Kemple, Kristen Mary; Kim, Hae Kyoung
Early childhood educators spend extensive amounts of time with young children, so they are often the first adults to notice signs that a child may be abused or neglected. All educators are required by law to report suspected maltreatment, and can play an important role in preventing and responding to abuse and neglect of young children. What is…
Jedwab, Merav; Benbenishty, Rami; Chen, Wendy; Glasser, Saralee; Siegal, Gil; Lerner-Geva, Liat
The present study focuses on the way child protection officers (CPOs) in Israel assess suspected abuse and neglect (SCAN) reports made by hospital child protection teams (CPTs), to determine whether the alleged maltreatment is substantiated. The study was conducted in six medical centers and included 358 reports investigated by CPOs for SCAN. A structured questionnaire was completed by hospital CPTs to capture all relevant information on each child referred to the CPTs. Structured phone interviews were conducted with each of the CPOs who received a CPT report. Bivariate associations and multivariate logistic regressions were conducted to estimate the substantiation rate of cases reported by CPTs and the types of maltreatment substantiated, as well as to identify case characteristics of the child and the family that were associated with the CPOs' substantiation decision. CPO follow-up investigations revealed a substantiation rate of 53.5%. The maltreatment type most commonly substantiated was neglect. The case characteristics associated with substantiation included socio-demographic background, parents' health and functioning, previous contact with social services, characteristics of the hospital referral, medical findings and an assessment of the parents' behaviors. The findings of the study highlighted the importance of cooperation between the health and welfare services and the policy makers. This cooperation is essential for identifying early signs of maltreatment. Enhanced cooperation and effective information transfer between various professionals would help prevent or at least reduce the recurrence of maltreatment and would ensure that the children and their families are treated appropriately. Copyright © 2014 Elsevier Ltd. All rights reserved.
Bennett, Susan; Ward, Michelle; Moreau, Katherine; Fortin, Gilles; King, Jim; MacKay, Morag; Plint, Amy
Objective: We sought to determine the incidence, clinical features, and demographic profile of head injury secondary to suspected child maltreatment (abuse or neglect) in Canada to help inform the development and evaluation of prevention programs for abusive head injuries. Methods: From March 1, 2005 to February 28, 2008, an average of 2,545…
Trickett, Penelope K.; Negriff, Sonya; Ji, Juye; Peckins, Melissa
Child abuse and neglect, often collectively called child maltreatment, are huge social problems affecting millions of children and adolescents in America. Adolescents are affected both by maltreatment which occurred during childhood with lingering effects and by maltreatment that continues into or begins in adolescence. Several decades of research…
Christina Paxson; Jane Waldfogel
This paper examines how child maltreatment is affected by the economic circumstances of parents. 'Child maltreatment' encompasses a wide range of behaviors that adversely affect children. It includes neglect, physical abuse, sexual abuse, and other forms of abuse or neglect. Using state-level panel data on the numbers of reports and substantiated cases of maltreatment, we examine whether socioeconomic factors play different roles for these different types of maltreatment. A key finding is tha...
Scribano, Philip V
Child maltreatment remains a prevalent problem for which notable best practices such as home visitation can be effective; however, most eligible families do not receive these beneficial services. Additionally, there are other promising prevention interventions to effectively address child maltreatment. This review focuses on the recent advances and strategies for child maltreatment prevention. Although home visiting does not have a single clearly defined methodology of providing service to children and families, the general supportive framework to improve maternal, child, and family factors makes this intervention the most widely studied and accepted prevention strategy. However, there has been limited effectiveness for most models. The Nurse-Family Partnership (NFP) has provided consistently positive results by targeting families with many risk factors by using highly trained professionals when implementing a research-based intervention. A promising public health approach to parent training (Triple P) may reduce maltreatment and out-of-home placement. Parent-child interaction therapy (PCIT), while a treatment model, is becoming an increasingly important approach to child maltreatment prevention. There may be an opportunity to reduce child maltreatment by enhancing care in the pediatric medical home setting. Effective child maltreatment prevention efforts exist; however, not all programs provide the same effectiveness, or target the same maltreatment issues. Pediatricians are in a key position to offer support to families in their own practice, as well as to direct families to the appropriate resources available.
Draws from works by Bronfenbrenner, Tinbergen, and Burgess to conceptualize child maltreatment as a social-psychological phenomenon that is multiply determined by individual, family, community, and cultural forces. (Author/GC)
Johnson, Charles Felzen
Child abuse is a major cause of morbidity and mortality in the USA and in all other countries which have studied its incidence. It is the second leading cause of death of children in the USA. To decrease the incidence of child abuse and improve the welfare of children there must be international efforts to recognize, and report child abuse and to decrease those risk factors, which place children in jeopardy. In the USA, reports of child maltreatment have decreased each year since 1994 after nearly two decades of increase. The increase was associated with the passage of laws that mandated reporting child maltreatment and increased recognition of maltreatment. Several theories have been proposed to explain the decrease. These include: improved economy with decreased caretaker stress and more vulnerable children in day-care, imprisonment of offenders, treatment of victims to prevent reactive abuse, decreased use of corporal punishment, earlier recognition and reporting, prevention programs including home visitors and less corporal punishment in schools. If early recognition is to occur there must be clearly defined and uniform laws that define abuse and the significant consequences to mandated reporters for failure to report. The laws must be concise, understandable and contain medically based definitions of abuse. A bruise should be considered a significant injury. The use of an instrument on a child, for any reason should be reportable as abusive. Society must be taught that a child's head and its contents are particularly susceptible to trauma. Heads should not be slapped, shaken, or struck. The purpose of a report of suspect maltreatment should be to obtain services for families. Without proper services, abuse will reoccur and victims will become victimizers. Any sexual act, including pornography, involving a child who is unable to give consent constitutes reportable sexual abuse. Recognition of what constitutes abuse would be simplified if all countries adopted
Child Maltreatment Among Elementary School Children. Indryas L. 1. ORIGINAL ... of child maltreatment. KEY WORDS: School children, child maltreatment, child abuse. ..... and teachers in teaching, counseling and prevention of sexual ...
Tanoue, Koji; Senda, Masayoshi; An, Byongmun; Tasaki, Midori; Taguchi, Megumi; Kobashi, Kosuke; Oana, Shinji; Mizoguchi, Fumitake; Shiraishi, Yuko; Yamada, Fujiko; Okuyama, Makiko; Ichikawa, Kotaro
In 2014, we created a training program for personnel in medical institutions in Japan to combat child maltreatment. The aim of the present study was to document the effectiveness of this program. Participants completed a questionnaire before and after the training lecture. The questionnaire designed for the training program included demographic questions such years of practice and area of specialty (i.e. physician, nurse, social worker, public health nurse, technician, and others), as well as experience of suspected child maltreatment cases and training in dealing with such cases. The questionnaire included 15 statements designed to ascertain practical knowledge and attitudes relevant to addressing child maltreatment. Baseline score measured before the lecture was compared with that obtained after the lecture. A total of 760 participants completed the survey, including 227 physicians, 223 nurses, 38 technologists, 27 social workers, 11 public health nurses, and 174 with other occupations, and 60 participants who left their occupation as blank. There was a significant difference between the baseline score of participants with versus without experience in suspected child maltreatment or training to deal with child maltreatment (F = 16.3; P child's injuries are due to maltreatment. The combination of increased clinical experience along with a high-quality didactic lecture, appears to be the most effective method of raising awareness and enhancing skills. © 2017 Japan Pediatric Society.
Jackson, Allison M; Kissoon, Natalie; Greene, Christian
Child maltreatment is a public health problem and toxic stress impacting at least 1 in 8 children by the age of 18 years. Maltreatment can take the form of physical and sexual abuse, neglect, and emotional maltreatment. While some children may experience only one form of maltreatment, others may survive multiple forms, and in some cases particularly complex forms of maltreatment such as torture and medical child abuse. When considering maltreatment, providers should be adept at obtaining a thorough history not only from the parent but when appropriate also from the patient. The most common form of child maltreatment is neglect, which encompasses nutritional and medical neglect, as well as other forms such as physical and emotional neglect. Talking with caregivers about stressors and barriers to care may give insight into the etiology for neglect and is an opportunity for the provider to offer or refer for needed assistance. Familiarity with injury patterns and distribution in the context of developmental milestones and injury mechanisms is critical to the recognition of physical abuse. While most anogenital exam results of child victims of sexual abuse are normal, knowing the normal variations for the female genitalia, and thereby recognizing abnormal findings, is important not only forensically but also more importantly for patient care. Pattern recognition does not only apply to specific injuries or constellation of injuries but also applies to patterns of behavior. Harmful patterns of behavior include psychological maltreatment and medical child abuse, both of which cause significant harm to patients. As health professionals serving children and families, pediatric providers are in a unique position to identify suspected maltreatment and intervene through the health care system in order to manage the physical and psychological consequences of maltreatment and to promote the safety and well-being of children and youth by making referrals to child protective
Kim, Bomi; Maguire-Jack, Kathryn
The way in which parents interact with their environment may have implications for their likelihood of abuse and neglect. This study examines the parent-environment relationship through community involvement and perception, using social disorganization theory. We hypothesize mothers who participate in their communities and have positive perceptions of them may be less likely to maltreat their children because of the potential protective capacity of neighborhood supports. Using information from the 5 year Fragile Families and Child Wellbeing Study (n=2991), the mother's self-reported acts of psychological and physical maltreatment and neglect are measured. A mother's community involvement index is the number of community activities a mother was involved in, and community perception is measured by two five-item Likert scales assessing perception of community collective efficacy. We analyze the relationship between community variables and each of mother's maltreatment behaviors as well as the interaction between community factors using a series of nested logistic regressions. Higher levels of community involvement are associated with lower levels of psychological aggression. More positive perception of community social control is associated with lower levels of physical assault. A moderation effect of community perception suggests that a mother's perception of her community changes the relationship between community involvement and psychological child abuse. The results provide important policy and empirical implications to build positive and supportive communities as a protective factor in child maltreatment. Getting parents involved in their communities can improve the environment in which children and families develop, and decrease the likelihood that maltreatment will occur. Copyright © 2013 Elsevier Ltd. All rights reserved.
Lavigne, Jenifer L; Portwood, Sharon G; Warren-Findlow, Jan; Brunner Huber, Larissa R
The purpose of this study was to explore the perceptions of child maltreatment among inpatient pediatric nurses. A cross-sectional survey was used to obtain responses to an online survey designed to examine perceptions of child maltreatment from inpatient pediatric nurses. Many nurses surveyed (41.25%) indicated that they had not received adequate training or had never received training on child maltreatment identification and many (40%) also indicated they were not familiar with the applicable reporting laws. Due to the serious immediate and long term effects of child maltreatment, it is imperative that pediatric inpatient nurses have adequate training on how to identify potential abuse and neglect cases, as well as legal reporting requirements, since they are in a unique position to identify potential cases of maltreatment. There is a continuing need for training on child maltreatment identification and reporting laws for inpatient pediatric nurses. Copyright © 2017 Elsevier Inc. All rights reserved.
Wood, Joanne N.; Pecker, Lydia H.; Russo, Michael E.; Henretig, Fred; Christian, Cindy W.
Objective: Although the majority of poisonings in young children are due to exploratory ingestions and might be prevented through improved caregiver supervision, the circumstances that warrant evaluation for suspected maltreatment and referral to Child Protective Services (CPS) are unclear. Therefore the objective of this study was to determine…
... Parents Have Safe, Stable, Nurturing Relationships [PDF 255KB] Essentials for Childhood Connecting the Dots: An Overview of the Links Among Multiple Forms of Violence [PDF 2.51MB] Economic Cost of Child Abuse Adverse Childhood Experiences (ACE) ...
Viezel, Kathleen D.; Davis, Andrew S.
Child maltreatment remains a relevant issue for school psychologists. This special issue was designed to provide school psychology practitioners, researchers, and other school personnel with current, empirically sound information about child maltreatment. This introduction provides context for the articles in this volume, including definitions of…
Li, X; Yue, Q; Wang, S; Wang, H; Jiang, J; Gong, L; Liu, W; Huang, X; Xu, T
A new, recently issued national law and regulation in China conferred the responsibility of healthcare professionals in child maltreatment intervention. However, few studies have reported on the recognition and reporting of child maltreatment by healthcare professionals in China. The aim of this study was to assess healthcare professionals' knowledge, attitudes, and self-perceived behaviour in terms of identifying, assessing, and reporting child maltreatment cases in China. A cross-sectional survey of 877 healthcare professionals from four provinces was conducted using a structured questionnaire. The respondents demonstrated insufficient knowledge on identifying potential child maltreatment cases. Over 30% of them were less than confident in the medical examination, evaluation, and treatment of child maltreatment cases, especially with regard to cases involving sexual abuse. Only 3.19% of respondents had ever received training on child maltreatment intervention, and as a result, lack of knowledge with regard to dealing with child maltreatment cases, referral procedures, and regulations was indicated to be the main cause of underreporting. Healthcare professionals in China have insufficient knowledge, skills, and confidence when it comes to dealing with all aspects of child maltreatment. Although participants reported a positive attitude towards their role in detecting and reporting child maltreatment cases, there are obstacles that hinder them from doing so. Appropriate training courses should be developed to empower professionals with knowledge and skills, as well as increase their confidence in dealing with suspected child maltreatment cases. © 2017 John Wiley & Sons Ltd.
Moore, Sophie E; Scott, James G; Ferrari, Alize J; Mills, Ryan; Dunne, Michael P; Erskine, Holly E; Devries, Karen M; Degenhardt, Louisa; Vos, Theo; Whiteford, Harvey A; McCarthy, Molly; Norman, Rosana E
Child maltreatment is a complex phenomenon, with four main types (childhood sexual abuse, physical abuse, emotional abuse, and neglect) highly interrelated. All types of maltreatment have been linked to adverse health consequences and exposure to multiple forms of maltreatment increases risk. In Australia to date, only burden attributable to childhood sexual abuse has been estimated. This study synthesized the national evidence and quantified the burden attributable to the four main types of child maltreatment. Meta-analyses, based on quality-effects models, generated pooled prevalence estimates for each maltreatment type. Exposure to child maltreatment was examined as a risk factor for depressive disorders, anxiety disorders and intentional self-harm using counterfactual estimation and comparative risk assessment methods. Adjustments were made for co-occurrence of multiple forms of child maltreatment. Overall, an estimated 23.5% of self-harm, 20.9% of anxiety disorders and 15.7% of depressive disorders burden in males; and 33.0% of self-harm, 30.6% of anxiety disorders and 22.8% of depressive disorders burden in females was attributable to child maltreatment. Child maltreatment was estimated to cause 1.4% (95% uncertainty interval 0.4-2.3%) of all disability-adjusted life years (DALYs) in males, and 2.4% (0.7-4.1%) of all DALYs in females in Australia in 2010. Child maltreatment contributes to a substantial proportion of burden from depressive and anxiety disorders and intentional self-harm in Australia. This study demonstrates the importance of including all forms of child maltreatment as risk factors in future burden of disease studies. Copyright © 2015 Elsevier Ltd. All rights reserved.
Tran, N.K. (Nhu K.); van Berkel, S.R. (Sheila R.); IJzendoorn, Rien; Alink, Lenneke R.A.
textabstractThis study aims to explore possible risk factors for child maltreatment in Vietnam by investigating the association of child and family factors with different types of child maltreatment (i.e., sexual abuse, physical abuse, emotional abuse, witnessing parental conflict, and neglect) and the occurrence of multiple types of child maltreatment. Cross-sectional data of 1,851 secondary and high school students aged 12 to 17 years (47.3% boys) in four provinces of Northern Vietnam were ...
Compier-de Block, Laura H.C.G.; Alink, Lenneke R.A.; Linting, Mariëlle; van den Berg, Lisa J.M.; Elzinga, Bernet M.; Voorthuis, Alexandra; Tollenaar, Marieke S.; Bakermans-Kranenburg, Marian J.
Parent-child agreement on child maltreatment was examined in a multigenerational study. Questionnaires on perpetrated and experienced child maltreatment were completed by 138 parent-child pairs. Multi-level analyses were conducted to explore whether parents and children agreed about levels of
Krase, Kathryn Suzanne
African American children are disproportionally overrepresented in the U.S. child protection system. Because educational personnel are a significant source of reports of suspected child maltreatment across the country and in all states, the present study examines the impact of these reports on racial disproportionality and disparity at the…
Pediatricians and other medical providers caring for children need to be aware of the dynamics in the significant relationship between substance abuse and child maltreatment. A caregiver's use and abuse of alcohol, marijuana, heroin, cocaine, methamphetamine, and other drugs place the child at risk in multiple ways. Members of the medical community need to understand these risks because the medical community plays a unique and important role in identifying and caring for these children. Substance abuse includes the abuse of legal drugs as well as the use of illegal drugs. The abuse of legal substances may be just as detrimental to parental functioning as abuse of illicit substances. Many substance abusers are also polysubstance users and the compounded effect of the abuse of multiple substances may be difficult to measure. Often other interrelated social features, such as untreated mental illness, trauma history, and domestic violence, affect these families.
Tran, N.K. (Nhu K.); van Berkel, S.R. (Sheila R.); M.H. van IJzendoorn (Rien); L.R.A. Alink (Lenneke R.A.)
textabstractThis study aims to explore possible risk factors for child maltreatment in Vietnam by investigating the association of child and family factors with different types of child maltreatment (i.e., sexual abuse, physical abuse, emotional abuse, witnessing parental conflict, and neglect) and
Compier-de Block, Laura H C G; Alink, Lenneke R A; Linting, Mariëlle; van den Berg, Lisa J M; Elzinga, Bernet M; Voorthuis, Alexandra; Tollenaar, Marieke S; Bakermans-Kranenburg, Marian J
Parent-child agreement on child maltreatment was examined in a multigenerational study. Questionnaires on perpetrated and experienced child maltreatment were completed by 138 parent-child pairs. Multi-level analyses were conducted to explore whether parents and children agreed about levels of parent-to-child maltreatment (convergence), and to examine whether parents and children reported equal levels of child maltreatment (absolute differences). Direct and moderating effects of age and gender were examined as potential factors explaining differences between parent and child report. The associations between parent- and child-reported maltreatment were significant for all subtypes, but the strength of the associations was low to moderate. Moreover, children reported more parent-to-child neglect than parents did. Older participants reported more experienced maltreatment than younger participants, without evidence for differences in actual exposure. These findings support the value of multi-informant assessment of child maltreatment to improve accuracy, but also reveal the divergent perspectives of parents and children on child maltreatment.
Discusses family factors associated with child abuse from an ecological perspective. Identifies economic and cultural generative factors of child abuse. Explores special circumstances affecting occurrence of child maltreatment. Examines dimensions of responsiveness, demandingness, and parental authority patterns in their application to abusive…
Otterman, Gabriel; Jalsenius, Marie; Maguire, Sabine; Sarkadi, Anna; Janson, Staffan
Little is known about the organisation of child maltreatment practice in Europe. We therefore explored medical child protection systems and training across Europe. An online survey was completed by physicians working in child maltreatment, identified through professional organisations in 28 member countries of the European Union, Iceland, Norway and Switzerland in 2012-2013. Respondents were questioned regarding management of suspected child maltreatment, mandatory reporting, professional training, patient referral and physician roles in multidisciplinary investigations. Responses underwent a narrative synthesis and descriptive enumerations. The survey was completed by 88 individuals, unevenly distributed in 22 of 31 countries. Physicians were mandated to report child maltreatment in 16 of 22 countries. All of 88 responding physicians described multidisciplinary involvement in the clinical and forensic management of suspected child maltreatment. Practitioners involved in physical examinations included general physicians, paediatricians, forensic medical examiners, gynaecologists and paediatric surgeons. Paediatricians were required to undergo child protection training according to 30 of 86 respondents in 14 of 22 countries. This survey demonstrates that there were wide variations in the organisation of child maltreatment paediatrics in Europe. The differing legislative frameworks and models of care are pertinent to consider when comparing epidemiology of maltreatment reported from across European countries. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.
Euser, Saskia; Alink, Lenneke R A; Pannebakker, Fieke; Vogels, Ton; Bakermans-Kranenburg, Marian J; Van IJzendoorn, Marinus H
The prevalence of child maltreatment in the Netherlands was in 2005 first systematically examined in the Netherlands' Prevalence study on Maltreatment of children and youth (NPM-2005), using sentinel reports and substantiated CPS cases, and in the Pupils on Abuse study (PoA-2005), using high school students' self-report. In this second National Prevalence study on Maltreatment (NPM-2010), we used the same three methods to examine the prevalence of child maltreatment in 2010, enabling a cross-time comparison of the prevalence of child maltreatment in the Netherlands. First, 1,127 professionals from various occupational branches (sentinels) reported each child for whom they suspected child maltreatment during a period of three months. Second, we included 22,661 substantiated cases reported in 2010 to the Dutch Child Protective Services. Third, 1,920 high school students aged 12-17 years filled out a questionnaire on their experiences of maltreatment in 2010. The overall prevalence of child maltreatment in the Netherlands in 2010 was 33.8 per 1,000 children based on the combined sentinel and CPS reports and 99.4 per 1,000 adolescents based on self-report. Major risk factors for child maltreatment were parental low education, immigrant status, unemployment, and single parenthood. We found a large increase in CPS-reports, whereas prevalence rates based on sentinel and self-report did not change between 2005 and 2010. Based on these findings a likely conclusion is that the actual number of maltreated children has not increased from 2005 to 2010, but that professionals have become more aware of child maltreatment, and more likely to report cases to CPS. Copyright © 2013 Elsevier Ltd. All rights reserved.
Hoytema van Konijnenburg, E.M.M.
The research described in this thesis focuses on the evaluation of several methods of screening for child maltreatment at the emergency department, with an emphasis on screening based on parental risk factors (‘child check’). The use of a screening checklist (mandatory in all Dutch emergency
Pence, Donna M.
Trauma-informed child welfare systems (CWSs) are the focus of several recent national and state initiatives. Since 2005 social work publications have focused on systemic and practice changes within CW which seek to identify and reduce trauma to children and families experiencing child maltreatment or other distressing events, as well as to the…
Stephenson, Rob; Sheikhattari, Payam; Assasi, Nazilla; Eftekhar, Hassan; Zamani, Qasem; Maleki, Bahram; Kiabayan, Hamid
Objective: This study examines the determinants of three types of child maltreatment: physical maltreatment, mental maltreatment, and child neglect among school children in the Kurdistan Province of Iran. The analysis examines the impact of socioeconomic, familial, demographic, and household dynamic factors on the three child maltreatment…
Hu, Xiaolin; Puddy, Richard W.
This paper presents an agent-based model that simulates the dynamics of child maltreatment and child maltreatment prevention. The developed model follows the principles of complex systems science and explicitly models a community and its families with multi-level factors and interconnections across the social ecology. This makes it possible to experiment how different factors and prevention strategies can affect the rate of child maltreatment. We present the background of this work and give an overview of the agent-based model and show some simulation results.
Scott Debbie A
Full Text Available Abstract Background International data on child maltreatment are largely derived from child protection agencies, and predominantly report only substantiated cases of child maltreatment. This approach underestimates the incidence of maltreatment and makes inter-jurisdictional comparisons difficult. There has been a growing recognition of the importance of health professionals in identifying, documenting and reporting suspected child maltreatment. This study aimed to describe the issues around case identification using coded morbidity data, outline methods for selecting and grouping relevant codes, and illustrate patterns of maltreatment identified. Methods A comprehensive review of the ICD-10-AM classification system was undertaken, including review of index terms, a free text search of tabular volumes, and a review of coding standards pertaining to child maltreatment coding. Identified codes were further categorised into maltreatment types including physical abuse, sexual abuse, emotional or psychological abuse, and neglect. Using these code groupings, one year of Australian hospitalisation data for children under 18 years of age was examined to quantify the proportion of patients identified and to explore the characteristics of cases assigned maltreatment-related codes. Results Less than 0.5% of children hospitalised in Australia between 2005 and 2006 had a maltreatment code assigned, almost 4% of children with a principal diagnosis of a mental and behavioural disorder and over 1% of children with an injury or poisoning as the principal diagnosis had a maltreatment code assigned. The patterns of children assigned with definitive T74 codes varied by sex and age group. For males selected as having a maltreatment-related presentation, physical abuse was most commonly coded (62.6% of maltreatment cases while for females selected as having a maltreatment-related presentation, sexual abuse was the most commonly assigned form of maltreatment (52.9% of
Tran, Nhu K; van Berkel, Sheila R; van IJzendoorn, Marinus H; Alink, Lenneke R A
This study aims to explore possible risk factors for child maltreatment in Vietnam by investigating the association of child and family factors with different types of child maltreatment (i.e., sexual abuse, physical abuse, emotional abuse, witnessing parental conflict, and neglect) and the occurrence of multiple types of child maltreatment. Cross-sectional data of 1,851 secondary and high school students aged 12 to 17 years (47.3% boys) in four provinces of Northern Vietnam were obtained using self-report questionnaires. Results indicated that the likelihood of emotional abuse, witnessing parental conflict, and experiencing multiple types of child maltreatment during lifetime increased with age. Boys had a higher risk than girls on lifetime sexual abuse, and past year and lifetime physical abuse. Living in a single parent family was the risk factor related to most types of child maltreatment including lifetime sexual abuse, neglect, and multiple types of child maltreatment, and both past year and lifetime witnessing parental conflict. Interestingly, low socioeconomic status (SES) and parental unemployment were associated with a decreased risk on experiencing emotional abuse in the past year and during lifetime, respectively. "Tiger parenting," a parenting style observed frequently in East Asian parents, may be more common in families with high SES and might explain this finding. This study highlights the importance of prioritizing single parent families in parenting programs and implementing child maltreatment interventions early because of the risk on child maltreatment increased with age. More research on emotional abuse and "Tiger parenting" in Vietnam could clarify the association of emotional abuse with high SES and parental employment. Finally, the underlying mechanisms of the risk factors in Vietnam should be studied more to inform interventions.
Daley, Dyann; Bachmann, Michael; Bachmann, Brittany A; Pedigo, Christian; Bui, Minh-Thuy; Coffman, Jamye
As indicated by research on the long-term effects of adverse childhood experiences (ACEs), maltreatment has far-reaching consequences for affected children. Effective prevention measures have been elusive, partly due to difficulty in identifying vulnerable children before they are harmed. This study employs Risk Terrain Modeling (RTM), an analysis of the cumulative effect of environmental factors thought to be conducive for child maltreatment, to create a highly accurate prediction model for future substantiated child maltreatment cases in the City of Fort Worth, Texas. The model is superior to commonly used hotspot predictions and more beneficial in aiding prevention efforts in a number of ways: 1) it identifies the highest risk areas for future instances of child maltreatment with improved precision and accuracy; 2) it aids the prioritization of risk-mitigating efforts by informing about the relative importance of the most significant contributing risk factors; 3) since predictions are modeled as a function of easily obtainable data, practitioners do not have to undergo the difficult process of obtaining official child maltreatment data to apply it; 4) the inclusion of a multitude of environmental risk factors creates a more robust model with higher predictive validity; and, 5) the model does not rely on a retrospective examination of past instances of child maltreatment, but adapts predictions to changing environmental conditions. The present study introduces and examines the predictive power of this new tool to aid prevention efforts seeking to improve the safety, health, and wellbeing of vulnerable children. Copyright Â© 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.
White, Oliver G; Hindley, Nick; Jones, David P H
Children who have been maltreated are at increased risk of further maltreatment. Identification of those at highest risk of further maltreatment is a priority for professionals working in child protection services. The current study is intended to consolidate and expand on previous work on recurrence of child maltreatment. It has sought to identify risk factors for maltreatment recurrence in the recent literature in the expectation that this may help in the practical identification of children at risk. We conducted a systematic review of cohort studies published between 2003 and 2009, identifying factors associated with maltreatment recurrence in children. Studies included demonstrated differing levels of substantiation of maltreatment. Fifteen studies met inclusion criteria but showed significant heterogeneity, varying in setting, recruitment of subjects, types of maltreatment considered and length of follow-up. Previous findings were replicated and expanded in the current study in relation to a range of factors, including rates of maltreatment recurrence, maltreatment types, frequency of previous episodes of maltreatment, child and family considerations, home environment and service provision. Factors were identified irrespective of level of maltreatment substantiation. This study provides further systematic evidence of the existence of a number of factors associated with child maltreatment recurrence. It points to the possibility of practical application of its findings within the wider context of decision making in child protection services, with the ultimate aim of reducing recurrence of maltreatment in individual cases. © The Author(s) 2014.
Lusk, Victoria L.; Zibulsky, Jamie; Viezel, Kathleen
A majority of substantiated maltreatment reports are made by educators and thus, teacher knowledge of child maltreatment reporting mandates and reporting behavior has been a focus of research. The knowledge and behavior of school psychologists, however, has not received similar attention. This study investigated the child maltreatment reporting…
Bartelink, C.; van Yperen, T. A.; ten Berge, I. J.; de Kwaadsteniet, L.; Witteman, C. L. M.
Background: Practitioners investigating cases of suspected child maltreatment often disagree whether a child is subject to or at risk of abuse or neglect in the family and, if so, what to do about such abuse or neglect. Structured decision-making is considered to be a solution to the problem of subjective judgments and decisions. Objective: This…
J Gordon Millichap
Full Text Available The relationship between inattentive and hyperactivity symptoms and child maltreatment was studied among a sample of 14,322 participants in the National Longitudinal Study of Adolescent Healh at the Centers for Disease Control and Prevention, Atlanta, GA.
Fallon, Barbara; Trocme, Nico; Fluke, John; MacLaurin, Bruce; Tonmyr, Lil; Yuan, Ying-Ying
Objective: This article reviewed the different surveillance systems used to monitor the extent of reported child maltreatment in North America. Methods: Key measurement and definitional differences between the surveillance systems are detailed and their potential impact on the measurement of the rate of victimization. The infrastructure…
Leeson, Fiona; Nixon, Reginald D. V.
Research of childhood psychological maltreatment has documented a range of severe and long-lasting difficulties for children who experience this type of abuse. Consequences can include but are not limited to emotional and behavioural problems, low self-esteem, and relationship difficulties. Accordingly, the development of therapy programs to…
Full Text Available The independent roles of each childhood maltreatment type on child abuse potential in adults have been insufficiently explored and are inconsistent, with dissociation as one of the possible suggested mediators of intergenerational child abuse. We investigated these effects among 164 non-clinical adult parents, who filled in general questionnaires: Childhood Trauma Questionnaire (CTQ, Child Abuse Potential Inventory (CAPI and Dissociative Experience Scale (DES. Among all maltreatment types (emotional, physical and sexual abuse, emotional and physical neglect, emotional abuse was the only independent predictor in the regression model of child abuse potential. The relationship between emotional abuse history and child abuse potential was partially mediated by dissociation. The findings could speak in favor of the potentially unique detrimental role of emotional abuse in intergenerational maltreatment, with dissociation as one of the possible mechanisms.
Toth, Sheree L.; Gravener-Davis, Julie A.; Guild, Danielle J.; Cicchetti, Dante
It is well established that child maltreatment has significant deleterious effects for the individual as well as for society. We briefly review research regarding the impact of child maltreatment on the attachment relationship, highlighting the need for relational interventions for maltreated children and their families to effectively thwart negative developmental cascades that are so often observed in the context of child maltreatment. Next, historical and contemporaneous perspectives on relational interventions for individuals with histories of child maltreatment are discussed with attention to the empirical evidence for and the current evidence-based status of several relationally based interventions for child maltreatment. Differential sensitivity to the environment is then discussed as a theoretical framework with important implications for interventions for individuals who have been reared in maltreating environments. Current research on neurobiology and maltreatment is then reviewed, with an emphasis on the need for future investigations on genetic variants, epigenetics, and the efficacy of relational interventions for maltreated children. We conclude with a discussion of the tenets of developmental psychopathology, their implications for relational interventions for child maltreatment, and recommendations for advancing the development, provision, and evaluation of relational interventions for individuals with histories of child maltreatment. PMID:24342858
Coohey, Carol; Renner, Lynette M.; Hua, Lei; Zhang, Ying J.; Whitney, Stephen D.
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…
Fuhua Zhai; Qin Gao
This article systematically reviews the characteristics of child maltreatment among Asian Americans and provides a theoretical explanatory framework. The reported rate of child maltreatment among Asian Americans is disproportionately low. A high rate of physical abuse and low rates of neglect and sexual abuse are found among Asian American victims. Some protective factors (e.g., the emphasis on family harmony and reputation and the indulgence to infants and toddlers) may lead to low probability of child maltreatment among Asian Americans. Some others (e.g., parental authority and beliefs in physical punishment) may be risk factors of child maltreatment, especially physical abuse. Meanwhile, many other coexisting factors (e.g., children's obedience to parents and families' invisibility to authorities) may prohibit child maltreatment from being disclosed. Therefore, the overall low reported rate of child maltreatment among Asian Americans may be a combination of low incidence and underreporting. Implications for practice and research are discussed.
Schreier, Hannah M. C.; Chen, Edith; Miller, Gregory E.
Background Child maltreatment is a common problem with known adverse consequences, yet its contributions to the development and course of pediatric asthma are only poorly understood. Main This review first describes possible pathways connecting child maltreatment to pediatric asthma, including aspects of the physical home environment, health behaviors and disease management, and psychological consequences of child maltreatment. We subsequently review existing studies, which generally report a...
Davis, Andrew S.; Moss, Lauren E.; Nogin, Margarita M.; Webb, Nadia Elizabeth
Child maltreatment has the potential to alter a child's neurodevelopmental trajectory and substantially increase the risk of later psychiatric disorders, as well as to deleteriously impact neurocognitive functioning throughout the lifespan. Child maltreatment has been linked to multiple domains of neurocognitive impairment, including…
Mª Ignacia Arruabarrena
Full Text Available Psychological maltreatment is one of the main and potentially more destructive forms of child maltreatment. It is difficult to identify, assess and treat. Compared to other forms of child maltreatment such as sexual abuse, physical abuse and neglect, attention received from researchers, child protection service managers and practitioners has been scarce. A review of available knowledge about psychological maltreatment reveals challenges to define the concept in ways useful to policy makers and practitioners. This paper presents a review of definitions of child psychological maltreatment and several measures available for assessing its severity. The review has been used in the Comunidad Autónoma Vasca (Spain to develop more specific criteria for the identification and severity assessment of child psychological maltreatment in Spanish children services. This paper develops these criteria.
Hosseinkhani, Z; Nedjat, S; Aflatouni, A; Mahram, M; Majdzadeh, R
Socioeconomic inequality and child maltreatment have not been studied using the concentration index as an indicator of inequality. The study aimed to assess the association of child maltreatment with socioeconomic status among schoolchildren in Qazvin province, Islamic Republic of Iran. In this cross-sectional study a questionnaire based on the ISPCAN Child Maltreatment Screening Tool-Children's Version and the Juvenile Victimization Questionnaire was filled by 1028 children aged 9-14 years, selected through multistage stratified random sampling. The concentration indices for economic inequality were -0.086 for any type of child maltreatment and -0.155, -0.098 and -0.139 for the physical, psychological and neglect subtypes of maltreatment respectively. The number of children and the economic status of the family also showed a significant association with child maltreatment in all 3 subtypes. Appropriate planning for effective interventions for at-risk children of lower socioeconomic status should be considered by the relevant decision-makers.
Atabaki, Armita; Heddaeus, Daniela; Metzner, Franka; Schulz, Holger; Siefert, Sonke; Pawils, Silke
Objectives: The current article describes the process evaluation of a social early warning system (SEWS) for the prevention of child maltreatment in the federal state of Hamburg. This prevention initiative targets expectant mothers and their partners including an initial screening of risk factors for child maltreatment, a subsequent structured…
Glass, Samuel; Gajwani, Ruchika; Turner-Halliday, Fiona
Background and Aims. Research on child maltreatment has largely overlooked the under-five age group and focuses primarily on quantitative measurement. This mixed-methods study of maltreated children (N = 92) entering care (age 6-60 months) combines a quantitative focus on the associations between care journey characteristics and mental health outcomes with a qualitative exploration of maltreatment in four different families. Methods. Care journey data was obtained from social care records; mental health and attachment assessments were carried out following entry to care; qualitative data comprised semistructured interviews with professionals, foster carers, and parents. Results. Significant associations were found between suspected sexual abuse and increased DAI inhibited attachment symptoms (p = 0.001) and between reported domestic violence and decreased DAI inhibited (p = 0.016) and disinhibited (p = 0.004) attachment symptoms. Qualitative results: two themes demonstrate the complexity of assessing maltreatment: (1) overlapping maltreatment factors occur in most cases and (2) maltreatment effects may be particularly challenging to isolate. Conclusions. Qualitative exploration has underscored the complexity of assessing maltreatment, indicating why expected associations were not found in this study and posing questions for the quantitative measurement of maltreatment in general. We therefore suggest a new categorisation of maltreatment and call for the complimentary research lenses of further mixed-methods approaches.
Full Text Available Background and Aims. Research on child maltreatment has largely overlooked the under-five age group and focuses primarily on quantitative measurement. This mixed-methods study of maltreated children (N=92 entering care (age 6–60 months combines a quantitative focus on the associations between care journey characteristics and mental health outcomes with a qualitative exploration of maltreatment in four different families. Methods. Care journey data was obtained from social care records; mental health and attachment assessments were carried out following entry to care; qualitative data comprised semistructured interviews with professionals, foster carers, and parents. Results. Significant associations were found between suspected sexual abuse and increased DAI inhibited attachment symptoms (p=0.001 and between reported domestic violence and decreased DAI inhibited (p=0.016 and disinhibited (p=0.004 attachment symptoms. Qualitative results: two themes demonstrate the complexity of assessing maltreatment: (1 overlapping maltreatment factors occur in most cases and (2 maltreatment effects may be particularly challenging to isolate. Conclusions. Qualitative exploration has underscored the complexity of assessing maltreatment, indicating why expected associations were not found in this study and posing questions for the quantitative measurement of maltreatment in general. We therefore suggest a new categorisation of maltreatment and call for the complimentary research lenses of further mixed-methods approaches.
Eckenrode, John; Smith, Elliott G; McCarthy, Margaret E; Dineen, Michael
To examine the relation between county-level income inequality and rates of child maltreatment. Data on substantiated reports of child abuse and neglect from 2005 to 2009 were obtained from the National Child Abuse and Neglect Data System. County-level data on income inequality and children in poverty were obtained from the American Community Survey. Data for additional control variables were obtained from the American Community Survey and the Health Resources and Services Administration Area Resource File. The Gini coefficient was used as the measure of income inequality. Generalized additive models were estimated to explore linear and nonlinear relations among income inequality, poverty, and child maltreatment. In all models, state was included as a fixed effect to control for state-level differences in victim rates. Considerable variation in income inequality and child maltreatment rates was found across the 3142 US counties. Income inequality, as well as child poverty rate, was positively and significantly correlated with child maltreatment rates at the county level. Controlling for child poverty, demographic and economic control variables, and state-level variation in maltreatment rates, there was a significant linear effect of inequality on child maltreatment rates (P income inequality across US counties was significantly associated with higher county-level rates of child maltreatment. The findings contribute to the growing literature linking greater income inequality to a range of poor health and well-being outcomes in infants and children.
Schreier, Hannah M C; Chen, Edith; Miller, Gregory E
Child maltreatment is a common problem with known adverse consequences, yet its contributions to the development and course of pediatric asthma are only poorly understood. This review first describes possible pathways connecting child maltreatment to pediatric asthma, including aspects of the physical home environment, health behaviors and disease management, and psychological consequences of child maltreatment. We subsequently review existing studies, which generally report an association between maltreatment experiences and asthma outcomes in childhood. However, this literature is in its early stages; there are only a handful studies, most of them rely on self-reports of both child maltreatment and asthma history, and none have investigated the physiological underpinnings of this association. Taken together, however, the studies are suggestive of child maltreatment playing a role in pediatric asthma incidence and expression that should be explored further. Existing data are sparse and do not allow for specific conclusions. However, the data are suggestive of child maltreatment influencing asthma risk and morbidity long before the adult years. Future research should focus on understanding how child maltreatment contributes to asthma disease risk and progression in this highly vulnerable population.
Introduction. Child abuse and neglect consists of any acts of commission ... of different types of child maltreatment in Iranian kids according to the reports of their caregivers. .... used to measure verbal and symbolic acts by the parents intended ...
