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1.

Objectives

This study examined individual and contextual factors that explain students’ victimization by peers among 4th- through 6th-grade Jewish and Arab students.

Method

A total of 120 homeroom teachers and 3,375 students from 47 schools participated. The study explored how students’ reports of violence are influenced by individual factors (gender, age, perception of school climate, victimization by teachers, and fear) teacher-class factors (school climate, homeroom teachers’ characteristics such as self-efficacy, and education) and cultural affiliation as a school level factor.

Results

The results showed that levels of victimization vary significantly between classes and between schools. However, the vast majority of variation in students’ victimization lay at the individual level. Factors such as fear, physical and emotional victimization by teachers, and gender affected levels of students’ victimization by peers.

Conclusions

Students victimized by peers are more likely to be victimized by their teachers and to miss school because of their fear of violence. Further research should be conducted to investigate additional teacher, class and school factors that can predict levels of students’ victimization.

Practice implication

Based on the study's results, efforts to deal with school violence should be targeted to students and school staff. It is essential to design and implement a “whole school” approach that includes participation of the entire school community. Furthermore, intensive individual treatment should be given to victimized students to improve their sense of safety and protection on school property. In addition, the findings emphasized the need to design and implement school intervention programs in a sensitive way that takes into consideration children's developmental stages and other factors that affect their levels of victimization. The results showed that younger children do not take advantage of the many positive effects that can be achieved from positive school policy and good relationships with staff. It might be that more efforts should be made to raise victimized students’ awareness by emphasizing that schools have rules that are there to protect them.  相似文献   

2.

Objectives

Adolescents often experience different types of victimization across a specified period of time in different situations. These multiple victimization experiences can have a number of deleterious effects on psychosocial well-being. To expand on research gathered primarily from US samples, the current study estimated the prevalence of multiple victimization in a nationally representative sample of Canadian adolescents. We also expanded on past research by adopting an ecological approach to identify correlates of multiple victimization.

Methods

Cross-sectional data from the 2000-2001 cycle of the National Longitudinal Survey of Children and Youth (NLSCY) were used to estimate the prevalence of multiple victimization (verbal harassment, threat of and actual physical assault, school social exclusion, discrimination) in 1,036 13-16 year olds. We also examined household (e.g., parental education), family (e.g., parenting practices), and adolescent (e.g., friendship quality) correlates of multiple victimization for the whole sample and separately by sex.

Results

Among the 6 in 10 adolescents who reported at least 1 victimization experience, 30.5% reported 2 types of victimization whereas 23.7% reported 3 or more types. There was an increased probability of multiple victimization (2 or more types) in adolescents who reported greater parental rejection, who engaged in more frequent out-of-school activities, and who experienced non-victimization adversity. The probability decreased if adolescents reported greater friendship quality.

Conclusions

The clustering of different types of victimization is common among adolescents. For both males and females, a difficult parent-child relationship characterized as rejecting is important when considering risk for multiple victimization, as is the adolescent's functioning outside of the home in the context of friendship quality and involvement in out-of-school activities. Non-victimization adversity (e.g., death of a loved one) also emerged as a significant multiple victimization correlate.

Practice implications

Non-physically invasive types of victimization (although adolescents also endorsed physical assault) are a reality for a number of adolescents. As such, we need to inquire about such experiences as school social exclusion, discrimination, and verbal threats in applied contexts. Moreover, in order to better identify adolescents who may be vulnerable to multiple forms of victimization, we need to adopt an ecological approach that considers individual, family, and household functioning.  相似文献   

3.

Objective

(1) To describe lacerations of the vaginal fornices, an injury known to be associated with consensual sexual intercourse, including known complications and treatment course, (2) to contrast these injuries with injuries sustained during sexual assault, and (3) to discuss the assessment of adolescent patients for sexual injuries.

Methods

We present a case series of 4 female adolescent patients seen at a children's hospital over a period of 6 months. Each patient developed significant vaginal bleeding after sexual intercourse, and 3 of the patients presented to the emergency department with vital signs consistent with compensated shock.

Results

Each patient was evaluated by pediatric surgery, and found to have a laceration of the vagina. Three of the patients described consensual intercourse prior to the onset of bleeding, and had lacerations of the vaginal fornices; these patients were determined to have injuries resulting from consensual sexual intercourse. The fourth patient reported sexual assault as the cause of her injuries, and was treated for longitudinal lacerations of the vaginal wall.

