence was close to the findings in the Western countries, whereas sub-clinical PTSD was less observed in Taiwan. Peri-traumatic subjective reactions, that is, Criterion A2 and perceived threat, were shown to be major predictors of PTSD symptom severity. The role of attitudes of child discipline in the Chinese societies in the prevalence of CPA and CPA-related PTSD is discussed.

Practice implications

By providing explicit epidemiological information of CPA and CPA-related PTSD in Taiwan, the current study extends our understanding of CPA and CPA-related PTSD more broadly from Western countries to the Eastern societies. By separately investigating CPA relating to different perpetrators, cross-study comparison is enhanced. In the current study, the significance of considering cultural background in defining CPA and examining CPA-related PTSD was pointed out. Meanwhile, the role of victims’ subjective reactions in the psychopathology of PTSD is highlighted. The findings and discussions could contribute for generating a more sophisticated clinical practice, especially with Asian or Chinese cases.  相似文献   

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