Whereas child maltreatment research has developed considerable evidence on post-natal risk-factors, pre-natal circumstances have been largely overlooked. The circumstances surrounding a pregnancy may considerably impact the environment in which later parenting behaviors occur. This study examines one of the earliest potentially identifiable risk-factors for child maltreatment: the intentions of a pregnancy. Utilizing both mother and father reports, this study focuses on maltreatment risk, as it relates with both parents' perspectives of the pregnancy's intention. Drawing upon data from the Fragile Families and Child Well Being study, a longitudinal, birth cohort study, survey questions were used that asked parents, at the time of the birth, whether they considered abortion for the child. Unintended pregnancy demonstrates predictive value as one of the earliest identifiable risk-factors for child maltreatment. Regardless of whether the mother or father reported the unintended pregnancy, the relationship with maltreating behavior is largely the same, although for different maltreatment types. Mothers' reports of unintended pregnancy are associated with psychological aggression, and neglect. Fathers' reports of unintended pregnancy are associated with physical aggression. Fathers' perspectives regarding pregnancy intentions matter just as much as mothers,' and accounting for their perspectives could be important in understanding the maltreating behaviors of both parents. Identifiable in the earliest stages of caregiving, unintended pregnancy may be an important risk-factor in predicting and understanding child maltreatment. Copyright © 2015 Elsevier Ltd. All rights reserved.
Röhr, Susanne; Dölemeyer, Ruth; Klinitzke, Grit; Steinig, Jana; Wagner, Birgit; Kersting, Annette
This review is to provide a first overview about prevalences and associations of forms of child maltreatment in binge eating disorder (BED). Systematic literature search in PubMed and Web of Science in December 2013. Terms considered were "binge eating disorder" AND "child* maltreatment", "child* abuse", "child* sexual abuse", "child* emotional abuse", "child* physical abuse", "child* emotional neglect" as well as "child* physical neglect". Inclusion criteria were studies published between 1990 and 2013, publications in English or German, adult patients, studies that considered patients with full DSM criteria for BED, and studies that reported prevalences of forms of child maltreatment. Eight studies out of 366 met criteria. Child maltreatment rates in BED were more than two times higher than in representative samples, but they were similar to psychiatric comparisons. Up to 83 % of patients with BED reported at least one form of child maltreatment. There were associations to psychiatric comorbidity, but not to gender, obesity and specific features of the eating behaviour. Child maltreatment is very prevalent among BED. Its contribution to the development and the maintenance of BED is not understood yet. © Georg Thieme Verlag KG Stuttgart · New York.
Zhang, Wenjing; Ma, Yating; Chen, Jingqi
The present study aimed to explore the prevalence and frequency of child psychological maltreatment and its correlated factors in Chinese families. A cross-sectional investigation was conducted among 1,002 parents of primary school students in Yuncheng City, China. Data were collected using the self-report questionnaire anonymously. Results showed that 696 (69.5%) surveyed parents had different extents of psychological maltreatment toward their children in the past 3 months. The high prevalence of parental psychology maltreatment was significantly associated with high scores on parental over-reactivity and low scores on recognition of child psychology maltreatment. These findings indicate that it is urgent to develop cultural interventions to raise parents' awareness of preventing child psychological maltreatment and to help parents use nonviolent child rearing in China.
This article applies a developmental-ecological perspective to the question of the etiology of physical child abuse and neglect by organizing the paper around a variety of "contexts of maltreatment." The roles of parent and child characteristics and processes are considered ("developmental context"), including an examination of intergenerational transmission. The "immediate interactional context" of maltreatment, which focuses on the parenting and parent-child interactional processes associated with abuse and neglect, is analyzed. Finally, the "broader context" is discussed with 3 specific subsections dealing with the community, cultural, and evolutionary contexts of child maltreatment. Implications for intervention are considered and future research directions are outlined.
Nurses are mandated reporters of actual or suspected child maltreatment or the threat thereof. The purpose of this quality improvement project was to determine the knowledge and comfort of nurses in telephone triage in pediatric clinics when dealing with suspected or actual child abuse calls. Nurses (N = 17) from three pediatric primary care clinics and one specialty care orthopedic clinic were surveyed. Based on results of the survey showing a lack of knowledge and adequate referral resources perceived by the nursing staff, resources and staff education were developed, along with a script for guiding maltreatment calls toward standardization of care. Following the intervention, nurses reported an increased comfort level when doing telephone triage for child maltreatment calls, an increase in knowledge of risk factors for county resources. Further, they reported a substantial shift in opinion about the need for a standardized script when responding to child maltreatment telephone calls. Nurses undertaking telephone triage of high-risk child maltreatment calls can improve their comfort and knowledge through a survey of their needs and directed education and resource development for the management of child maltreatment telephone triage.
English, D.J.; Graham, J.C.; Litrownik, A.J.; Everson, M.; Bangdiwala, S.I.
Objective:: For nearly 25 years researchers have suggested that better taxonomic systems conceptualizing and reliably differentiating among different dimensions of maltreatment are required. This study examines the utility of three different characterizations of one dimension of maltreatment, chronicity, to predict child behavioral and emotional…
Baker, Louisa K.; Rigazio-DiGilio, Sandra A.
The authors empirically evaluated a spiritually based 1-day child maltreatment training program. Pretest, posttest, and follow-up results indicated that participants' recognition of hypothetical maltreatment did not increase after training. Furthermore, although participants decreased their use of items known to dissuade decisions to report, they…
McConnell, David; Feldman, Maurice; Aunos, Marjorie; Prasad, Narasimha
Objectives: The aim of this study was to determine the prevalence of parental cognitive impairment in cases opened for child maltreatment investigation in Canada, and to examine the relationship between parental cognitive impairment and maltreatment investigation outcomes including substantiation, case disposition and court application. Methods:…
Alink, Lenneke R. A.; Cicchetti, Dante; Kim, Jungmeen; Rogosch, Fred A.
Child maltreatment increases the risk for impaired social functioning and cortisol regulation. However, the longitudinal interplay among these factors is still unclear. This study aimed to shed light on the effect of maltreatment on social functioning and cortisol regulation over time. The sample consisted of 236 children (mean age 7.64 years, SD…
Sidebotham, Peter; Bailey, Sue; Belderson, Pippa; Brandon, Marian
Objective: This paper presents comprehensive and up-to-date data covering 4 years of Serious Case Reviews into fatal child maltreatment in England. Methods: Information on all notified cases of fatal maltreatment between April 2005 and March 2009 was examined to obtain case characteristics related to a systemic classification of 5 broad groups of…
Sofuoğlu, Zeynep; Sarıyer, Görkem; Ataman, M Gökalp
Child maltreatment, i.e. abuse and neglect, is a significant problem worldwide and can cause impaired physical and mental health throughout life. The true extent still remains unknown in all countries, including Turkey. The aim of this study was to apply the two versions of the International Society for the Prevention of Child Abuse and Neglect (ISPCAN) Child Abuse Screening Tool of ICAST-C and ICAST-P, which are used to assess child and parent feedback and to compare reports given by children and those given by parents. This is the first study of its kind conducted in Turkey. First, ICAST was translated into Turkish by bilingual experts. Students and their parents were asked to complete ICAST-C and ICAST-P respectively, with the help of trained researchers. In total, data from 2,608 matched reports (2,608 children and 2,608 parents) was obtained. Descriptive statistics were used to evaluate demographical variables, and chi-square tests were employed to investigate the statistical significance of comparisons. The present study demonstrated that Turkish parents consider rebukes, insults and corporal punishment effective ways of disciplining children. According to parents' reports, the use of psychological abuse was most prevalent against boys aged 16, while the use of physical abuse was most prevalent against boys aged 13. A statistically significant relationship was found between parents' economic conditions and child abuse (p0.05). However, the relationship between paternal educational background and psychological abuse was observed to be significant (pchildren's and parents' reports shows that parents tended to under-report child maltreatment. The results show that there is a significant healthcare problem in Turkey, since child maltreatment is prevalent, but parents are not generally aware of its extent. Possible approaches to changing this situation include efforts to increase education levels, promoting public awareness, and strengthening political commitments
Raghavan, Ramesh; Brown, Derek S; Allaire, Benjamin T; Garfield, Lauren D; Ross, Raven E; Hedeker, Donald
Medicaid data contain International Classification of Diseases, Clinical Modification (ICD-9-CM) codes indicating maltreatment, yet there is a little information on how valid these codes are for the purposes of identifying maltreatment from health, as opposed to child welfare, data. This study assessed the validity of Medicaid codes in identifying maltreatment. Participants (n = 2,136) in the first National Survey of Child and Adolescent Well-Being were linked to their Medicaid claims obtained from 36 states. Caseworker determinations of maltreatment were compared with eight sets of ICD-9-CM codes. Of the 1,921 children identified by caseworkers as being maltreated, 15.2% had any relevant ICD-9-CM code in any of their Medicaid files across 4 years of observation. Maltreated boys and those of African American race had lower odds of displaying a maltreatment code. Using only Medicaid claims to identify maltreated children creates validity problems. Medicaid data linkage with other types of administrative data is required to better identify maltreated children. © The Author(s) 2014.
Prior research suggests that income and child maltreatment are related, but questions remain about the specific types of economic factors that affect the risk of maltreatment. The need to understand the role of economics in child welfare is critical, given the significant public health costs of child maltreatment. One factor that has been overlooked is regressive taxation. This study addresses this need by examining whether state-level changes in cigarette tax rates predict changes in state-level child maltreatment rates. The results of both a fixed effects (FE) and a fixed effects instrumental variables (FE-IV) estimator show that increases in state cigarette tax rates are followed by increases in child abuse and neglect. An additional test finds that increases in the sales tax (another tax deemed to be regressive) also predict increases in child maltreatment rates. Taken as a whole, the findings suggest that regressive taxes have a significant effect on the risk of child maltreatment. Copyright © 2018 Elsevier Ltd. All rights reserved.
Slep, Amy M Smith; Heyman, Richard E; Foran, Heather M
Child maltreatment is widespread and has a tremendous impact on child victims and their families. Over the past decade, definitions of child maltreatment have been developed that are operationalized, face valid, and can be reliably applied in clinical settings. These definitions have informed the revised Diagnostic and Statistical Manual (American Psychiatric Association, 2013) and are being considered for the International Classification of Disease-11 (World Health Organization). Now that these definitions are available in major diagnostic systems, primary healthcare providers and clinicians who see children and families are poised to help screen for, identify, prevent, and treat child maltreatment. This article reviews the definitions of maltreatment in these diagnostic systems, along with assessment and screening tools, and empirically supported prevention and intervention approaches. © 2015 Family Process Institute.
McLaughlin, Katie A; Peverill, Matthew; Gold, Andrea L; Alves, Sonia; Sheridan, Margaret A
The strong associations between child maltreatment and psychopathology have generated interest in identifying neurodevelopmental processes that are disrupted following maltreatment. Previous research has focused largely on neural response to negative facial emotion. We determined whether child maltreatment was associated with neural responses during passive viewing of negative and positive emotional stimuli and effortful attempts to regulate emotional responses. A total of 42 adolescents aged 13 to 19 years, half with exposure to physical and/or sexual abuse, participated. Blood oxygen level-dependent (BOLD) response was measured during passive viewing of negative and positive emotional stimuli and attempts to modulate emotional responses using cognitive reappraisal. Maltreated adolescents exhibited heightened response in multiple nodes of the salience network, including amygdala, putamen, and anterior insula, to negative relative to neutral stimuli. During attempts to decrease responses to negative stimuli relative to passive viewing, maltreatment was associated with greater recruitment of superior frontal gyrus, dorsal anterior cingulate cortex, and frontal pole; adolescents with and without maltreatment down-regulated amygdala response to a similar degree. No associations were observed between maltreatment and neural response to positive emotional stimuli during passive viewing or effortful regulation. Child maltreatment heightens the salience of negative emotional stimuli. Although maltreated adolescents modulate amygdala responses to negative cues to a degree similar to that of non-maltreated youths, they use regions involved in effortful control to a greater degree to do so, potentially because greater effort is required to modulate heightened amygdala responses. These findings are promising, given the centrality of cognitive restructuring in trauma-focused treatments for children. Copyright © 2015 American Academy of Child and Adolescent Psychiatry
Family structure as a risk for child maltreatment has long been viewed as a static state in the child maltreatment literature. Drawing on data from the Fragile Families and Child Wellbeing Study, the author uses a series of individual fixed-effects models to investigate whether particular types of relationship transitions over children's first decade of life are associated with increased risk for maternal and paternal child abuse and maternal neglect. Findings question and confirm a number of long-standing theoretical and empirical findings from the child maltreatment literature. Results indicate that transitions to being single are associated with increased risk for maternal child abuse and neglect. In addition, the frequency and severity of paternal harsh parenting may be closely linked with the nature of fathers' relationship transitions. Last, results largely do not provide support for the theory that the presence of social (nonbiological) fathers increases mothers' risk for engaging in child abuse or neglect.
Tatiana Quarti Irigaray
Full Text Available This systematic review sought to assess the impact of child maltreatment on cognitive functioning. Seventeen papers from Medline, PsycINFO, Embase and Amed (1995-2011 databases were analyzed based on inclusion/exclusion criteria. The studies have shown that maltreatment during childhood has deleterious effects on cognitive functioning. Overall, adults or children/teenagers exposed to abuse during childhood performed poorly on tasks meant to assess verbal episodic memory, working memory, attention, and executive functions. We conclude that child maltreatment is a risk factor for short and long-term development due to potential adverse effects on cognitive functioning.
Weber, S; Jud, A; Landolt, M A
To review data on health-related quality of life (HRQoL) in individuals with childhood trauma, including psychological maltreatment, physical maltreatment, sexual abuse, and neglect. The literature search was conducted with pre-defined keywords using the following electronic bibliographic databases: EMBASE, PubMed, MEDLINE, CINAHL, PsyINFO, PSYNDEX, and Cochrane Database of Systematic Reviews. Further databases were searched for relevant dissertations. Study selection and data extraction were completed by two independent reviewers. The literature search yielded 1568 entries. Nineteen articles met all inclusion criteria and were retained for further analysis. Findings quite consistently showed significant negative associations between child maltreatment and both self- and proxy-rated HRQoL. Effect sizes range from small to large. Number of types of maltreatment and HRQoL were found to be negatively related. Data on HRQoL for maltreated children are still rare. Studies often investigate adult survivors of child maltreatment. Considering HRQoL in children and adolescents who suffered maltreatment would allow the planning of effective interventions and the evaluation of treatments to improve HRQoL of these children.
Hornor, Gail; Herendeen, Pamela
Child maltreatment is a problem of epidemic proportions in the United States. Pediatric nurse practitioners and other advanced practice nurses (APNs) have been caring for maltreated children for decades, yet to date no comprehensive assessment of their practice characteristics or their clinical and academic contributions to the field has been performed. The purpose of this study is to describe the practice characteristics of APNs who care for maltreated children. A descriptive design was used for this study. Child advocacy centers and children's hospitals were contacted to inquire about employment of child maltreatment APNs in their institution, and contact information for the lead APN was obtained. The Nurse Practitioner Survey was then sent to lead APNs by e-mail. The majority of APNs who work primarily in child maltreatment are pediatric nurse practitioners who work in child advocacy centers. They are providing care to children with physical and/or sexual abuse concerns; however, APNs provide care for children with all types of child maltreatment concerns. APNs play a vital role in the care of abused/neglected children. Their important contributions include not only clinical care but also the provision of clinical and didactic education to other professionals, parents, and the public. Research and publication are also essential to their role. Copyright © 2014 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.
Chen, Chih-Tsai; Yang, Nan-Ping; Chou, Pesus
Cases of child maltreatment are being increasingly reported in Taiwan. However, the trend or changes of child maltreatment in Taiwan are fragmentary and lack empirical evidence. This study analyzed the epidemiological characteristics of substantiated child maltreatment cases from the previous decade, using mortality as an indicator to investigate the care of children who experienced substantiated maltreatment in the past to determine any new developments. Data for analysis and estimates were retrieved from the Department of Statistics in the Ministry of the Interior from 2004 to 2013. Trend analyses were conducted using the Joinpoint Regression Program. The child maltreatment rate in Taiwan was found to have nearly tripled from 2004 to 2013. A greater increase in the maltreatment of girls than boys and the maltreatment of aboriginal children than non-aboriginal children was noted from 2004 to 2013. When stratified by age group, the increase in maltreatment was most pronounced in children aged 12-17 years, and girls aged 12-17 years experienced the greatest increase in maltreatment. In terms of the proportional changes of different maltreatment forms among substantiated child maltreatment cases, child neglect was decreasing. The increase in sexual abuse was higher than for any other form of maltreatment and surpassed neglect by the end of 2013. Furthermore, the mortality rate of children with substantiated maltreatment record is increasing in Taiwan, whereas the mortality rate among children without any substantiated maltreatment record is decreasing. The results of this study highlight the need for policy reform in Taiwan regarding child maltreatment. Copyright © 2015 Elsevier Ltd. All rights reserved.
Witt, Andreas; Brown, Rebecca C; Plener, Paul L; Brähler, Elmar; Fegert, Jörg M
Child maltreatment and its consequences are considered a major public health problem. So far, there is only one study from Germany reporting prevalence rates on different types of maltreatment. A representative sample of the German general population was examined for experiences of child maltreatment using the Childhood Trauma Questionnaire (CTQ) between September and November 2016. A total of 2510 (53.3% female) participants between 14 and 94 years (M = 48.8 years) were enrolled. Besides the CTQ, a range of sociodemographic information was collected. The interrelatedness of different types of maltreatment was examined using configuration analysis and predictors for maltreatment were identified by performing binary logistic regression analyses. Overall, 2.6% (f: 3.9%, m: 1.2%) of all participants reported severe emotional abuse, 3.3% (f: 3.4%, m: 3.3%) severe physical abuse, 2.3% (f: 3.7%, m: 0.7%) severe sexual abuse, 7.1% (f: 8.1%, m: 5.9%) severe emotional neglect and 9% (f: 9.2%, m: 8.9%) severe physical neglect. Women were more likely to report at least moderate sexual and emotional abuse than men. The largest difference between age groups was reported for physical neglect, with participants aged over 70 years reporting the highest rates. Participants who reported childhood maltreatment were more likely to be unemployed or have lower educational outcomes. The most common combination of maltreatment types were physical and emotional neglect, all five types of maltreatment combined and physical and emotional neglect and physical abuse combined. Child maltreatment, especially physical neglect is common in the German population. Women seem to be at greater risk for sexual and emotional abuse than men. Knowledge about different types of maltreatment based on the Childhood Trauma Questionnaire (CTQ) can help to put findings of future studies into an epidemiological and societal context.
LeBrun, Annie; Hassan, Ghayda; Boivin, Mylène; Fraser, Sarah-Louise; Dufour, Sarah; Lavergne, Chantal
Study results on child maltreatment based on general population samples cannot be extrapolated with confidence to vulnerable immigrant or refugee families because of the specific characteristics and needs of these families. The aims of this paper are 1) to conduct an evidence review of the prevalence, risk factors and protective factors for child maltreatment in immigrant and refugee populations, and 2) to integrate the evidence in an analytical ecosystemic framework that would guide future research. We used a 14-step process based on guidelines from Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Canadian Collaboration for Immigrant and Refugee Health. We searched major databases from "the oldest date available to July 2014". The eligibility criteria for paper selection included qualitative or quantitative methodologies; papers written in English or French; papers that describe, assess or review prevalence, risk and protection factors for child maltreatment; and a studied population of immigrants or refugees. Twenty-four articles met the criteria for eligibility. The results do not provide evidence that immigrant or refugee children are at higher risk of child maltreatment. However, recently settled immigrants and refugees experience specific risk factors related to their immigration status and to the challenges of settlement in a new country, which may result in high risk of maltreatment. Future research must incorporate more immigrant and refugee samples as well as examine, within an ecosystemic framework, the interaction between migratory and cultural factors with regard to the prevalence, consequences and treatment of child maltreatment for the targeted groups.
Reading, Richard; Bissell, Susan; Goldhagen, Jeffrey; Harwin, Judith; Masson, Judith; Moynihan, Sian; Parton, Nigel; Pais, Marta Santos; Thoburn, June; Webb, Elspeth
In medical literature, child maltreatment is considered as a public-health problem or an issue of harm to individuals, but less frequently as a violation of children's human rights. Public-health approaches emphasise monitoring, prevention, cost-effectiveness, and population strategies; protective approaches concentrate on the legal and professional response to cases of maltreatment. Both approaches have been associated with improvement in outcomes for children, yet maltreatment remains a major global problem. We describe how children's rights provide a different perspective on child maltreatment, and contribute to both public-health and protective responses. Children's rights as laid out in the UN convention on the rights of the child (UNCRC) provide a framework for understanding child maltreatment as part of a range of violence, harm, and exploitation of children at the individual, institutional, and societal levels. Rights of participation and provision are as important as rights of protection. The principles embodied in the UNCRC are concordant with those of medical ethics. The greatest strength of an approach based on the UNCRC is that it provides a legal instrument for implementing policy, accountability, and social justice, all of which enhance public-health responses. Incorporation of the principles of the UNCRC into laws, research, public-health policy, and professional training and practice will result in further progress in the area of child maltreatment.
Thornhill, Randy; Fincher, Corey L.
Researchers using the parasite-stress theory of human values have discovered many cross-cultural behavioural patterns that inform a range of scholarly disciplines. Here, we apply the theory to major categories of interpersonal violence, and the empirical findings are supportive. We hypothesize that the collectivism evoked by high parasite stress is a cause of adult-on-adult interpersonal violence. Across the US states, parasite stress and collectivism each positively predicts rates of men's and women's slaying of a romantic partner, as well as the rate of male-honour homicide and of the motivationally similar felony-related homicide. Of these four types of homicide, wealth inequality has an independent effect only on rates of male-honour and felony-related homicide. Parasite stress and collectivism also positively predict cross-national homicide rates. Child maltreatment by caretakers is caused, in part, by divestment in offspring of low phenotypic quality, and high parasite stress produces more such offspring than low parasite stress. Rates of each of two categories of the child maltreatment—lethal and non-lethal—across the US states are predicted positively by parasite stress, with wealth inequality and collectivism having limited effects. Parasite stress may be the strongest predictor of interpersonal violence to date. PMID:22042922
Milani, Gregorio P; Vianello, Federica A; Cantoni, Barbara; Agostoni, Carlo; Fossali, Emilio F
Early detection of child maltreatment in pediatric emergency department is one of the most important challenges for the Italian and European medical care system. Several interventions have been proposed, but results are often unquantifiable or inadequate to face this problem. We promoted an educational program and built up an interdisciplinary team to improve the identification and management of maltreated children. Aim of this study is to report preliminary results of these interventions. Meetings structured with lecture-based teaching and case-based lessons were focused on identification and management of maltreatment cases. An interdisciplinary team with forensic physicians, dermatologists, orthopedics, radiologists, gynecologists, oculists, psychologists and psychiatrics, was created to manage children with suspected diagnosis of maltreatment. We analysed the characteristics of subjects diagnosed after these interventions and their number was compared with the one in the two previous years. An increased rate of diagnoses of 16.9 % was found. Results of the reported program are encouraging, but many efforts are still mandatory to improve the child maltreatment identification in emergency departments.
Cui, Naixue; Xue, Jia; Connolly, Cynthia A; Liu, Jianghong
Child maltreatment is a public health problem worldwide, and China is no exception. However, the pattern of child maltreatment remains unknown, including whether the gender of children and their parents has an impact on the occurrence of maltreatment. This study aims at examining the rates and frequency of child maltreatment, including physical abuse, psychological abuse and neglect perpetrated by mothers and fathers. We also test whether the interaction between parents' gender and their child's gender affects the occurrence of child maltreatment in China. 997 children from the China Jintan Child Cohort Study participated in the present study and reported their maltreatment experience perpetrated by their mothers and fathers using the questionnaire, Parent-Child Conflict Tactics Scale (CTSPC_CA). Generalized linear model analyses show that boys were more likely than girls to report physical abuse, and, in particular, boys were more likely than girls to be physically abused by their fathers. On the other hand, mothers were more likely than fathers to exhibit psychological aggression and use corporal punishment for both boys and girls. There was no difference based on the child's or parent's gender in the occurrence of neglect. The findings present empirical evidence that enhances the understanding of the pattern of child maltreatment in China, provide implications for social workers and health professionals to identify children at risk of child maltreatment, and shed light on future research studies. Copyright © 2016 Elsevier Ltd. All rights reserved.
Alink, Lenneke R A; Euser, Saskia; van Ijzendoorn, Marinus H; Bakermans-Kranenburg, Marian J
In this study we tested whether children from Dutch-immigrant families are at increased risk for maltreatment, and if so, what factors could explain this risk. Three data sources from the second Netherlands Prevalence Study of Maltreatment of Youth (NPM-2010) were used to answer these questions. First, 1127 professionals from various occupational branches (sentinels) were asked to report each child (including some background information on the child and family) for whom they suspected child maltreatment during a period of three months. Second, we included the 2010 data from the Dutch Child Protective Services and third, 1759 high school students aged 11-17 years filled out a questionnaire on their experiences of maltreatment in the past year. We found that children from traditional immigrant families with a relatively long migration history in the Netherlands (Turkish, Moroccan, Surinamese, and Antillean) and from nontraditional immigrant families (African [except Morocco], Eastern European, Central Asian, and South and Central American; often refugees) were at increased risk for child maltreatment compared to native Dutch families. However, in the professionals' and CPS data this risk disappeared for the traditional immigrant families after correction for educational level of the parents and for step-parenthood. Within the group of families with low education or step-parents, the risk for child maltreatment was similar for traditional immigrant families as for native Dutch families. Nontraditional families remained at increased risk after correction for sociodemographic and family factors. In conclusion, we found that children from both traditional and nontraditional immigrant families are at increased risk for maltreatment as compared to children from native Dutch families. For the traditional immigrants this risk could partially be explained by socioeconomic status. This implies that socioeconomic factors should be taken into account when outlining policies to
In this thesis we describe, combine and compare results of a series of meta-analyses on the prevalence of child sexual, physical, and emotional abuse and of physical and emotional neglect, including 244 publications and 577 prevalence rates for the various types of maltreatment. Child maltreatment
Sege, Robert D; Amaya-Jackson, Lisa
Children who have suffered early abuse or neglect may later present with significant health and behavior problems that may persist long after the abusive or neglectful environment has been remediated. Neurobiological research suggests that early maltreatment may result in an altered psychological and physiologic response to stressful stimuli, a response that deleteriously affects the child's subsequent development. Pediatricians can assist caregivers by helping them recognize the abused or neglected child's emotional and behavioral responses associated with child maltreatment and guide them in the use of positive parenting strategies, referring the children and families to evidence-based therapeutic treatment and mobilizing available community resources. Copyright © 2017 by the American Academy of Pediatrics.
Wolfe, David A.; McIsaac, Caroline
Objective: This paper was intended to distinguish between poor parenting and child emotional maltreatment (CEM), to inform child welfare and public health policymakers of the need for differentiated responses. Methods: Scientific literature was integrated with current practice and assumptions relating to poor/dysfunctional parenting and child…
The effects of child maltreatment on children's chronic health conditions have become more visible during recent years. This is true for mental health problems as well as some chronic physical conditions, both summarized as new morbidity within pediatrics. As several Bradford Hill criteria (criteria from epidemiology for the determination of the causal nature of a statistical association) are met, the likely causal nature of underlying associations is discussed. Early family support may have the potential to modify such associations, although empirical evidence is lacking. At least for attachment-based interventions with foster carerers after child maltreatment, positive effects on child HPA axis dysregulation have been demonstrated.
Jaffee, Sara R
Although rates of child maltreatment are declining, more than 600,000 children in the United States are substantiated victims of abuse or neglect. The focus of this review is on the relationship between maltreatment and mental health problems in childhood and adulthood. Children and adults who are exposed to abuse or neglect in childhood are at risk for a range of poor mental health outcomes, including internalizing and externalizing psychopathology, posttraumatic stress disorder, psychotic symptoms, and personality disorders. I review three potential mechanisms by which maltreatment may increase risk for various forms of psychopathology, (a) hypervigilance to threat, (b) deficits in emotion recognition and understanding, and (c) low responsivity to reward. I also review genetic and psychosocial factors that moderate the relationship between maltreatment and risk for psychopathology. Finally, I discuss methodological limitations of the literature on maltreatment, with an emphasis on the challenges associated with establishing a causal role for maltreatment (and moderators or mediators of maltreatment) in the development of mental health problems and the reliance of many studies on retrospective self-reports.
This study expands research on the relationship between community (defined here as a locality) characteristics and child maltreatment. Research in this field is not new, but it is scarce. Our study is unique by examining changes between two periods rather than focusing on one point in time. Furthermore, our study examines structural conditions in small and medium size localities in Israel, a non-Western and non-Christian society. We compare our results with those from studies on inner-city and suburban neighborhoods in Western countries and earlier studies in Israel. We collected data on 169 Israeli localities, ranging from small ones (with as few as 1,500 residents) to medium size localities (i.e., towns) (with as many as 50,000 residents) in which approximately 34% of the Israeli child population resides. Our study tested four hypotheses: (1) Socioeconomic characteristics of the locality will be negatively correlated with the availability of social services; (2) Reported child maltreatment rates will be negatively correlated with the socioeconomic characteristics of the locality; (3) The availability of social services will be positively correlated with reported child maltreatment rates; and (4) Overall reported child maltreatment rates will be negatively correlated with the overall status of the localities. We have supported our second and third hypothesis in full, and partially supported our first and fourth hypothesis. In particular we have demonstrated that while demographics play a different role in Israel than in other countries in regard to child maltreatment, social, economic and cultural context are crucial for understating reported rates of child maltreatment. Copyright © 2014 Elsevier Ltd. All rights reserved.
Taylor, Julie; Bradbury-Jones, Caroline; Lazenbatt, Anne; Soliman, Francesca
The manifesto Start Well, Live Better by the UK Faculty of Public Health (Start Well, Live Better-A Manifesto for the Public's Health. London: UK Faculty of Public Health, 2014) sets out 12 compelling priorities for the protection of people's health. The focus of this document is preventative, calling for a comprehensive strategy to target a wide-ranging set of challenges to public health; however, it fails to mention child maltreatment and its negative impact on long-term health outcomes. In this article, we explore the long-term negative consequences of child maltreatment and how these can be conceptually aligned with four different characteristics of long-term health conditions. We suggest that situating child maltreatment within a long-term conditions framework could have significant advantages and implications for practice, policy and research, by strengthening a commitment across disciplines to apply evidence-based principles linked with policy and evaluation and recognizing the chronic effects of maltreatment to concentrate public, professional and government awareness of the extent and impact of the issue. We argue that a public health approach is the most effective way of focusing preventative efforts on the long-term sequelae of child maltreatment and to foster cooperation in promoting children's rights to grow and develop in a safe and caring environment free from violence and abuse. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: email@example.com.
Research questions Research on child maltreatment has suggested that children exposed to abuse and neglect exhibit various social, cognitive and emotional developmental problems. The paper explores long-term consequences and addresses the following questions: how many is exposed to child...... and hospital wards. While 5.6 percent of the birth cohort experienced physical abuse only 1.1 percent of a birth cohort was known to the local authorities, and only 0.1 percent of a birth cohort registered at a hospital ward. Less than half of child maltreatment known to the local authorities was reduced...... is associated with a reduced risk of PTSD symptoms even when experienced poor parenting with the destructiveness of physical abuse, sexual assault, psychological maltreatment and physical neglect. ADHD symptoms turn out to be associated with later PTSD also when accounted for poor parenting and other risk...
van Ijzendoorn, Marinus H; Euser, Eveline M; Prinzie, Peter; Juffer, Femmie; Bakermans-Kranenburg, Marian J
Does child maltreatment occur more often in adoptive and stepfamilies than in biological families? Data were collected from all 17 Dutch child protective services (CPS) agencies on 13,538 cases of certified child maltreatment in 2005. Family composition of the maltreated children was compared to a large national representative sample of the Netherlands Kinship Panel Study (NKPS). Larger families, one-parent families, and families with a stepparent showed elevated risks for child maltreatment. Adoptive families, however, showed significantly less child maltreatment than expected. The findings are discussed in the context of parental investment theory that seems to be applicable to stepparents but not to adoptive parents.
Pinto Pereira, Snehal M; Li, Leah; Power, Chris
Child maltreatment (abuse and neglect) has established effects on mental health. Less is known about its influence on adult economic circumstances. We aimed to establish associations of child maltreatment with such outcomes and explore potential pathways. We used 1958 British birth cohort data (N = 8076) to examine associations of child neglect and abuse with adult (50 years) long-term sickness absence, not in employment, education or training (NEET), lacking assets, income-related support, poor qualifications, financial insecurity, manual social class, and social mobility. We assessed mediation of associations by 16-year cognition and mental health. Abuse prevalence varied from 1% (sexual) to 10% (psychological); 16% were neglected. A total of 21% experienced 1 maltreatment type, 10% experienced ≥2 types. Sexual and nonsexual abuse were associated with several outcomes; eg, for sexual abuse, adjusted odds ratio (aOR) of income-related support was 1.75 (95% confidence interval [CI], 1.12-2.72). Associations were little affected by potential mediating factors. Neglect was associated with several adult outcomes (eg, aOR of NEET was 1.43 [95% CI, 1.10-1.85]) and associations were mediated by cognition and mental health (primarily by cognition): percent explained varied between 4% (NEET) to 70% (poor qualifications). In general, the risk of poor outcome increased by number of maltreatment types (eg, aOR for long-term sickness absence increased from 1.0 [reference] to 1.76 [95% CI, 1.32-2.35] to 2.69 [95% CI, 1.96-3.68], respectively, for 0, 1, and ≥2 types of maltreatment. Childhood maltreatment is associated with poor midadulthood socioeconomic outcomes, with accumulating risk for those experiencing multiple types of maltreatment. Cognitive ability and mental health are implicated in the pathway to outcome for neglect but not abuse. Copyright © 2017 by the American Academy of Pediatrics.
Bosquet Enlow, Michelle; Englund, Michelle M; Egeland, Byron
The objectives of this study were to examine whether a maternal history of maltreatment in childhood has a detrimental impact on young children's mental health and to test theoretically and empirically informed pathways by which maternal history may influence child mental health. Mother-child dyads (N = 187) were evaluated between birth and 64 months of age via home and laboratory observations, medical and child protection record reviews, and maternal interviews to assess maternal history of childhood maltreatment and microsystem and exosystem measures of the caregiving context, including child maltreatment, maternal caregiving quality, stress exposures, and social support. When the children were 7 years of age, mothers and teachers reported on child emotional and behavioral problems. Analyses examined whether the caregiving context variables linked maternal maltreatment history with child emotional and behavioral problems, controlling for child sex (54% male), race/ethnicity (63% White), and family sociodemographic risk at birth. Maltreated mothers experienced greater stress and diminished social support, and their children were more likely to be maltreated across early childhood. By age 7, children of maltreated mothers were at increased risk for clinically significant emotional and behavioral problems. A path analysis model showed mediation of the effects of maternal childhood maltreatment history on child symptoms, with specific effects significant for child maltreatment. Interventions that reduce child maltreatment risk and stress exposures and increase family social support may prevent deleterious effects of maternal childhood maltreatment history on child mental health.
Lynne, Ellen Grace; Gifford, Elizabeth J; Evans, Kelly E; Rosch, Joel B
Child maltreatment is underreported in the United States and in North Carolina. In North Carolina and other states, mandatory reporting laws require various professionals to make reports, thereby helping to reduce underreporting of child maltreatment. This study aims to understand why emergency medical services (EMS) professionals may fail to report suspicions of maltreatment despite mandatory reporting policies. A web-based, anonymous, voluntary survey of EMS professionals in North Carolina was used to assess knowledge of their agency's written protocols and potential reasons for underreporting suspicion of maltreatment (n=444). Results were based on descriptive statistics. Responses of line staff and leadership personnel were compared using chi-square analysis. Thirty-eight percent of respondents were unaware of their agency's written protocols regarding reporting of child maltreatment. Additionally, 25% of EMS professionals who knew of their agency's protocol incorrectly believed that the report should be filed by someone other than the person with firsthand knowledge of the suspected maltreatment. Leadership personnel generally understood reporting requirements better than did line staff. Respondents indicated that peers may fail to report maltreatment for several reasons: they believe another authority would file the report, including the hospital (52.3%) or law enforcement (27.7%); they are uncertain whether they had witnessed abuse (47.7%); and they are uncertain about what should be reported (41.4%). This survey may not generalize to all EMS professionals in North Carolina. Training opportunities for EMS professionals that address proper identification and reporting of child maltreatment, as well as cross-agency information sharing, are warranted.
Solomon, David; Åsberg, Kia; Peer, Samuel; Prince, Gwendolyn
Although Child Protective Services (CPS) and other child welfare agencies aim to prevent further maltreatment in cases of child abuse and neglect, recidivism is common. Having a better understanding of recidivism predictors could aid in preventing additional instances of maltreatment. A previous study identified two CPS interventions that predicted recidivism: psychotherapy for the parent, which was related to a reduced risk of recidivism, and temporary removal of the child from the parent's custody, which was related to an increased recidivism risk. However, counter to expectations, this previous study did not identify any other specific risk factors related to maltreatment recidivism. For the current study, it was hypothesized that (a) cumulative risk (i.e., the total number of risk factors) would significantly predict maltreatment recidivism above and beyond intervention variables in a sample of CPS case files and that (b) therapy for the parent would be related to a reduced likelihood of recidivism. Because it was believed that the relation between temporary removal of a child from the parent's custody and maltreatment recidivism is explained by cumulative risk, the study also hypothesized that that the relation between temporary removal of the child from the parent's custody and recidivism would be mediated by cumulative risk. After performing a hierarchical logistic regression analysis, the first two hypotheses were supported, and an additional predictor, psychotherapy for the child, also was related to reduced chances of recidivism. However, Hypothesis 3 was not supported, as risk did not significantly mediate the relation between temporary removal and recidivism. Copyright © 2016 Elsevier Ltd. All rights reserved.
Lane, Wendy; Sacco, Paul; Downton, Katherine; Ludeman, Emilie; Levy, Lauren; Tracy, J Kathleen
This study systematically reviews research on child maltreatment and risk of gambling problems in adulthood. It also reviews adult problem gamblers' risk of abusing or neglecting their own children. Multiple database searches were conducted using pre-defined search terms related to gambling and child abuse and neglect. We identified 601 unique references and excluded studies if they did not report original research, or did not specifically measure child maltreatment or gambling. Twelve studies that included multivariable analysis of childhood maltreatment exposure and problem gambling were identified. Six of seven studies examining childhood sexual abuse and four of five examining physical abuse showed a significant positive association between abuse and later gambling problems (odds ratios for sexual abuse 2.01-3.65; physical abuse 2.3-2.8). Both studies examining psychological maltreatment and two of three examining neglect identified positive associations with problem gambling. In most studies, risks were reduced or eliminated when controlling for other mental health disorders. The three studies measuring risk of child abuse and neglect among current problem gamblers suggest an increased risk for child physical abuse and medical conditions indicative of neglect although there is a considerable amount of variation among studies. Child abuse is associated with increased risk of gambling problems - gambling treatment providers should ask about maltreatment history as part of their clinical assessment. Problem gamblers may be more likely to physically abuse or neglect their children, but data here are more limited. Child welfare professionals should consider asking questions about parental gambling when assessing family risk. Copyright © 2016 Elsevier Ltd. All rights reserved.
Mikton, Christopher; Butchart, Alexander
To synthesize recent evidence from systematic and comprehensive reviews on the effectiveness of universal and selective child maltreatment prevention interventions, evaluate the methodological quality of the reviews and outcome evaluation studies they are based on, and map the geographical distribution of the evidence. A systematic review of reviews was conducted. The quality of the systematic reviews was evaluated with a tool for the assessment of multiple systematic reviews (AMSTAR), and the quality of the outcome evaluations was assessed using indicators of internal validity and of the construct validity of outcome measures. The review focused on seven main types of interventions: home visiting, parent education, child sex abuse prevention, abusive head trauma prevention, multi-component interventions, media-based interventions, and support and mutual aid groups. Four of the seven - home-visiting, parent education, abusive head trauma prevention and multi-component interventions - show promise in preventing actual child maltreatment. Three of them - home visiting, parent education and child sexual abuse prevention - appear effective in reducing risk factors for child maltreatment, although these conclusions are tentative due to the methodological shortcomings of the reviews and outcome evaluation studies they draw on. An analysis of the geographical distribution of the evidence shows that outcome evaluations of child maltreatment prevention interventions are exceedingly rare in low- and middle-income countries and make up only 0.6% of the total evidence base. Evidence for the effectiveness of four of the seven main types of interventions for preventing child maltreatment is promising, although it is weakened by methodological problems and paucity of outcome evaluations from low- and middle-income countries.