Conclusions

Lacerations of the upper vagina are not frequently reported in forced vaginal intercourse, but are occasionally reported as injuries sustained during consensual coitus. In the absence of reported sexual assault, a severe vaginal fornix laceration is consistent with the diagnosis of coital injury from consensual intercourse. Diagnosis and treatment of this injury can be delayed due to the sensitive nature of these injuries. Bleeding can be profuse, leading to hemorrhagic shock, and these injuries may require transfusion of blood products and surgical repair in some cases. Complications may include hemoperitoneum, pneumoperitoneum, or retroperitoneal hematoma, even in the absence of complete vaginal perforation.

Practice implications

Knowledge of the consensual sexual injuries that may occur in adolescent patients can guide diagnosis, treatment, and counseling for the patient and her family, preventing long-term medical complications and legal consequences.  相似文献   

4.

Objective

While the relationship between abusive parenting and violent delinquency has been well established, the cognitive and emotional processes by which this occurs remain relatively unidentified. The objective of this work is to apply a conceptual model linking abusive parenting to the conversion of shame into blaming others and therefore to violent delinquency.

Methods

A retrospective study of 112 adolescents (90 male; 22 female; ages 12-19 years; M = 15.6; SD = 1.4) who were incarcerated in a juvenile detention facility pending criminal charges, completed measures of exposure to abusive and nonabusive discipline, expressed and converted shame, and violent delinquency.

Results

Findings tend to confirm the conceptual model. Subjects who converted shame (i.e., low expressed shame, high blaming others) tended to have more exposure to abusive parenting and showed more violent delinquent behavior than their peers who showed expressed shame. Subjects who showed expressed shame (i.e., high expressed shame, low blaming others) showed less violent delinquency than those who showed converted shame.

Conclusions

Abusive parenting impacts delinquency directly and indirectly through the effects of shame that is converted. Abusive parenting leads to the conversion of shame to blaming others, which in turn leads to violent delinquent behavior.

Practice implications

For juvenile offenders, the conversion of shame into blaming others appears to contribute to pathological outcomes in relation to trauma. Translation of this work into clinical practice is recommended.  相似文献   

5.

Objectives

This paper reports on the prevalence of student victimization by teachers in junior high schools in a Chinese cultural context (Taiwan) and examines how student demographic variables (gender, grade level, and family socioeconomic status) and school social experiences (student-teacher relationships and involvement with at-risk peers) are associated with such victimization.

Methods

Data were obtained from a large-scale random sample of 1,376 junior-high students (grades 7-9) in the city of Taichung, Taiwan. Students were given an anonymous structured questionnaire, including items regarding basic demographics and school social experiences.

Results

Overall, 26.9% of students reported having been maltreated by teachers at least 1 time in the previous semester. Hitting, beating, or slapping was the most common maltreatment, and the most vulnerable students were boys and senior students. Students who perceived that student-teacher relationships were poor, and those who were involved with at-risk peers, were more likely to report victimization.

Conclusion

Although there are clear guidelines and regulations prohibiting teacher aggression against students, Taiwanese students are still exposed to high levels of maltreatment. The findings provide empirical evidence to support school social workers and policymakers in taking immediate action to educate politicians, the general public, and the media about the severity of student victimization by teachers as well as to build up mechanisms to supervise the government's enforcement of regulation. These findings clearly imply that promoting positive social experiences for students is crucial for successful intervention.  相似文献   

6.

Objectives

The current study examined the independent effects of mothers’ childhood abuse (CA) and intimate partner violence (IPV) on psychopathology and functional impairment in children; and the potential moderating and mediating role of individual and family factors in these relationships. Additionally, this study explored the potential cumulative effects of both maternal CA and IPV on children's outcomes.

Method

The sample included 547 Spanish children and adolescents aged between 8 and 17 years, and their parents, who had accessed mental health services. The assessment was based on structured interviews with the children and their parents. Statistical analyses were carried out through hierarchical multiple, negative-binomial and logistic regressions, and Structural Equation Models.

Results

Children whose mothers experienced CA and those whose mothers suffered physical IPV showed increased DSM-IV disruptive disorders and externalizing behavior problems, respectively. Children who directly observed physical IPV and also suffered physical punishment by parents showed increased internalizing problems. IPV had effects, either direct or indirect by physical punishment, on children's externalizing problems. Cumulative effect analyses indicated that the prevalence of disruptive disorders was highest in children whose mothers had suffered both CA and IPV.

Conclusion

Spanish children whose mothers have suffered CA, IPV or both, are at high risk of serious conduct problems, whereas children exposed to IPV and who were also physically abused are at greater risk of internalizing problems. Physical punishment of children contributes in part to explain externalizing problems of IPV-exposed children. These findings indicate potential targets of assessment and intervention for families seeking help in mental health services.  相似文献   

7.

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   

8.