How often does child maltreatment occur in the Netherlands and which factors increase the risk of child maltreatment? In this thesis we describe the findings of two epidemiological studies aimed at answering these questions. First, in the Netherlands’ Prevalence study on Maltreatment of children and
Constantino, John N
Child maltreatment is one of the most deleterious known influences on the mental health and development of children. This article briefly reviews a complement of methods that are ready to incorporate into child and adolescent psychiatric practice, by having been validated either with respect to the prevention of child maltreatment or with respect to adverse outcomes associated with maltreatment (and primarily focused on enhancing the caregiving environment); they are feasible for integration into clinical decision making, and most importantly, can be included in the training of the next generation of clinicians. Copyright © 2016 The Author. Published by Elsevier Inc. All rights reserved.
Fang, Xiangming; Fry, Deborah A; Ji, Kai; Finkelhor, David; Chen, Jingqi; Lannen, Patricia; Dunne, Michael P
To estimate the health and economic burdens of child maltreatment in China. We did a systematic review for studies on child maltreatment in China using PubMed, Embase, PsycInfo, CINAHL-EBSCO, ERIC and the Chinese National Knowledge Infrastructure databases. We did meta-analyses of studies that met inclusion criteria to estimate the prevalence of child neglect and child physical, emotional and sexual abuse. We used data from the 2010 global burden of disease estimates to calculate disability-adjusted life-years (DALYs) lost as a result of child maltreatment. From 68 studies we estimated that 26.6% of children under 18 years of age have suffered physical abuse, 19.6% emotional abuse, 8.7% sexual abuse and 26.0% neglect. We estimate that emotional abuse in childhood accounts for 26.3% of the DALYs lost because of mental disorders and 18.0% of those lost because of self-harm. Physical abuse in childhood accounts for 12.2% of DALYs lost because of depression, 17.0% of those lost to anxiety, 20.7% of those lost to problem drinking, 18.8% of those lost to illicit drug use and 18.3% of those lost to self-harm. The consequences of physical abuse of children costs China an estimated 0.84% of its gross domestic product - i.e. 50 billion United States dollars - in 2010. The corresponding losses attributable to emotional and sexual abuse in childhood were 0.47% and 0.39% of the gross domestic product, respectively. In China, child maltreatment is common and associated with large economic losses because many maltreated children suffer substantial psychological distress and might adopt behaviours that increase their risk of chronic disease.
Hutchens, Bridget F; Kearney, Joan; Kennedy, Holly Powell
An integrative review was performed to explore the relationship between a maternal history of child maltreatment and subsequent postpartum depression (PPD) symptoms. Six electronic databases were used to explore the literature, including PubMed, CINAHL, MEDLINE, PsycINFO, Embase, and Scopus. Studies were included that used victims of child maltreatment as one of the independent variables and PPD symptoms as one of the dependent variables. Studies were excluded if they focused only on women with adult intimate partner violence or women with PPD who were perpetrators of child abuse rather than survivors. The studies were required to be original research, and there was no limit to years or language. The search yielded 589 studies, 16 of which were included in the final sample. These studies were assessed for quality, and a data display matrix was developed to extract the sample, design, methods, operational definitions for independent and dependent variables of interest, major findings with effect sizes, and limitations. Using the data display matrix, the studies' methods and findings were synthesized for divergent and convergent patterns. Studies were varied in their designs, samples, and operational definitions of child maltreatment and PPD, and were low to moderate in quality. Results were inconsistent, but a majority suggest a positive association between a maternal history of child maltreatment and subsequent symptoms of PPD. Child maltreatment and PPD are complex issues that require careful screening by women's health care providers and clearly defined operational definitions in future research. Implications for clinical practice and research are discussed. © 2017 by the American College of Nurse-Midwives.
Brownell, Marni D.; Jutte, Douglas P.
Linking administrative data records for the same individuals across services and over time offers a powerful, population-wide resource for child maltreatment research that can be used to identify risk and protective factors and to examine outcomes. Multistage de-identification processes have been developed to protect privacy and maintain…
Schryer, Catherine F.; Bell, Stephanie; Mian, Marcellina; Spafford, Marlee M.; Lingard, Lorelei
Using rhetorical genre theory and research on reported speech, this study investigates the citation practices in 81 forensic letters written by paediatricians and nurse practitioners that provide their opinion for the courts as to whether a child has experienced maltreatment. These letters exist in a complex social situation where a lack of…
Schnitzer, Patricia G.; Slusher, Paula L.; Kruse, Robin L.; Tarleton, Molly M.
Objective: In order to be reimbursed for the care they provide, hospitals in the United States are required to use a standard system to code all discharge diagnoses: the International Classification of Disease, 9th Revision, Clinical Modification (ICD-9). Although ICD-9 codes specific for child maltreatment exist, they do not identify all…
Dubowitz, Howard; Kim, Jeongeun; Black, Maureen M.; Weisbart, Cindy; Semiatin, Joshua; Magder, Laurence S.
Objective: To help professionals identify factors that place families at risk for future child maltreatment, to facilitate necessary services and to potentially help prevent abuse and neglect. Method: The data are from a prospective, longitudinal study of 332 low-income families recruited from urban pediatric primary care clinics, followed for…
Shanahan, Meghan E; Fliss, Mike D; Proescholdbell, Scott K
BACKGROUND As child maltreatment often occurs in private, child welfare numbers underestimate its true prevalence. Child maltreatment surveillance systems have been used to ascertain more accurate counts of children who experience maltreatment. This manuscript describes the results from a pilot child maltreatment surveillance system in Wake County, North Carolina. METHODS We linked 2010 and 2011 data from 3 sources (Child Protective Services, Raleigh Police Department, and Office of the Chief Medical Examiner) to obtain rates of definite and possible child maltreatment. We separately analyzed emergency department visits from 2010 and 2011 to obtain counts of definite and possible child maltreatment. We then compared the results from the surveillance systems to those obtained from Child Protective Services (CPS) data alone. RESULTS In 2010 and 2011, rates of definite child maltreatment were 11.7 and 11.3 per 1,000 children, respectively, when using the linked data, compared to 10.0 and 9.5 per 1,000 children using CPS data alone. The rates of possible maltreatment were 25.3 and 23.8 per 1,000, respectively. In the 2010 and 2011 emergency department data, there were 68 visits and 84 visits, respectively, that met the case definition for maltreatment. LIMITATIONS While 4 data sources were analyzed, only 3 were linked in the current surveillance system. It is likely that we would have identified more cases of maltreatment had more sources been included. CONCLUSION While the surveillance system identified more children who met the case definition of maltreatment than CPS data alone, the rates of definite child maltreatment were not considerably higher than official reports. Rates of possible child maltreatment were much higher than both the definite case definition and child welfare records. Tracking both definite and possible case definitions and using a variety of data sources provides a more complete picture of child maltreatment in North Carolina. ©2018 by the
Kolhatkar, Gauri; Berkowitz, Carol
Cultural diversity poses challenges within the health care setting, particularly regarding the question of how health professionals can resolve the tension between respecting cultural norms or child-rearing practices and the importance of determining what constitutes harm and child maltreatment. Cultural competency and respect for cultural diversity does not imply universal tolerance of all practices. The United Nations provides a standard of universal child rights, protecting them from harmful practices. Pediatric providers must respect cross-cultural differences while maintaining legal and ethical standards of safety and wellbeing for children, promoting evidence-based prevention of maltreatment, and advocating for child wellness across all cultures. Copyright © 2014 Elsevier Inc. All rights reserved.
Villodas, Miguel T.; Litrownik, Alan J.; Thompson, Richard; Roesch, Scott C.; English, Diana J.; Dubowitz, Howard; Kotch, Jonathan B.; Runyan, Desmond K.
Objective The present study applied person-centered data analytic techniques to identify groups of youth with allegations for combinations of maltreatment types during preschool, early and late childhood. Method Latent Class Analyses were conducted using officially reported child maltreatment data for five types of maltreatment (i.e., failure-to-provide and lack-of-supervision neglect, and physical, sexual and emotional abuse) from 788 youth in a large prospective study during preschool, early, and late childhood. Results Three similar classes were identified during preschool and early childhood, characterized by no maltreatment allegations, allegations for neglect and emotional maltreatment, and allegations for all maltreatment types. During late childhood, four classes were identified characterized by no maltreatment allegations, mixed patterns of maltreatment allegations, physical and emotional abuse allegations, and allegations for all maltreatment types. Youth in maltreated classes were more likely to be re-victimized during subsequent developmental periods, often by similar maltreatment combinations. Youth in maltreated classes characterized by physically violent maltreatment types had higher Externalizing and Total behavior problems at each age. Conclusions These findings confirm the vulnerability of maltreated youth to re-victimization, particularly by similar combinations of maltreatment. They also indicate that youth’s susceptibilities to specific forms of maltreatment may vary across developmental periods. PMID:24999441
One-hundred-ninety-nine adult mental health service users were interviewed with a protocol that included the Childhood Trauma Questionnaire, the Structured Clinical Interviews for Axis I and II DSM-IV disorders, the Global Assessment of Functioning scale, the SCORE family assessment measure, the Camberwell Assessment of Need Short Appraisal Schedule, and the Readiness for Psychotherapy Index. Compared to a U.S. normative sample, Irish clinical cases had higher levels of maltreatment. Cases with comorbid axis I and II disorders reported more child maltreatment than those with axis I disorders only. There was no association between types of CM and types of psychopathology. Current family adjustment and service needs (but not global functioning and motivation for psychotherapy) were correlated with a CM history. It was concluded that child maltreatment may contribute to the development of adult psychopathology, and higher levels of trauma are associated with co-morbid personality disorder, greater service needs and poorer family adjustment. A history of child maltreatment should routinely be determined when assessing adult mental health service users, especially those with personality disorders and where appropriate evidence-based psychotherapy which addresses childhood trauma should be offered.
Jud, Andreas; Fegert, J?rg M.; Finkelhor, David
Research on child maltreatment epidemiology has primarily been focused on population surveys with adult respondents. Far less attention has been paid to analyzing reported incidents of alleged child maltreatment and corresponding agency responses. This type of research is however indispensable to know how well a child protection system works and if the most vulnerable are identified and served. Notable findings of child maltreatment epidemiological research are summarized and directions for f...
Berlin, Lisa J.; Appleyard, Karen; Dodge, Kenneth A.
In the interest of improving child maltreatment prevention, this prospective, longitudinal, community-based study of 499 mothers and their infants examined (a) direct associations between mothers' experiences of childhood maltreatment and their offspring's maltreatment, and (b) mothers' mental health problems, social isolation, and social…
Prosser Lisa A
Full Text Available Abstract Background Child maltreatment causes substantial morbidity and mortality in the U.S. Morbidity associated with child maltreatment can reduce health-related quality of life. Accurately measuring the reduction in quality of life associated with child maltreatment is essential to the economic evaluation of educational programs and interventions to reduce the incidence of child maltreatment. The objective of this study was to review the literature for existing approaches and instruments for measuring quality-of-life for child maltreatment outcomes. Methods We reviewed the current literature to identify current approaches to valuing child maltreatment outcomes for economic evaluations. We also reviewed available preference-based generic QOL instruments (EQ-5D, HUI, QWB, SF-6D for appropriateness in measuring change in quality of life due to child maltreatment. Results We did not identify any studies that directly evaluated quality-of-life in maltreated children. We identified 4 studies that evaluated quality of life for adult survivors of child maltreatment and 8 studies that measured quality-of-life for pediatric injury not related to child maltreatment. No study reported quality-of-life values for children younger than age 3. Currently available preference-based QOL instruments (EQ-5D, HUI, QWB, SF-6D have been developed primarily for adults with the exception of the Health Utilities Index. These instruments do not include many of the domains identified as being important in capturing changes in quality of life for child maltreatment, such as potential for growth and development or psychological sequelae specific to maltreatment. Conclusion Recommendations for valuing preference-based quality-of-life for child maltreatment will vary by developmental level and type of maltreatment. In the short-term, available multi-attribute utility instruments should be considered in the context of the type of child maltreatment being measured. However
Hu, Xiaolin; Puddy, Richard
This paper extends previous work to develop cognitive modeling for agent-based simulation of child maltreatment (CM). The developed model is inspired from parental efficacy, parenting stress, and the theory of planned behavior. It provides an explanatory, process-oriented model of CM and incorporates causality relationship and feedback loops from different factors in the social ecology in order for simulating the dynamics of CM. We describe the model and present simulation results to demonstrate the features of this model.
Yokoyama, Yoshie; Oda, Terumi; Nagai, Noriyo; Sugimoto, Masako; Mizukami, Kenji
The occurrence of multiple births has been recognized as a risk factor for child maltreatment. However, few population-based studies have examined the relationship between multiple births and child maltreatment. This study aimed to evaluate the degree of risk of child maltreatment among singletons and multiple births in Japan and to identify factors associated with increased risk. Using population-based data, we analyzed the database of records on child maltreatment and medical checkups for infants aged 1.5 years filed at Nishinomiya City Public Health Center between April 2007 and March 2011. To protect personal information, the data were transferred to anonymized electronic files for analysis. After adjusting by logistic regression for each associated factor and gestation number, multiples themselves were not associated with the risk of child maltreatment. However, compared with singletons, multiples had a significantly higher rate of risk factors for child maltreatment, including low birth weight and neural abnormality. Moreover, compared with mothers of singleton, mothers of twins had a significantly higher rate of poor health, which is a risk factor of child maltreatment. Multiples were not associated with the risk of child maltreatment. However, compared with singletons, multiples and their mothers had a significantly higher rate of risk factors of child maltreatment.
Palusci, Vincent J.; Wirtz, Stephen J.; Covington, Theresa M.
Objectives: To (1) test the use of capture-recapture methods to estimate the total number of child maltreatment deaths in a single state using information from death certificates, child welfare reports, child death review teams, and uniform crime reports; and to (2) compare these estimates to the number of maltreatment deaths identified through an…
Zimmerman, Francie; Mercy, James A.
Child abuse prevention programs have historically focused on individual and family dynamics rather than community-based or societal strategies to prevent child maltreatment. Recently, there has been a growing recognition of the importance of communitywide efforts to prevent child maltreatment before abuse or neglect occurs by offering a continuum…
Afifi, Tracie O; Taillieu, Tamara; Cheung, Kristene; Katz, Laurence Y; Tonmyr, Lil; Sareen, Jitender
Identifying child and household characteristics that are associated with specific child maltreatment types and child functional impairment are important for informing prevention and intervention efforts. Our objectives were to examine the distribution of several child and household characteristics among substantiated child maltreatment types in Canada; to determine if a specific child maltreatment type relative to all other types was associated with increased odds of child functional impairment; and to determine which child and household characteristics were associated with child functional impairment. Data were from the Canadian Incidence Study of Reported Child Abuse and Neglect (collection 2008) from 112 child welfare sites across Canada (n = 6163 children). Physical abuse, sexual abuse, and emotional maltreatment were highly prevalent among children aged 10 to 15 years. For single types of child maltreatment, the highest prevalence of single-parent homes (50.6%), social assistance (43.0%), running out of money regularly (30.7%), and unsafe housing (30.9%) were reported for substantiated cases of neglect. Being male, older age, living in a single-parent home, household running out of money, moving 2 or more times in the past year, and household overcrowding were associated with increased odds of child functional impairment. More work is warranted to determine if providing particular resources for single-parent families, financial counselling, and facilitating adequate and stable housing for families with child maltreatment histories or at risk for child maltreatment could be effective for improving child functional outcomes.
Afifi, Tracie O; Taillieu, Tamara; Cheung, Kristene; Katz, Laurence Y; Tonmyr, Lil; Sareen, Jitender
Objective: Identifying child and household characteristics that are associated with specific child maltreatment types and child functional impairment are important for informing prevention and intervention efforts. Our objectives were to examine the distribution of several child and household characteristics among substantiated child maltreatment types in Canada; to determine if a specific child maltreatment type relative to all other types was associated with increased odds of child functional impairment; and to determine which child and household characteristics were associated with child functional impairment. Method: Data were from the Canadian Incidence Study of Reported Child Abuse and Neglect (collection 2008) from 112 child welfare sites across Canada (n = 6163 children). Results: Physical abuse, sexual abuse, and emotional maltreatment were highly prevalent among children aged 10 to 15 years. For single types of child maltreatment, the highest prevalence of single-parent homes (50.6%), social assistance (43.0%), running out of money regularly (30.7%), and unsafe housing (30.9%) were reported for substantiated cases of neglect. Being male, older age, living in a single-parent home, household running out of money, moving 2 or more times in the past year, and household overcrowding were associated with increased odds of child functional impairment. Conclusions: More work is warranted to determine if providing particular resources for single-parent families, financial counselling, and facilitating adequate and stable housing for families with child maltreatment histories or at risk for child maltreatment could be effective for improving child functional outcomes. PMID:26175390
Woydt, L; König, C; Bernhard, M K; Nickel, P; Dreßler, J; Ondruschka, B
In order to accurately diagnose child abuse or neglect, a physician needs to be familiar with diseases and medical conditions that can simulate maltreatment. Unrecognized cases of abuse may lead to insufficient child protection, whereas, on the other hand, over-diagnosis could be the cause of various problems for the family and their potentially accused members. Regarding child abuse, numerous cases of false diagnoses with undetected causes of bleeding are described in the scientific literature, but, specifically concerning leukemia in childhood, only very few case reports exist. Here, for the first time, we report a case of a 2-year-old boy who got hospitalized twice because of suspicious injuries and psychosocial conspicuities, in a family situation known for repeated endangerment of the child's well-being. After his first hospitalization with injuries typical for child abuse, but without paraclinical abnormalities, medical inspections were arranged periodically. The child was hospitalized with signs of repeated child abuse again five months later. During second admission, an acute lymphoblastic leukemia was revealed by intermittent laboratory examination, ordered due to new bruises with changes in morphology, identifiable as petechial hemorrhages. This case elucidates the discussion of known cases of leukemia in childhood associated with suspected child abuse in order to provide an overview of possible diseases mimicking maltreatment. To arrange necessary supportive examinations, a skillful interaction between pediatrician and forensic pathologist is crucial in the differentiation between accidental and non-accidental injury. Copyright © 2017 Elsevier B.V. All rights reserved.
Williams, James Herbert; Van Dorn, Richard A; Bright, Charlotte Lyn; Jonson-Reid, Melissa; Nebbitt, Von E
Child welfare and criminology research have increasingly sought to better understand factors that increase the likelihood that abused and neglected children will become involved in the juvenile justice system. However, few studies have addressed this relationship among African American male adolescents. The current study examines the relationship between child maltreatment (i.e., neglect, physical abuse, sexual abuse, and other/mixed abuse) and the likelihood of a delinquency petition using a sample of African American males ( N = 2,335) born before 1990. Multivariable logistic regression models compared those with a delinquency-based juvenile justice petition to those without. Results indicate that African American males with a history of neglect, physical abuse, or other/mixed abuse were more likely to be involved in the juvenile justice system than those without any child maltreatment. Additionally, multiple maltreatment reports, a prior history of mental health treatment, victimization, and having a parent who did not complete high school also increased the likelihood of a delinquency petition. Implications for intervention and prevention are discussed.
Elklit, Ask; Karstoft, Karen-Inge; Armour, Cherie; Feddern, Dagmar; Christoffersen, Mogens
Background The associations between childhood abuse and subsequent criminality and posttraumatic stress disorder (PTSD) are well known. However, a major limitation of research related to childhood abuse and its effects is the focus on one particular type of abuse at the expense of others. Recent work has established that childhood abuse rarely occurs as a unidimensional phenomenon. Therefore, a number of studies have investigated the existence of abuse typologies. Methods The study is based on a Danish stratified random probability survey including 2980 interviews of 24-year-old people. The sample was constructed to include an oversampling of child protection cases. Building on a previous latent class analysis of four types of childhood maltreatment, three maltreatment typologies were used in the current analyses. A criminality scale was constructed based on seven types of criminal behavior. PTSD symptoms were assessed by the PC-PTSD Screen. Results Significant differences were found between the two genders with males reporting heightened rates of criminality. Furthermore, all three maltreatment typologies were associated with criminal behavior with odds ratios (ORs) from 2.90 to 5.32. Female gender had an OR of 0.53 and possible PTSD an OR of 1.84. Conclusion The independent association of participants at risk for PTSD and three types of maltreatment with criminality should be studied to determine if it can be replicated, and considered in social policy and prevention and rehabilitation interventions. PMID:23626869
Full Text Available Background: The associations between childhood abuse and subsequent criminality and posttraumatic stress disorder (PTSD are well known. However, a major limitation of research related to childhood abuse and its effects is the focus on one particular type of abuse at the expense of others. Recent work has established that childhood abuse rarely occurs as a unidimensional phenomenon. Therefore, a number of studies have investigated the existence of abuse typologies. Methods: The study is based on a Danish stratified random probability survey including 2980 interviews of 24-year-old people. The sample was constructed to include an oversampling of child protection cases. Building on a previous latent class analysis of four types of childhood maltreatment, three maltreatment typologies were used in the current analyses. A criminality scale was constructed based on seven types of criminal behavior. PTSD symptoms were assessed by the PC-PTSD Screen. Results: Significant differences were found between the two genders with males reporting heightened rates of criminality. Furthermore, all three maltreatment typologies were associated with criminal behavior with odds ratios (ORs from 2.90 to 5.32. Female gender had an OR of 0.53 and possible PTSD an OR of 1.84. Conclusion: The independent association of participants at risk for PTSD and three types of maltreatment with criminality should be studied to determine if it can be replicated, and considered in social policy and prevention and rehabilitation interventions.
Douglas, Emily M; Serino, Patricia J
Previous research has established that child welfare workers lack important information about child maltreatment fatalities and risk factors leading to death. Further, training has not been associated with improvements in knowledge. The authors assessed the presence of evidence-based information about child maltreatment fatalities and risk factors for death in 24 social science textbooks about child abuse and neglect or child welfare. The results indicate that basic information, such as definitions and incidence rates of child maltreatment fatalities are routinely included in social science textbooks, but information about child, parent, and household risk factors are not, and that inaccurate information is often included. Implications of the findings are discussed.
Ahmed, Ayesha; Wan-Yuen, Choo; Marret, Mary Joseph; Guat-Sim, Cheah; Othman, Sajaratulnisah; Chinna, Karuthan
Official reports of child maltreatment in Malaysia have persistently increased throughout the last decade. However there is a lack of population surveys evaluating the actual burden of child maltreatment, its correlates and its consequences in the country. This cross sectional study employed 2 stage stratified cluster random sampling of public primary schools, to survey 3509 ten to twelve year old school children in Selangor state. It aimed to estimate the prevalence of parental physical and emotional maltreatment, parental neglect and teacher- inflicted physical maltreatment. It further aimed to examine the associations between child maltreatment and important socio-demographic factors; family functioning and symptoms of depression among children. Logistic regression on weighted samples was used to extend results to a population level. Three quarters of 10-12 year olds reported at least one form of maltreatment, with parental physical maltreatment being most common. Males had higher odds of maltreatment in general except for emotional maltreatment. Ethnicity and parental conflict were key factors associated with maltreatment. The study contributes important evidence towards improving public health interventions for child maltreatment prevention in the country.
Full Text Available Official reports of child maltreatment in Malaysia have persistently increased throughout the last decade. However there is a lack of population surveys evaluating the actual burden of child maltreatment, its correlates and its consequences in the country. This cross sectional study employed 2 stage stratified cluster random sampling of public primary schools, to survey 3509 ten to twelve year old school children in Selangor state. It aimed to estimate the prevalence of parental physical and emotional maltreatment, parental neglect and teacher- inflicted physical maltreatment. It further aimed to examine the associations between child maltreatment and important socio-demographic factors; family functioning and symptoms of depression among children. Logistic regression on weighted samples was used to extend results to a population level. Three quarters of 10-12 year olds reported at least one form of maltreatment, with parental physical maltreatment being most common. Males had higher odds of maltreatment in general except for emotional maltreatment. Ethnicity and parental conflict were key factors associated with maltreatment. The study contributes important evidence towards improving public health interventions for child maltreatment prevention in the country.
Ahmed, Ayesha; Wan-Yuen, Choo; Marret, Mary Joseph; Guat-Sim, Cheah; Othman, Sajaratulnisah; Chinna, Karuthan
Official reports of child maltreatment in Malaysia have persistently increased throughout the last decade. However there is a lack of population surveys evaluating the actual burden of child maltreatment, its correlates and its consequences in the country. This cross sectional study employed 2 stage stratified cluster random sampling of public primary schools, to survey 3509 ten to twelve year old school children in Selangor state. It aimed to estimate the prevalence of parental physical and emotional maltreatment, parental neglect and teacher- inflicted physical maltreatment. It further aimed to examine the associations between child maltreatment and important socio-demographic factors; family functioning and symptoms of depression among children. Logistic regression on weighted samples was used to extend results to a population level. Three quarters of 10–12 year olds reported at least one form of maltreatment, with parental physical maltreatment being most common. Males had higher odds of maltreatment in general except for emotional maltreatment. Ethnicity and parental conflict were key factors associated with maltreatment. The study contributes important evidence towards improving public health interventions for child maltreatment prevention in the country. PMID:25786214
Ip, Patrick; Ho, Frederick Ka-Wing; Chan, Ko Ling; Yip, Paul Siu-Fai; Lau, Joseph Tak-Fai; Wong, Wilfred Hing-Sang; Chow, Chun-Bong; Jiang, Fan
We investigated the incidence and seasonal patterns of child maltreatment hospitalisations in Hong Kong. A retrospective study of subjects aged under 19 years with a primary diagnosis of child maltreatment admitted to hospitals in Hong Kong from 2001 to 2010. Data were retrieved from the centralised database of all 42 public hospitals in the Hospital Authority. Child maltreatment incidence rate. A consistent seasonal pattern was found for non-sexual maltreatment in children aged 6-18 years (pmaltreatment or among children under 6 years. The seasonal pattern of child maltreatment coincided with the two school examination periods. The annual child maltreatment hospitalisation rate in Hong Kong in 2010 was 73.4 per 100 000 children under 19 years, more than double that in 2001. A peculiar seasonal pattern and an alarming increasing trend in child maltreatment hospitalisation were observed in Hong Kong, which we speculated to be related to school examination stress and increasing socioeconomic disparity. Our findings highlighted differences in the trends of child maltreatment between Hong Kong and the West. Professionals and policymakers should be made aware of these trends and develop effective strategies to tackle child maltreatment. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Ngiam, Xin Ying; Kang, Ying Qi; Aishworiya, Ramkumar; Kiing, Jennifer; Law, Evelyn Chung Ning
This study aimed to describe the demographic, social, developmental and behavioural profile of children hospitalised for alleged child maltreatment syndrome (CMS). This study was a retrospective review of the consecutive inpatient records of children (0-16 years) admitted to the National University Hospital, Singapore, for alleged CMS over a three-year period. Descriptive data on the demographic characteristics, alleged maltreatment, medical and developmental histories, and family background of these children were collected and analysed. Chi-square statistics were used to test whether family factors were associated with the type of maltreatment and the presence of developmental disorders. A total of 89 children, who accounted for 90 admission cases, were studied. Physical abuse (70.0%) was the most common, followed by neglect (11.1%) and sexual abuse (7.8%). Child protection services had already been involved in 29.2% of the cases prior to the child's admission. Children who were victims of abuse were more likely to come from homes with a prior history of domestic violence (p = 0.028). Financial difficulty was found to be a risk factor for neglect (p = 0.005). Among the 89 children, 15.7% were found to have developmental disorders and 10.1% had mental health diagnoses. Children who had developmental disorders were more likely to have a parent with a mental health disorder (p = 0.002). A sizeable proportion of the children admitted for alleged CMS had developmental or behavioural disorders. Clinicians have a role in ensuring that these children have appropriate follow-up plans. Children from high-risk families should be screened for maltreatment.
McCarroll, James E; Fisher, Joscelyn E; Cozza, Stephen J; Robichaux, Renè J; Fullerton, Carol S
Preventing child maltreatment fatalities is a critical goal of the U.S. society and the military services. Fatality review boards further this goal through the analysis of circumstances of child deaths, making recommendations for improvements in practices and policies, and promoting increased cooperation among the many systems that serve families. The purpose of this article is to review types of child maltreatment death, proposed classification models, risk and protective factors, and prevention strategies. This review is based on scientific and medical literature, national reports and surveys, and reports of fatality review boards. Children can be killed soon after birth or when older through a variety of circumstances, such as with the suicide of the perpetrator, or when the perpetrator kills the entire family. Death through child neglect may be the most difficult type of maltreatment death to identify as neglect can be a matter of opinion or societal convention. These deaths can occur as a result of infant abandonment, starvation, medical neglect, drowning, home fires, being left alone in cars, and firearms. Models of classification for child maltreatment deaths can permit definition and understanding of child fatalities by providing reference points that facilitate research and enhance clinical prediction. Two separate approaches have been proposed: the motives of the perpetrator and the circumstances of death of the child victim. The latter approach is broader and is founded on an ecological model focused on the nature and circumstances of death, child victim characteristics, perpetrator characteristics, family and environmental circumstances, and service provision and need. Many risk factors for maternal and paternal filicide have been found, but most often included are young maternal age, no prenatal care, low education level, mental health problems, family violence, and substance abuse. Many protective factors can be specified at the individual, family
Font, Sarah A; Berger, Lawrence M
Associations between experiencing child maltreatment and adverse developmental outcomes are widely studied, yet conclusions regarding the extent to which effects are bidirectional, and whether they are likely causal, remain elusive. This study uses the Fragile Families and Child Wellbeing Study, a birth cohort of 4,898 children followed from birth through age 9. Hierarchical linear modeling and structural equation modeling are employed to estimate associations of maltreatment with cognitive and social-emotional well-being. Results suggest that effects of early childhood maltreatment emerge immediately, though developmental outcomes are also affected by newly occurring maltreatment over time. Additionally, findings indicate that children's early developmental scores predict their subsequent probability of experiencing maltreatment, though to a lesser extent than early maltreatment predicts subsequent developmental outcomes. © 2014 The Authors. Child Development © 2014 Society for Research in Child Development, Inc.
Hecht, Kathryn F; Cicchetti, Dante; Rogosch, Fred A; Crick, Nicki R
Child maltreatment has been established as a risk factor for borderline personality disorder (BPD), yet few studies consider how maltreatment influences the development of BPD features through childhood and adolescence. Subtype, developmental timing, and chronicity of child maltreatment were examined as factors in the development of borderline personality features in childhood. Children (M age = 11.30, SD = 0.94), including 314 maltreated and 285 nonmaltreated children from comparable low socioeconomic backgrounds, provided self-reports of developmentally salient borderline personality traits. Maltreated children had higher overall borderline feature scores, had higher scores on each individual subscale, and were more likely to be identified as at high risk for development of BPD through raised scores on all four subscales. Chronicity of maltreatment predicted higher overall borderline feature scores, and patterns of onset and recency of maltreatment significantly predicted whether a participant would meet criteria for the high-risk group. Implications of findings and recommendations for intervention are discussed.
Hecht, Kathryn F.; Cicchetti, Dante; Rogosch, Fred A.; Crick, Nicki
Child maltreatment has been established as a risk factor for borderline personality disorder (BPD), yet few studies consider how maltreatment influences the development of BPD features through childhood and adolescence. Subtype, developmental timing and chronicity of child maltreatment were examined as factors in the development of borderline personality features in childhood. Children (M age = 11.30, SD = 0.94), including 314 maltreated and 285 nonmaltreated children from comparable low socioeconomic backgrounds, provided self-reports of developmentally salient borderline personality traits. Maltreated children had higher overall borderline feature scores, higher scores on each individual subscale and were more likely to be identified as at high risk for development of BPD through raised scores on all 4 subscales. Chronicity of maltreatment predicted higher overall borderline feature scores and patterns of onset and recency of maltreatment significantly predicted whether a participant would meet criteria for the high-risk group. Implications of findings and recommendations for intervention are discussed. PMID:25047300
supportive significant others have developed resilience with a strengthened self. The study confirms that social support for a great many of the young adults reduces the risk of low self-esteem and suicidal ideations even when they have experienced poor parenting with the destructiveness of psychological...... maltreatment and sexual abuse. While being offer for bullying increases the risk of suicidal thoughts and low self-esteem, when accounted for other risk factors....... children haven’t? The study is based on standardized personal interview with a national sample of 3,000 young people, supplemented with prospective longitudinal register data. The hypotheses are that the adolescents who have experienced child maltreatment during childhood but also had experienced...
Doidge, James C; Higgins, Daryl J; Delfabbro, Paul; Segal, Leonie
Child maltreatment and other adverse childhood experiences adversely influence population health and socioeconomic outcomes. Knowledge of the risk factors for child maltreatment can be used to identify children at risk and may represent opportunities for prevention. We examined a range of possible child, parent and family risk factors for child maltreatment in a prospective 27-year population-based birth cohort of 2443 Australians. Physical abuse, sexual abuse, emotional abuse, neglect and witnessing of domestic violence were recorded retrospectively in early adulthood. Potential risk factors were collected prospectively during childhood or reported retrospectively. Associations were estimated using bivariate and multivariate logistic regressions and combined into cumulative risk scores. Higher levels of economic disadvantage, poor parental mental health and substance use, and social instability were strongly associated with increased risk of child maltreatment. Indicators of child health displayed mixed associations and infant temperament was uncorrelated to maltreatment. Some differences were observed across types of maltreatment but risk profiles were generally similar. In multivariate analyses, nine independent risk factors were identified, including some that are potentially modifiable: economic disadvantage and parental substance use problems. Risk of maltreatment increased exponentially with the number of risk factors experienced, with prevalence of maltreatment in the highest risk groups exceeding 80%. A cumulative risk score based on the independent risk factors allowed identification of individuals at very high risk of maltreatment, while a score that incorporated all significant risk and protective factors provided better identification of low-risk individuals. Copyright © 2016 Elsevier Ltd. All rights reserved.
Al Hajeri, H; Al Halabi, M; Kowash, M; Khamis, A H; Welbury, R; Hussein, I
Child safeguarding is society's responsibility. Dentists are uniquely positioned to recognise Child Abuse and Neglect (CAN) in dental practice and the wider society. The United Arab Emirates (UAE) introduced a child protection law in 2016. We aimed to assess the awareness of UAE dentists of child maltreatment, protection and safeguarding. Study Design A cross-sectional survey. We surveyed 381 UAE dentists about the knowledge and practice of CAN and safeguarding issues using a self-administered anonymous questionnaire. Statistical analysis was carried out using Chi-square, t-test, ANOVA and Pearson's correlation test and statistical significance was set as p knowledgeable about diagnosing CAN. Paediatric dentists attended more CAN-related postgraduate training (pprotection guidelines. Dentists barriers to child protection reporting were; fear of family violence (59.6%, n=227), lack of knowledge of referral process (60.2%, n=228) and lack of diagnosis certainty (54.9%, n=206). UAE dentists qualified in Western and Asian countries had fewer barriers for child protection reporting (p=0.022) than the Arab and Gulf Cooperation Council qualified dentists. A large minority of UAE dentists suspected CAN. Factors influencing child protection reporting were identified. Dentists' gender, specialty, and country of qualification affected their knowledge of CAN and practice of safeguarding. Child protection training is recommended.
van der Kooij, Inger W.; Bipat, Shandra; Boer, Frits; Lindauer, Ramón J. L.; Graafsma, Tobi L. G.
The prevention of child maltreatment has become a global health concern because child maltreatment is a violation of children's rights. Across the world, a variety of parenting programs have been developed to address this problem. However, no such parenting program currently exists in Suriname. This
Shenk, Chad E.; Putnam, Frank W.; Noll, Jennie G.
Previous research demonstrates that both child maltreatment and intellectual performance contribute uniquely to the accurate identification of facial affect by children and adolescents. The purpose of this study was to extend this research by examining whether child maltreatment affects the accuracy of facial recognition differently at varying…
Jonkman, Caroline S.; Verlinden, Eva; Bolle, Eva A.; Boer, Frits; Lindauer, Ramón J. L.
The sequelae of child maltreatment tend to extend current posttraumatic stress disorder (PTSD) symptoms. This study examined this assumption, hypothesizing that (a) PTSD and trauma-related symptoms are more severe after single trauma than after child maltreatment; (b) symptoms unrelated to trauma
Mills, Ryan; Scott, James; Alati, Rosa; O'Callaghan, Michael; Najman, Jake M.; Strathearn, Lane
Objective: To examine whether notified child maltreatment is associated with adverse psychological outcomes in adolescence, and whether differing patterns of psychological outcome are seen depending on the type of maltreatment. Methods: The participants were 7,223 mother and child pairs enrolled in a population-based birth cohort study in…
Takehara, Kenji; Suto, Maiko; Kakee, Naoko; Tachibana, Yoshiyuki; Mori, Rintaro
We investigated the association of paternal depression in the prenatal and early postnatal period with child maltreatment tendency at two months postpartum among Japanese fathers. This population-based longitudinal study recruited Japanese perinatal women and their partners living in Nishio City, Aichi, Japan. Of the 270 fathers who participated, 196 were included in the analysis. All data were collected via self-administrated questionnaires at four time points: 20 weeks' gestation and in the first few days, one month, and two months postpartum. Paternal depression was assessed using the Edinburgh Postnatal Depression Scale. Three definitions of paternal depression were coded based on participants' scores on this measure: prenatal, prior, and current. Child maltreatment tendency was evaluated using the Child Maltreatment Scale at two months postpartum. The associations of the three definitions of paternal depression and child maltreatment tendency were separately analyzed using logistic regression analysis. The prevalence of prenatal, prior, and current paternal depression was 9.7%, 10.2%, and 8.8%, respectively. According to the multivariate analysis, current paternal depression was significantly associated with child maltreatment tendency at two months postpartum (adjusted odds ratio: 7.77, 95% CI: 1.83-33.02). The other two types of depression, however, were not related to child maltreatment tendency. Thus, current paternal depression increased the risk of child maltreatment tendency in the postnatal period, suggesting that early detection and treatment of paternal depression might be useful for the prevention of child maltreatment. Copyright © 2017 Elsevier Ltd. All rights reserved.
van Delft, I.; Finkenauer, C.; Verbruggen, J.
This study aimed to examine the effects of child maltreatment subtypes (physical abuse, sexual abuse, neglect, and exposure to domestic violence) and cumulative child maltreatment on depressive symptoms in adulthood, and examine the protective effects of social connectedness in a sample of formerly
van Delft, I.; Finkenauer, C.; Verbruggen, J.; Bijleveld, C.C.J.H.
The relationship between child maltreatment and negative adult outcomes is well established. Child maltreatment is associated with depression and decreased well-being in adulthood. However, a growing body of literature suggests that the risk of depression varies as a function of subtype,
Stoltenborgh, M.; Bakermans-Kranenburg, M.J.; Alink, L.R.A.; van IJzendoorn, M.H.
In this review, we combine and compare the results of a series of meta-analyses on the prevalence of child sexual, physical and emotional abuse and physical and emotional neglect, including 244 publications and 551 prevalence rates for the various types of maltreatment. Child maltreatment research
van der Put, C.E.; Assink, M.; Gubbels, J.; Boekhout van Solinge, N.F.
There is a lack of knowledge about specific components that make interventions effective in preventing or reducing child maltreatment. The aim of the present meta-analysis was to increase this knowledge by summarizing findings on effects of interventions for child maltreatment and by examining
Dion, Jacinthe; Paquette, Geneviève; Tremblay, Karine-N.; Collin-Vézina, Delphine; Chabot, Martin
This study aims to compare, among a representative sample of substantiated child maltreatment cases, the characteristics of those with intellectual disability (ID) from those without ID. Using the 2008 Canadian Incidence Study of Reported Child Abuse and Neglect, 5,797 cases of substantiated maltreatment that involved children aged between 0 and…
Jonson-Reid, Melissa; Presnall, Ned; Drake, Brett; Fox, Louis; Bierut, Laura; Reich, Wendy; Kane, Phyllis; Todd, Richard D.; Constantino, John N.
Objective: Evidence is steadily accumulating that a preventable environmental hazard, child maltreatment, exerts causal influences on the development of long-standing patterns of antisocial behavior in humans. The relationship between child maltreatment and antisocial outcome, however, has never previously been tested in a large-scale study in…
Fang, Xiangming; Brown, Derek S.; Florence, Curtis S.; Mercy, James A.
Objectives: To present new estimates of the average lifetime costs per child maltreatment victim and aggregate lifetime costs for all new child maltreatment cases incurred in 2008 using an incidence-based approach. Methods: This study used the best available secondary data to develop cost per case estimates. For each cost category, the paper used…
Tachibana, Yoshiyuki; Takehara, Kenji; Kakee, Naoko; Mikami, Masashi; Inoue, Eisuke; Mori, Rintaro; Ota, Erika; Koizumi, Tomoe; Okuyama, Makiko; Kubo, Takahiko
Previous work has suggested that maternal developmental disorder traits related to autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD) are significantly associated with child maltreatment. However, there may be other important maternal characteristics that contribute to child maltreatment. We hypothesized that maternal impulse control disability may also affect child maltreatment in addition to maternal developmental disorder traits. We aimed to test this hypothesis via a cohort study performed in Tokyo (n = 1,260). Linear regression analyses using the Behavioural Inhibition/Behavioural Activation Scales, the self-administered short version of the Pervasive Developmental Disorders Autism Society Japan Rating Scale, the short form of the Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale, and the Child Maltreatment Scale, revealed that excessive inhibition of behaviour and affect, which is impulse control disability, is significantly associated with child maltreatment (b = 0.031, p = 0.018) in addition to maternal developmental disorder traits (ASD: b = 0.052, p = 0.004; ADHD: b = 0.178, p child maltreatment, while ADHD was associated (AOR = 1.034, p = 0.022) with severe child maltreatment. These maternal characteristics may inform the best means for prevention and management of child maltreatment cases.
Smith, Brenda D; Kay, Emma Sophia; Pressley, Tracy D
Building on research that has identified community characteristics associated with child maltreatment, this study investigates the adequacy and equity of the child welfare response at the county level. The study focuses on states in the U.S. south with demographic characteristics that make it possible to disentangle county racial composition from county rurality. County-level child maltreatment data were merged with data from the U.S. Census and other publicly-available sources for the 354 counties in four southern states. Results from multiple regression models indicated that, despite a greater preponderance of risk factors typically associated with child maltreatment, rural, majority African-American counties had lower rates of reported and substantiated child maltreatment compared to other southern counties. Cross-sectional results were consistent across three years: 2012, 2013, and 2014. The findings suggest that children and families in rural, majority African-American counties in the South may not be receiving adequate or equitable responses from the formal child welfare system. Copyright © 2018 Elsevier Ltd. All rights reserved.
Hagborg, Johan Melander; Berglund, Kristina; Fahlke, Claudia
School absenteeism is a potent predictor of academic failure. Maltreated adolescents have been found to be more absent from school compared to their peers. However, it is scarcely studied in what degree a general population of students with high levels of school absenteeism has been exposed to child maltreatment. Furthermore, it is not known if maltreated school-absentees have specific characteristics compared to not-maltreated absentees. In this article, the first objective was to present and compare the prevalence of six types of child maltreatment in a general population of high school students reporting no, moderate or excessive absenteeism. The second objective was to compare maltreated and not-maltreated students who report absenteeism in respect to mental health, perceived school environment and peer victimization in school. Data from 667 girls and 649 boys (mean age 14.3) was used from the longitudinal multidisciplinary research program LoRDIA (Longitudinal Research on Development In Adolescence). Data was collected via self-report questionnaires in classroom settings. All six types of child maltreatment were overrepresented among absentees. Roughly 25% of absentees reported one subtype of maltreatment (16% in the total population) and a mean of 22% of absentees reported two or more types of maltreatment (11% in the total population). Maltreated absentees reported more mental health problems, personal harassment and worse relationship with their teachers than not-maltreated absentees. There might be specific correlates of school absenteeism among maltreated adolescents and professionals involved in preventing school-absenteeism should be made aware of the relationship between maltreatment and absenteeism. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.
Jordan, Kathleen S; MacKay, Peggy; Woods, Stephanie J
School nurses perform a crucial role in the prevention, identification, intervention, and reporting of child maltreatment. The purpose of this article is to share the highlights of a research project conducted to (a) examine the effectiveness of an educational intervention program in increasing the knowledge, confidence, and self-efficacy in school nurses regarding children at risk of maltreatment; and (b) discover issues surrounding the comfort level engaging with children, communicating with teachers and other personnel, and ethical issues. The study consisted of two phases. Phase 1 was a face-to-face evidenced-based educational intervention. Focus groups implemented in Phase 2 discovered specific concerns of school nurses. Results indicate a significant increase in school nurse knowledge, confidence, and self-efficacy related to children at risk. Five themes were identified from the focus groups: the importance of interprofessional collaboration, identifiers of children at risk of maltreatment, the role of the school nurse as a mentor and leader, the importance of advancing one's knowledge and skill set, and constraints faced by school nurses.
Conrad-Hiebner, Aislinn; Byram, Elizabeth
Economically insecure children experience 3-9 times more maltreatment than economically secure children. Although economic insecurity is associated with child physical abuse, neglect, and psychological maltreatment, there have been no systematic reviews dedicated to the relation between familial economic insecurity and child maltreatment. This is problematic because multiple forms of familial economic insecurity-including debt, material hardship, income, unemployment, and income transfers-are related to child maltreatment. These findings, however, are not causal or reliably replicated across studies. Until we identify the state of the evidence concerning the temporal association between economic insecurity and child maltreatment, our ability to reduce child maltreatment may be limited. In this systematic review (PROSPERO registration # CRD42017081445), we searched PsycINFO, PubMed, Scopus, ProQuest Dissertations, and the gray literature for English-language, peer-reviewed articles and dissertations published between 1970 and 2016. We synthesized evidence from 26 longitudinal studies on the temporal relation between economic insecurity and child maltreatment. Income losses, cumulative material hardship, and housing hardship were the most reliable predictors of child maltreatment. Implications for research, policy, and practice are discussed.
Proctor, Laura J; Lewis, Terri; Roesch, Scott; Thompson, Richard; Litrownik, Alan J; English, Diana; Arria, Amelia M; Isbell, Patricia; Dubowitz, Howard
Youth with a history of child maltreatment use substances and develop substance use disorders at rates above national averages. Thus far, no research has examined pathways from maltreatment to age of substance use initiation for maltreated youth. We examined the longitudinal impact of maltreatment in early childhood on age of alcohol and marijuana use initiation, and whether internalizing and externalizing behaviors at age 8 mediates the link between maltreatment and age of substance use initiation. Data were drawn from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) at ages 4, 8, 12, and 18. Maltreatment was assessed through reviews of administrative records and youth self-reports. Behavior problems were assessed with the Child Behavior Checklist. Age of substance use initiation was assessed with the Young Adult version of the Diagnostic Interview Schedule for Children. Path analyses indicated mediated effects from a history of maltreatment to age at first alcohol and marijuana use through externalizing behaviors. Considering type of maltreatment, direct effects were found from physical abuse to age of alcohol initiation, and mediated effects were found from sexual abuse and neglect to initial age of alcohol and marijuana use through externalizing behaviors. Direct effects for marijuana use initiation and indirect effects through internalizing behavior problems were not significant for either substance. Externalizing behavior is one pathway from childhood maltreatment to age of substance use initiation. Services for maltreated youth should incorporate substance use prevention, particularly among those with early externalizing problems. Copyright © 2017 Elsevier Ltd. All rights reserved.
On 2 May, 2007, the New Zealand Parliament passed a law repealing Section 59 of the Crimes Act. In so doing, New Zealand became the first English-speaking nation in the world to make corporal punishment of a child illegal. The passage of this legislation was surrounded by intense and persistent public debate, and supporters of corporal punishment continue to advocate against the law change to the present day. In Sweden, where the first stage of similar repeal took place in 1957, it may be difficult for many to understand the strength of the public opposition to this change in New Zealand. This article will present a viewpoint on the evolution of the debate in New Zealand, review the wider context of child maltreatment and family violence in New Zealand and summarize a range of attempts to prevent or intervene effectively in the cycle of dysfunction. Child maltreatment and family violence are public health issues of great importance, and a stain on all societies. While corporal punishment may be a significant contributing factor, there is no single 'solution'. Change must occur on multiple levels (political, economic, cultural, familial and professional) before the tide will turn.
Valentino, Kristin; Hibel, Leah C; Cummings, E. Mark; Nuttall, Amy K.; Comas, Michelle; McDonnell, Christina G.
Theoretical and empirical evidence suggest that the way in which parents discuss everyday emotional experiences with their young children (i.e., elaborative reminiscing) has significant implications for child cognitive and socio-emotional functioning, and that maltreating parents have a particularly difficult time in engaging in this type of dialogue. This dyadic interactional exchange, therefore, has the potential to be an important process variable linking child maltreatment to developmental outcomes at multiple levels of analysis. The current investigation evaluated the role of maternal elaborative reminiscing in associations between maltreatment and child cognitive, emotional, and physiological functioning. Participants included 43 maltreated and 49 nonmaltreated children (aged 3–6) and their mothers. Dyads participated in a joint reminiscing task about four past emotional events, and children participated in assessments of receptive language and emotion knowledge. Child salivary cortisol was also collected from children three times a day (waking, midday, and bedtime) on two consecutive days to assess daily levels and diurnal decline. Results indicated that maltreating mothers engaged in significantly less elaborative reminiscing than nonmaltreating mothers. Maternal elaborative reminiscing mediated associations between child maltreatment and child receptive language and child emotion knowledge. Additionally, there was support for an indirect pathway between child maltreatment and child cortisol diurnal decline through maternal elaborative reminiscing. Directions for future research are discussed and potential clinical implications are addressed. PMID:26535941
Sloman, Leon; Taylor, Peter
Child maltreatment is a prevalent societal problem that has been linked to a wide range of social, psychological, and emotional difficulties. Maltreatment impacts on two putative evolved psychobiological systems in particular, the attachment system and the social rank system. The maltreatment may disrupt the child's ability to form trusting and reassuring relationships and also creates a power imbalance where the child may feel powerless and ashamed. The aim of the current article is to outline an evolutionary theory for understanding the impact of child maltreatment, focusing on the interaction between the attachment and the social rank system. We provide a narrative review of the relevant literature relating to child maltreatment and these two theories. This research highlights how, in instances of maltreatment, these ordinarily adaptive systems may become maladaptive and contribute to psychopathology. We identify a number of novel hypotheses that can be drawn from this theory, providing a guide for future research. We finally explore how this theory provides a guide for the treatment of victims of child maltreatment. In conclusion, the integrated theory provides a framework for understanding and predicting the consequences of maltreatment, but further research is required to test several hypotheses made by this theory. © The Author(s) 2015.
Frontline workers in the area of child welfare often enter the field without having taken any specialized coursework in the area of child maltreatment. This article discusses an interdisciplinary certificate program that is specifically designed to teach persons from various academic areas the knowledge and skills necessary to work with children who experience maltreatment. The child advocacy studies certificate program specifically focuses on coursework in the area of child maltreatment and child advocacy to better train future frontline workers in their vital roles. This certificate will decrease underreporting of child abuse cases by mandated reporters by making them more aware of the signs and symptoms of child maltreatment and also give students a greater understanding of how to work with individuals from various fields.
A number of research studies have documented an association between child maltreatment and family income. Yet, little is known about the specific types of economic shocks that affect child maltreatment rates. The paucity of information is troubling given that more than six million children are reported for maltreatment annually in the U.S. alone. This study examines whether an exogenous shock to families' disposable income, a change in the price of gasoline, predicts changes in child maltreatment. The findings of a fixed-effects regression show that increases in state-level gas prices are associated with increases in state-level child maltreatment referral rates, even after controlling for demographic and other economic variables. The results are robust to the manner of estimation; random-effects and mixed-effects regressions produce similar estimates. The findings suggest that fluctuations in the price of gas may have important consequences for children. Copyright © 2017 Elsevier Ltd. All rights reserved.
Font, Sarah A.; Berger, Lawrence M.
Associations between experiencing child maltreatment and adverse developmental outcomes are widely studied, yet conclusions regarding the extent to which effects are bidirectional, and whether they are likely causal, remain elusive. This study uses the Fragile Families and Child Well-Being study, a birth cohort of 4,898 children followed from birth through age 9. Hierarchical linear modeling and structural equation modeling are employed to estimate associations of maltreatment with cognitive and social-emotional well-being. Results suggest that effects of early childhood maltreatment emerge immediately, though developmental outcomes are also affected by newly occurring maltreatment over time. Additionally, findings indicate that children's early developmental scores predict their subsequent probability of experiencing maltreatment, though to a lesser extent than early maltreatment predicts subsequent developmental outcomes. PMID:25521556
Marina Sousa Azevedo
Full Text Available Child abuse is a serious public health problem and affects the victims' physical and mental health and development. The aims of this study were two-fold: to assess the attitudes and perceptions of dentists regarding child abuse, and to investigate professional characteristics associated with the identification of suspected child abuse. A questionnaire was sent to the 276 dentists of Pelotas, RS, Brazil , and 187 (68.0% were returned. Demographic characteristics and profiles of the dentists, and information about their knowledge and attitudes regarding child abuse were collected. Descriptive analysis was performed, and associations were tested by chi-square and Fisher's exact tests. From all dentists surveyed, 123 (71.9% reported providing treatment for children. Most dentists believed they could detect cases of child abuse (78.7%, but 85.7% had never suspected it. Among those who did suspect, 76.0% did not report the cases to authorities. No differences were observed between sexes, years of graduation, types of licenses, and the frequency at which children were treated. A higher proportion of dentists working at university had suspected child abuse. Even though dentists considered themselves able to identify suspicious cases, only a small percentage reported those suspicions, indicating a lack of awareness by these professionals in the adoption of protective measures for victims of aggression. It is necessary that dental professionals receive interdisciplinary training to enhance their ability to care for and protect children.
Shenk, Chad E; Noll, Jennie G; Peugh, James L; Griffin, Amanda M; Bensman, Heather E
To evaluate the impact of contamination, or the presence of child maltreatment in a comparison condition, when estimating the broad, longitudinal effects of child maltreatment on female health at the transition to adulthood. The Female Adolescent Development Study (N = 514; age range: 14-19 years) used a prospective cohort design to examine the effects of substantiated child maltreatment on teenage births, obesity, major depression, and past-month cigarette use. Contamination was controlled via a multimethod strategy that used both adolescent self-report and Child Protective Services records to remove cases of child maltreatment from the comparison condition. Substantiated child maltreatment significantly predicted each outcome, relative risks = 1.47-2.95, 95% confidence intervals: 1.03-7.06, with increases in corresponding effect size magnitudes, only when contamination was controlled using the multimethod strategy. Contamination truncates risk estimates of child maltreatment and controlling it can strengthen overall conclusions about the effects of child maltreatment on female health. © The Author 2015. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
Wibbenmeyer, Lucy; Liao, Junlin; Heard, Jason; Kealey, Lyn; Kealey, Gerald; Oral, Resmiye
The underpinnings of maltreatment in children presenting with burn injuries are necessary to discern as detection and prevention rest on a clear delineation of factors associated with maltreatment. Inaccurate identification of child victims can result in perpetuation of the maltreatment and its attendant neuropsychological sequela. The authors sought to determine factors associated with maltreatment in children presenting with burn injuries, which would guide the burn team in assessing the likelihood of maltreatment. All consenting children admitted with burn injuries were surveyed regarding their injury mechanism and current sociodemographic status. Suspicious injuries were referred by the burn team to the multidisciplinary review team (MRT). The MRT reported injuries with signs of physical abuse, supervision neglect, neglect of other basic needs, or sexual abuse. These children constituted the cases in our study. Variables related to maltreatment were entered into stepwise logistic regression to identify independent predicting variables. Pmaltreatment. Risk factors related to suspicions of maltreatment included: young age, large burns, tap water injury, immersion lines, delay in care, absence of a two-parent family (unconventional family structure), young parents, inconsistent history, and injury pattern. In this single-center prospective study, the authors identified several factors that, when present in injuries with initial suspicion of maltreatment, should trigger a child maltreatment workup. Burn clinicians have an important role as advocates for children and their families. It is important to continue to further the knowledge of maltreatment detection and prevention among children presenting with burn injuries.
Yoon, Susan; Kobulsky, Julia M.; Yoon, Dalhee; Kim, Wonhee
While many studies have identified a significant relation between child maltreatment and adolescent substance use, the developmental pathways linking this relation remain sparsely explored. The current study examines posttraumatic stress (PTS) symptoms, mother-child relationships, and internalizing and externalizing problems as potential longitudinal pathways through which child maltreatment influences adolescent substance use. Structural equation modeling was conducted on 883 adolescents drawn from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). The pathways of PTS symptoms linked physical and sexual abuse to substance use, and the pathways of mother-child relationships linked emotional abuse and neglect to substance use. None of the four types of maltreatment affected substance use via internalizing or externalizing problems. The findings suggest that intervention efforts aimed at addressing posttraumatic stress symptoms and improving mother-child relationship quality may be beneficial in reducing substance use among adolescents with child maltreatment histories. PMID:29503490
Marcus K. Rogers; Kathryn C. Seigfried-Spellar
Digital evidence plays a crucial role in child pornography investigations. However, in the following case study, the authors argue that the behavioral analysis or “profiling” of digital evidence can also play a vital role in child pornography investigations. The following case study assessed the Internet Browsing History (Internet Explorer Bookmarks, Mozilla Bookmarks, and Mozilla History) from a suspected child pornography user’s computer. The suspect in this case claimed to be conducting an...
Miu, A C; Cărnuţă, M; Vulturar, R; Szekely-Copîndean, R D; Bîlc, M I; Chiş, A; Cioară, M; Fernandez, K C; Szentágotai-Tătar, A; Gross, J J
Child maltreatment is associated with increased risk for virtually all common mental disorders, but it is not yet clear why. One possible mechanism is emotion regulation ability. The present study investigated for the first time the influence of a BDNF Val66Met genotype × child maltreatment interaction on emotion regulation, and compared differential susceptibility and diathesis-stress models. A sample of N = 254 healthy volunteers were genotyped for the BDNF Val66Met polymorphism and underwent an experimental assessment of reappraisal ability (i.e. the success of using reappraisal to downregulate negative affect). A self-report instrument previously validated against a clinical interview was used to investigate child maltreatment. There was a significant BDNF Val66Met genotype × child maltreatment interaction (B = -0.31, P maltreated participants, and the highest level of reappraisal ability in non-maltreated participants. By assessing alternative models, we found that the best fitting model was in line with strong differential susceptibility. As expected, reappraisal ability was negatively correlated with depressive symptoms. Therefore, the BDNF Val66Met polymorphism moderates the link between child maltreatment and emotion regulation ability. Future studies could investigate whether improving reappraisal in maltreated BDNF Met carriers results in reduced risk for mental disorders. © 2016 John Wiley & Sons Ltd and International Behavioural and Neural Genetics Society.
Eniola, Kehinde; Evarts, Lori
Cases of child maltreatment (CM) in the United States remain high, and primary care providers lack the confidence and training to diagnose these cases. This study provides recommendations to improve family medicine physicians' confidence in diagnosing CM. We e-mailed an electronic survey to family medicine residents and physicians practicing in the United States. Responses were collected during August and September 2015. Respondents were asked about their familiarity and competence level regarding the diagnosis of CM. They also were asked about the frequency of their correctly diagnosing CM, timeliness of diagnosis, barriers to a diagnosis or early diagnosis of CM, and receipt of adequate CM training. Of the 420 surveys emailed, 258 (61%) were completed. The majority of respondents stated their self-reported level of competence in diagnosing CM as average or below average, with few (8%) indicating a competence level of above average. A timely diagnosis of child maltreatment was reported by 46% of respondents, whereas 54% were either late (19.2%) in diagnosing or could not recall (34.6%). The barriers to diagnosis cited by responders were inexperience (58%), lack of confidence and certainty (50%), lack of diagnosis protocol (43.3%), lack of confidence in communicating with parents (38.3%), and inadequate training (34.9%). The introduction of CM training into the family medicine residency training curriculum, coupled with the development of a standardized CM diagnosis protocol, may improve self-reported family medicine physicians' confidence and competence levels in diagnosing CM.
Fang, Xiangming; Brown, Derek S; Florence, Curtis S; Mercy, James A
To present new estimates of the average lifetime costs per child maltreatment victim and aggregate lifetime costs for all new child maltreatment cases incurred in 2008 using an incidence-based approach. This study used the best available secondary data to develop cost per case estimates. For each cost category, the paper used attributable costs whenever possible. For those categories that attributable cost data were not available, costs were estimated as the product of incremental effect of child maltreatment on a specific outcome multiplied by the estimated cost associated with that outcome. The estimate of the aggregate lifetime cost of child maltreatment in 2008 was obtained by multiplying per-victim lifetime cost estimates by the estimated cases of new child maltreatment in 2008. The estimated average lifetime cost per victim of nonfatal child maltreatment is $210,012 in 2010 dollars, including $32,648 in childhood health care costs; $10,530 in adult medical costs; $144,360 in productivity losses; $7,728 in child welfare costs; $6,747 in criminal justice costs; and $7,999 in special education costs. The estimated average lifetime cost per death is $1,272,900, including $14,100 in medical costs and $1,258,800 in productivity losses. The total lifetime economic burden resulting from new cases of fatal and nonfatal child maltreatment in the United States in 2008 is approximately $124 billion. In sensitivity analysis, the total burden is estimated to be as large as $585 billion. Compared with other health problems, the burden of child maltreatment is substantial, indicating the importance of prevention efforts to address the high prevalence of child maltreatment. Published by Elsevier Ltd.
Bottoms, Bette L; Goodman, Gail S; Tolou-Shams, Marina; Diviak, Kathleen R; Shaver, Phillip R
Religion can foster, facilitate, and be used to justify child maltreatment. Yet religion-related child abuse and neglect have received little attention from social scientists. We examined 249 cases of religion-related child maltreatment reported to social service agencies, police departments, and prosecutors' offices nationwide. We focused on cases involving maltreatment perpetrated by persons with religious authority, such as ministers and priests; the withholding of medical care for religious reasons; and abusive attempts to rid a child of supposed evil. By providing a descriptive statistical profile of the major features of these cases, we illustrate how these varieties of religion-related child maltreatment occur, who the victims and perpetrators are, and how religion-related child abuse and neglect are reported and processed by the social service and criminal justice systems. We end with a call for greater research attention to these important offenses against children. Copyright © 2015 John Wiley & Sons, Ltd.
Kim, Hyunil; Drake, Brett
Child maltreatment is a pressing social problem in the USA and internationally. There are increasing calls for the use of a public health approach to child maltreatment, but the effective adoption of such an approach requires a sound foundation of epidemiological data. This study estimates for the first time, using national data, total and type-specific official maltreatment risks while simultaneously considering environmental poverty and race/ethnicity. National official maltreatment data (2009-13) were linked to census data. We used additive mixed models to estimate race/ethnicity-specific rates of official maltreatment (total and subtypes) as a function of county-level child poverty rates. The additive model coupled with the multilevel design provided empirically sound estimates while handling both curvilinearity and the nested data structure. With increasing county child poverty rates, total and type-specific official maltreatment rates increased in all race/ethnicity groups. At similar poverty levels, White maltreatment rates trended higher than Blacks and Hispanics showed lower rates, especially where the data were most sufficient. For example, at the 25% poverty level, total maltreatment report rates were 6.91% [95% confidence interval (CI): 6.43%-7.40%] for Whites, 6.30% (5.50%-7.11%) for Blacks and 3.32% (2.88%-3.76%) for Hispanics. We find strong positive associations between official child maltreatment and environmental poverty in all race/ethnicity groups. Our data suggest that Black/White disproportionality in official maltreatment is largely driven by Black/White differences in poverty. Our findings also support the presence of a 'Hispanic paradox' in official maltreatment, where Hispanics have lower risks compared with similarly economically situated Whites and Blacks. © The Author(s) 2018; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association
Chen, Mengtong; Chan, Ko Ling
The objective of this study is to evaluate the effectiveness of parenting programs in reducing child maltreatment and modifying associated factors as well as to examine the moderator variables that are linked to program effects. For this meta-analysis, we searched nine electronic databases to identify randomized controlled trials published before September 2013. The effect sizes of various outcomes at different time points were computed. From the 3,578 studies identified, we selected 37 studies for further analysis. The total random effect size was 0.296. Our results showed that parenting programs successfully reduced substantiated and self-reported child maltreatment reports and reduced the potential for child maltreatment. The programs also reduced risk factors and enhanced protective factors associated with child maltreatment. However, the effects of the parenting programs on reducing parental depression and stress were limited. Parenting programs produced positive effects in low-, middle-, and high-income countries and were effective in reducing child maltreatment when applied as primary, secondary, or tertiary child maltreatment intervention. In conclusion, parenting programs are effective public health approaches to reduce child maltreatment. The evidence-based service of parenting programs could be widely adopted in future practice. © The Author(s) 2015.
Castro, Maravillas; Alcántara-López, Mavi; Martínez, Antonia; Fernández, Visitación; Sánchez-Meca, Julio; López-Soler, Concepción
This correlational cross-sectional study was designed to investigate whether the intimate partner violence (IPV) suffered by mothers (physical and psychological maltreatment), child eyewitness of psychological and physical maltreatment suffered by the mother, the neglect suffered by children, and the maltreatment (physical and psychological) directly suffered by children are statistically associated to post-traumatic stress disorder (PTSD) symptoms exhibited by the child. In addition, the prevalence of child PTSD was estimated, as well as the concordance between the PTSD symptoms assessed by the Child PTSD Symptom Scale (CPSS) and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria for child PTSD. The sample consisted of 152 Spanish children aged 8 to 17 and their mothers, who were recruited from Centers of Specialized Assistance for Women Victims of IPV. PTSD prevalence was 20.4%. The results of a canonical correlation analysis showed that the two types of maltreatment with the largest contribution to the canonical variable were physical maltreatment directly suffered by the child, and child eyewitness of physical maltreatment suffered by the mother. The potential developmental pathway of PTSD when both children and mothers suffer severe maltreatment needs to be examined, and this will contribute to the choice of the most effective type of specialized intervention.
Hornor, Gail; Bretl, Deborah; Chapman, Evelyn; Herendeen, Pamela; Mitchel, Nancy; Mulvaney, Barbara; Quinones, Saribel Garcia; VanGraafeiland, Brigit
Given the number of children affected by child maltreatment and the dire consequences that can develop, prompt identification of child maltreatment is crucial. The purpose of this study was to describe pediatric nurse practitioner (PNP) practice behaviors related to screening and providing anticipatory guidance for child maltreatment and its psychosocial risk factors. The Risk Assessment Survey was developed for this study by 12 PNPs, all of whom were members of NAPNAP's Child Maltreatment Special Interest Group to ensure face validity; all 12 PNPs were content experts in child maltreatment. The content of the survey was derived from key characteristics from the evidence on child maltreatment. The survey was emailed to the more than 8500 NAPNAP members. Two hundred forty-three PNPs responded to the survey, which represents a response rate of 3%. Approximately half of the participants (n = 121; 51%) stated that they never/rarely ask parents questions about domestic violence, more than one-fourth (n = 71; 30%) reported that they never/rarely ask parents questions about discipline, and half of the responding PNPs (n = 120; 50%) reported that they perform an ano-genital exam at well visits. This study demonstrates that a significant number of PNPs do not routinely screen for child maltreatment and psychosocial risk factors. This is especially true in regards to sexual abuse screening and anticipatory guidance. Copyright © 2017 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.
Stevens, Kristopher I; Schneiderman, Janet U; Negriff, Sonya; Brinkmann, Andrea; Trickett, Penelope K
The purpose of the current study was to describe the maltreatment experiences of a sample of urban youths identified as physically abused using the Maltreatment Case Record Abstraction Instrument (MCRAI). The sample (n=303) of 9-12 year old youths was recruited from active child protective services (CPS) cases in 2002-2005, and five years of child protective service records were reviewed. The demographic and maltreatment experiences of MCRAI-identified youths with physical abuse were compared to maltreated youths who were not physically abused and youths who were identified as physically abused by CPS when they entered this longitudinal study. T-tests and chi-square tests were used to compare the demographics and maltreatment experiences of the sample MCRAI-identified physically abused to the sample MCRAI-identified as nonphysically abused maltreated by gender. Of the total sample, 156 (51%) were identified by MCRAI as physically abused and 96.8% of these youth also experienced other types of maltreatment. Whereas youth with the initial CPS identification of physical abuse showed little co-occurrence (37.7%) with other forms of maltreatment. The MCRAI-identified physically abused youths had a significantly higher mean number of CPS reports and higher mean number of incidents of maltreatment than MCRAI-identified nonphysically maltreated youths. Lifeline plots of case record history from the time of first report to CPS to entry into the study found substantial individual variability in maltreatment experiences for both boys and girls. Thus, obtaining maltreatment information from a single report vastly underestimates the prevalence of physical abuse and the co-occurrence of other maltreatment types. Copyright © 2015 Elsevier Ltd. All rights reserved.
Valle, Linda Anne; Whitaker, Daniel J.; Lutzker, John R.; Filene, Jill H.; Wyatt, Jennifer M.; Cephas, Kendell C.; Hoover, D. Michele
The Centers for Disease Control and Prevention (CDC) recognize child maltreatment as a serious public health problem with extensive short- and long-term health effects. In addition to the immediate physical and emotional effects of maltreatment, children who have experienced abuse and neglect are at increased risk of adverse health effects and…
Oshri, Assaf; Rogosch, Fred A.; Cicchetti, Dante
The purpose of this study is to investigate longitudinal risk processes linking early child maltreatment, childhood personality organizations, and adolescent maladaptation. In a sample of maltreated and nonmaltreated children ("N" = 400; 62.3% African American, 11.8% Hispanic; 40.8% girls), a tripartite personality typology based on…
Lawson, Monica; Valentino, Kristin; McDonnell, Christina G; Speidel, Ruth
In the current investigation, we examined associations between maternal attachment and the way that mothers and children discuss past emotional experiences (i.e., reminiscing) among 146 maltreating and 73 nonmaltreating mothers and their 3- to 6-year-old children. Recent studies demonstrate that maltreating mothers engage in less elaborative reminiscing compared with nonmaltreating mothers. To further explicate the nature of reminiscing among maltreating families, we examined maternal and child contributions to reminiscing, their interrelations, and associations with maternal attachment among dyads from maltreating and nonmaltreating families. Maternal attachment is theoretically and empirically associated with mother-child reminiscing, and an insecure maternal attachment style was hypothesized to exacerbate poor elaborative reminiscing among maltreating families. Mothers and children reminisced about four emotional experiences. Maternal attachment was measured with the Experience in Close Relationships-Revised questionnaire. Mothers and children from maltreating families engaged in less elaborative and emotion-rich reminiscing compared with nonmaltreating dyads. Maternal attachment anxiety was negatively associated with maternal elaborative reminiscing, but only among nonmaltreating mothers. Mother-child reminiscing among dyads with nonmaltreating and low attachment anxiety mothers was highly collaborative; whereas reminiscing among dyads with maltreating and high attachment anxiety mothers was less reciprocal. Our findings largely support communicative perspectives of attachment theory and also indicate that maternal attachment is differentially associated with mother-child reminiscing among maltreating and nonmaltreating families. Copyright © 2017 Elsevier Inc. All rights reserved.
Euser, S.; Alink, L.R.A.; Pannebakker, F.; Vogels, T.; Bakermans-Kranenburg, M.J.; IJzendoorn, M.H. van
The prevalence of child maltreatment in the Netherlands was in 2005 first systematically examined in the Netherlands’ Prevalence study on Maltreatment of children and youth (NPM-2005), using sentinel reports and substantiated CPS cases, and in the Pupils on Abuse study (PoA-2005), using high school
Taylor, Christine M; Ross, Michelle E; Wood, Joanne N; Griffis, Heather M; Harb, Gerlinde C; Mi, Lanyu; Song, Lihai; Strane, Douglas; Lynch, Kevin G; Rubin, David M
We described the risk for maltreatment among toddlers of US Army soldiers over different deployment cycles to develop a systematic response within the US Army to provide families appropriate supports. We conducted a person-time analysis of substantiated maltreatment reports and medical diagnoses among children of 112,325 deployed US Army soldiers between 2001 and 2007. Risk of maltreatment was elevated after deployment for children of soldiers deployed once but not for children of soldiers deployed twice. During the 6 months after deployment, children of soldiers deployed once had 4.43 substantiated maltreatment reports and 4.96 medical diagnoses per 10,000 child-months. The highest maltreatment rate among children of soldiers deployed twice occurred during the second deployment for substantiated maltreatment (4.83 episodes per 10,000 child-months) and before the first deployment for medical diagnoses of maltreatment (3.78 episodes per 10,000 child-months). We confirmed an elevated risk for child maltreatment during deployment but also found a previously unidentified high-risk period during the 6 months following deployment, indicating elevated stress within families of deployed and returning soldiers. These findings can inform efforts by the military to initiate and standardize support and preparation to families during periods of elevated risk.
Shenk, Chad E.; Putnam, Frank W.; Noll, Jennie G.
Objective: Not every adolescent exposed to child maltreatment develops symptoms of post-traumatic stress disorder (PTSD), emphasizing the need to identify variables that explain how some maltreated children come to develop these symptoms. This study tested whether a set of variables, respiratory sinus arrhythmia (RSA) and cortisol reactivity as…
Kim, Jungmeen; Cicchetti, Dante
Background: The aim of this study was to investigate longitudinal relations among child maltreatment, emotion regulation, peer acceptance and rejection, and psychopathology. Methods: Data were collected on 215 maltreated and 206 nonmaltreated children (ages 6-12 years) from low-income families. Children were evaluated by camp counselors on emotion…
Tonmyr, Lil; Jack, Susan
A media strategy was developed to disseminate Canadian child maltreatment surveillance data. Print media were systematically searched and 29 articles reporting on the data were retrieved. Using content analysis, the articles were analyzed to assess informational accuracy and to understand how the media framed the issue of maltreatment. This…
Klevens, Joanne; Leeb, Rebecca T.
Objective: To describe the distribution of child maltreatment fatalities of children under 5 by age, sex, race/ethnicity, type of maltreatment, and relationship to alleged perpetrator using data from the National Violent Death Reporting System (NVDRS). Study design: Two independent coders reviewed information from death certificates, medical…
Richey, Allora; Brown, Shaquanna; Fite, Paula J.; Bortolato, Marco
The present study examined the relations between child maltreatment and reactive and proactive functions of aggression, and whether hostile attribution biases partially accounted for these associations in a sample of 339 college students (mean age = 19; 51% male). Child maltreatment was associated with reactive, but not proactive, aggression, and instrumental hostile attribution biases accounted for this association. Relational hostile attributions were correlated with both reactive and proactive aggression, but did not play a role in the link between child maltreatment and reactive aggression. PMID:29386881
Brown, Shaquanna; Fite, Paula J; Stone, Katie; Bortolato, Marco
Internalizing difficulties are one of the most widely documented consequences of child maltreatment. However, there is a need for studies delineating the factors that account for this association. Despite research showing that alexithymia is associated with both child maltreatment and internalizing problems, the role of alexithymia in the link between child maltreatment and internalizing problems has not received much attention in the literature. The current study evaluated whether a history of child maltreatment was associated with symptoms of depression, anxiety, and loneliness in emerging adulthood, and whether alexithymia partially accounted for these associations. Participants included 339 emerging adults ranging between 18 and 25 years of age (M=19.00, SD=1.26, 51.3% male). Exposure to child maltreatment (i.e., physical abuse, physical neglect, sexual abuse, emotional abuse, and emotional neglect) was positively associated with depression, anxiety, and loneliness symptoms. Tests of indirect effects suggested that associations between emotional neglect and symptoms of depression, anxiety, and loneliness were partially explained by alexithymia. However, alexithymia did not account for any other associations between the remaining four maltreatment types and internalizing problems. Findings highlight the need for further evaluation of the factors that might account for associations between child maltreatment and internalizing difficulties. Future directions and implications for interventions are reviewed. Copyright © 2015 Elsevier Ltd. All rights reserved.
Lin, Xiuyun; Li, Longfeng; Chi, Peilian; Wang, Zhonghui; Heath, Melissa Allen; Du, Hongfei; Fang, Xiaoyi
Child maltreatment negatively affects children's development and wellbeing. This study investigated the associations between child maltreatment (i.e., emotional neglect, emotional abuse, and physical abuse) and interpersonal functioning, including parent-child relationship, teacher-student relationship, and peer relationships among children with oppositional defiant disorder (ODD). A total of 256 children with ODD and their parents and class master teachers from Mainland China completed questionnaires. Results showed a negative correlation between emotional abuse (parent-reported) and children's interpersonal relationships with parents, teachers, and peers. Emotional neglect and physical abuse were related to poor parent-child relationships. Latent profile analysis revealed three profiles of child maltreatment among children with ODD. ODD children with more severe levels of one type of maltreatment were also more likely to have experienced severe levels of other types of maltreatment. Children with ODD who were in the group of high maltreatment had the poorest quality of interpersonal relationships. Our findings highlight the urgent need to prevent child maltreatment and promote more positive parenting in families with ODD children. Copyright © 2015 Elsevier Ltd. All rights reserved.
Schafer, Markus H; Morton, Patricia M; Ferraro, Kenneth F
This study considers the long-term health consequences of child maltreatment. Distinct from previous research, we examine the effects of maltreatment in the context of more general parental evaluations. Analyses used retrospective and current data from the Midlife Development in the United States (MIDUS) study. A considerable proportion of middle- and older-age adults who experienced frequent maltreatment nevertheless evaluated the relationship with their offending parent as "excellent", "very good", or "good" (e.g., 47% for physical and emotional maltreatment by mothers). Maltreated respondents generally evaluated their maltreating parents less favorably than non-maltreating parents, but there was considerable variation in these recollected relationships. Adults who experienced child maltreatment reported a greater number of chronic medical conditions and physical symptoms and lower self-rated health, but effects were smaller when they had positive relationships with their parents than when one or more of the relationships was perceived as negative. These findings highlight a common and seemingly paradoxical pattern among MIDUS participants: the co-presence of harsh parental behavior and positive recollections of parental relationships during childhood. Moreover, these surprising patterns of retrospective interpretation predict very different experiences of adult health - health problems are most pronounced among maltreatment in cases where the respondent had a generally negative relationship with one or more of his or her parents. Copyright © 2013 Elsevier Ltd. All rights reserved.
Tran, Nhu K; Van Berkel, Sheila R; van IJzendoorn, Marinus H; Alink, Lenneke R A
There is a paucity of research on correlates of child maltreatment in limited-resource countries with a relatively high tolerance of harsh discipline. This Vietnamese study aimed to investigate associations between different types of child maltreatment and child emotional, cognitive, and physical health functioning as well as moderation effects of gender and ethnicity. This cross-sectional study was conducted with 1851 randomly selected students aged 12-17 years. Both self-report and more objective measures (weight, height, study ranking, and a memory test) were used. All types of child maltreatment were associated with emotional dysfunctioning. Life time and past year experiences of physical abuse and life time experiences of sexual abuse and neglect were related to poorer perceived physical health. The study did not find associations between any type of child maltreatment and overweight or underweight status. Regarding cognitive functioning, life time experience of sexual abuse and neglect were related to poorer working memory performance. Noticeably, emotional abuse was related to better academic performance, which might be an indication of "tiger parenting" practice in Vietnam, implying academic performance stimulation at the expense of emotional security. No significant moderation effects by gender and ethnicity were found. Even in a culture in which harsh discipline is normative, child maltreatment was related to negative aspects of child wellbeing including emotional, cognitive, and physical health functioning. Efficient and low-cost interventions on child maltreatment should be developed and conducted in Vietnam as well as other countries with similar contexts.