Objectives

To measure the prevalence of maltreatment and other types of victimization among children, young people, and young adults in the UK; to explore the risks of other types of victimization among maltreated children and young people at different ages; using standardized scores from self-report measures, to assess the emotional wellbeing of maltreated children, young people, and young adults taking into account other types of childhood victimization, different perpetrators, non-victimization adversities and variables known to influence mental health.

Methods

A random UK representative sample of 2,160 parents and caregivers, 2,275 children and young people, and 1,761 young adults completed computer-assisted self-interviews. Interviews included assessment of a wide range of childhood victimization experiences and measures of impact on mental health.

Results

2.5% of children aged under 11 years and 6% of young people aged 11–17 years had 1 or more experiences of physical, sexual, or emotional abuse, or neglect by a parent or caregiver in the past year, and 8.9% of children under 11 years, 21.9% of young people aged 11–17 years, and 24.5% of young adults had experienced this at least once during childhood. High rates of sexual victimization were also found; 7.2% of females aged 11–17 and 18.6% of females aged 18–24 reported childhood experiences of sexual victimization by any adult or peer that involved physical contact (from sexual touching to rape). Victimization experiences accumulated with age and overlapped. Children who experienced maltreatment from a parent or caregiver were more likely than those not maltreated to be exposed to other forms of victimization, to experience non-victimization adversity, a high level of polyvictimization, and to have higher levels of trauma symptoms.

Conclusions

The past year maltreatment rates for children under age 18 were 7–17 times greater than official rates of substantiated child maltreatment in the UK. Professionals working with children and young people in all settings should be alert to the overlapping and age-related differences in experiences of childhood victimization to better identify child maltreatment and prevent the accumulative impact of different victimizations upon children's mental health.  相似文献   

9.

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   

10.

Objective

Being bullied has adverse effects on children's health. Children's family experiences and parenting behavior before entering school help shape their capacity to adapt and cope at school and have an impact on children's peer relationship, hence it is important to identify how parenting styles and parent–child relationship are related to victimization in order to develop intervention programs to prevent or mitigate victimization in childhood and adolescence.

Methods

We conducted a systematic review of the published literature on parenting behavior and peer victimization using MEDLINE, PsychINFO, Eric and EMBASE from 1970 through the end of December 2012. We included prospective cohort studies and cross-sectional studies that investigated the association between parenting behavior and peer victimization.

Results

Both victims and those who both bully and are victims (bully/victims) were more likely to be exposed to negative parenting behavior including abuse and neglect and maladaptive parenting. The effects were generally small to moderate for victims (Hedge's g range: 0.10–0.31) but moderate for bully/victims (0.13–0.68). Positive parenting behavior including good communication of parents with the child, warm and affectionate relationship, parental involvement and support, and parental supervision were protective against peer victimization. The protective effects were generally small to moderate for both victims (Hedge's g: range: −0.12 to −0.22) and bully/victims (−0.17 to −0.42).

Conclusions

Negative parenting behavior is related to a moderate increase of risk for becoming a bully/victim and small to moderate effects on victim status at school. Intervention programs against bullying should extend their focus beyond schools to include families and start before children enter school.  相似文献   

11.
Lin D  Li X  Fan X  Fang X 《Child abuse & neglect》2011,35(9):680-687

Objective

The current study was designed to explore the prevalence of child sexual abuse (CSA) and its association with health risk behaviors (i.e., smoking, alcohol use, binge drinking, suicidal ideation, and suicide attempt) among rural children and adolescents in China.

Methods

A sample of 683 rural children and adolescents (8 to 18 years of age) completed an anonymous questionnaire which assessed experiences of CSA and 5 health risk behaviors. Data on several potential confounding factors were also collected.

Results

A total of 123 (18%) respondents reported experiencing at least 1 kind of CSA before 16 years of age, with more boys reporting CSA than girls (21.5% vs. 14.2%). In addition, attending non-boarding schools, lower levels of self-esteem, and higher levels of perceived peer pressure for engagement in health risk behaviors were associated with higher rates of CSA. Multivariate logistic regression analyses revealed that CSA experience was significantly associated with cigarette smoking (aOR = 2.14), binge drinking (aOR = 2.68), suicidal ideation (aOR = 1.69), and suicide attempt (aOR = 2.69) after controlling for several demographic and psychological factors.

Conclusion

More attention should be paid to the issues of CSA among rural children and adolescents in China. Effective CSA prevention intervention needs to address the vulnerabilities of the population, increase children's and parents’ awareness of CSA and ability of self-protection.  相似文献   

12.

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   

13.
14.
15.

Objectives

This research study explored children's views on issues about child abuse in Hong Kong and examined their implications on child protection work and research in Chinese societies.