Hein, Tyler C; Monk, Christopher S
Child maltreatment is common and has long-term consequences for affective function. Investigations of neural consequences of maltreatment have focused on the amygdala. However, developmental neuroscience indicates that other brain regions are also likely to be affected by child maltreatment, particularly in the social information processing network (SIPN). We conducted a quantitative meta-analysis to: confirm that maltreatment is related to greater bilateral amygdala activation in a large sample that was pooled across studies; investigate other SIPN structures that are likely candidates for altered function; and conduct a data-driven examination to identify additional regions that show altered activation in maltreated children, teens, and adults. We conducted an activation likelihood estimation analysis with 1,733 participants across 20 studies of emotion processing in maltreated individuals. Maltreatment is associated with increased bilateral amygdala activation to emotional faces. One SIPN structure is altered: superior temporal gyrus, of the detection node, is hyperactive in maltreated individuals. The results of the whole-brain corrected analysis also show hyperactivation of the parahippocampal gyrus and insula in maltreated individuals. The meta-analysis confirms that maltreatment is related to increased bilateral amygdala reactivity and also shows that maltreatment affects multiple additional structures in the brain that have received little attention in the literature. Thus, although the majority of studies examining maltreatment and brain function have focused on the amygdala, these findings indicate that the neural consequences of child maltreatment involve a broader network of structures. © 2016 Association for Child and Adolescent Mental Health.
Doom, Jenalee R.; Cicchetti, Dante; Rogosch, Fred A.; Dackis, Melissa N.
Summary Child maltreatment is a potent stressor associated with neuroendocrine dysregulation and increased risk for mental and physical disorders throughout the lifespan. Gender differences in stress reactivity and adult psychopathology prevalence may be related to sex-specific responsivity to stress. The purpose of this study is to examine whether gender interacts with the stress of maltreatment to produce differential neuroendocrine profiles in children. Participants included 137 maltreated and 110 nonmaltreated low-income, racially and ethnically diverse children (range: 7.9–10.9 years; M= 9.42 years; 52% male) who attended a summer research day camp. Saliva was collected 3 times across the day for 5 days for cortisol and dehydroepiandosterone (DHEA) analysis. Department of Human Services records were examined to determine the type, severity, chronicity, onset, and recency of maltreatment for children in the maltreated group. Significant interactions between gender and maltreatment pervasiveness predicted diurnal cortisol, DHEA, and cortisol/DHEA ratio levels. Elevated daily cortisol levels were reported for boys compared to girls in the group with more pervasive maltreatment. Boys with less pervasive maltreatment had lower DHEA and higher cortisol/DHEA ratio levels than girls with similar experiences, nonmaltreated boys, and boys with more pervasive maltreatment. Further results are consistent with down-regulation of cortisol production in girls with more pervasive maltreatment and girls who experienced maltreatment that was early onset and not recent. The effectiveness of interventions for maltreated children may be improved with greater knowledge of how maltreatment differentially affects neuroendocrine regulation by gender. PMID:23333253
Cicchetti, Dante; Hetzel, Susan; Rogosch, Fred A.; Handley, Elizabeth D.; Toth, Sheree L.
In the present investigation, differential methylation analyses of the whole genome were conducted among a sample of 548 school-aged low-income children (47.8% female, 67.7% Black, M age=9.40 years), 54.4% of whom had a history of child maltreatment. In the context of a summer research camp, DNA samples via saliva were obtained. Using GenomeStudio, Methylation Module and the Illumina Custom Model, differential methylation analyses revealed a pattern of greater methylation at low methylation sites (n=197 sites) and medium methylation sites (n=730 sites) and less methylation at high methylation sites (n=907 sites) among maltreated children. The mean difference in methylation between the maltreated and nonmaltreated children was 6.2%. The relative risk of maltreatment with known disease biomarkers was also investigated using GenoGo MetaCore Software. A large number of network objects previously associated with mental health, cancer, cardiovascular systems, and immune functioning were identified evidencing differential methylation among maltreated and nonmaltreated children. Site-specific analyses were also conducted for ALDH2, ANKK1, and NR3C1 and results highlight the importance of considering gender and the developmental timing of maltreatment. For ALDH2, results indicated that maltreated girls evidenced significantly lower methylation compared to nonmaltreated girls, and maltreated boys evidenced significantly higher methylation compared to nonmaltreated boys. Moreover, early onset-not recently maltreated boys evidenced significantly higher methylation at ALDH2 compared to nonmaltreated boys. Similarly, children with early onset-non recent maltreatment evidenced significantly higher methylation compared to nonmaltreated children at ANKK1. The site-specific results were not altered by controlling for genotypic variation of respective genes. The findings demonstrate increased risk for adverse physical and mental health outcomes associated with differences in
Ammerman, Robert T; Peugh, James L; Teeters, Angelique R; Putnam, Frank W; Van Ginkel, Judith B
Child maltreatment contributes to depression in adults. Evidence indicates that such experiences are associated with poorer outcomes in treatment. Mothers in home visiting programs display high rates of depression and child maltreatment histories. In-Home Cognitive Behavioral Therapy (IH-CBT) was developed to treat maternal depression in home visiting. The purpose of this study was to examine the moderating effects of child maltreatment history on depression, social functioning, and parenting in mothers participating in a clinical trial of IH-CBT. Ninety-three depressed mothers in home visiting between 2 and 10 months postpartum were randomly assigned to IH-CBT (n = 47) plus home visiting or standard home visiting (SHV; n = 46). Mothers were identified via screening and then confirmation of major depressive disorder diagnosis. Measures of child maltreatment history, depression, social functioning, and parenting were administered at pre-treatment, post-treatment, and 3-month follow-up. Results indicated high rates of maltreatment in both conditions relative to the general population. Mixed model analyses found a number of main effects in which experiences of different types of trauma were associated with poorer functioning regardless of treatment condition. Evidence of a moderating effect of maltreatment on treatment outcomes was found for physical abuse and parenting and emotional abuse and social network size. Future research should focus on increasing the effectiveness of IH-CBT with depressed mothers who have experienced child maltreatment. © The Author(s) 2014.
Full Text Available Objectives. To describe how Finnish public health nurses identify and intervene in child maltreatment and how they implement the National Clinical Guideline in their work. Design and Sample. Cross-sectional survey of 367 public health nurses in Finland. Measures. A web-based questionnaire developed based on the content areas of the guideline: identifying, intervening, and implementing. Results. The respondents reported they identify child maltreatment moderately (mean 3.38, intervene in it better (4.15, and implement the guideline moderately (3.43, scale between 1 and 6. Those with experience of working with maltreated children reported they identify them better P<0.001, intervene better P<0.001, and implement the guideline better P<0.001 than those with no experience. This difference was also found for those who were aware of the guideline, had read it, and participated in training on child maltreatment, as compared to those who were not aware of the guideline, had not read it, or had not participated in such training. Conclusions. The public health nurses worked quite well with children who had experienced maltreatment and families. However, the results point out several developmental targets for increasing training on child maltreatment, for devising recommendations for child maltreatment, and for applying these recommendations systematically in practice.
Adams, Kenneth Alan
In the psychohistory of the antebellum South, the extent of child abuse in slaveholder families is important for understanding how members of the southern elite were reared and the extent to which they were infected with the toxic residue of their elders’ passions and rages. It is argued that the Old South was a developing region, rather than an already developed one. Consequently, the rate of child abuse that is characteristic of contemporary postindustrial societies is not the proper paradigm for conceptualizing the abuse rate in slaveholder families. It is proposed instead that the rate of child abuse in contemporary developing societies is a better fit for estimating abuse in the antebellum South. Societal and familial variables impinging on the abuse of slaveholder children—corporal punishment, alcohol consumption, hyper-masculinity, a traumatogenic culture of violence, wife abuse, maternal ambivalence and neglect, miscegenation and incest are discussed, as is the likelihood of maltreatment by slaves. Using a study of child abuse across 28 nations, tentative rates of abuse are proposed.
Nadan, Yochay; Spilsbury, James C; Korbin, Jill E
In the early 1990s, the U.S. Advisory Board on Child Abuse and Neglect commissioned a series of reviews that appeared as the edited volume, Protecting Children from Abuse and Neglect (Melton & Barry, 1994). Using the 1994 review "Sociocultural Factors in Child Maltreatment" (Korbin, 1994) as a background, this article reconsiders culture and context in child maltreatment work. Since 1994, conditions promoting research and practice attention in this area include immigration-driven global increases in diverse, multicultural societies where different beliefs and practices meet (and clash); expanding purview of the human rights discourse to children; and the disproportionate and disparate representation of cultural, ethnic, and racial groups in child-welfare systems. Although research on child maltreatment has advanced in many ways over 20 years, the complexity of child maltreatment leaves many critical questions demanding further attention, culture and context among them. To help address these questions, we propose two approaches for future maltreatment research: intersectionality - the simultaneous examination of multiple identities (such as gender, race, and socioeconomic status) - as a framework for understanding the complexity of cultural factors; and neighborhood-based research as a means for understanding the context of child maltreatment from the perspective of an ecological framework. Copyright © 2014 Elsevier Ltd. All rights reserved.
Gracia, Enrique; López-Quílez, Antonio; Marco, Miriam; Lila, Marisol
'Place' matters in understanding prevalence variations and inequalities in child maltreatment risk. However, most studies examining ecological variations in child maltreatment risk fail to take into account the implications of the spatial and temporal dimensions of neighborhoods. In this study, we conduct a high-resolution small-area study to analyze the influence of neighborhood characteristics on the spatio-temporal epidemiology of child maltreatment risk. We conducted a 12-year (2004-2015) small-area Bayesian spatio-temporal epidemiological study with all families with child maltreatment protection measures in the city of Valencia, Spain. As neighborhood units, we used 552 census block groups. Cases were geocoded using the family address. Neighborhood-level characteristics analyzed included three indicators of neighborhood disadvantage-neighborhood economic status, neighborhood education level, and levels of policing activity-, immigrant concentration, and residential instability. Bayesian spatio-temporal modelling and disease mapping methods were used to provide area-specific risk estimations. Results from a spatio-temporal autoregressive model showed that neighborhoods with low levels of economic and educational status, with high levels of policing activity, and high immigrant concentration had higher levels of substantiated child maltreatment risk. Disease mapping methods were used to analyze areas of excess risk. Results showed chronic spatial patterns of high child maltreatment risk during the years analyzed, as well as stability over time in areas of low risk. Areas with increased or decreased child maltreatment risk over the years were also observed. A spatio-temporal epidemiological approach to study the geographical patterns, trends over time, and the contextual determinants of child maltreatment risk can provide a useful method to inform policy and action. This method can offer a more accurate description of the problem, and help to inform more
Kim, Kihyun; Mennen, Ferol E.; Trickett, Penelope K.
This study examined the patterns and correlates of the types of maltreatment experienced by adolescents aged 9–12, participating in an ongoing longitudinal study on the impact of neglect on children’s development. Using case record abstraction, the study compared the child protection classification and findings from the case record abstraction with regard to the rates of four types of maltreatment (i.e. physical, sexual, emotional abuse and neglect) as well as co-occurrence across multiple types of maltreatment. Next, the study examined the frequently observed patterns of child maltreatment. Finally, the study investigated whether aspects of caretaker functioning and the detailed incident characteristics in the cases of neglect differed by the number of different types of maltreatment the children experienced. Results showed significant discrepancies between the Child Protective Service classification and case record abstraction. Child Protective Service classification considerably underestimated the rate of co-occurrence across multiple types of maltreatment. Neglect accompanied by physical and emotional abuse was the most common form. Some of the caretaker functioning variables distinguished the number of types of maltreatment. Based on the findings, future-research directions and practice implication were discussed. PMID:29225485
Jung, Hyunzee; Herrenkohl, Todd I; Klika, J Bart; Lee, Jungeun Olivia; Brown, Eric C
Bivariate analyses of adult crime and child maltreatment showed that individuals who had been maltreated as children, according to child welfare reports, subsequently committed more crime than others who had not been maltreated. Analyses of crimes by category-property, person, and society-provided further evidence of a link between child maltreatment and crime at the bivariate level. Tests of gender differences showed that crime generally is more prevalent among males, although females with a history of maltreatment were more likely than those in a no-maltreatment (comparison) group to report having had some prior involvement in crime. Surprisingly, multivariate analyses controlling for childhood socioeconomic status, gender, minority racial status, marital status, and education level showed that, with one exception (crimes against society), the significant association between child maltreatment and crime observed in bivariate tests was not maintained. Implications for future research are discussed. © The Author(s) 2014.
Parrish, Jared W; Schnitzer, Patricia G; Lanier, Paul; Shanahan, Meghan E; Daniels, Julie L; Marshall, Stephen W
Accurate estimation of the incidence of maltreatment-related child mortality depends on reliable child fatality review. We examined the inter-rater reliability of maltreatment designation for two Alaskan Child Death Review (CDR) panels. Two different multidisciplinary CDR panels each reviewed a series of 101 infant and child deaths (ages 0-4 years) in Alaska. Both panels independently reviewed identical medical, autopsy, law enforcement, child welfare, and administrative records for each death utilizing the same maltreatment criteria. Percent agreement for maltreatment was 64.7% with a weighted Kappa of 0.61 (95% CI 0.51, 0.70). Across maltreatment subtypes, agreement was highest for abuse (69.3%) and lowest for negligence (60.4%). Discordance was higher if the mother was unmarried or a smoker, if residence was rural, or if there was a family history of child protective services report(s). Incidence estimates did not depend on which panel's data were used. There is substantial room for improvement in the reliability of CDR panel assessment of maltreatment related mortality. Standardized decision guidance for CDR panels may improve the reliability of their data. Copyright © 2017 Elsevier Ltd. All rights reserved.
Garner, Bryan R; Hunter, Brooke D; Smith, Douglas C; Smith, Jane Ellen; Godley, Mark D
Emerging adulthood is the period of greatest risk for problematic substance use. The primary aim of the current study was to examine the relationship between a broad measure of child maltreatment and several key outcomes for a large clinical sample of emerging adults (n = 858) and adolescents (n = 2,697). The secondary aim was to examine the extent to which the relationship between child maltreatment and treatment outcomes differed between emerging adults and adolescents. Multilevel latent growth curve analyses revealed emerging adults and adolescents who experienced child maltreatment reported significantly greater reductions over time on several treatment outcomes (e.g., substance use, substance-related problems, and emotional problems). Overall, analyses did not support differential relationships between child maltreatment and changes over time in these substance use disorder treatment outcomes for emerging adults and adolescents. The one exception was that although emerging adults with child maltreatment did reduce their HIV risk over time, their improvements were not as great as were the improvements in HIV risk reported by adolescents who had experienced child maltreatment. © The Author(s) 2014.
van der Put, Claudia E; Assink, Mark; Gubbels, Jeanne; Boekhout van Solinge, Noëlle F
There is a lack of knowledge about specific components that make interventions effective in preventing or reducing child maltreatment. The aim of the present meta-analysis was to increase this knowledge by summarizing findings on effects of interventions for child maltreatment and by examining potential moderators of this effect, such as intervention components and study characteristics. Identifying effective components is essential for developing or improving child maltreatment interventions. A literature search yielded 121 independent studies (N = 39,044) examining the effects of interventions for preventing or reducing child maltreatment. From these studies, 352 effect sizes were extracted. The overall effect size was significant and small in magnitude for both preventive interventions (d = 0.26, p child maltreatment. For preventive interventions, larger effect sizes were found for short-term interventions (0-6 months), interventions focusing on increasing self-confidence of parents, and interventions delivered by professionals only. Further, effect sizes of preventive interventions increased as follow-up duration increased, which may indicate a sleeper effect of preventive interventions. For curative interventions, larger effect sizes were found for interventions focusing on improving parenting skills and interventions providing social and/or emotional support. Interventions can be effective in preventing or reducing child maltreatment. Theoretical and practical implications are discussed.
Evans, Sarah E.; Steel, Anne; DiLillo, David
Objectives The current study investigates the moderating effect of perceived social support on associations between child maltreatment severity and adult trauma symptoms. We extend the existing literature by examining the roles of severity of multiple maltreatment types (i.e., sexual, physical, and emotional abuse; physical and emotional neglect) and gender in this process. Methods The sample included 372 newlywed individuals recruited from marriage license records. Participants completed a number of self-report questionnaires measuring the nature and severity of child maltreatment history, perceived social support from friends and family, and trauma-related symptoms. These questionnaires were part of a larger study, investigating marital and intrapersonal functioning. We conducted separate, two-step hierarchical multiple regression models for perceived social support from family and perceived social support from friends. In each of these models, total trauma symptomatology was predicted from each child maltreatment severity variable, perceived social support, and the product of the two variables. In order to examine the role of gender, we conducted separate analyses for women and men. Results As hypothesized, increased severity of several maltreatment types (sexual abuse, emotional abuse, emotional neglect, and physical neglect) predicted greater trauma symptoms for both women and men, and increased physical abuse severity predicted greater trauma symptoms for women. Perceived social support from both family and friends predicted lower trauma symptoms across all levels of maltreatment for men. For women, greater perceived social support from friends, but not from family, predicted decreased trauma symptoms. Finally, among women, perceived social support from family interacted with child maltreatment such that, as the severity of maltreatment (physical and emotional abuse, emotional neglect) increased, the buffering effect of perceived social support from family on
Full Text Available Early childhood care and education providers (CCPs work with over 7 million young children. These children are vulnerable to physical, sexual and emotional abuse, and neglect. However, CCPs make less than 1% of all reports of suspected child abuse and neglect that are made to child protective services. CCPs are therefore an untapped resource in the public health response to child maltreatment. However, their knowledge and attitudes about duties to report child maltreatment are poorly understood. Moreover, no rigorous research has tested whether their knowledge and attitudes about reporting child maltreatment can be improved. These gaps in knowledge are important because knowledge of the duty and positive attitudes towards it produce more effective reporting, and little evidence exists about how to enhance cognitive and affective attributes. Using the CONSORT approach, we report a single-blind test-retest randomized controlled trial evaluating iLook Out for Child Abuse, a customized online educational intervention for CCPs to increase knowledge and attitudes towards the reporting duty. 762 participants were randomized with results analyzed for 741 participants (372 in the intervention group; 369 in the control. Knowledge of the reporting duty increased in the intervention group from 13.54 to 16.19 out of 21 (2.65 increase, 95% CI: (2.37, 2.93; large effect size 0.95, p < 0.001; the control group remained stable, moving from 13.54 to 13.59 (0.05 increase, 95% CI: (-0.12, 0.22; negligible effect size 0.03, p = 0.684. Attitudes were enhanced on all 13 items for the intervention group, remaining stable in the control, with significant differences between groups on all items (p < 0.05. Gains were largely sustained at four month follow-up. Findings support education for CCPs and other professions. Future research should also explore effects of education on reporting behavior.US National Institutes of Health NCT02225301.
Mathews, Ben; Yang, Chengwu; Lehman, Erik B; Mincemoyer, Claudia; Verdiglione, Nicole; Levi, Benjamin H
Early childhood care and education providers (CCPs) work with over 7 million young children. These children are vulnerable to physical, sexual and emotional abuse, and neglect. However, CCPs make less than 1% of all reports of suspected child abuse and neglect that are made to child protective services. CCPs are therefore an untapped resource in the public health response to child maltreatment. However, their knowledge and attitudes about duties to report child maltreatment are poorly understood. Moreover, no rigorous research has tested whether their knowledge and attitudes about reporting child maltreatment can be improved. These gaps in knowledge are important because knowledge of the duty and positive attitudes towards it produce more effective reporting, and little evidence exists about how to enhance cognitive and affective attributes. Using the CONSORT approach, we report a single-blind test-retest randomized controlled trial evaluating iLook Out for Child Abuse, a customized online educational intervention for CCPs to increase knowledge and attitudes towards the reporting duty. 762 participants were randomized with results analyzed for 741 participants (372 in the intervention group; 369 in the control). Knowledge of the reporting duty increased in the intervention group from 13.54 to 16.19 out of 21 (2.65 increase, 95% CI: (2.37, 2.93); large effect size 0.95, p < 0.001); the control group remained stable, moving from 13.54 to 13.59 (0.05 increase, 95% CI: (-0.12, 0.22); negligible effect size 0.03, p = 0.684). Attitudes were enhanced on all 13 items for the intervention group, remaining stable in the control, with significant differences between groups on all items (p < 0.05). Gains were largely sustained at four month follow-up. Findings support education for CCPs and other professions. Future research should also explore effects of education on reporting behavior. US National Institutes of Health NCT02225301.
Erfurt, C.; Schmidt, U.; Hahn, G.; Roesner, D.
Advanced and specialized radiological diagnostics are essential in the case of clinical suspicion of pediatric injuries to the head, thorax, abdomen, and extremities when there is no case history or when ''battered child syndrome'' is assumed on the basis of inadequate trauma. In particular, the aim of this sophisticated diagnostic procedure is the detection of lesions of the central nervous system (CNS) in order to initiate prompt medical treatment. If diagnostic imaging shows typical findings of child abuse, accurate documented evidence of the diagnostic results is required to prevent further endangerment of the child's welfare. (orig.) [de
Raghavan, Ramesh; Brown, Derek S; Allaire, Benjamin T; Ross, Raven E; Landsverk, John
This study examined relationships between various measures of the severity of child maltreatment and expenditures on psychotropic drugs among children in the welfare system. Child participants (N=4,453) in the first National Survey of Child and Adolescent Well-Being (NSCAW) were linked to their Medicaid claims from 36 states. Three specifications for severity of maltreatment were developed. A two-part regression of logistic and generalized linear models of expenditures on psychotropic medications was estimated for each specification. Physically abused children had higher odds (odds ratio [OR]=1.34) and neglected children had lower odds (OR=.76) of incurring psychotropic drug expenditures. Children who experienced the most severe level of harm had higher odds (OR=1.33) of medication use, compared with children without appreciable harm. No maltreatment specifications were associated with increased expenditures on psychotropic drugs. The magnitude of maltreatment affected odds of use of psychotropic drugs but had no effect on Medicaid expenditures for these drugs.
Morton, Cory M.
This study investigates how the relationship between dense concentrations of alcohol retailers and high rates of child maltreatment may be moderated by the presence of substance abuse service facilities. Using a cross-sectional design, the study utilized data from Bergen County, New Jersey on child maltreatment reports, alcohol-selling retailers, substance abuse service facilities, and the United States Census. Findings indicate child maltreatment rates were higher in neighborhoods with lower...
Rabenhorst, Mandy M; McCarthy, Randy J; Thomsen, Cynthia J; Milner, Joel S; Travis, Wendy J; Colasanti, Marie P
This study examined child maltreatment perpetration among 99,697 active-duty U.S. Air Force parents who completed a combat deployment. Using the deploying parent as the unit of analysis, we analyzed whether child maltreatment rates increased postdeployement relative to predeployment. These analyses extend previous research that used aggregate data and extend our previous work that used data from the same period but used the victim as the unit of analysis and included only deploying parents who engaged in child maltreatment. In this study, 2% (n = 1,746) of deploying parents perpetrated child maltreatment during the study period. Although no overall differences were found in child maltreatment rates postdeployment compared to predeployment, several maltreatment-related characteristics qualified this finding. Rates for emotional abuse and mild maltreatment were lower following deployment, whereas child maltreatment rates for severe maltreatment were higher following deployment. The finding that rates of severe child maltreatment, including incidents involving alcohol use, were higher postdeployment suggests a need for additional support services for parents following their return from combat deployment, with a focus on returning parents who have an alcohol use problem. © The Author(s) 2014.
Danielson, Carla Kmett; Amstadter, Ananda B.; Dangelmaier, Ruth E.; Resnick, Heidi S.; Saunders, Benjamin E.; Kilpatrick, Dean G.
We investigated the link between child maltreatment, including child sexual assault (CSA) and child physical assault (CPA), and addiction-related symptomatology in a subsample of adolescents from the National Survey of Adolescents, all of whom met DSM-IV criteria for substance abuse or dependence (N = 281). More than 60% of the sample reported a…
Palusci, Vincent J.; Yager, Steve; Covington, Theresa M.
Objective: Child maltreatment (CM) fatalities are often preventable, and reviewing these deaths often highlights problems in law, policy or practice that can be addressed to prevent future deaths. Citizen Review Panels (CRPs) comprised of medical and child welfare professionals were established in 1996 to review Child Protective Services (CPS)…
Handley, Elizabeth D.; Rogosch, Fred A.; Cicchetti, Dante
The current study examined the prospective association between child maltreatment and the development of substance use disorder (SUD) in adolescence with the aim of investigating pathways underlying this relation, as well as genetic moderation of these developmental mechanisms. Specifically, we tested whether youth who experienced maltreatment prior to age 8 were at risk for the development of marijuana dependence in adolescence by way of a childhood externalizing pathway and a childhood internalizing pathway. Moreover, we tested whether variation in FKBP5 CATT haplotype moderated these pathways. The participants were 326 children (n=179 maltreated; n=147 nonmaltreated) assessed across two waves of data collection (childhood: ages 7–9 and adolescence: ages 15–18). Results indicated that higher levels of child externalizing symptoms significantly mediated the effect of child maltreatment on adolescent marijuana dependence symptoms for individuals with 1–2 copies of the FKBP5 CATT haplotype only. We did not find support for an internalizing pathway from child maltreatment to adolescent marijuana dependence, nor did we find evidence of moderation of the internalizing pathway by FKBP5 haplotype variation. Findings extend previous research by demonstrating that whether a maltreated child will traverse an externalizing pathway toward SUD in adolescence is dependent on FKBP5 genetic variation. PMID:26535939
van Delft, Ivanka; Finkenauer, Catrin; Verbruggen, Janna
This study aimed to examine the effects of child maltreatment subtypes (physical abuse, sexual abuse, neglect, and exposure to domestic violence) and cumulative child maltreatment on depressive symptoms in adulthood, and examine the protective effects of social connectedness in a sample of formerly institutionalized females. The sample consisted of 124 females who were institutionalized in a Dutch juvenile justice institution during adolescence and were followed-up when they were on average 32 years old. Information about child maltreatment was extracted from treatment files. Retrospective data on social connectedness in young adulthood were established during interviews using a Life History Calendar. Relationship quality at follow-up was assessed with items derived from the Rochester Youth Development Study. The Center for Epidemiological Studies Scale for Depression (CES-D) was used to measure depressive symptoms in adulthood. Results showed that 85.5% of the females experienced child maltreatment, and co-occurrence of subtypes was high. Cumulative child maltreatment increased the risk of depression in adulthood. Furthermore, social connectedness, that is, more employment over time and the quality of the romantic relationship at follow-up, protected against the development of depression. However, social connectedness did not buffer the effect of maltreatment on depression. Our findings indicate that treatment of these girls should focus on improving the social-emotional development to promote positive interpersonal relationships and include educational and vocational components to guide these girls toward increased opportunities on the labor market. © The Author(s) 2015.
Carlson, Matthew; Oshri, Assaf; Kwon, Josephine
Child maltreatment poses significant risk to the development of callous/unemotional traits as well as risk behaviors such as engaging in violence, having sex with strangers, and binge drinking. In the current study, the indirect pathway from child maltreatment to risk behaviors was examined via callous/unemotional traits; whereas the conscientious personality trait was tested as a moderator of this indirect pathway. Young adults and parents (N=361; Mage=19.14, SD=1.44) completed questionnaires on child maltreatment histories, callousness/unemotional traits, personality characteristics, and risk behaviors. Structural equation modeling was used to examine the hypothesized direct, indirect and conditional indirect effects. Findings showed indirect links between the child maltreatment latent factor and physical fighting, having sex with strangers, and binge drinking via callous/unemotional traits. Furthermore, the conscientiousness personality type significantly buffered the connection between callous/unemotional traits and physical fighting, supporting a conditional indirect effects. Callous/unemotional traits are important factors in the underlying mechanism between child maltreatment and risk behaviors among young adults, and conscientiousness serves as a protective factor against violence. Preventive intervention programs and clinicians may benefit from focusing in addressing callous/unemotional traits among youth who report childhood maltreatment experiences as well as targeting conscientiousness as a protective factor. Copyright © 2015 Elsevier Ltd. All rights reserved.
Feng, Jui-Ying; Chang, Yi-Ting; Chang, Hsin-Yi; Fetzer, Susan; Wang, Jung-Der
Reported cases of child maltreatment are increasing in Taiwan. Yet, comprehensive epidemiological characteristics of adolescents' exposure over the wide spectrum of violence are still lacking. The purpose of this study was to estimate the prevalence and magnitude of child maltreatment among Taiwanese adolescents. A population-based study was conducted with 5,276 adolescents aged 12-18 from 35 schools in 17 cities and townships to determine the prevalence of five forms of child maltreatment in Taiwan. A total of 5,236 adolescents completed anonymous, self-report, structured questionnaires. Most adolescents (91%, n=4,788) experienced at least one form of maltreatment with 83% (n=4,347) exposed during the previous year. Violence exposure was the most common type of child maltreatment experienced, followed by psychological abuse, physical abuse, neglect, and sexual abuse. Adolescents reported an average of 7.4 (SD=5.87) victimizations over their lifetime and 4.8 (SD=4.82) victimizations during the past year. Females reported a higher rate of neglect, while males reported a higher rate of sexual abuse. Most of the sexual abuse perpetrators were known by their victims. Adolescents' victimization and polyvictimization from child maltreatment in Taiwan deserves a review and modification of national control and prevention policies. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.
Jaschek, Graciela; Carter-Pokras, Olivia; He, Xin; Lee, Sunmin; Canino, Glorisa
This article compares multiple types of child maltreatment among Puerto Rican youth. We seek to expand the limited knowledge of the effects of multiple types of maltreatment on depressive symptoms in a specific Latino population as emerging studies indicate that children who are exposed to one type of maltreatment are often exposed to other types. This study examines the predictive strength of different and multiple types of lifetime child maltreatment (i.e., physical, sexual, and emotional abuse; and neglect), and the effect of youth support from parents, youth coping, youth self-esteem, and place of residence on depressive symptoms among Puerto Rican youth. Secondary data analyses were performed using three annual waves (2000-2004) of data from the Boricua Youth Study. The analytic sample consists of 1041 10-13 year old Puerto Rican youth living in New York and Puerto Rico. Results indicate that: (1) youth who experienced 'sexual abuse only', 'multiple maltreatment' (2 or more types of maltreatment), 'physical abuse only' have a significant increase in depressive symptoms (75.1%, 61.6%, and 40.5% respectively) compared to those without maltreatment; and (2) place of residence, exposure to violence, and mental disorders were significant risk factors. When developing psychosocial interventions, professionals should particularly focus on youth who report past lifetime experience with child maltreatment. Particular attention should be given to children living in the Bronx, New York and similar urban low-income areas who report past lifetime experience with multiple types of child maltreatment and who present symptoms or a diagnosis of co-occurring mental health problems. Copyright © 2016 Elsevier Ltd. All rights reserved.
Negriff, Sonya; Schneiderman, Janet U; Trickett, Penelope K
The present study used data from an ongoing longitudinal study of the effects of maltreatment on adolescent development to (1) describe rates of maltreatment experiences obtained from retrospective self-report versus case record review for adolescents with child welfare-documented maltreatment histories, (2) examine self-reported versus child welfare-identified maltreatment in relation to mental health and risk behavior outcomes by maltreatment type, and (3) examine the association between the number of different types of maltreatment and mental health and risk behavior outcomes. Maltreatment was coded from case records using the Maltreatment Case Record Abstraction Instrument (MCRAI) and participants were asked at mean age = 18.49 about childhood maltreatment experiences using the Comprehensive Trauma Interview (CTI). Results showed that an average of 48% of maltreatment found by the MCRAI for each type of maltreatment were unique cases not captured by the CTI, whereas an average of 40% self-reported maltreatment (CTI) was not indicated by the MCRAI. Analyses with outcomes showed generally, self-reported maltreatment, regardless of concordance with MCRAI, was related to the poorest outcomes. The difference in associations with the outcomes indicates both self-report and case record review data may have utility depending on the outcomes being assessed.
van Berkel, Sheila R; Tucker, Corinna Jenkins; Finkelhor, David
This study examined how the combination of sibling victimization and parental child maltreatment is related to mental health problems and delinquency in childhood and adolescence. Co-occurrence, additive associations, and interactive associations of sibling victimization and parental child maltreatment were investigated using a sample of 2,053 children aged 5-17 years from the National Survey of Children's Exposure to Violence. The results provide primarily evidence for additive associations and only suggest some co-occurrence and interactive associations of sibling victimization and child maltreatment. Evidence for co-occurrence was weak and, when controlling for the other type of maltreatment, only found for neglect. Sibling victimization was related to more mental health problems and delinquency over and above the effect of child abuse and neglect. Moderation by sibling victimization depended on child age and was only found for the relation between both types of child maltreatment by parents and delinquency. For mental health, no interactive associations were found. These results highlight the unique and combined associations between sibling victimization on child development.
Bunting, Lisa; Davidson, Gavin; McCartan, Claire; Hanratty, Jennifer; Bywaters, Paul; Mason, Will; Steils, Nicole
Child maltreatment is a global problem affecting millions of children and is associated with an array of cumulative negative outcomes later in life, including unemployment and financial difficulties. Although establishing child maltreatment as a causal mechanism for adult economic outcomes is fraught with difficulty, understanding the relationship between the two is essential to reducing such inequality. This paper presents findings from a systematic review of longitudinal research examining experiences of child maltreatment and economic outcomes in adulthood. A systematic search of seven databases found twelve eligible retrospective and prospective cohort studies. From the available evidence, there was a relatively clear relationship between 'child maltreatment' and poorer economic outcomes such as reduced income, unemployment, lower level of job skill and fewer assets, over and above the influence of family of origin socio-economic status. Despite an extremely limited evidence base, neglect had a consistent relationship with a number of long-term economic outcomes, while physical abuse has a more consistent relationship with income and employment. Studies examining sexual abuse found less of an association with income and employment, although they did find a relationship other outcomes such as sickness absence, assets, welfare receipt and financial insecurity. Nonetheless, all twelve studies showed some association between at least one maltreatment type and at least one economic measure. The task for future research is to clarify the relationship between specific maltreatment types and specific economic outcomes, taking account of how this may be influenced by gender and life course stage. Copyright © 2018 Elsevier Ltd. All rights reserved.
Fowler, Patrick J; Schoeny, Michael
A longitudinal randomized controlled trial tested whether access to permanent housing reduces child maltreatment among inadequately housed families under investigation for child abuse and neglect. The study followed homeless and child welfare-involved families randomly assigned to receive a referral for housing subsidies plus housing case management (n = 75, 196 children) or housing case management alone (n = 75, 186 children). Latent growth models examined change in caregiver-reported frequencies of psychological aggression, physical abuse, and neglect toward children at five time points across 2.5 years. Intent-to-treat analyses suggested treatment differences for minor assault and neglect that approached significance; families randomly assigned to permanent housing plus case management exhibited marginally greater declines compared to families referred for housing case management only. Caregiver psychological aggression remained high over time, regardless of treatment condition. No evidence indicated higher risk families benefitted more from permanent housing. Results show some promise of permanent housing and highlight the complex needs of homeless families under investigation for child maltreatment. Findings emphasize the importance of continued involvement from the child welfare system to connect families with important resources. © Society for Community Research and Action 2017.
Dubowitz, Howard; Feigelman, Susan; Lane, Wendy; Kim, Jeongeun
Effective strategies for preventing child maltreatment are needed. Few primary care-based programs have been developed, and most have not been well evaluated. Our goal was to evaluate the efficacy of the Safe Environment for Every Kid model of pediatric primary care in reducing the occurrence of child maltreatment. A randomized trial was conducted from June 2002 to November 2005 in a university-based resident continuity clinic in Baltimore, Maryland. The study population consisted of English-speaking parents of children (0-5 years) brought in for child health supervision. Of the 1118 participants approached, 729 agreed to participate, and 558 of them completed the study protocol. Resident continuity clinics were cluster randomized by day of the week to the model (intervention) or standard care (control) groups. Model care consisted of (1) residents who received special training, (2) the Parent Screening Questionnaire, and (3) a social worker. Risk factors for child maltreatment were identified and addressed by the resident physician and/or social worker. Standard care involved routine pediatric primary care. A subset of the clinic population was sampled for the evaluation. Child maltreatment was measured in 3 ways: (1) child protective services reports using state agency data; (2) medical chart documentation of possible abuse or neglect; and (3) parental report of harsh punishment via the Parent-Child Conflict Tactics scale. Model care resulted in significantly lower rates of child maltreatment in all the outcome measures: fewer child protective services reports, fewer instances of possible medical neglect documented as treatment nonadherence, fewer children with delayed immunizations, and less harsh punishment reported by parents. One-tailed testing was conducted in accordance with the study hypothesis. The Safe Environment for Every Kid (SEEK) model of pediatric primary care seems promising as a practical strategy for helping prevent child maltreatment
Conroy, Elizabeth; Degenhardt, Louisa; Mattick, Richard P.; Nelson, Elliot C.
Objective: To examine the prevalence, characteristics and risk factors for child maltreatment among opioid-dependent persons compared to a community sample of similar social disadvantage. Method: The study employed a case-control design. Cases had a history of opioid pharmacotherapy. Controls were frequency matched to cases with regard to age, sex…
Violence against children has many faces. Child physical abuse, neglect, sexual abuse and interparental violence can cause acute and permanent damage and affect children's development and their life plans in the long term. In industrialized nations almost 1 child in 10 is affected. Up to 10% of child physical abuse cases involve the central nervous system with 80% of these cases occurring during the first year of life. Worldwide more than 50,000 children die as a result of violence, abuse and neglect every year, according to the United Nations Children's Fund UNICEF. In Germany, there are about 120 cases of non-accidental head injury per year. In addition to the officially known cases there is a large grey area for all forms of violence. Recognition of these cases and the provision of help for the victims require an appropriate suspicion and understanding of the pertinent pathophysiology. Suspicion must be based on a well-documented medical history and multidisciplinary diagnostic assessment. Medical confidentiality prevents the disclosure of such information making early detection networks and guidelines for collaboration absolutely indispensable. (orig.) [de
Mullick, M; Miller, L J; Jacobsen, T
This study examined the relationship between insight into mental illness and current child maltreatment risk among mothers who had a major psychiatric disorder and who had lost custody of a child because of abuse, neglect, or having placed the child at risk of harm. Specifically, a measure of insight was examined in relation to systematically observed parenting behaviors known to be correlated with past child maltreatment and in relation to a comprehensive clinical determination of risk. Forty-four mothers who had a major psychiatric disorder were independently rated for their insight into their illness, the quality of mother-child interaction, and the overall clinical risk of maltreatment. Better insight into mental illness was associated with more sensitive mothering behavior and with lower assessed clinical risk of maltreatment. The association remained when mothers with current psychotic symptoms were excluded from the analyses. Better insight did not appear to be associated with past psychotic symptoms, maternal psychiatric diagnosis, or the mother's level of education. Insight into mental illness may function as a protective factor that influences the risk of child maltreatment in mothers with mental illness. Measures of insight could be usefully incorporated into comprehensive parenting assessments for mothers with psychiatric disorders.
Rero, Allanie; Aipit, Jimmy; Yarong-Kote, Tina; Watch, Villa; Bolnga, John W; Vei, Robert; Morris, Marilyn; Lufele, Elvin; Laman, Moses
Child maltreatment is prevalent globally. In Papua New Guinea (PNG), child maltreatment remains an under-reported problem. As part of a 10 month prospective observational study conducted at Modilon Hospital in PNG, we investigated the burden of child maltreatment in the form of sexual abuse, physical abuse and neglect, leading to hospitalization in children ≤14 years. Of 1061 screened admissions, 107 (10%) fulfilled the definition of child maltreatment. The in-hospital admission prevalence of sexual abuse was 5.7% [60 of 1061; 95% confidence interval (CI): 4.4-7.3]. Neglect accounted for 3.4% (36 of 1061; 95% CI: 2.4-4.7) of admissions, while physical abuse accounted for 1.0% (11 of 1061; 95% CI: 0.6-1.9). Mortality was highest in the neglected group, with severe acute malnutrition accounting for 89% of deaths. Improved awareness, establishment of appropriate channels for addressing child maltreatment and enforcement of child protection laws in PNG and other epidemiologically similar settings are urgently needed. © The Author . Published by Oxford University Press. All rights reserved. For Permissions, please email: email@example.com.