Method

Six primary schools were recruited from different districts of Hong Kong. Five vignettes of child maltreatment in the form of flash movies were presented to 87 children in 12 focus groups for discussion. The process was video-taped and the data were transcribed verbatim for data analysis by NUDIST.

Results

(1) Children do not have a homogeneous view on issues about child abuse and neglect, and their awareness and sensitivity to different kinds of child abuse are also different; (2) some of their views on child abuse and neglect are uniquely their own and are markedly different from those of adults; (3) some of the views expressed by children, however, are very much akin to those of adults, such as the factors they would consider in deciding whether a case is child abuse or not; (4) children's disclosure of abuse in Hong Kong is often affected by the Chinese culture in which they live, like filial piety and loyalty to parents.

Conclusion

Children's views on issues of child abuse and neglect, no matter they are the same or different from those of adults, serve to inform and improve child protection work. Children are not only victims in need of protection. They are also valuable partners with whom adult practitioners should closely work.

Practice implications

Children have, and are able to give, views on child abuse. They should be listened to in any child protection work no matter their views are same with or different from those of adults. As this study suggests, the relatively low sensitivity of the children to child neglect and sexual abuse, and their reluctance to disclose abuse and neglect due to their loyalty to parents are areas to focus on in preventive child protection work in a Chinese society like Hong Kong.  相似文献   

16.

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   

17.

Objective

Childhood sexual abuse (CSA) is associated with increased sexual risk behavior in adulthood, and this association may be mediated by traumagenic dynamics constructs (i.e., traumatic sexualization, trust, guilt, and powerlessness). However, few studies have investigated whether such relationships hold for women who do not identify as having experienced CSA despite meeting objective criteria that CSA occurred. This study sought to determine whether individuals who met research criteria for CSA and who self-defined as sexually abused differed on traumagenic dynamics constructs and current sexual risk behavior from individuals who met research criteria for CSA and who did not self-define as sexually abused.

Methods

Participants were 481 women recruited from a publicly funded STD clinic. Participants completed a computerized survey assessing childhood sexual experiences and adult sexual risk behavior.

Results

Of the total sample, 206 (43%) met research criteria for CSA. Of the women meeting research criteria for CSA, 142 (69%) self-defined as sexually abused. Women who met research criteria for CSA reported more traumatic sexualization, more trust of a partner, more powerlessness, less sexual guilt, more episodes of unprotected sex, more sex partners, and greater likelihood of sex trading, compared to women who did not meet research criteria for CSA. Among women meeting research criteria, those who self-defined as sexually abused did not differ from those who did not self-define on any of the traumagenic dynamics constructs or on current sexual risk behavior, controlling for CSA characteristics.

Conclusions

Individuals who were sexually abused as children by behavioral research criteria are at risk for engaging in sexual risk behavior as adults, regardless of whether or not they perceive the experience to be CSA. Future research is needed to understand how non-definers perceive these childhood sexual experiences.  相似文献   

18.

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   

19.

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   

20.

Objective

Analysis of the validity and implementation of a child maltreatment actuarial risk assessment model, the California Family Risk Assessment (CFRA).

Questions addressed

(1) Is there evidence of the validity of the CFRA under field operating conditions? (2) Do actuarial risk assessment results influence child welfare workers’ service delivery decisions? (3) How frequently are CFRA risk scores overridden by child welfare workers? (4) Is there any difference in the predictive validity of CFRA risk assessments and clinical risk assessments by child welfare workers?

Method

The study analyzes 7,685 child abuse/neglect reports originating in 5 California counties followed prospectively for 2 years to identify further substantiated child abuse/neglect. Measures of model calibration and discrimination were used to assess CFRA validity and compare its accuracy with the accuracy of clinical predictions made by child welfare workers. The extent of use of an override feature of the CFRA and child welfare worker reliance on CFRA risk scores for making service decisions were analyzed.

Results

Imperfect but better-than-chance predictive validity was found for the CFRA on a range of measures in a large temporal validation sample (n = 6,543). For 114 cases where both CFRA risk assessments and child welfare worker clinical risk assessments were available, the CFRA exhibited evidence of imperfect but better-than-chance predictive validity, while child welfare worker risk assessments were found to be invalid. Child welfare workers overrode CFRA risk assessments in only 114 (1.5%) of 7,685 cases and provided in-home services in statistically significantly larger proportions of higher- versus lower-risk cases, consistent with heavy reliance on the CFRA.

Conclusions/practice implications

Until research identifies actuarial models exhibiting superior predictive validity when applied in every-day practice, the CFRA is, and will be a valuable tool for assessing risk in order to make in-home service-provision decisions.  相似文献   

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