Plant, Dominic T.; Pariante, Carmine M.; Sharp, Deborah; Pawlby, Susan
Background Studies have shown that maternal depression during pregnancy predicts offspring depression in adolescence. Child maltreatment is also a risk factor for depression. Aims To investigate (a) whether there is an association between offspring exposure to maternal depression in pregnancy and depression in early adulthood, and (b) whether offspring child maltreatment mediates this association. Method Prospectively collected data on maternal clinical depression in pregnancy, offspring child maltreatment and offspring adulthood (18–25 years) DSM-IV depression were analysed in 103 mother–offspring dyads of the South London Child Development Study. Results Adult offspring exposed to maternal depression in pregnancy were 3.4 times more likely to have a DSM-IV depressive disorder, and 2.4 times more likely to have experienced child maltreatment, compared with non-exposed offspring. Path analysis revealed that offspring experience of child maltreatment mediated the association between exposure to maternal depression in pregnancy and depression in adulthood. Conclusions Maternal depression in pregnancy is a key vulnerability factor for offspring depression in early adulthood. PMID:26045352
Mennen, Ferol E; Kim, Kihyun; Sang, Jina; Trickett, Penelope K
The purpose of this study was to describe the nature of neglect in child welfare clients, to describe these experiences, to examine its typologies, and to understand how different types of neglect co-occurred with each other and with other types of maltreatment. Case record abstraction was conducted on the child welfare case records of an urban, ethnically-diverse sample of youths (n=303) identified as maltreated by a very large public child welfare agency. We utilized the Maltreatment Case Record Abstraction Instrument (MCRAI) which was based on the work of Barnett et al. (1993) as modified by English and LONGSCAN (1997). Thirteen items of parental behavior deemed neglectful were coded and organized into 5 subtypes of neglect (care neglect, environmental neglect, medical neglect, educational neglect, supervisory neglect). Neglect was present in 71.0% of the sample as compared to the 41.0% classified as neglected by CPS records. Neglect was accompanied by other types of maltreatment in 95% of the cases. Children who were neglected had more reports of maltreatment and experienced a greater number of different types of maltreatment than those who were maltreated, but not neglected. The most common type of neglect was supervisory neglect (72.5%) followed by environmental neglect (61.6%). With the exception of medical neglect, all types of neglect were significantly correlated with each other. The abstraction resulted in rich data showing that under a one-word label of neglect, the nature of neglect that the youngsters actually experienced was quite diverse and heterogeneous in its phenomenology. Furthermore, neglect is pervasive for children in the child welfare system and official classifications underestimate its occurrence. Neglect does not happen in isolation; children who are reported as neglected are likely to experience other forms of maltreatment. Official classifications should not be used in determining interventions for children and families. Interventions
Negriff, Sonya; Schneiderman, Janet U.; Trickett, Penelope K.
The present study used data from an ongoing longitudinal study of the effects of maltreatment on adolescent development to (1) describe rates of maltreatment experiences obtained from retrospective self-report versus case record review for adolescents with child welfare?documented maltreatment histories, (2) examine self-reported versus child welfare?identified maltreatment in relation to mental health and risk behavior outcomes by maltreatment type, and (3) examine the association between th...
Cipriano-Essel, Elizabeth; Skowron, Elizabeth A.; Stifter, Cynthia A.; Teti, Douglas M.
This study examined the contribution of child temperament, parenting, and their interaction on inhibitory control development in a sample of maltreated and non-maltreated preschool children. One hundred and eighteen mother–child dyads were drawn from predominantly low-income, rural communities. Dyads participated in a laboratory session in which maternal warm autonomy support, warm guidance, and strict/hostile control were observationally coded during a joint teaching task. Independent assess...
Molnar, Beth E; Goerge, Robert M; Gilsanz, Paola; Hill, Andrea; Subramanian, S V; Holton, John K; Duncan, Dustin T; Beatriz, Elizabeth D; Beardslee, William R
Child maltreatment is a preventable public health problem. Research has demonstrated that neighborhood structural factors (e.g. poverty, crime) can influence the proportion of a neighborhood's children who are victims of maltreatment. A newer strategy is the identification of potentially modifiable social processes at the neighborhood level that can also influence maltreatment. Toward this end, this study examines neighborhood-level data (maltreatment cases substantiated by Illinois' child protection agency, 1995-2005, social processes measured by the Project on Human Development in Chicago Neighborhoods, U.S. Census data, proportions of neighborhoods on public assistance, and crime data) that were linked across clusters of contiguous, relatively homogenous Chicago, IL census tracts with respect to racial/ethnic and socioeconomic composition. Our analysis-an ecological-level, repeated cross-sectional design utilizing random-intercept logit models-with a sensitivity analysis using spatial models to control for spatial autocorrelation-revealed consistent associations between neighborhood social processes and maltreatment. Neighborhoods higher in collective efficacy, intergenerational closure, and social networks, and lower in disorder had lower proportions of neglect, physical abuse, and sexual abuse substantiated cases, controlling for differences in structural factors. Higher collective efficacy and social network size also predicted a lower proportion of substance-exposed infants. This research indicates that strategies to mobilize neighborhood-level protective factors may decrease child maltreatment more effectively than individual and family-focused efforts alone. Copyright © 2015 Elsevier Ltd. All rights reserved.
Cuadra, Lorraine E; Jaffe, Anna E; Thomas, Renu; DiLillo, David
Criminal thinking styles were examined as mediational links between different forms of child maltreatment (i.e., sexual abuse, physical abuse, and physical neglect) and adult criminal behaviors in 338 recently adjudicated men. Analyses revealed positive associations between child sexual abuse and sexual offenses as an adult, and between child physical abuse/neglect and endorsing proactive and reactive criminal thinking styles. Mediation analyses showed that associations between overall maltreatment history and adult criminal behaviors were accounted for by general criminal thinking styles and both proactive and reactive criminal thinking. These findings suggest a potential psychological pathway to criminal behavior associated with child maltreatment. Limitations of the study as well as research and clinical implications of the results are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.
Kandel, P; Kunwar, R; Karki, S; Kandel, D; Lamichhane, P
Child maltreatment is a global public health problem. There is limited information about this problem in low-income countries. We aimed to document the prevalence and factors associated with physical punishment of children less than 14 years of age in Nepal. Population-based cross-sectional study. We conducted an in-depth analysis using data from the Nepal Multiple Indicator Cluster Survey, a nationally representative multi-stage-stratified cluster sampling survey. Data were collected from 13,000 households in 520 sample enumeration areas. We assessed prevalence of physical punishment and different child violence related acts on 5081 children aged 3-14 years for whom complete information on all acts and attitude towards violence was available. Logistic regression was used to investigate the association between physical punishment of child and factors such as household and maternal demographics. Our results suggested violence is common across Nepal, with data showing one in every second child is physically punished. One in every third (33%) of children were spanked, hit or slapped on the bottom, 25% were hit or slapped on the face and approximately 3% were beaten up hard. Odds of facing physical punishment were higher among children aged 3-5 years (odds ratio [OR] 2.9, 95% confidence interval [CI]: 2.0-4.3), aged 6-8 years (OR 2.8, 95% CI: 2.2-3.7), engaged in child labour activities (OR 1.4, 95% CI: 1.1-1.7), with mother that accepted wife beating by husband is justified (OR 1.2, 95% CI: 1.1-1.4), whose father is currently abroad (OR 1.5, 95% CI: 1.2-1.9) and whose father is away from home but in the same country (OR 1.60, 95% CI: 1.1-2.3). The risk was also higher among children living in households that believe physical punishment of children is necessary (OR 3.5, 95% CI: 2.9-4.3) and from lower caste/indigenous (dalit/janajati) ethnicity (OR 1.3, 95% CI: 1.1-1.7). Those less likely to experience physical punishment included female children (OR 0.7, 95% CI: 0
Jennissen, Simone; Holl, Julia; Mai, Hannah; Wolff, Sebastian; Barnow, Sven
The present study investigated the mediating effects of emotion dysregulation on the relationship between child maltreatment and psychopathology. An adult sample (N=701) from diverse backgrounds of psychopathology completed the Childhood Trauma Questionnaire (CTQ), the Difficulties in Emotion Regulation Scale (DERS), the Brief Symptom Inventory (BSI), and the negative affect subscale of the Positive and Negative Affect Schedule (PANAS) in a cross-sectional online survey. Correlational analyses showed that all types of child maltreatment were uniformly associated with emotion dysregulation, and dimensions of emotion dysregulation were strongly related to psychopathology. Limited access to strategies for emotion regulation emerged as the most powerful predictor. Structural equation modeling analyses revealed that emotion dysregulation partially mediated the relationship between child maltreatment and psychopathology, even after controlling for shared variance with negative affect. These findings emphasize the importance of emotion dysregulation as a possible mediating mechanism in the association between child maltreatment and later psychopathology. Additionally, interventions targeting specific emotion regulation strategies may be effective to reduce psychopathology in victims of child maltreatment. Copyright Â© 2016 Elsevier Ltd. All rights reserved.
van der Put, Claudia E; Assink, Mark; Boekhout van Solinge, Noëlle F
Risk assessment is crucial in preventing child maltreatment since it can identify high-risk cases in need of child protection intervention. Despite widespread use of risk assessment instruments in child welfare, it is unknown how well these instruments predict maltreatment and what instrument characteristics are associated with higher levels of predictive validity. Therefore, a multilevel meta-analysis was conducted to examine the predictive accuracy of (characteristics of) risk assessment instruments. A literature search yielded 30 independent studies (N=87,329) examining the predictive validity of 27 different risk assessment instruments. From these studies, 67 effect sizes could be extracted. Overall, a medium significant effect was found (AUC=0.681), indicating a moderate predictive accuracy. Moderator analyses revealed that onset of maltreatment can be better predicted than recurrence of maltreatment, which is a promising finding for early detection and prevention of child maltreatment. In addition, actuarial instruments were found to outperform clinical instruments. To bring risk and needs assessment in child welfare to a higher level, actuarial instruments should be further developed and strengthened by distinguishing risk assessment from needs assessment and by integrating risk assessment with case management. Copyright © 2017 Elsevier Ltd. All rights reserved.
Nhu K. Tran
Full Text Available Abstract Background There is a paucity of research on correlates of child maltreatment in limited-resource countries with a relatively high tolerance of harsh discipline. This Vietnamese study aimed to investigate associations between different types of child maltreatment and child emotional, cognitive, and physical health functioning as well as moderation effects of gender and ethnicity. Methods This cross-sectional study was conducted with 1851 randomly selected students aged 12–17 years. Both self-report and more objective measures (weight, height, study ranking, and a memory test were used. Results All types of child maltreatment were associated with emotional dysfunctioning. Life time and past year experiences of physical abuse and life time experiences of sexual abuse and neglect were related to poorer perceived physical health. The study did not find associations between any type of child maltreatment and overweight or underweight status. Regarding cognitive functioning, life time experience of sexual abuse and neglect were related to poorer working memory performance. Noticeably, emotional abuse was related to better academic performance, which might be an indication of “tiger parenting” practice in Vietnam, implying academic performance stimulation at the expense of emotional security. No significant moderation effects by gender and ethnicity were found. Conclusion Even in a culture in which harsh discipline is normative, child maltreatment was related to negative aspects of child wellbeing including emotional, cognitive, and physical health functioning. Efficient and low-cost interventions on child maltreatment should be developed and conducted in Vietnam as well as other countries with similar contexts.
Jaffee, Sara R; Caspi, Avshalom; Moffitt, Terrie E; Polo-Tomas, Monica; Price, Thomas S; Taylor, Alan
Research on child effects has demonstrated that children's difficult and coercive behavior provokes harsh discipline from adults. Using a genetically sensitive design, the authors tested the limits of child effects on adult behavior that ranged from the normative (corporal punishment) to the nonnormative (physical maltreatment). The sample was a 1994-1995 nationally representative birth cohort of 1,116 twins and their families who participated in the Environmental Risk Longitudinal Study. Results showed that environmental factors accounted for most of the variation in corporal punishment and physical maltreatment. However, corporal punishment was genetically mediated in part, and the genetic factors that influenced corporal punishment were largely the same as those that influenced children's antisocial behavior, suggesting a child effect. The authors conclude that risk factors for maltreatment are less likely to reside within the child and more likely to reside in characteristics that differ between families. (c) 2004 APA, all rights reserved
Lindauer, Ramón J. L.
Child maltreatment has a high prevalence. It can lead to severe psychological and physical problems from childhood to late adulthood. At present, the recognition and treatment of child abuse and its consequences is inadequate. Diagnostic criteria, such as those defined in the Diagnostic and
AlBuhairan, Fadia S.; Inam, Sarah S.; AlEissa, Majid A.; Noor, Ismail K.; Almuneef, Maha A.
Objectives: The Convention on the Rights of the Child (CRC) was ratified by Saudi Arabia 15 years ago; yet addressing the issue of child maltreatment only began in more recent years. School professionals play a significant role in children's lives, as they spend a great deal of time with them and are hence essential to protecting and identifying…
Font, Sarah A.; Berger, Lawrence M.
Associations between experiencing child maltreatment and adverse developmental outcomes are widely studied, yet conclusions regarding the extent to which effects are bidirectional, and whether they are likely causal, remain elusive. This study uses the Fragile Families and Child Wellbeing Study, a birth cohort of 4,898 children followed from birth…
Putnam-Hornstein, Emily; Needell, Barbara; Rhodes, Anne E.
In this article, we argue for expanded efforts to integrate administrative data systems as a "practical strategy" for developing a richer understanding of child abuse and neglect. Although the study of child maltreatment is often critiqued for being atheoretical, we believe that a more pressing concern is the absence of population-based and…
van der Zalm, Y.C.; Nugteren, W.A.; Hafsteinsdottir, T.B.; van der Venne, C.G.J.M.; Kool, N.; van Meijel, B.
Purpose: To determine what is known from the literature about nursing care of psychiatric patients with a history of child maltreatment. Conclusions: Psychiatric nurses underline the importance of a routine inquiry of child abuse on admission of patients to psychiatric care, but are reluctant to ask
Chae, Yoojin; Goodman, Gail S.; Bederian-Gardner, Daniel; Lindsay, Adam
Scientific studies of child maltreatment victims' memory abilities and court experiences have important legal, psychological, and clinical implications. However, state-of-the-art research on child witnesses is often hindered by methodological challenges. In this paper, we address specific problems investigators may encounter when attempting such…
Oshri, Assaf; Rogosch, Fred A; Cicchetti, Dante
The purpose of this study is to investigate longitudinal risk processes linking early child maltreatment, childhood personality organizations, and adolescent maladaptation. In a sample of maltreated and nonmaltreated children (N = 400; 62.3% African American, 11.8% Hispanic; 40.8% girls), a tripartite personality typology based on California Child Q-Set items representative of ego resiliency and ego control personality dimensions (Block & Block, 1969/1980 ) was derived at Wave 1 (age range = 10-12). The typology, composed of Resilient, Overcontrolled, and Undercontrolled profiles, was evaluated for associations with previous child maltreatment, and for its utility in predicting adolescent psychopathology (age range = 15-18). Maltreated children were significantly more likely than nonmaltreated children to be classified into the overcontrolled (Odds Ratio = 1.847) and undercontrolled profiles (Odds Ratio = 2.101), compared to the Resilient profile. The undercontrolled profile reported higher cannabis symptoms and externalizing problems in adolescence than the other two profiles. The overcontrolled group showed the highest levels of internalizing and lowest levels of alcohol problems compared to the other profiles. Person-centered mediation analyses showed that the overcontrolled and the undercontrolled profiles significantly and differentially mediated the link between number of child maltreatment subtypes and the development of adolescent psychopathology. Child maltreatment is a potent environmental stressor that potentiates compromised personality development, eventuating in heightened psychopathology in adolescence. These findings have important implications for prevention and intervention of psychopathology and substance abuse among low income and maltreated youth.
Cheung, Kristene; Taillieu, Tamara; Turner, Sarah; Fortier, Janique; Sareen, Jitender; MacMillan, Harriet L; Boyle, Michael H; Afifi, Tracie O
Research on factors associated with good mental health following child maltreatment is often based on unrepresentative adult samples. To address these limitations, the current study investigated the relationship between individual-level factors and overall mental health status among adolescents with and without a history of maltreatment in a representative sample. The objectives of the present study were to: 1) compute the prevalence of mental health indicators by child maltreatment types, 2) estimate the prevalence of overall good, moderate, and poor mental health by child maltreatment types; and 3) examine the relationship between individual-level factors and overall mental health status of adolescents with and without a history of maltreatment. Data were from the National Comorbidity Survey of Adolescents (NCS-A; n = 10,123; data collection 2001-2004); a large, cross-sectional, nationally representative sample of adolescents aged 13-17 years from the United States. All types of child maltreatment were significantly associated with increased odds of having poor mental health (adjusted odds ratios ranged from 3.2 to 9.5). The individual-level factors significantly associated with increased odds of good mental health status included: being physically active in the winter; utilizing positive coping strategies; having positive self-esteem; and internal locus of control (adjusted odds ratios ranged from 1.7 to 38.2). Interventions targeted to adolescents with a history of child maltreatment may want to test for the efficacy of the factors identified above. Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.
Crowne, Sarah Shea; Gonsalves, Kay; Burrell, Lori; McFarlane, Elizabeth; Duggan, Anne
Prior research indicates that closely spaced births are associated with poor outcomes for the mother and subsequent child. Limited research has focused on outcomes for the index child (the child born immediately prior to a subsequent child in a birth interval). The objectives are to assess the association of short birth intervals in at-risk families with: (1) indicators of harsh and neglectful parenting behaviors towards the index child, including substantiated maltreatment reports across 6 years; and (2) the index child's behavior and development in first grade. This is a longitudinal study of 658 women screened to be at-risk for child maltreatment. Twenty percent of women had a rapid repeat birth (RRB), defined as the birth of a subsequent child within 24 months of the index child. Generalized estimating equations, survival analyses, and linear and logistic regression models were used to assess the associations between RRB and index child outcomes. Women with an RRB were more likely than those without an RRB to report neglectful parenting of the index child. Children of mothers with an RRB were more likely than children of mothers without an RRB to have more behavioral problems and lower cognitive functioning in first grade. This study is among the first to focus on the associations of birth spacing with maltreatment, behavior and development outcomes in the index child. Future work regarding the effects of birth spacing should include a focus on the index child.
Dubowitz, Howard; Thompson, Richard; Arria, Amelia M; English, Diana; Metzger, Richard; Kotch, Jonathan B
There has been increasing acceptance of marijuana use in the United States in recent years, and rates among adolescents have risen. At the same time, marijuana use during adolescence has been linked to an array of health and social problems. Maltreated children are at risk for marijuana use, but the relationships among characteristics of maltreatment and marijuana use are unclear. In this article, we examine how the type and the extent of maltreatment are related to the level of adolescent marijuana use. Data analyses were conducted on a subsample of maltreated adolescents (n = 702) from the Longitudinal Studies of Child Abuse and Neglect project. Approximately half the sample had used marijuana, and maltreatment was associated with its use. Multivariate regression models showed that being male, extensive maltreatment, and peer marijuana use were associated with heavy use of marijuana. These findings suggest the importance of comprehensively assessing children's maltreatment experiences and their peers' drug use to help prevent or address possible marijuana use in these high-risk adolescents. © The Author(s) 2015.
Chiang, Wan-Lin; Huang, Yu-Tung; Feng, Jui-Ying; Lu, Tsung-Hsueh
Objectives: Little is known regarding the epidemiology of child maltreatment in Asian countries. This study aimed to examine the incidence of hospitalization coded as due to child maltreatment in Taiwan. Methods: We used inpatient claims data of the National Health Insurance for the years 1996 through 2007 for estimation. Hospitalization of…
Bugental, Daphne Blunt; Happaney, Keith
Maternal attributions and child neonatal status at birth were assessed as predictors of infant maltreatment (harsh parenting and safety neglect). The population included low-income, low-education families who were primarily Hispanic. Child maltreatment during the 1st year of life (N = 73) was predicted by neonatal status (low Apgar scores, preterm…
Swannell, Sarah; Martin, Graham; Page, Andrew; Hasking, Penelope; Hazell, Philip; Taylor, Anne; Protani, Melinda
Objective: Although child maltreatment is associated with later non-suicidal self-injury (NSSI), the mechanism through which it might lead to NSSI is not well understood. The current retrospective case-control study examined associations between child maltreatment and later NSSI, and investigated the mediating roles of dissociation, alexithymia,…
Longman-Mills, Samantha; Gonzalez, Yolanda W.; Melendez, Marlon O.; Garcia, Monica R.; Gomez, Juan D.; Juarez, Cristina G.; Martinez, Eduardo A.; Penalba, Sobeyda J.; Pizzanelli, Miguel E.; Solorzano, Lucia I.; Wright, Gloria; Cumsille, Francisco; Sapag, Jaime; Wekerle, Christine; Hamilton, Hayley; Erickson, Patricia; Mann, Robert
Child maltreatment and substance abuse are both international public health priorities. Research shows that child maltreatment increases the risk for substance use and problems. Thus, recognition of this relationship may have important implications for substance demand reduction strategies, including efforts to prevent and treat substance use and…
Giovanni A. Salum
Full Text Available Objective To investigate the validity and reliability of a multi-informant approach to measuring child maltreatment (CM comprising seven questions assessing CM administered to children and their parents in a large community sample. Methods Our sample comprised 2,512 children aged 6 to 12 years and their parents. Child maltreatment (CM was assessed with three questions answered by the children and four answered by their parents, covering physical abuse, physical neglect, emotional abuse and sexual abuse. Confirmatory factor analysis was used to compare the fit indices of different models. Convergent and divergent validity were tested using parent-report and teacher-report scores on the Strengths and Difficulties Questionnaire. Discriminant validity was investigated using the Development and Well-Being Assessment to divide subjects into five diagnostic groups: typically developing controls (n = 1,880, fear disorders (n = 108, distress disorders (n = 76, attention deficit hyperactivity disorder (n = 143 and oppositional defiant disorder/conduct disorder (n = 56. Results A higher-order model with one higher-order factor (child maltreatment encompassing two lower-order factors (child report and parent report exhibited the best fit to the data and this model's reliability results were acceptable. As expected, child maltreatment was positively associated with measures of psychopathology and negatively associated with prosocial measures. All diagnostic category groups had higher levels of overall child maltreatment than typically developing children. Conclusions We found evidence for the validity and reliability of this brief measure of child maltreatment using data from a large survey combining information from parents and their children.
Salum, Giovanni A; DeSousa, Diogo Araújo; Manfro, Gisele Gus; Pan, Pedro Mario; Gadelha, Ary; Brietzke, Elisa; Miguel, Eurípedes Constantino; Mari, Jair J; do Rosário, Maria Conceição; Grassi-Oliveira, Rodrigo
To investigate the validity and reliability of a multi-informant approach to measuring child maltreatment (CM) comprising seven questions assessing CM administered to children and their parents in a large community sample. Our sample comprised 2,512 children aged 6 to 12 years and their parents. Child maltreatment (CM) was assessed with three questions answered by the children and four answered by their parents, covering physical abuse, physical neglect, emotional abuse and sexual abuse. Confirmatory factor analysis was used to compare the fit indices of different models. Convergent and divergent validity were tested using parent-report and teacher-report scores on the Strengths and Difficulties Questionnaire. Discriminant validity was investigated using the Development and Well-Being Assessment to divide subjects into five diagnostic groups: typically developing controls (n = 1,880), fear disorders (n = 108), distress disorders (n = 76), attention deficit hyperactivity disorder (n = 143) and oppositional defiant disorder/conduct disorder (n = 56). A higher-order model with one higher-order factor (child maltreatment) encompassing two lower-order factors (child report and parent report) exhibited the best fit to the data and this model's reliability results were acceptable. As expected, child maltreatment was positively associated with measures of psychopathology and negatively associated with prosocial measures. All diagnostic category groups had higher levels of overall child maltreatment than typically developing children. We found evidence for the validity and reliability of this brief measure of child maltreatment using data from a large survey combining information from parents and their children.
AlBuhairan, Fadia S; Inam, Sarah S; AlEissa, Majid A; Noor, Ismail K; Almuneef, Maha A
The Convention on the Rights of the Child (CRC) was ratified by Saudi Arabia 15 years ago; yet addressing the issue of child maltreatment only began in more recent years. School professionals play a significant role in children's lives, as they spend a great deal of time with them and are hence essential to protecting and identifying those in danger or at risk. The objective of this study is to identify school professional's awareness of child maltreatment and the existing national policies and procedures to examine the extent of efforts made in Saudi Arabia and to activate the roles of schools and school professionals in protecting children from violence and implementation of Article 19 of the CRC. This was a cross-sectional study, where school professionals from randomly selected schools throughout the country were invited to participate in a self-administered questionnaire. A total of 3,777 school professionals participated in the study. Fifty-five percent of professionals had at least 10 years of work experience. A low-level of awareness of child maltreatment was found in about 1/3 of school professionals. Only 1.9% of school professionals had ever attended any sort of specific training on child maltreatment, though 69.3% of those who had not, were willing to attend future training. With regards to awareness of CRC Article 19 or policies and procedures addressing child maltreatment, only 22% reported being aware of it. The majority of school professionals in Saudi Arabia have a low-intermediate level of awareness of child maltreatment, ratification of CRC, and related national policies and procedures, yet most are willing to attend training programs on this subject matter. Efforts need to be made in the country to fill this gap. Copyright © 2011 Elsevier Ltd. All rights reserved.
Thornberry, Terence P.; Henry, Kimberly L.
Identification of the causes of child maltreatment perpetration is prerequisite for developing efficacious prevention initiatives to reduce its occurrence. Earlier maltreatment victimization is often suggested as an important cause of subsequent maltreatment perpetration. This study investigates a) whether maltreatment victimization causes subsequent perpetration and b) whether the timing of maltreatment victimization—childhood versus adolescence—alters this relationship. We use data from the...
Archer, Gemma; Pinto Pereira, Snehal; Power, Christine
Child maltreatment (abuse and neglect) has established associations with mental health; however, little is known about its relationship with physical functioning. Physical functioning (ie, the ability to perform the physical tasks of daily living) in adulthood is an important outcome to consider, as it is strongly associated with an individual's ability to work, and future disability and dependency. We aimed to establish whether maltreatment was associated with physical functioning, independent of other early-life factors. 1958 British birth cohort. 8150 males and females with data on abuse and who participated at age 50 years. The primary outcome was poor physical functioning at 50 years ( mental health and self-reported health at 50 years. 23% of participants reported at least one type of maltreatment; 12% were identified with poor physical functioning. Neglect (OR adj 1.55, 95% CI 1.24 to 1.93), psychological abuse (OR adj 1.49, 1.17-1.88) and sexual abuse (OR adj 2.56, 1.66-3.96) were associated with poor physical functioning independent of other maltreatments and covariates, including childhood social class, birth weight and childhood illness. Odds of poor physical functioning increased with multiple types of maltreatment (p trend 3 types of maltreatment, compared with those with none. Associations of similar magnitude were observed for mental and self-reported health outcomes. Child neglect, psychological and sexual abuse were associated with poor physical functioning at 50 years, with accumulating risk for those with multiple types of maltreatment. Associations were independent of numerous early-life factors and were comparable in magnitude to those observed for mental health and self-rated health. Prevention or alleviation of the ill effects of maltreatment could be an effective policy intervention to promote healthy ageing. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No
Helweg-Larsen, Karin; Larsen, Helmer Bøving
Cross National Comparisons: Youth Population Surveys About Child Maltreatment In this multi-session track, researchers will present the results concerning the epidemiology of child maltreatment from over one dozen general population surveys of youth, covering four continents and portions...... of the world where epidemiologic data has not been previously available. Organizers will request in advance that the presenters include some data in formats that can be compared across studies. In a final session, the organizers will lead a discussion about the challenges of national surveys and cross national...
Wu, Qinglu; Chi, Peilian; Lin, Xiuyun; Du, Hongfei
Child maltreatment, including abuse (physical, emotional, and sexual) and neglect (physical and emotional), is positively associated with depressive symptoms in adulthood. However, most studies have been conducted within a psychopathological framework and focused on underlying dysfunctional processes (e.g., insecure attachment styles, maladaptive schemas, and negative attribution styles). Protective factors that affect the relationship between child maltreatment and adult depressive symptoms are underexplored. Guided by emotion regulation theory and the perspective of positive psychology, we examined the roles of self-compassion and gratitude as protective factors in the relationship between child maltreatment and adult depressive symptoms in a sample of 358 college students. Results showed that psychological maltreatment (emotional abuse and emotional neglect) was associated with adult depressive symptoms through decreased self-compassion. Neglect (emotional neglect and physical neglect) and sexual abuse were associated with adult depressive symptoms through decreased gratitude. There was no association between physical abuse and depressive symptoms through either self-compassion or gratitude. Our findings suggest that clinical practices focusing on self-compassion and gratitude might help prevent the development of adult depressive symptoms among clients with a history of maltreatment in childhood. Copyright © 2018 Elsevier Ltd. All rights reserved.
Campbell, Kristine A; Telford, S Russell; Cook, Lawrence J; Waitzman, Norman J; Keenan, Heather T
Child maltreatment is associated with physical and mental health problems. The objective of this study was to compare Medicaid expenditures based on a first-time finding of child maltreatment by Child Protective Services (CPS). This retrospective cohort study included children aged 0 to 14 years enrolled in Utah Medicaid between January 2007 and December 2009. The exposed group included children enrolled in Medicaid during the month of a first-time CPS finding of maltreatment not resulting in out-of-home placement. The unexposed group included children enrolled in Medicaid in the same months without CPS involvement. Quantile regression was used to describe differences in average nonpharmacy Medicaid expenditures per child-year associated with a first-time CPS finding of maltreatment. A total of 6593 exposed children and 39 181 unexposed children contributed 20 670 and 105 982 child-years to this analysis, respectively. In adjusted quantile regression, exposed children at the 50th percentile of health care spending had annual expenditures $78 (95% confidence interval [CI], 65 to 90) higher than unexposed children. This difference increased to $336 (95% CI, 283 to 389) and $1038 (95% CI, 812 to 1264) at the 75th and 90th percentiles of health care spending. Differences were higher among older children, children with mental health diagnoses, and children with repeated episodes of CPS involvement; differences were lower among children with severe chronic health conditions. Maltreatment is associated with increased health care expenditures, but these costs are not evenly distributed. Better understanding of the reasons for and outcomes associated with differences in health care costs for children with a history of maltreatment is needed. Copyright © 2016 by the American Academy of Pediatrics.
Thielen, Frederick W; Ten Have, Margreet; de Graaf, Ron; Cuijpers, Pim; Beekman, Aartjan; Evers, Silvia; Smit, Filip
Child maltreatment is prognostically associated with long-term detrimental consequences for mental health. These consequences are reflected in higher costs due to health service utilization and productivity losses in adulthood. An above-average sense of mastery can have protective effects in the pathogenesis of mental disorders and thus potentially cushion adverse impacts of maltreatment. This should be reflected in lower costs in individuals with a history of child maltreatment and a high sense of mastery. The aims of the study were to prognostically estimate the excess costs of health service uptake and productivity losses in adults with a history of child maltreatment and to evaluate how mastery may act as an effect modifier. Data were used on 5618 individuals participating in the Netherlands Mental Health Survey and Incidence Study (NEMESIS). We focussed on measures of child maltreatment (emotional neglect, physical, psychological and sexual abuse) and economic costs owing to health-care uptake and productivity losses when people with a history of abuse have grown into adulthood. We evaluated how mastery acted as an effect modifier. Estimates were adjusted for demographics and parental psychopathology. Post-stratification weights were used to account for initial non-response and dropout. Due to the non-normal distribution of the costs data, sample errors, 95 % confidence intervals, and p values were calculated using non-parametric bootstrapping (1000 replications). Exposure to child maltreatment occurs frequently (6.9-24.8 %) and is associated with substantial excess costs in adulthood. To illustrate, adjusted annual excess costs attributable to emotional neglect are €1,360 (95 % CI: 615-215) per adult. Mastery showed a significant effect on these figures: annual costs were €1,608 in those with a low sense of mastery, but only €474 in those with a firmer sense of mastery. Child maltreatment has profound mental health consequences and is associated with
Full Text Available Aim. This study aimed to investigate how public health nurses identify, intervene in, and implement the guidelines on child maltreatment in Finland and Japan and to compare the data between the two countries. Method. This study employed a cross-sectional design. Public health nurses’ knowledge and skills with respect to child maltreatment prevention were assessed using a questionnaire consisting of three categories: identification, intervention, and implementation of guidelines. Public health nurses working in the area of maternal and child health care in Finland (n=193 and Japan (n=440 were the participants. Results. A significantly higher percentage of Japanese public health nurses identified child maltreatment compared to Finnish public health nurses, while Finnish nurses intervened in child maltreatment better than their Japanese counterparts. In both countries, public health nurses who had read and used the guidelines dealt with child maltreatment better than those who did not. Conclusion. The results suggest that effective training on child maltreatment and the use of guidelines are important to increase public health nurses’ knowledge and skills for identifying and intervening in child maltreatment.
Tanaka, Masako; Georgiades, Katholiki; Boyle, Michael H; MacMillan, Harriet L
There is increasing evidence for the adverse effects of child maltreatment on academic performance; however, most of these studies used selective samples and did not account for potential confounding or mediating factors. We examined the relationship between child physical abuse (PA; severe and non-severe) and sexual abuse (SA) and educational attainment (years of education, failure to graduate from high school) with a Canadian community sample. We used data from the Ontario Child Health Study (N = 1,893), a province-wide longitudinal survey. Potential confounding variables (family socio-demographic and parental capacity) and child-level characteristics were assessed in 1983, and child abuse was determined in 2000-2001 based on retrospective self-report. Results showed that PA and SA were associated with several factors indicative of social disadvantage in childhood. Multilevel regression analyses for years of education revealed a significant estimate for severe PA based on the unadjusted model (-0.60 years, 95% CI = [-0.45, -0.76]); estimates for non-severe PA (0.05 years, CI = [-0.15, 0.26]) and SA (-0.25 years, CI = [-0.09, -0.42]) were not significant. In the adjusted full model, the only association to reach significance was between severe PA and reduced years of education (-0.31 years, CI = [-0.18, -0.44]). Multilevel regression analyses for failure to graduate from high school showed significant unadjusted estimates for severe PA (OR = 1.77, 95% CI = [1.21, 2.58]) and non-severe PA (OR = 1.61, CI = [1.01, 2.57]); SA was not associated with this outcome (OR = 1.40, CI = [0.94, 2.07]). In the adjusted full models, there were no significant associations between child abuse variables and failure to graduate. The magnitude of effect of PA on both outcomes was reduced largely by child individual characteristics. These findings generally support earlier research, indicating the adverse effects of child maltreatment on educational attainment. Of particular note
Meng, Xiangfei; Fleury, Marie-Josee; Xiang, Yu-Tao; Li, Muzi; D'Arcy, Carl
To provide an overview of resilience and protective factors associated with a better life following child maltreatment exposure, to compare protective factors across specific subtypes of maltreatment, and to explore existing issues in the current state of the literature. Electronic databases and grey literature up to October 2017 were systematically searched for English language with observational study designs for the research on resilience and childhood maltreatment. Systematic review and qualitative approaches were used to synthesize the results. Study quality and heterogeneity were also examined. Initial screening of titles and abstracts resulted in 247 papers being reviewed. A total of 85 articles met eligibility criteria of this review. Most of these studies had low or middle study quality. There were two subgroups of studies reviewed: (1) 11 studies examined whether resilience protected against the negative consequence of childhood maltreatment, and, (2) 75 studies explored what protective factor was associated with a kind of adaptive functioning. Although the conceptualization of resilience significantly varied from study to study, protective factors associated with resilience at individual, familial, and societal levels reduced the likelihood of negative consequences of childhood maltreatment. Negative consequences following childhood maltreatment can be prevented or moderated if protective factors are provided in time. Future research needs to address the conceptualization issue of resilience. Public and population mental health preventions should focus on early childhood and apply preventive strategies as early as possible. Cost-effective studies should be considered in the evaluation of resilience prevention program.
Bronsard, Guillaume; Auquier, Pascal; Boyer, Laurent
Early child maltreatment has been widely associated with the development of mental disorders in both childhood and adulthood. However, such association cannot be systematically established, as only few factors are observed regularly, such as high prevalence of comorbidities and externalized disorders. Similarly, the association between early abuse and cortisol secretion anomalies has been well-documented. Whereas early hypercortisolism followed by hypocortisolism was often described, the results proved inconsistent and at times contradictory. The physiopathological mechanisms are quite complex and varied, including mixed neurotoxicity and stress response anomalies, linked to circadian rhythm disturbances. One of the difficulties inherent to research on this topic is to better define maltreatment in childhood. Studying children's groups at risk of maltreatment, such as children followed by juvenile justice or in child welfare systems, could be a very good tool, provided that social, judiciary, and mental health professionals are able to work together and implement common research objectives. Copyright © 2017 Elsevier Ltd. All rights reserved.
Noirhomme-Renard, F; Blavier, A; Lachaussée, S; Monville, C; Nihoul, C; Gosset, C
Child maltreatment, including all forms of mal¬treatment, remains a major public health problem in high-income countries. Healthcare professionals only contribute to a small proportion of reports. In French-speaking Belgium, almost 100 % of school-aged children are regularly submitted to periodical school health visits. The school health doctor is well placed to recognize neglected or abused children. Based on international good practice recommendations, this paper proposes means for the detection and management of child abuse in the context of school medicine.
Fang, Xiangming; Fry, Deborah A; Brown, Derek S; Mercy, James A; Dunne, Michael P; Butchart, Alexander R; Corso, Phaedra S; Maynzyuk, Kateryna; Dzhygyr, Yuriy; Chen, Yu; McCoy, Amalee; Swales, Diane M
This study estimated the health and economic burden of child maltreatment in the East Asia and Pacific region, addressing a significant gap in the current evidence base. Systematic reviews and meta-analyses were conducted to estimate the prevalence of child physical abuse, sexual abuse, emotional abuse, neglect, and witnessing parental violence. Population Attributable Fractions were calculated and Disability-Adjusted Life Years (DALYs) lost from physical and mental health outcomes and health risk behaviors attributable to child maltreatment were estimated using the most recent comparable Global Burden of Disease data. DALY losses were converted into monetary value by assuming that one DALY is equal to the sub-region's per capita GDP. The estimated economic value of DALYs lost to violence against children as a percentage of GDP ranged from 1.24% to 3.46% across sub-regions defined by the World Health Organization. The estimated economic value of DALYs (in constant 2000 US$) lost to child maltreatment in the EAP region totaled US $151 billion, accounting for 1.88% of the region's GDP. Updated to 2012 dollars, the estimated economic burden totaled US $194 billion. In sensitivity analysis, the aggregate costs as a percentage of GDP range from 1.36% to 2.52%. The economic burden of child maltreatment in the East Asia and Pacific region is substantial, indicating the importance of preventing and responding to child maltreatment in this region. More comprehensive research into the impact of multiple types of childhood adversity on a wider range of putative health outcomes is needed to guide policy and programs for child protection in the region, and globally. Copyright © 2015 Elsevier Ltd. All rights reserved.
Fang, Xiangming; Fry, Deborah A.; Brown, Derek S.; Mercy, James A.; Dunne, Michael P.; Butchart, Alexander R.; Corso, Phaedra S.; Maynzyuk, Kateryna; Dzhygyr, Yuriy; Chen, Yu; McCoy, Amalee; Swales, Diane M.
This study estimated the health and economic burden of child maltreatment in the East Asia and Pacific region, addressing a significant gap in the current evidence base. Systematic reviews and meta-analyses were conducted to estimate the prevalence of child physical abuse, sexual abuse, emotional abuse, neglect, and witnessing parental violence. Population Attributable Fractions were calculated and Disability-Adjusted Life Years (DALYs) lost from physical and mental health outcomes and health risk behaviors attributable to child maltreatment were estimated using the most recent comparable Global Burden of Disease data. DALY losses were converted into monetary value by assuming that one DALY is equal to the sub-region’s per capita GDP. The estimated economic value of DALYs lost to violence against children as a percentage of GDP ranged from 1.24% to 3.46% across sub-regions defined by the World Health Organization. The estimated economic value of DALYs (in constant 2000 US$) lost to child maltreatment in the EAP region totaled US $151 billion, accounting for 1.88% of the region’s GDP. Updated to 2012 dollars, the estimated economic burden totaled US $194 billion. In sensitivity analysis, the aggregate costs as a percentage of GDP range from 1.36% to 2.52%. The economic burden of child maltreatment in the East Asia and Pacific region is substantial, indicating the importance of preventing and responding to child maltreatment in this region. More comprehensive research into the impact of multiple types of childhood adversity on a wider range of putative health outcomes is needed to guide policy and programs for child protection in the region, and globally. PMID:25757367
Vidal, Sarah; Prince, Dana; Connell, Christian M; Caron, Colleen M; Kaufman, Joy S; Tebes, Jacob K
This study prospectively examines the transition from the child welfare system into the juvenile justice system among 10,850 maltreated children and adolescents and explores how patterns of risks, including severity and chronicity of maltreatment, adverse family environment, and social risk factors, affect service systems transition. Almost three percent of maltreated children and adolescents had their first juvenile justice adjudication within an average of approximately six years of their initial child protective services investigation (CPS). Social risk factors, including a child's age at index CPS investigation (older), gender (boys), and race/ethnicity (Black and Hispanic) significantly predicted the risk of transition into the juvenile justice system. Recurrence of maltreatment and experiencing at least one incident of neglect over the course of the study period also increased the risk of transition into the juvenile justice system. However, subtypes of maltreatment, including physical, sexual, and other types of abuse did not significantly predict the risk of juvenile justice system transition. Finally, family environment characterized by poverty also significantly increased the risk of juvenile justice system transition. These findings have important implications for developing and tailoring services for maltreated children, particularly those at-risk for transitioning into the juvenile justice system. Copyright © 2016 Elsevier Ltd. All rights reserved.
McGovern, Andrew Peter; Woodman, Jenny; Allister, Janice; van Vlymen, Jeremy; Liyanage, Harshana; Jones, Simon; Rafi, Imran; de Lusignan, Simon; Gilbert, Ruth
Recording concerns about child maltreatment, including minor concerns, is recommended by the General Medical Council (GMC) and National Institute for Health and Clinical Excellence (NICE) but there is evidence of substantial under-recording. To determine whether a simple coding strategy improved recording of maltreatment-related concerns in electronic primary care records. Clinical audit of rates of maltreatment-related coding before January 2010-December 2011 and after January-December 2012 implementation of a simple coding strategy in 11 English family practices. The strategy included encouraging general practitioners to use, always and as a minimum, the Read code 'Child is cause for concern'. A total of 25,106 children aged 0-18 years were registered with these practices. We also undertook a qualitative service evaluation to investigate barriers to recording. Outcomes were recording of 1) any maltreatment-related codes, 2) child protection proceedings and 3) child was a cause for concern. We found increased recording of any maltreatment-related code (rate ratio 1.4; 95% CI 1.1-1.6), child protection procedures (RR 1.4; 95% CI 1.1-1.6) and cause for concern (RR 2.5; 95% CI 1.8-3.4) after implementation of the coding strategy. Clinicians cited the simplicity of the coding strategy as the most important factor assisting implementation. This simple coding strategy improved clinician's recording of maltreatment-related concerns in a small sample of practices with some 'buy-in'. Further research should investigate how recording can best support the doctor-patient relationship. HOW THIS FITS IN: Recording concerns about child maltreatment, including minor concerns, is recommended by the General Medical Council (GMC) and National Institute for Health and Clinical Excellence (NICE), but there is evidence of substantial under-recording. We describe a simple clinical coding strategy that helped general practitioners to improve recording of maltreatment-related concerns
Andrew Peter McGovern
Full Text Available Background Recording concerns about child maltreatment, including minor concerns, is recommended by the General Medical Council (GMC and National Institute for Health and Clinical Excellence (NICE but there is evidence of substantial under-recording.Aim To determine whether a simple coding strategy improved recording of maltreatment-related concerns in electronic primary care records.Design and Setting Clinical audit of rates of maltreatment-related coding before January 2010–December 2011 and after January–December 2012 implementation of a simple coding strategy in 11 English family practices. The strategy included encouraging general practitioners to use, always and as a minimum, the Read code ‘Child is cause for concern’. A total of 25,106 children aged 0–18 years were registered with these practices. We also undertook a qualitative service evaluation to investigate barriers to recording.Method Outcomes were recording of 1 any maltreatment-related codes, 2 child protection proceedings and 3 child was a cause for concern.Results We found increased recording of any maltreatment-related code (rate ratio 1.4; 95% CI 1.1–1.6, child protection procedures (RR 1.4; 95% CI 1.1–1.6 and cause for concern (RR 2.5; 95% CI 1.8–3.4 after implementation of the coding strategy. Clinicians cited the simplicity of the coding strategy as the most important factor assisting implementation.Conclusion This simple coding strategy improved clinician’s recording of maltreatment-related concerns in a small sample of practices with some ‘buy-in’. Further research should investigate how recording can best support the doctor–patient relationshipHow this fits in Recording concerns about child maltreatment, including minor concerns, is recommended by the General Medical Council (GMC and National Institute for Health and Clinical Excellence (NICE, but there is evidence of substantial underrecording. We describe a simple clinical coding
Wekerle, C; Wolfe, D A
Utilizing attachment theory as a basis for conceptualizing close relationships among adolescents, this study investigated two important relationship risk factors (child maltreatment, and adolescent self-perceived insecure attachment style) as predictors of "offender" and "victim" experiences in youth relationships. In addition to considering the influence of these risk factors, we further considered their interaction in predicting conflict in close relationships. Of interest was the extent to which attachment styles may function as a moderator of the relationship between childhood abuse and current abuse in teen close relationships. High school students (N = 321) in grades 9 and 10 completed questionnaires tapping their histories of maltreatment, currently viewed styles of attachment, and conflict in close relationships over the past 6 months. Maltreatment alone emerged as the most consistent predictor, accounting for 13-18% of the variance in male's physically, sexually, and verbally abusive behaviors; in contrast, it was not highly predictive of female's abusive behaviors. Maltreatment was predictive of victimization experiences for both males and females. Attachment style did not substantially add to the prediction of relationship conflict beyond maltreatment; however, avoidant attachment style emerged repeatedly as a significant predictor of female abusiveness and victimization. Attachment self-ratings were found to function as a moderator of child maltreatment in predicting primarily male coercive behavior towards a relationship partner as well as predicting male's experience of coercion from a partner. Thus, the presence of childhood maltreatment and adolescent self-perceived insecure attachment style applies predominantly to male youth. The implication of these gender differences for understanding relationship violence is discussed.
Visscher, Simeon J A; van Stel, Henk F
This article provides both qualitative and quantitative data on practice variation amongst preventive child healthcare professionals in the prevention of child maltreatment in the Netherlands. Qualitative data consist of topics identified during interviews with 11 experts (with quotes), resulting in an online survey. The quantitative data are survey responses from 1104 doctors and nurses working in 29 preventive child healthcare organizations. Additionally, the interview topic list, the qualitative data analysis methodology, the survey (in English and Dutch) and anonymized raw survey data (http://hdl.handle.net/10411/5LJOGH) are provided as well. This data-in-brief article accompanies the paper "Variation in prevention of child maltreatment by Dutch child healthcare professionals" by Simeon Visscher and Henk van Stel .
Simeon J.A. Visscher
Full Text Available This article provides both qualitative and quantitative data on practice variation amongst preventive child healthcare professionals in the prevention of child maltreatment in the Netherlands. Qualitative data consist of topics identified during interviews with 11 experts (with quotes, resulting in an online survey. The quantitative data are survey responses from 1104 doctors and nurses working in 29 preventive child healthcare organizations. Additionally, the interview topic list, the qualitative data analysis methodology, the survey (in English and Dutch and anonymized raw survey data (http://hdl.handle.net/10411/5LJOGH are provided as well. This data-in-brief article accompanies the paper âVariation in prevention of child maltreatment by Dutch child healthcare professionalsâ by Simeon Visscher and Henk van Stel .
Kim, Hyunil; Drake, Brett
This study examined the relationship of a family's duration in poverty-related programs (i.e., Aid to Families with Dependent Children/Temporary Assistance for Needy Families and Medicaid) to the subject child's number of maltreatment reports while considering race and baseline neighborhood poverty. Children from a large Midwestern metropolitan area were followed through a linked cross-sector administrative database from birth to age 15. Generalized multilevel models were employed to account for the multilevel structure of the data (i.e., nesting of families within neighborhoods). The data showed a unique and significant contribution of duration in poverty-related programs to the number of maltreatment reports. The predicted number of maltreatment reports increased by between 2.5 and 3.7 times, as duration in poverty-related programs increased from 0 to 9 years. This relationship was consistent between Whites and non-Whites (over 98% Black), but non-Whites showed a significantly lower number of total maltreatment reports while controlling for duration in poverty-related programs. We were unable to find a significant association between child maltreatment reports and baseline neighborhood poverty.
Tran, Nhu K; van Berkel, Sheila R; Nguyen, Huong T; van IJzendoorn, Marinus H; Alink, Lenneke R A
In the context of the shortage of studies on child maltreatment changes over time in limited resource settings, this paper explored the changes in the prevalence of multiple types of child maltreatment over a period of 10 years in Vietnam and tested the moderating role of some demographic characteristics in these changes. We used data from two prevalence studies conducted in 2004 and in 2014 using similar methodologies. Both studies used self-report questionnaires which were completed by randomly selected students aged 12-17 years from different provinces in Vietnam. We also compared Hanoi subgroups to examine the trend using the most equivalent samples. While the prevalence estimates of sexual abuse and neglect were unchanged over 10 years, the prevalence of physical abuse and emotional abuse declined. The decrease in the prevalence of physical abuse was larger for younger adolescents and boys than for their counterparts. For sexual abuse, older adolescents reported an increase in the prevalence of sexual abuse. In the Hanoi sample comparison, only the prevalence of emotional abuse declined and this reduction was smaller for younger adolescents than for the older group. Despite the reduction of emotional and physical abuse in the whole sample and emotional abuse in the Hanoi sample, all types of child maltreatment were still highly prevalent in Vietnam. We argue that interventions on all types of child maltreatment should be further implemented. Similar studies could be conducted to evaluate the effect of child protection policies on the prevalence of child maltreatment. Copyright © 2018 Elsevier Ltd. All rights reserved.
Marcus K. Rogers
Full Text Available Digital evidence plays a crucial role in child pornography investigations. However, in the following case study, the authors argue that the behavioral analysis or “profiling” of digital evidence can also play a vital role in child pornography investigations. The following case study assessed the Internet Browsing History (Internet Explorer Bookmarks, Mozilla Bookmarks, and Mozilla History from a suspected child pornography user’s computer. The suspect in this case claimed to be conducting an ad hoc law enforcement investigation. After the URLs were classified (Neutral; Adult Porn; Child Porn; Adult Dating sites; Pictures from Social Networking Profiles; Chat Sessions; Bestiality; Data Cleaning; Gay Porn, the Internet history files were statistically analyzed to determine prevalence and trends in Internet browsing. First, a frequency analysis was used to determine a baseline of online behavior. Results showed 54% (n = 3205 of the URLs were classified as “neutral” and 38.8% (n = 2265 of the URLs were classified as a porn website. Only 10.8% of the URLs were classified as child pornography websites. However when the IE history file was analyzed by visit, or “hit,” count, the Pictures/Profiles (31.5% category had the highest visit count followed by Neutral (19.3%, Gay Porn (17%, and Child Porn (16.6%. When comparing the frequency of URLs to the Hit Count for each pornography type, it was noted that the accused was accessing gay porn, child porn, chat rooms, and picture profiles (i.e., from Facebook more often than adult porn and neutral websites. The authors concluded that the suspect in this case was in fact a child pornography user and not an ad hoc investigator, and the findings from the behavioral analysis were admitted as evidence in the sentencing hearing for this case. The authors believe this case study illustrates the ability to conduct a behavioral analysis of digital evidence. More work is required to further validate the
van Vugt, E.; Lanctôt, N.; Paquette, G.; Collin-Vezina, D.; Lemieux, A.
The current study examined the association between child maltreatment and trauma-related symptoms in emerging adulthood - over and above the incidence of such symptoms and conduct problems during adolescence - among a sample of female adolescents in residential care. This study used data from a
Wathen, C Nadine; MacGregor, Jennifer C D; Hammerton, Joanne
Intimate partner violence (IPV) and child maltreatment (CM) are major global public health problems. The Preventing Violence Across the Lifespan (PreVAiL) Research Network, an international group of over 60 researchers and national and international knowledge-user partners in CM and IPV, sought...
Bartelink, Cora; van Yperen, Tom A.; ten Berge, Ingrid J.
Assessment and decision-making in child maltreatment cases is difficult. Practitioners face many uncertainties and obstacles during their assessment and decision-making process. Research exhibits shortcomings in this decision-making process. The purpose of this literature review is to identify and
Yossef Alnasser, MBBS
Conclusion: Saudi medical students, pediatrics trainees and pediatricians have good basic knowledge, positive attitude and willingness to learn more to provide a safe environment for children in Saudi Arabia. However, knowledge in regards to reporting child maltreatment is a major observed defect. Still, further education and training are needed to combat CAN in Saudi Arabia.
Ondeck, Lynnette; Combe, Laurie; Feeser, Cindy Jo; King, Rebecca
It is the position of the National Association of School Nurses (NASN) that prevention, early recognition, intervention and treatment of child maltreatment are critical to the physical well-being and academic success of students. Registered professional school nurses (hereinafter referred to as school nurses) serve a vital role in the recognition…
Tonmyr, L; MacMillan, H L; Jamieson, E; Kelly, K
The population health perspective (PHP) is commonly used in addressing a wide range of health issues. This article examines the strengths and limitations of the perspective. The determinants of health that are an integral part of the PHP are used as a framework in considering the range of outcomes associated with exposure to child maltreatment. Directions for further research are outlined.
Martin, Anne; Gardner, Margo; Brooks-Gunn, Jeanne
Previous research has linked parents' social support to decreased child maltreatment, but questions remain surrounding the mechanisms explaining this association. Furthermore, it is unclear whether this association applies to support provided by family alone (and not friends), and whether it is moderated by the presence of neighborhood violence.…
Mikton, Christopher; Mehra, Radhika; Butchart, Alexander; Addiss, David; Almuneef, Maha; Cardia, Nancy; Cheah, Irene; Chen, JingQi; Makoae, Mokhantso; Raleva, Marija
The study's aim was to develop a multidimensional model for the assessment of child maltreatment prevention readiness in low- and middle-income countries. The model was developed based on a conceptual review of relevant existing models and approaches, an international expert consultation, and focus groups in six countries. The final model…
Yun, Ilhong; Ball, Jeremy D.; Lim, Hyeyoung
This study uses the National Longitudinal Study of Adolescents (Add Health) data, a nationally representative sample of adolescents, to disentangle the relationship between child maltreatment and violent delinquency. Also examined are potential moderating effects of gender, socioeconomic status (SES), and religiosity on the association between…
Duffy, Jennifer Y; Hughes, Marcia; Asnes, Andrea G; Leventhal, John M
The relationship between risk factors and Child Protective Services (CPS) outcomes in families who participate in home visiting programs to prevent abuse and neglect and who are reported to CPS is largely unknown. We examined the relationship between parental risk factors and the substantiation status and number of CPS reports in families in a statewide prevention program. We reviewed CPS reports from 2006 to 2008 for families in Connecticut's child abuse prevention program. Six risk factors (histories of CPS, domestic violence [DV], mental health, sexual abuse, substance abuse, and criminal involvement) and the number of caregivers were abstracted to create risk scores for each family member. Maltreatment type, substantiation, and number of reports were recorded. Odds ratios were calculated. Of 1,125 families, 171 (15.6%) had at least one CPS report, and reports of 131 families were available for review. Families with a substantiated (25.2%) versus unsubstantiated (74.8%) first report had a high number of paternal risk factors (OR=6.13, 95% CI [1.89, 20.00]) and were more likely to have a history of maternal DV (OR=8.47, 95% CI [2.96, 24.39]), paternal DV (OR=11.23, 95% CI [3.33, 38.46]), and maternal criminal history (OR=4.55; 95% CI [1.32, 15.60]). Families with >1 report (34.4%) versus 1 report (65.6%) were more likely to have >3 caregivers, but this was not statistically significant (OR=2.53, 95% CI [0.98, 6.54]). In a prevention program for first-time families, DV, paternal risk, maternal criminal history, and an increased number of caregivers were associated with maltreatment outcomes. Targeting parental violence may impact child abuse prevention. Copyright © 2014 Elsevier Ltd. All rights reserved.
Kurtz, P. David; And Others
This study evaluated the school performance of 139 school-age and adolescent children, 22 of whom had been physically abused and 47 neglected. The abused children displayed pervasive and severe academic and socioemotional problems, while neglected children displayed academic delays. Both groups of maltreated children showed unexpected strengths on…
Victor, Bryan G; Grogan-Kaylor, Andrew; Ryan, Joseph P; Perron, Brian E; Gilbert, Terri Ticknor
Families that experience domestic violence and parental substance misuse are disproportionately involved with the child welfare system. Prior research suggests that child protective services (CPS) caseworkers are more likely to substantiate maltreatment allegations when domestic violence and parental substance misuse are identified during the investigation, pointing to one possible mechanism for this disproportionate involvement. While previous studies have relied on nationally representative data sets, the current study used administrative records from a large Midwestern child welfare agency that accounts for state-level variation in child welfare policy and practice. A total of 501,060 substantiation decisions made between 2009 and 2013 were examined to assess the influence of caseworker-perceived domestic violence and parental substance misuse on the decision to substantiate reported maltreatment. Results from multilevel modeling suggest that the identification of domestic violence and parental substance misuse during an investigation significantly increased the probability that an allegation would be substantiated. The implication of these findings for child welfare practice are considered in light of the fact that many child welfare agencies do not consider exposure to domestic violence and parental substance misuse in and of themselves to constitute child maltreatment. Copyright © 2018 Elsevier Ltd. All rights reserved.
Lauterbach, Dean; Armour, Cherie
Very few studies have investigated the longitudinal trajectory of depression and anxiety related symptomatology among child victims of maltreatment or among those at risk for maltreatment. The current study examined latent class trajectories of anxiety/depression symptoms in a sample of 1354 (n = 657 boys, n = 697 girls) victimized or at risk children using data collected from the Longtitudinal Studies of Child Abuse and Neglect (LONGSCAN). Four trajectory groups were identified labeled low-stable, moderate-stable, moderate-increasing, and high-decreasing. This study also sought to investigate predictors of group membership. Relative to the low-stable group, membership in the three more pathological groups (i.e., moderate-stable, moderate-increasing, and high-decreasing) was predicted by a greater number of maltreatment allegations, more visits to a primary care physician for psychological issues, less perceived support by primary maternal caregiver, and lower rated popularity of the child. Implications for early identification of child maltreatment victims in primary health care settings was discussed.
Waldron, Jonathan C; Scarpa, Angela; Kim-Spoon, Jungmeen
Child maltreatment can have a lasting impact, which is why it is important to understand factors that may exacerbate or mitigate self-esteem difficulties in adulthood. Although there is tremendous benefit that can come from religion and spirituality, few studies examine religious views after child maltreatment. Subsequent interpersonal difficulties may also affect self-esteem in maltreatment survivors. This study sought to examine interpersonal problems and religiosity as mediators in the link between childhood maltreatment and self-esteem in adulthood. The study recruited 718 women (M = 19.53 years) from a large public university. Participants completed questionnaires related to child abuse and neglect, interpersonal problems, religiosity, and self-esteem. Results demonstrated that all forms of maltreatment were associated with negative views of God and with more interpersonal difficulties. Viewing God as a punishing figure mediated the relationship between childhood emotional abuse and low adult self-esteem, along with several areas associated with interpersonal problems. Further, for both child emotional neglect and physical abuse, viewing God as less supportive mediated the relationship between child maltreatment and low adult self-esteem. The results may help in intervention for child maltreatment survivors by increasing awareness of the importance of religiosity in treatment to self-esteem issues in both childhood and adulthood. Copyright © 2018 Elsevier Ltd. All rights reserved.
Bachmann, Michael; Bachmann, Brittany A
Context The lifelong, negative consequences of exposure to adverse childhood experiences (ACEs) for individuals and their families are well established. Objective To demonstrate the importance of including ACE information in child maltreatment education curricula using path analysis. Design Survey data examined the impact of child maltreatment education programs and knowledge about ACEs on medical practitioners’ reporting habits and ability to detect maltreatment. A path diagram distinguished between the direct impact of education programs on outcome measures and the indirect effect that is mediated through knowledge of ACEs. Main Outcome Measures Medical practitioners’ ability to detect child maltreatment and their number of referrals to Child Protective Services (CPS). Results The optimized path diagram (χ2SB(3) = 3.9, p = 0.27; RMSEA-SB = 0.017; R2 = 0.21, where SB is Satorra-Bentler coefficient and RMSEA is root-mean-square error of approximation) revealed the mediating variable “knowledge about ACEs” as the strongest structural effect (SB-β = 0.34) on the number of CPS referrals. It was almost twice as high as the second strongest effect of formal education programs (SB-β = 0.19). For workplace training programs, the total effect when including knowledge of ACEs was almost double as strong as the direct effect alone. Even when previous child maltreatment education was controlled for, practitioners familiar with the consequences of ACEs were significantly more likely to recognize and to report abuse to CPS. Conclusion This study documented the importance of specialized training programs on ACEs, and the essential role ACE knowledge plays in the effectiveness of provider education programs. PMID:29616910
Bachmann, Michael; Bachmann, Brittany A
The lifelong, negative consequences of exposure to adverse childhood experiences (ACEs) for individuals and their families are well established. To demonstrate the importance of including ACE information in child maltreatment education curricula using path analysis. Survey data examined the impact of child maltreatment education programs and knowledge about ACEs on medical practitioners' reporting habits and ability to detect maltreatment. A path diagram distinguished between the direct impact of education programs on outcome measures and the indirect effect that is mediated through knowledge of ACEs. Medical practitioners' ability to detect child maltreatment and their number of referrals to Child Protective Services (CPS). The optimized path diagram (χ 2 SB(3) = 3.9, p = 0.27; RMSEA-SB = 0.017; R 2 = 0.21, where SB is Satorra-Bentler coefficient and RMSEA is root-mean-square error of approximation) revealed the mediating variable "knowledge about ACEs" as the strongest structural effect (SB-β = 0.34) on the number of CPS referrals. It was almost twice as high as the second strongest effect of formal education programs (SB-β = 0.19). For workplace training programs, the total effect when including knowledge of ACEs was almost double as strong as the direct effect alone. Even when previous child maltreatment education was controlled for, practitioners familiar with the consequences of ACEs were significantly more likely to recognize and to report abuse to CPS. This study documented the importance of specialized training programs on ACEs, and the essential role ACE knowledge plays in the effectiveness of provider education programs.
Sidebotham, P; Golding, J
To identify and validate factors within the parental background affecting risk of child maltreatment. A nested case-control study based on the Avon Longitudinal Study of Parents and Children ("Children of the Nineties"), a cohort of children born in Avon in 1991 through 1992. Data on the childhood and psychiatric histories of the parents, along with other data on the social and family environments, have been collected through postal questionnaires from early antenatal booking onwards. Out of 14,138 participating children, 162 have been identified as having been maltreated. Using logistic regression analysis, significant risk factors within the mothers' backgrounds were age factors in the fathers' backgrounds were age factors on univariate, but not multivariate analysis included a parental history of childhood physical abuse; divorce or separation of the mother's parents; a maternal history of having been in care, or separated from her mother; parental alcohol or drug abuse; and a maternal history of depression. This study, the first of its kind in the UK, supports the findings of others that parental age, educational achievement, and a history of psychiatric illness are of prime importance in an understanding of child maltreatment. With the exception of maternal sexual abuse, a history of abuse in childhood is not significant once adjusted for other background factors. The study suggests that psychodynamic models are inadequate to explain child maltreatment, and wider models incorporating other ecological domains are needed.
Full Text Available This study examined differences in the attitudes of professional social workers regarding corporal punishment and the perception and reporting of child maltreatment, according to the worker’s ethnic group membership (Asian, Black American, Black Caribbean, Hispanic, and non-Hispanic White. Data were obtained by mailed questionnaires from 808 members of the New York City chapter of NASW. Data were analyzed by analysis of variance. Results indicate that approval of corporal punishment and perception of maltreatment differed according to ethnic group membership. However, ethnicity had no effect on the likelihood of reporting maltreatment. Findings suggest that social work values override personal-culture values in the execution of job-related responsibilities. Implications for education and practice are discussed.
Developmental theories can be affirmed, challenged, and augmented by incorporating knowledge about atypical ontogenesis. Investigations of the biological, socioemotional, and personality development in individuals with high-risk conditions and psychopathological disorders can provide an entrée into the study of system organization, disorganization, and reorganization. This article examines child maltreatment to illustrate the benefit that can be derived from the study of individuals subjected to nonnormative caregiving experiences. Relative to an average expectable environment, which consists of a species-specific range of environmental conditions that support adaptive development among genetically normal individuals, maltreating families fail to provide many of the experiences that are required for normal development. Principles gleaned from the field of developmental psychopathology provide a framework for understanding multilevel functioning in normality and pathology. Knowledge of normative developmental processes provides the impetus to design and implement randomized control trial (RCT) interventions that can promote resilient functioning in maltreated children.
Lepistö, Sari; Ellonen, Noora; Helminen, Mika; Paavilainen, Eija
To describe the family health, functioning, social support and child maltreatment risk and associations between them in families expecting a baby. Finland was one of the first countries in banning corporal punishment against children over 30 years ago. Despite of this, studies have shown that parents physically abuse their children. In addition, professionals struggle in intervention of this phenomenon. Abusive parents should be recognised and helped before actual violent behaviour. A follow-up case-control study, with a supportive intervention in the case group (families with a heightened risk) in maternity and child welfare clinics. The baseline results of families are described here. Child maltreatment risk in families expecting a baby was measured by Child Abuse Potential Inventory. The health and functioning was measured by Family Health, Functioning and Social Support Scale. Data included 380 families. A total of 78 families had increased risk for child maltreatment. Heightened risk was associated with partners' age, mothers' education, partners' father's mental health problems, mothers' worry about partners' drinking and mothers' difficulties in talking about the family's problems. Risk was associated with family functioning and health. Families with risk received a less support from maternity clinics. Families with child maltreatment risk and related factors were found. This knowledge can be applied for supporting families both during pregnancy and after the baby is born. Professionals working with families in maternity clinics need tools to recognise families with risk and aid a discussion with them about the family life situation. The Child Abuse Potential, as a part of evaluating the family life situation, seems to prove a useful tool in identifying families at risk. The results offer a valid and useful tool for recognising families with risk and provide knowledge about high-risk family situations. © 2016 John Wiley & Sons Ltd.
Edwards-Gaura, Anna; Whitaker, Daniel; Self-Brown, Shannon
Child maltreatment is one of the United States' most significant public health problems. In efforts to prevent maltreatment experts recommend use of Behavioral Parent Training Programs (BPTs), which focus on teaching skills that will replace and prevent maltreating behavior. While there is research to support the effectiveness of BPTs in maltreatment prevention, the reach of such programs is still limited by several barriers, including poor retention of families in services. Recently, new technologies have emerged that offer innovative opportunities to improve family engagement. These technologies include smartphones and social networking; however, very little is known about the potential of these to aid in maltreatment prevention. The primary goal of this study was to conduct 2 pilot exploratory projects. The first project administered a survey to parents and providers to gather data about at-risk parents' use of smartphones and online social networking technologies. The second project tested a social networking-enhanced brief parenting program with 3 intervention participants and evaluated parental responses. Seventy-five percent of parents surveyed reported owning a computer that worked. Eighty-nine percent of parents reported that they had reliable Internet access at home, and 67% said they used the Internet daily. Three parents participated in the intervention with all reporting improvement in parent-child interaction skills and a positive experience participating in the social networking-enhanced SafeCare components. In general, findings suggest that smartphones, social networking, and Facebook, in particular, are now being used by individuals who show risk factors for maltreatment. Further, the majority of parents surveyed in this study said that they like Facebook, and all parents surveyed said that they use Facebook and have a Facebook account. As well, all saw it as a potentially beneficial supplement for future parents enrolling in parenting programs.
Pajer, Kathleen A; Gardner, William; Lourie, Andrea; Chang, Chien-Ni; Wang, Wei; Currie, Lisa
Adolescent mothers are at increased risk of mistreating their children. Intervening before they become pregnant would be an ideal primary prevention strategy. Our goal was to determine whether psychopathology, exposure to maltreatment, preparedness for child-bearing, substance use disorders (SUDs), IQ, race, and socioeconomic status were associated with the potential for child abuse in nonpregnant adolescent girls. The Child Abuse Potential Inventory (CAPI) was administered to 195 nonpregnant girls (aged 15 to 16 years; 54% African American) recruited from the community. Psychiatric diagnoses from a structured interview were used to form 4 groups: conduct disorder (CD), internalizing disorders (INTs; that is, depressive disorder, anxiety disorder, or both), CD + INTs, or no disorder. Exposure to maltreatment was assessed with the Childhood Trauma Questionnaire, and the Childbearing Attitudes Questionnaire measured maternal readiness. CAPI scores were positively correlated with all types of psychopathology, previous exposure to maltreatment, and negative attitudes toward child-bearing. IQ, SUDs, and demographic factors were not associated. Factors associated with child abuse potential interacted in complex ways, but the abuse potential of CD girls was high, regardless of other potentially protective factors. Our study demonstrates that adolescent girls who have CD or INT are at higher risk of perpetrating physical child abuse when they have children. However, the core features of CD may put this group at a particularly high risk, even in the context of possible protective factors. Treatment providers should consider pre-pregnant counselling about healthy mothering behaviours to girls with CD.
Green, Beth L.; Ayoub, Catherine; Bartlett, Jessica Dym; Von Ende, Adam; Furrer, Carrie; Chazan-Cohen, Rachel; Vallotton, Claire; Klevens, Joanne
The high societal and personal costs of child maltreatment make identification of effective early prevention programs a high research priority. Early Head Start (EHS), a dual generational program serving low-income families with children prenatally through age three years, is one of the largest federally funded programs for infants and toddlers in the United States. A national randomized trial found EHS to be effective in improving parent and child outcomes, but its effectiveness in reducing child maltreatment was not assessed. The current study used administrative data from state child welfare agencies to examine the impact of EHS on documented abuse and neglect among children from seven of the original seventeen programs in the national EHS randomized controlled trial. Results indicated that children in EHS had significantly fewer child welfare encounters between the ages of five and nine years than did children in the control group, and that EHS slowed the rate of subsequent encounters. Additionally, compared to children in the control group, children in EHS were less likely to have a substantiated report of physical or sexual abuse, but more likely to have a substantiated report of neglect. These findings suggest that EHS may be effective in reducing child maltreatment among low-income children, in particular, physical and sexual abuse. PMID:26744550
Cicchetti, Dante; Handley, Elizabeth D.; Rogosch, Fred A.
Prior research has found inconsistent evidence regarding the association among childhood adversity, inflammation, and internalizing symptoms, perhaps because previous studies have yet to adequately integrate important factors such as the timing of the adversity, genetic variation, and other relevant processes such as neuroendocrine regulation. The aims of the present study were threefold: 1) Determine whether the effect of the timing of child maltreatment on C-reactive protein (CRP), an inflammatory marker, varies by CRP gene variation; 2) Explore whether links between salivary CRP and childhood internalizing symptoms depend on the presence and timing of maltreatment experiences; 3) Investigate the role of CRP in the relations between child neuroendocrine regulation and internalizing symptoms and examine whether these associations are moderated by the presence and timing of child maltreatment. Participants included a sample of 267 maltreated and 222 nonmaltreated children (M age= 9.72, SD=0.99; 52.4% male; 66% African-American) who attended a summer day camp research program designed for school-aged low-income children. Department of Human Services records were examined to determine the onset and recency of maltreatment for children in the maltreated group. Results indicated that among children with recent onset maltreatment, those with at least one A allele from CRP SNP rs1417938 evidenced significantly higher CRP levels compared to recently maltreated children carrying the TT genotype. Moreover, higher levels of CRP were associated with higher levels of internalizing symptoms only for recently maltreated children. Finally, we did not find support for salivary CRP as a mechanism in the relation between neuroendocrine regulation and childhood internalizing symptoms. Our findings highlight the importance of the timing of child maltreatment and have important implications for characterizing variability in inflammation and internalizing symptoms among youth. PMID
Harpur, Lisa Jane; Polek, Ela; van Harmelen, Anne-Laura
Research indicates that childhood maltreatment is strongly associated with high levels of adolescent depression and anxiety symptoms. Using LONGSCAN data and taking into account the range of family characteristics related to adversity (poverty, primary caregiver substance abuse) and protective factors (living with biological mother and father), the present study assessed the complex resilience process in which child intelligence (age 6) mediated the relationship between early childhood maltreatment (age 0-4) and adolescent symptoms of depression and anxiety (age 14). We also assessed if mid (age 6-8) and late (age 10-12) childhood maltreatment moderated this mediation. We found that mid-childhood intelligence mediated the negative effect of early childhood maltreatment (age 0-4) on anxiety symptoms (age 14), but not on depressive symptoms (age 14). We also found the effect of timing of maltreatment: early childhood maltreatment (age 0-4) predicted more anxiety symptoms in adolescence, whereas late childhood/early adolescent (age 10-12) maltreatment predicted more symptoms of depression in adolescence. In addition, mid (age 6-8) and late (age 10-12) childhood maltreatment dampened the protective effect of IQ (age 6) against anxiety (age 14). In sum, current evidence shows that low anxiety and depression symptoms in adolescence following childhood maltreatment was achieved through different pathways, and that early and late childhood/early adolescence were more sensitive periods for development of psychopathology related to depression and anxiety in adolescence. Copyright © 2015 Elsevier Ltd. All rights reserved.
Rosen, Abigail L; Handley, Elizabeth D; Cicchetti, Dante; Rogosch, Fred A
Previous research has revealed a large prevalence of trauma experienced by children, creating high risk for the development of psychopathology. Research investigating the negative impacts of child maltreatment and other traumas has typically examined these experiences individually, controlling for co-occurring traumas, or has combined these experiences into a general variable of risk, thereby obscuring the complex relationships among environmental traumas and maltreatment. The current study expands on previous research by elucidating relationships between multiple contexts of overlapping traumas and maltreatment experienced by children, and by categorizing how these experiences join together to impact internalizing and externalizing symptomatology. Participants included 316 maltreated children and 269 nonmaltreated children (M age = 9.4, SD = 0.88) who attended a summer day camp research program for low-income children. Latent Class Analysis (LCA) identified three differential patterns of trauma exposure across children: 1) community violence and loss; 2) pervasive trauma; and 3) low trauma. Covariate analyses demonstrated that child maltreatment was significantly associated with class membership, suggesting that maltreated children were more likely to experience diverse traumas extending beyond their maltreatment experiences (pervasive trauma class). A two-way analysis of variance also demonstrated that trauma latent class membership and child maltreatment each represented unique predictors of internalizing and externalizing symptoms, with each having an independent effect on symptomatology. This investigation provides unique insight into the differential impact of patterns of trauma exposure and child maltreatment, providing support for further research and clinical practice addressing multiple levels of a child's ecology. Copyright © 2018 Elsevier Ltd. All rights reserved.
Thornberry, Terence P.; Henry, Kimberly L.
Identification of the causes of child maltreatment perpetration is prerequisite for developing efficacious prevention initiatives to reduce its occurrence. Earlier maltreatment victimization is often suggested as an important cause of subsequent maltreatment perpetration. This study investigates a) whether maltreatment victimization causes…
Babcock Fenerci, Rebecca L; DePrince, Anne P
The current study investigated associations between appraisals of shame and alienation related to mothers' own experiences of child maltreatment and symptoms across generations-in mothers themselves as well as their toddler/preschool-aged children. Mothers who survived maltreatment (N = 113) with a child between the ages of 2 and 5 were recruited to participate in an online study on Maternal Coping, Attachment and Health. Mother participants completed a series of questionnaires, including those that asked about posttrauma appraisals of their own maltreatment experiences as well as their child's and their own mental health symptoms. When taking into account other posttrauma appraisals (e.g., fear, betrayal, anger, self-blame), maternal shame and alienation were both significantly associated with maternal trauma-related distress (a composite of anxiety, PTSD, dissociation, and depressive symptoms). Maternal shame was also significantly linked to child internalizing symptoms and externalizing symptoms. Lower levels of fear and higher levels of betrayal were associated with externalizing symptoms as well. Maternal trauma-related distress mediated the relationship between maternal shame and child externalizing symptoms, and partially mediated the relationship between shame and internalizing symptoms. This study is the first of its kind to examine the role of posttrauma appraisals among mother survivors of maltreatment as they relate to symptoms in their young children. Although additional research is necessary, findings suggest that mothers' posttrauma appraisals, such as shame, could be a relevant factor in the early social-emotional development of survivors' children. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Atteraya, Madhu Sudhan; Ebrahim, Nasser B; Gnawali, Shreejana
We examined the prevalence of child maltreatment as measured by the level of physical (moderate to severe) and emotional abuse and child labor, and the associated household level determinants of child maltreatment in Nepal. We used a nationally representative data set from the fifth round of the Nepal Multiple Indicator Cluster Survey (the 2014 NMICS). The main independent variables were household level characteristics. Dependent variables included child experience of moderate to severe physical abuse, emotional abuse, and child labor (domestic work and economic activities). Bivariate analyses and logistic regressions were used to examine the associations between independent and dependent variables. The results showed that nearly half of the children (49.8%) had experienced moderate physical abuse, 21.5% experienced severe physical abuse, and 77.3% experienced emotional abuse. About 27% of the children had engaged in domestic work and 46.7% in various economic activities. At bivariate level, educational level of household's head and household wealth status had shown significant statistical association with child maltreatment (pchild labor. In general, child maltreatment is a neglected social issue in Nepal and the high rates of child maltreatment calls for mass awareness programs focusing on parents, and involving all stakeholders including governments, local, and international organizations. Copyright © 2017 Elsevier Ltd. All rights reserved.
Li, Yang; Seng, Julia S
Studies of the relationship between cortisol and posttraumatic stress disorder (PTSD) have had inconsistent results. Gender, trauma type, and age at trauma exposure may explain the inconsistencies. The objective of the review was to examine cortisol levels in relation to PTSD in women with a history of child maltreatment trauma. A review of literature found 13 articles eligible for inclusion. Despite limiting focus to the relatively homogeneous population, the patterns of associations between PTSD and cortisol levels were still inconsistent. The reasons for the inconsistencies likely include highly varied methods across studies, small convenience samples, and unmeasured neuroendocrine hormones that may be stronger predictors of PTSD. The review does not point to a clear bio-behavioral target for psychiatric nursing intervention. It is important to continue to address the developmental and clinical stress response aspects of child maltreatment trauma-related PTSD without assuming that these stress responses are hypothalamic-pituitary-adrenal-axis driven.
Buriel, Raymond; And Others
Examines disciplinary practices and child-maltreatment attitudes in foreign- and native-born Mexican-American mothers. Subjects responded to accounts of child misconduct and mistreatment. Foreign-born mothers more likely than natives to use spanking and verbal reasoning. Spanking not preferred by either group. Child-mistreatment-response…
Handley, Elizabeth D; Rogosch, Fred A; Cicchetti, Dante
The current study examined the prospective association between child maltreatment and the development of substance use disorder in adolescence with the aim of investigating pathways underlying this relation, as well as genetic moderation of these developmental mechanisms. Specifically, we tested whether youth who experienced maltreatment prior to age 8 were at risk for the development of marijuana dependence in adolescence by way of a childhood externalizing pathway and a childhood internalizing pathway. Moreover, we tested whether variation in FK506 binding protein 5 gene (FKBP5) CATT haplotype moderated these pathways. The participants were 326 children (n =179 maltreated; n = 147 nonmaltreated) assessed across two waves of data collection (childhood: ages 7-9 and adolescence: ages 15-18). Results indicated that higher levels of child externalizing symptoms significantly mediated the effect of child maltreatment on adolescent marijuana dependence symptoms for individuals with one or two copies of the FKBP5 CATT haplotype only. We did not find support for an internalizing pathway from child maltreatment to adolescent marijuana dependence, nor did we find evidence of moderation of the internalizing pathway by FKBP5 haplotype variation. Findings extend previous research by demonstrating that whether a maltreated child will traverse an externalizing pathway toward substance use disorder in adolescence is dependent on FKBP5 genetic variation.
Full Text Available Introduction: Child maltreatment is one of the United States’ most significant public health problems. In efforts to prevent maltreatment experts recommend use of Behavioral Parent Training Programs (BPTs, which focus on teaching skills that will replace and prevent maltreating behavior. While there is research to support the effectiveness of BPTs in maltreatment prevention, the reach of such programs is still limited by several barriers, including poor retention of families in services. Recently, new technologies have emerged that offer innovative opportunities to improve family engagement. These technologies include smartphones and social networking; however, very little is known about the potential of these to aid in maltreatment prevention. The primary goal of this study was to conduct 2 pilot exploratory projects. Methods: The first project administered a survey to parents and providers to gather data about at-risk parents’ use of smartphones and online social networking technologies. The second project tested a social networking-enhanced brief parenting program with 3 intervention participants and evaluated parental responses. Results: Seventy-five percent of parents surveyed reported owning a computer that worked. Eighty-nine percent of parents reported that they had reliable Internet access at home, and 67% said they used the Internet daily. Three parents participated in the intervention with all reporting improvement in parent-child interaction skills and a positive experience participating in the social networking-enhanced SafeCare components. Conclusion: In general, findings suggest that smartphones, social networking, and Facebook, in particular, are now being used by individuals who show risk factors formal treatment. Further, the majority of parents surveyed in this study said that they like Facebook, and all parents surveyed said that they use Facebook and have a Facebook account. As well, all saw it as a potentially
Negriff, Sonya; Schneiderman, Janet U.; Trickett, Penelope K.
The present study used data from an ongoing longitudinal study of the effects of maltreatment on adolescent development to (1) describe rates of maltreatment experiences obtained from retrospective self-report versus case record review for adolescents with child welfare–documented maltreatment histories, (2) examine self-reported versus child welfare–identified maltreatment in relation to mental health and risk behavior outcomes by maltreatment type, and (3) examine the association between the number of different types of maltreatment and mental health and risk behavior outcomes. Maltreatment was coded from case records using the Maltreatment Case Record Abstraction Instrument (MCRAI) and participants were asked at mean age = 18.49 about childhood maltreatment experiences using the Comprehensive Trauma Interview (CTI). Results showed that an average of 48% of maltreatment found by the MCRAI for each type of maltreatment were unique cases not captured by the CTI, whereas an average of 40% self-reported maltreatment (CTI) was not indicated by the MCRAI. Analyses with outcomes showed generally, self-reported maltreatment, regardless of concordance with MCRAI, was related to the poorest outcomes. The difference in associations with the outcomes indicates both self-report and case record review data may have utility depending on the outcomes being assessed. PMID:27777329
Mills, Ryan; Kisely, Steve; Alati, Rosa; Strathearn, Lane; Najman, Jake M
To investigate whether: (1) child maltreatment is associated with life-time cannabis use, early-onset cannabis use, daily cannabis use and DSM-IV cannabis abuse in young adulthood; and (2) behaviour problems, tobacco use and alcohol use at age 14 are associated with cannabis use. Birth cohort using linked government agency child protection data to define exposure to child maltreatment. The Mater-University of Queensland Study of Pregnancy in Brisbane, Australia. Of the original cohort of 7223 mother and child pairs, obtained from consecutive presentations for prenatal care at a hospital serving a cross-section of the community, 3778 (52.3%) of the young people participated at age 21 years. Exposure to child maltreatment was established by substantiated government agency reports. Cannabis outcomes were by self-report questionnaire and Composite International Diagnostic Interview (CIDI)-Auto at age 21. Associations were adjusted for a range of potential confounders. Additional adjustment was carried out for variables measured at age 14-youth behaviour problems [Achenbach Child Behavior Checklist (CBCL)], tobacco use and alcohol use. After adjustment, substantiated child maltreatment was associated with any life-time cannabis use [odds ratio (OR) = 1.60, 95% confidence interval (CI) = 1.08-2.39], cannabis use prior to age 17 (OR = 2.47, 95 % CI = 1.67-3.65), daily cannabis use (OR = 2.68, 95% CI = 1.49-4.81) and DSM-IV cannabis abuse/dependence (OR = 1.72, 95% CI = 1.07-2.77). Externalizing behaviour and tobacco and alcohol use at age 14 were associated significantly with almost all cannabis outcomes (P maltreated are more likely to go on to use cannabis before the age of 17, use cannabis as an adult, use cannabis daily and meet DSM-IV criteria for cannabis dependence. Externalizing behaviour in adolescence appears partly to mediate the association with adult cannabis use. © 2016 Society for the Study of Addiction.
Dare, Tim; Vaithianathan, Rhema; De Haan, Irene
Jonathan Boston provides an insightful analysis of the emergence and persistence of child poverty in New Zealand (Boston, 2014, "Educational Philosophy and Theory"). His remarks on why child poverty matters are brief but, as he reports, "there is a large and robust body of research on the harmful consequences of child poverty"…
Devries, Karen M; Knight, Louise; Child, Jennifer C; Kyegombe, Nambusi; Hossain, Mazeda; Lees, Shelley; Watts, Charlotte; Naker, Dipak
Existing evidence, mainly from high-income countries, shows children who witness intimate partner violence (IPV) at home are more likely to experience other forms of violence, but very little evidence is available from lower income countries. In this paper we aim to explore whether Ugandan children who witness IPV at home are also more likely to experience other forms of maltreatment, factors associated with witnessing and experiencing violence, and whether any increased risk comes from parents, or others outside the home. A representative cross-sectional survey of primary schools. 3427 non-boarding primary school students, aged about 11-14 years. Luwero District, Uganda, 2012. Exposure to child maltreatment was measured using the International Society for the Prevention of Child Abuse and Neglect Child Abuse Screening Tool-Child Institutional, and 2 questions measured witnessing IPV. 26% of children reported witnessing IPV, but nearly all of these children had also experienced violence themselves. Only 0.6% of boys and 1.6% of girls had witnessed partner violence and not experienced violence. Increased risk of violence was from parents and also from other perpetrators besides parents. Both girls and boys who witnessed and experienced violence had between 1.66 (95% CI 0.96 to 2.87) and 4.50 (95% CI 1.78 to 11.33) times the odds of reporting mental health difficulties, and 3.23 (95% CI 1.99 to 5.24) and 8.12 (95% CI 5.15 to 12.80) times the odds of using physical or sexual violence themselves. In this sample, witnessing IPV almost never occurred in isolation-almost all children who witnessed partner violence also experienced violence themselves. Our results imply that children in Uganda who are exposed to multiple forms of violence may benefit from intervention to mitigate mental health consequences and reduce use of violence. IPV prevention interventions should be considered to reduce child maltreatment. Large numbers of children also experience maltreatment in
Rogosch, Fred A.; Dackis, Melissa N.; Cicchetti, Dante
Child maltreatment and biomarkers of allostatic load were investigated in relation to child health problems and psychological symptomatology. Participants attended a summer research day camp and included 137 maltreated and 110 nonmaltreated low-income children, who were aged 8 to 10 years (M = 9.42) and racially and ethnically diverse; 52% were male. Measurements obtained included salivary cortisol and DHEA, body-mass index, waist-hip ratio, and blood pressure; these indicators provided a composite index of allostatic load. Child self-report and camp adult-rater reports of child symptomatology were obtained; mothers provided information on health problems. The results indicated that higher allostatic load and child maltreatment status independently predicted poorer health outcomes and greater behavior problems. Moderation effects indicated that allostatic load was related to somatic complaints, attention problems, and thought problems only among maltreated children. Risks associated with high waist-hip ratio, low morning cortisol, and high morning DHEA also were related to depressive symptoms only for maltreated children. The results support an allostatic load conceptualization of the impact of high environmental stress and child abuse and neglect on child health and behavioral outcomes and have important implications for long-term physical and mental health. PMID:22018084
Menz, Stacy M; Hatten, Kristin; Grant-Beuttler, Marybeth
Children with developmental coordination disorder (DCD) demonstrate difficulty with feedforward motor control and use varied compensatory strategies. To examine gross motor function changes following strength training in a child with motor control difficulties. A girl aged 6 years 11 months, with apraxia and hypotonia, and demonstrating motor delays consistent with DCD. Twenty-four strength training sessions were completed using a universal exercise unit. Postintervention scores significantly improved on the Bruininks-Oseretsky test of motor proficiency, second edition, and the Canadian occupational performance measure scores and raised the developmental coordination disorder questionnaire, revised 2007, scores above the range where DCD is suspected. Nonsignificant changes in strength were observed. Improved function and significant gains in manual coordination were observed following blocked practice of isolated, simple joint movements during strength training. Improved motor skills may be because of effective use of feedforward control and improved stabilization. Strength training does not rehearse skills using momentum, explaining nonsignificant changes in locomotor or locomotion areas.
Full Text Available Abstract Background Child maltreatment can cause significant physical and psychological problems. The present study aimed to investigate the prevalence and determinants of child maltreatment in Guangzhou, China, where such issues are often considered a taboo subject. Methods A school-based survey was conducted in southern China in 2005. 24 high schools were selected using stratified random sampling strategy based on their districts and bandings. The self-administered validated Chinese version of parent-child Conflict Tactics Scale (CTSPC was used as the main assessment tool to measure the abusive experiences encountered by students in the previous six months. Results The response rate of this survey was 99.7%. Among the 6592 responding students, the mean age was 14.68. Prevalence of parental psychological aggression, corporal punishment, severe and very serve physical maltreatment in the past 6 months were 78.3%, 23.2%, 15.1% and 2.8% respectively. The prevalence of sexual abuse is 0.6%. The most commonly cited reasons for maltreatment included 'disobedience to parents', 'poor academic performance', and 'quarrelling between parents'. Age, parental education, places of origins and types of housing were found to be associated with physical maltreatments whereas gender and fathers' education level were associated with sexual abuse. Conclusion Though largely unspoken, child maltreatment is a common problem in China. Identification of significant determinants in this study can provide valuable information for teachers and health professionals so as to pay special attention to those at-risk children.
Leung, Phil W S; Wong, William C W; Chen, W Q; Tang, Catherine S K
Child maltreatment can cause significant physical and psychological problems. The present study aimed to investigate the prevalence and determinants of child maltreatment in Guangzhou, China, where such issues are often considered a taboo subject. A school-based survey was conducted in southern China in 2005. 24 high schools were selected using stratified random sampling strategy based on their districts and bandings. The self-administered validated Chinese version of parent-child Conflict Tactics Scale (CTSPC) was used as the main assessment tool to measure the abusive experiences encountered by students in the previous six months. The response rate of this survey was 99.7%. Among the 6592 responding students, the mean age was 14.68. Prevalence of parental psychological aggression, corporal punishment, severe and very serve physical maltreatment in the past 6 months were 78.3%, 23.2%, 15.1% and 2.8% respectively. The prevalence of sexual abuse is 0.6%. The most commonly cited reasons for maltreatment included 'disobedience to parents', 'poor academic performance', and 'quarrelling between parents'. Age, parental education, places of origins and types of housing were found to be associated with physical maltreatments whereas gender and fathers' education level were associated with sexual abuse. Though largely unspoken, child maltreatment is a common problem in China. Identification of significant determinants in this study can provide valuable information for teachers and health professionals so as to pay special attention to those at-risk children.
Chaiyachati, Barbara H; Gaither, Julie R; Hughes, Marcia; Foley-Schain, Karen; Leventhal, John M
Although home visiting has been used in many populations in prevention efforts, the impact of scaled-up home-visiting programs on abuse and neglect remains unclear. The objective of this study was to assess the impact of voluntary participation in an established statewide home-visiting program for socially high-risk families on child maltreatment as identified by Child Protective Services (CPS). Propensity score matching was used to compare socially high-risk families with a child born between January 1, 2008 and December 31, 2011 who participated in Connecticut's home-visiting program for first-time mothers and a comparison cohort of families who were eligible for the home-visiting program but did not participate. The main outcomes were child maltreatment investigations, substantiations, and out-of-home placements by CPS between January 1, 2008 and December 31, 2013. In the unmatched sample, families who participated in home-visiting had significantly higher median risk scores (P home visiting. First substantiations also occurred later in the child's life among home-visited families. There was a trend toward decreased out-of-home placement (HR 0.73, 95% CI 0.53-1.02, P = .06). These results from a scaled-up statewide program highlight the potential of home visiting as an important approach to preventing child abuse and neglect. Copyright © 2018 Elsevier Ltd. All rights reserved.
Ohashi, Hirotsuna; Wada, Ichiro; Yamaoka, Yui; Nakajima-Yamaguchi, Ryoko; Ogai, Yasukazu; Morita, Nobuaki
Building an effective casework system for child maltreatment is a global issue. We estimated the effect of household dysfunction (i.e., interparental violence, caregiver mental health problems, and caregiver substance abuse) on child maltreatment to understand how to advance the current framework of child welfare. The sample comprised 759 children (1- to 17-year-old; mean age was 10.6; 404 boys and 355 girls) placed in temporary custody units (one of the strongest intervention of the Japanese child protection system). Caseworkers from 180 units across 43 prefectures completed questionnaires on children and their family and were asked whether a child maltreatment report had been made after cancelation of custody in a 15-month follow-up period. The relations of household dysfunction and maltreatment reports were assessed using the Cox proportional hazard model. About half (48.4%) of the children had been placed in the unit because of maltreatment, and 88.3% had a history of victimization. Seventy-six cases had maltreatment reports after cancelation. We entered household dysfunction variables individually into the model, and each had a significant relationship with maltreatment reports (hazard ratios for interparental violence, caregiver mental health problem, and substance abuse were 1.69, 1.69, and 2.19, respectively) after covariate adjustment. When treating these three variables as cumulative risk score model of household dysfunction, the hazard ratio increased with increasing number of score (1.96 for score two; 2.35 for score three; score 0 as reference). Greater household dysfunction score is a risk of maltreatment after intensive intervention. It is imperative to construct systems facilitating cooperation between child and adult service sectors and to deliver seamless services to children and families. Our findings provide child protect services with risk-stratified interventions for children at victimization risk and promote adult-focused services to be
Mikton, Christopher; Power, Mick; Raleva, Marija; Makoae, Mokhantso; Al Eissa, Majid; Cheah, Irene; Cardia, Nancy; Choo, Claire; Almuneef, Maha
This study aimed to systematically assess the readiness of five countries - Brazil, the Former Yugoslav Republic of Macedonia, Malaysia, Saudi Arabia, and South Africa - to implement evidence-based child maltreatment prevention programs on a large scale. To this end, it applied a recently developed method called Readiness Assessment for the Prevention of Child Maltreatment based on two parallel 100-item instruments. The first measures the knowledge, attitudes, and beliefs concerning child maltreatment prevention of key informants; the second, completed by child maltreatment prevention experts using all available data in the country, produces a more objective assessment readiness. The instruments cover all of the main aspects of readiness including, for instance, availability of scientific data on the problem, legislation and policies, will to address the problem, and material resources. Key informant scores ranged from 31.2 (Brazil) to 45.8/100 (the Former Yugoslav Republic of Macedonia) and expert scores, from 35.2 (Brazil) to 56/100 (Malaysia). Major gaps identified in almost all countries included a lack of professionals with the skills, knowledge, and expertise to implement evidence-based child maltreatment programs and of institutions to train them; inadequate funding, infrastructure, and equipment; extreme rarity of outcome evaluations of prevention programs; and lack of national prevalence surveys of child maltreatment. In sum, the five countries are in a low to moderate state of readiness to implement evidence-based child maltreatment prevention programs on a large scale. Such an assessment of readiness - the first of its kind - allows gaps to be identified and then addressed to increase the likelihood of program success. Copyright © 2013 Elsevier Ltd. All rights reserved.
Visscher, Simeon J A; van Stel, Henk F
Child maltreatment (CM) is a common condition with a large impact on the victim and society. In the Netherlands, the preventive child healthcare (CHC) aims to protect children against such threats. However, several studies indicate that the efficacy in this area may be suboptimal for many CHC professionals. Therefore, this study aims to map the practice variation in the primary and secondary prevention of CM, by CHC physicians and nurses. This mixed-methods study used interviews to identify relevant topics and develop an online questionnaire. All CHC organizations in the Netherlands (n=45) were asked to forward this questionnaire to their professionals. Practice variation was described with domain scores and item response distributions. Multi-level analysis was used to assess case mix-corrected variance between organizations. Interview participants (n=11) expected suboptimal care in 35 topics which they considered important for prevention of CM, resulting in a 15min questionnaire. Nearly two-thirds of the organizations (n=29) agreed to forward the questionnaire to their employees. The response rate was 42% (n=1104). Suboptimal care and practice variation was found in all domains (i.e. communication, medical expertise, collaboration, involvement in prevention of CM, and improvement opportunities), mostly caused by intra-organization variance. Significant inter-organization variance was found for collaboration (variance partition coefficient 6-7%) and involvement (2-3%). Furthermore, the majority of the respondents (96%) reported fear in acting upon suspicions of CM. Substantial suboptimal care and practice variation in prevention of CM warrant action from authorities, CHC training institutes, CHC organizations, and professionals. Copyright © 2017 Elsevier Ltd. All rights reserved.
Prinz, Ronald J; Sanders, Matthew R; Shapiro, Cheri J; Whitaker, Daniel J; Lutzker, John R
A previous article published several years ago (Prinz et al. Prevention Science, 10, 1-12, 2009) described the main results of a place-randomized-design study focused on the prevention of child-maltreatment-related outcomes at a population level through the implementation of a multilevel system of parenting and family support (the Triple P-Positive Parenting Program). The current report, prepared at the encouragement of the journal, provides additional details about procedures, measures, and design-related decisions, presents an additional analysis of the main outcome variables, and poses questions about the study and its implications. We also offer guidance about how the field can move forward to build on this line of research. From the outset, the three designated primary child maltreatment outcomes were county-wide rates for substantiated child maltreatment cases, out-of-home placements, and hospital-treated child maltreatment injuries, derived from independent data sources available through administrative archival records. Baseline equivalence between the two intervention conditions was reaffirmed. The additional analysis, which made use of a 5-year baseline (replacing a 1-year baseline) and ANCOVA, yielded large effect sizes for all three outcomes that converged with those from the original analyses. Overall, the study underscored the potential for community-wide parenting and family support to produce population-level preventive impact on child maltreatment. Issues addressed included (1) the need for replication of population-oriented maltreatment prevention strategies like the one tested in this randomized experiment, (2) the need to demonstrate that a parenting-based population approach to maltreatment prevention can also impact children's adjustment apart from child abuse, and (3) the role of implementation science for achieving greater population reach and maintenance over time.
Collier, A F; McClure, F H; Collier, J; Otto, C; Polloi, A
Providing culturally sensitive definitions of child abuse is difficult as perceptions of what constitutes abuse can vary around the world. This study was undertaken to assess how teachers in the Republic of Palau perceived the severity of potentially abusive incidents and what types of recommendations, if any, they would have for situations judged as severely abusive. Attitudes about child rearing practices were also evaluated. Teachers (n = 141 ) were given: (1) a questionnaire consisting of 25 vignettes describing parent/child interactions that were potentially abusive and asked to rate the severity of abuse and recommended interventions for each vignette; and (2) a 40-item parenting styles questionnaires to evaluate attitudes about child-rearing practices. Teachers identified and recommended interventions for more severe forms of abuse at rates similar to other international samples. For less severe parental misconduct, teachers were reluctant to involve nonfamily and outside agencies. Sexual abuse was rated as the most serious type of abuse and when identified, intervention was highly recommended. Some traditional Palauan parenting practices that might be considered maltreatment by other cultures were not considered abusive. For parenting styles, older individuals were more likely to use guilt induction and less likely to use methods of acceptance. Aggressive parenting styles were negatively correlated with all forms of abuse, suggesting that teachers who used aggressive disciplinary styles were less likely to perceive abusive situations as harmful. These results indicate that cultural values and practices play important roles in shaping the definition and interpretation of child maltreatment.
Data were analyzed using Pearson Correlation coefficient and one.way ANOVA. Results: Prevalence of emotional assault, physical assault, and child neglect were respectively 90.6% (509/562), 82.9% (466/562) and 78.8% (443/562), which were more frequent in preschool age children. Furthermore, different kinds of child ...
Cicchetti, Dante; Rogosch, Fred A.
Genetic moderation of the effects of child maltreatment on depression and internalizing symptoms was investigated in a sample of low-income maltreated and nonmaltreated African-American children (N = 1,096). Lifetime child maltreatment experiences were independently coded from Child Protective Services records and maternal report. Child depression and internalizing problems were assessed in the context of a summer research camp by self-report (Children’s Depression Inventory, CDI) and adult counselor-report (Teacher Report Form, TRF). DNA was obtained from buccal cell or saliva samples and genotyped for polymorphisms of the following genes: 5-HTTLPR, BDNF, NET, and CRHR1. ANCOVAs with age and gender as covariates were conducted, with maltreatment status and respective polymorphism as main effects and their GxE interactions. Maltreatment consistently was associated with higher CDI and TRF symptoms. Results for child self-report symptoms indicated a GxE interaction for BDNF and maltreatment. Additionally, BDNF and tri-allelic 5-HTTLPR interacted with child maltreatment in a GxGxE interaction. Analyses for counselor-report of child anxiety/depression symptoms on the TRF indicated moderation of child maltreatment effects by tri-allelic 5-HTTLPR. These effects were elaborated based on variation in developmental timing of maltreatment experiences. NET was found to further moderate the GxE interaction of 5-HTTLPR and maltreatment status revealing a GxGxE interaction. This GxGxE was extended by consideration of variation in maltreatment subtype experiences. Finally, GxGxE effects were observed for the co-action of BDNF and the CRHR1 haplotype. The findings illustrate the variable influence of specific genotypes in GxE interactions based on variation in maltreatment experiences and the importance of a multi-genic approach for understanding influences on depression and internalizing symptoms among African-American children. PMID:25422957
Vondra, Joan I.; Toth, Sheree L.
Discusses the multiple determinants of abusive treatment of children in terms of factors inside and outside the family. Also describes intervention models, including child-focused, early childhood, later childhood, parent-focused, and sociocultural interventions. (RJC)
Bramsen, Rikke Holm; Lasgaard, Mathias; Koss, Mary P
: Estimates from the mediation model indicated significant indirect effects of child physical abuse on sexual aggression via peer influence and insecure-hostile masculinity. No significant total effect of child sexual abuse and child neglect on sexual aggression was found. CONCLUSIONS: Findings of the present......OBJECTIVE: The aim of the present study was to investigate the relationship between child maltreatment and severe early adolescent peer-on-peer sexual aggression, using a multiple mediator model. METHODS: The study comprised 330 male Grade 9 students with a mean age of 14.9 years (SD=0.5). RESULTS...... study identify risk factors that are potentially changeable and therefore of value in informing the design of prevention programs aiming at early adolescent peer-on-peer sexual aggression in at-risk youth....
Full Text Available There is strong evidence that poverty and economic disadvantage are associated with child maltreatment; however, research in this area is underdeveloped in Canada. The purpose of this paper is to examine the relationship between economic hardship and maltreatment for families and children identified to the Ontario child protection system for a maltreatment concern. Secondary analyses of the Ontario Incidence Study of Reported Child Abuse and Neglect-2013 (OIS-2013 were conducted. The OIS-2013 examines the incidence of reported maltreatment and the characteristics of children and families investigated by child welfare authorities in Ontario in 2013. Descriptive and bivariate chi-square analyses were conducted in addition to a logistic regression predicting the substantiation of maltreatment. In 9% of investigations, the household had run out of money for food, housing, and/or utilities in the past 6 months. Children in these households were more likely to have developmental concerns, academic difficulties, and caregivers with mental health concerns and substance use issues. Controlling for key clinical and case characteristics, children living in families facing economic hardship were almost 2 times more likely to be involved in a substantiated maltreatment investigation (OR = 1.91, p < 0.001. The implications in regard to future research and promoting resilience are discussed.
Marquis, Robyn A.; Leschied, Alan W.; Chiodo, Debbie; O'Neill, Arlene
Dramatic increases in child welfare rates in Canada over recent years have been largely driven by an increased reporting of neglect cases (Trocme, Fallon, MacLaurin, & Neves, 2005). To a large extent, exploring the importance of neglect separate from physical maltreatment has been ignored in the child maltreatment literature. This study…
Kraan, Tamar C.; Velthorst, Eva; Themmen, Manouk; Valmaggia, Lucia; Kempton, Matthew J.; McGuire, Phillip; Van Os, Jim; Rutten, Bart P.F.; Smit, Filip; De Haan, Lieuwe; Van Der Gaag, Mark; McGuire, Philip; Valmaggia, Lucia R.; Calem, Maria; Tognin, Stefania; Modinos, Gemma; Burger, Nadine; Van Dam, Daniella S.; Barrantes-Vidal, Neus; Domínguez-Martínez, Tecelli; Cristóbal-Narváez, Paula; Kwapil, Thomas R.; Monsonet-Bardají, Manel; Hinojosa, Lídia; Riecher-Rössler, Anita; Borgwardt, Stefan; Rapp, Charlotte; Ittig, Sarah; Studerus, Erich; Smieskova, Renata; Bressan, Rodrigo; Gadelha, Ary; Brietzke, Elisa; Asevedo, Graccielle; Asevedo, Elson; Zugman, Andre; Ruhrmann, Stephan; Gebhard, Dominika; Arnhold, Julia; Klosterkötter, Joachim; Nordholm, Dorte; Randers, Lasse; Krakauer, Kristine; Naumann, Tanya Louise; Glenthøj, Louise Birkedal; Nordentoft, Merete; De Hert, Marc; Van Winkel, Ruud; Nelson, Barnaby; McGorry, Patrick
Background: Child maltreatment has been associated with a wide range of mental disorders in adulthood. Whether child maltreatment is specifically associated with psychosis risk in individuals at ultra-high risk (UHR) for psychosis, or leads to a general vulnerability for overall psychopathology in
Ghanem, Maha A H; Moustafa, Tarek A; Megahed, Haidy M; Salama, Naglaa; Ghitani, Sara A
Lack of awareness and recognition of child maltreatment is the major reason behind underreporting. All victims often interact with the health care system for routine or emergency care. In several research works, non-accidental fractures are the second most common injury in maltreated children and it is represented up to one-third of cases. To determine the incidence of different types of accidental and non-accidental skeletal injuries among children, estimate the severity of injuries according to the modified injury severity score and to determine the degree of fractures either closed or opened (Gustiloe-Anderson open fracture classification). Moreover, identifying fractures resulting from child abuse and neglect. This aimed for early recognition of non-accidental nature of fractures in child maltreatment that can prevent further morbidity and mortality. A descriptive study was carried out on all children (109) with skeletal injuries who were admitted to both Main Alexandria and El-Hadara Orthopedic and Traumatology University Hospitals during six months. History, physical examination and investigations were done for the patients. A detailed questionnaire was taken to diagnose child abuse and neglect. Gustiloe-Anderson open fracture classification was used to estimate the degree of open fractures. Out of 109 children, twelve cases (11%) were categorized as child maltreatment. One case was physical abuse, eight cases (7.3%) were child neglect and three cases (2.8%) were labour exploitation. Road traffic accidents (RTA) was the commonest cause of skeletal injuries followed by falling from height. Regarding falls, they included 4 cases of stair falls in neglected children and another four cases of falling from height (balcony/window). The remaining 36 cases of falls were accidental. The skeletal injuries were in the form of fractures in 99 cases, dislocation in two cases, both fracture and/or dislocation in three cases, and bone deformity from brachial plexus injury
McTavish, Jill R; Kimber, Melissa; Devries, Karen; Colombini, Manuela; MacGregor, Jennifer C D; Wathen, C Nadine; Agarwal, Arnav; MacMillan, Harriet L
To systematically search for research about the effectiveness of mandatory reporting of child maltreatment and to synthesise qualitative research that explores mandated reporters' (MRs) experiences with reporting. As no studies assessing the effectiveness of mandatory reporting were retrieved from our systematic search, we conducted a meta-synthesis of retrieved qualitative research. Searches in Medline (Ovid), Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Sociological Abstracts, Education Resources Information Center, Criminal Justice Abstracts and Cochrane Library yielded over 6000 citations, which were deduplicated and then screened by two independent reviewers. English-language, primary qualitative studies that investigated MRs' experiences with reporting of child maltreatment were included. Critical appraisal involved a modified checklist from the Critical Appraisal Skills Programme and qualitative meta-synthesis was used to combine results from the primary studies. All healthcare and social-service settings implicated by mandatory reporting laws were included. Included studies crossed nine high-income countries (USA, Australia, Sweden, Taiwan, Canada, Norway, Finland, Israel and Cyprus) and three middle-income countries (South Africa, Brazil and El Salvador). The studies represent the views of 1088 MRs. Factors that influence MRs' decision to report and MRs' views towards and experiences with mandatory reporting of child maltreatment. Forty-four articles reporting 42 studies were included. Findings indicate that MRs struggle to identify and respond to less overt forms of child maltreatment. While some articles (14%) described positive experiences MRs had with the reporting process, negative experiences were reported in 73% of articles and included accounts of harm to therapeutic relationships and child death following removal from their family of origin. The findings of this meta-synthesis suggest that there are many potentially
Whitt-Woosley, Adrienne; Sprang, Ginny; Royse, David G
Children in the child welfare system comprise a group characterized by exposure to trauma via experiences of maltreatment, under circumstances presenting multiple risk factors for traumatic stress. High rates of posttraumatic stress have been observed in this population. However, there is currently no standard for the universal screening of children in child welfare for trauma exposure and traumatic stress. This study examined the trauma experiences of a sample of maltreated children and whether their child welfare workers were effective screeners of traumatic stress symptoms. Descriptive and correlational analyses were conducted regarding a sample of children (N = 131) with trauma screenings completed by their child welfare workers and clinical measures of traumatic stress symptoms. Four hierarchical regression models were also examined to determine whether workers' screening information regarding child age, trauma exposure history and symptoms of traumatic stress were predictive of outcomes on clinical measures. The analyses revealed complex trauma exposure histories and high rates of traumatic stress symptoms among this generally younger sample of maltreated children. Additionally, the models supported workers' efficacy in screening for symptoms of total posttraumatic stress and specific trauma symptoms of intrusion and avoidance. Workers were less effective in screening for the symptoms of arousal. These findings support the importance of identifying the trauma recovery needs of maltreated children and the utility of child protection workers in assisting with the trauma screening process. Implications are provided for related practice, policy and training efforts in child welfare. Published by Elsevier Ltd.
Appleyard, Karen; Berlin, Lisa J.; Rosanbalm, Katherine D.; Dodge, Kenneth A.
In the interest of improving child maltreatment prevention science, this longitudinal, community based study of 499 mothers and their infants tested the hypothesis that mothers’ childhood history of maltreatment would predict maternal substance use problems, which in turn would predict offspring victimization. Mothers (35% White/non-Latina, 34% Black/non-Latina, 23% Latina, 7% other) were recruited and interviewed during pregnancy, and child protective services records were reviewed for the presence of the participants’ target infants between birth and age 26 months. Mediating pathways were examined through structural equation modeling and tested using the products of the coefficients approach. The mediated pathway from maternal history of sexual abuse to substance use problems to offspring victimization was significant (standardized mediated path [ab]=.07, 95% CI [.02, .14]; effect size=.26), as was the mediated pathway from maternal history of physical abuse to substance use problems to offspring victimization (standardized mediated path [ab]=.05, 95% CI [.01, .11]; effect size =.19). There was no significant mediated pathway from maternal history of neglect. Findings are discussed in terms of specific implications for child maltreatment prevention, including the importance of assessment and early intervention for maternal history of maltreatment and substance use problems, targeting women with maltreatment histories for substance use services, and integrating child welfare and parenting programs with substance use treatment. PMID:21240556
Euser, Saskia; Alink, Lenneke Ra; Stoltenborgh, Marije; Bakermans-Kranenburg, Marian J; van IJzendoorn, Marinus H
Consistent findings about the effectiveness of parent programs to prevent or reduce child maltreatment are lacking. In the present meta-analysis we synthesized findings from 27 independent samples from randomized controlled trials (RCTs) on the effectiveness of 20 different intervention programs aimed at (i) preventing the occurrence of child maltreatment in the general population or with at-risk but non-maltreating families, or (ii) reducing the incidence of child maltreatment in maltreating families. A significant combined effect on maltreatment (d = 0.13; N = 4883) disappeared after the trim-and-fill approach that takes into account publication bias against smaller studies without significant outcomes. However, moderator analyses showed that larger effect sizes were found for more recent studies, studies with smaller samples, programs that provide parent training instead of only support, programs that target maltreating instead of at-risk families, and programs with a moderate length (6-12 months) or a moderate number of sessions (16-30). More RCTs are needed to further unravel which factors are associated with program effectiveness. Because currently existing programs appeared to only reduce and not prevent child maltreatment, efforts in the field of preventive intervention should also focus on the development and testing of preventive programs for families at risk for child maltreatment.
Mueller-Pfeiffer, Christoph; Moergeli, Hanspeter; Schumacher, Sonja; Martin-Soelch, Chantal; Wirtz, Gustav; Fuhrhans, Christoph; Hindermann, Esther; Rufer, Michael
Little is known about the influence of particular characteristics of childhood maltreatment, such as developmental stage, relationship to the perpetrator, and nature of the trauma, on adult psychopathology. The effects of childhood maltreatment were assessed in adult psychiatric patients (N = 287) using self-rating scales and diagnostic checklists. Maltreatment was strongly associated with dissociation. This relationship was observed for all childhood developmental stages and was strongest when the perpetrator was outside the family. Dissociation was more strongly correlated with childhood emotional abuse and sexual harassment than with sexual or physical abuse. Childhood sexual abuse was found to be associated with symptoms of posttraumatic stress. The findings suggest that dissociation is a relatively specific consequence of childhood maltreatment that is largely independent of the familial relationship to the perpetrator or the child's developmental stage.
Full Text Available Objective: The present study investigated the relationship between different types of childhood maltreatment (emotional, sexual, overall abuse, and no abuse and the symptoms of attention deficit hyperactivity disorder (ADHD in young adulthood. Method: Data were collected from a Danish national study conducted by The Danish National Centre for Social Research in 2008 and 2009. A sample of 4,718 young adults (24 years of age were randomly selected using the total birth cohort of children born in 1984. Structured interviews were conducted with a response rate of 63%, equating to a total sample size of 2,980 participants. Results: Chi-square analyses revealed significant relationships between child maltreatment groups and a probable diagnosis of ADHD using the Adult ADHD Self-Report Scale (ASRS. Binary logistic regression analysis showed that the overall abuse class was more strongly associated with probable ADHD (OR=5.08, followed by emotional abuse (OR=3.09 and sexual abuse (OR=2.07. Conclusions: The results showed that childhood maltreatment was associated with increased risk of ADHD symptoms in young adulthood. The findings of this study are discussed within the existing literature and suggestions for future research are outlined in order to replicate these findings in other adult populations.
Cicchetti, Dante; Rogosch, Fred A.
In this investigation, gene-environment interaction effects in predicting resilience in adaptive functioning among maltreated and nonmaltreated low-income children (N = 595) were examined. A multi-component index of resilient functioning was derived and levels of resilient functioning were identified. Variants in four genes, 5-HTTLPR, CRHR1, DRD4 -521C/T, and OXTR, were investigated. In a series of ANCOVAs, child maltreatment demonstrated a strong negative main effect on children’s resilient functioning, whereas no main effects for any of the genotypes of the respective genes were found. However, gene-environment interactions involving genotypes of each of the respective genes and maltreatment status were obtained. For each respective gene, among children with a specific genotype, the relative advantage in resilient functioning of nonmaltreated compared to maltreated children was stronger than was the case for nonmaltreated and maltreated children with other genotypes of the respective gene. Across the four genes, a composite of the genotypes that more strongly differentiated resilient functioning between nonmaltreated and maltreated children provided further evidence of genetic variations influencing resilient functioning in nonmaltreated children, whereas genetic variation had a negligible effect on promoting resilience among maltreated children. Additional effects were observed for children based on the number of subtypes of maltreatment children experienced, as well as for abuse and neglect subgroups. Finally, maltreated and nonmaltreated children with high levels of resilience differed in their average number of differentiating genotypes. These results suggest that differential resilient outcomes are based on the interaction between genes and developmental experiences. PMID:22559122
Tjaden, Patricia G.; Thoennes, Nancy
Analysis of records of dependency and criminal filings in 833 substantiated intrafamilial child abuse and neglect cases in 3 U.S. cities indicated that legal intervention was rare, with dependency filings and prosecutions in just 21% and 4% of the sample, respectively, although treatment plans and out-of-home placements occurred more frequently.…
Williams, James Herbert; Van Dorn, Richard A.; Bright, Charlotte Lyn; Jonson-Reid, Melissa; Nebbitt, Von E.
Child welfare and criminology research have increasingly sought to better understand factors that increase the likelihood that abused and neglected children will become involved in the juvenile justice system. However, few studies have addressed this relationship among African American male adolescents. The current study examines the relationship…
Damashek, Amy; Bonner, Barbara L.
Objectives: Many children who die from abuse or neglect are survived by siblings. However, little data are available about what happens to these siblings after the victim's death, such as whether they are removed from their home. Even less is known about how decisions are made regarding sibling removal following a child fatality. This study…
Chan, Ko Ling
The study examined the prevalence of the co-occurrence of intimate partner violence (IPV) and child maltreatment (CM) to determine whether IPV is a factor associated with the latter. A total of 5,841 students from a representative sample of schools in Hong Kong were surveyed. The results show that the lifetime and preceding-year co-occurrence rates of IPV and CM were 12.3% and 3.6%, respectively. IPV and parents' use of psychological aggression and corporal punishment led to increased odds of physical violence. This study suggests a need for the comprehensive assessment of IPV and CM. © The Author(s) 2015.
Scott, Debbie; Lonne, Bob; Higgins, Daryl
Contemporary approaches to child protection are dominated by individualized forensically focused interventions that provide limited scope for more holistic preventative responses to children at risk and the provision of support to struggling families and communities. However, in many jurisdictions, it is frequently shown, often through public inquiries and program reviews, that investigatory and removal approaches are failing in critically important ways, particularly regarding reducing the inequities that underpin neglect and abuse. Consequently, there have been increasing calls for a public health model for the protection of children, although there is often a lack of clarity as to what exactly this should entail. Yet, there are opportunities to learn from public health approaches successfully used in the field of injury prevention. Specifically, we advocate for the use of Haddon's Matrix, which provides a detailed theoretical and practical framework for the application of a comprehensive and integrated public health model to guide intervention program design and responses to child protection risk factors. A broad overview of the application of Haddon's Matrix's principles and methods is provided with examples of program and intervention design. It is argued that this framework provides the range of interventions necessary to address the complex social and structural factors contributing to inequity and the maltreatment of children. It also provides the foundation for a holistic and integrated system of prevention and intervention to contribute to system-level change and address child maltreatment. © The Author(s) 2016.
Vasquez Guerrero, Desi Alonzo
This study examines the relationships between hypermasculinity, sexual aggression, intimate partner violence, social support, and child maltreatment risk among heterosexual fathers completing parenting classes. Hypermasculinity scores were found to be significant predictors of study participants' reported verbal, physical, and sexual aggression toward their intimate partners. Only lack of social support, operationalized as the reported frequency of participants' conversations with friends, relatives, or neighbors about their problems, was found to be a significant predictor of child maltreatment risk. Alcohol frequency, education, and monthly income were not found to be unique, significant predictors of any dependent variables. Implications for clinical practice and research as well as limitations to the current study are discussed.
Kepple, Nancy Jo
Child maltreatment studies predominantly have operationalized parental substance use as dichotomous variables for any use, any harmful/risky use, or any substance use disorder (SUD). This limits our understanding about how a range of use behaviors may contribute to child maltreatment. Build upon prior studies by incorporating a multi-faceted approach to operationalizing parental substance use. Cross-sectional, secondary data analyses were conducted using the National Survey of Child and Adolescent Well-being (NSCAW I). The study used weighted negative binomial regression to examine relationships between annual child maltreatment frequency and different ways of operationalizing substance use among 2,100 parents. Several, inter-related behaviors (i.e., heavy drinking, illicit drug use, polysubstance use, SUD, and prior SUD child maltreatment frequencies. A gradient effect was detected across five substance use behavior patterns: (1) lowest estimated counts were observed for nonusers, light-to-moderate drinkers, and parents with a prior (but not past year) SUD (ӯ child harm. Parents reporting risky substance use behaviors may benefit from prevention or brief intervention services related to both their substance use and parenting behaviors. Administrative systems also could benefit from detailed tracking of substance use behaviors for future program evaluation and development.
Adams, Kenneth Alan
Examining the inner workings of the slaveholder family, including slave caretakers, this article probes the psychodynamics of slaveholder development to assess the extent of child abuse in the Old South. Childcare was haphazard and premised on paternal absence, maternal ambivalence, and the exigencies of slave surrogacy. Corporal punishment, sanctified by southern religion, was the rule. The likelihood of slave negligence and retaliatory attacks against slaveholder children are addressed. Childrearing practices such as swaddling, aunt adoption, and maternal incest are considered, as well as the possible usage of a West African cleansing ritual. The article classifies planter families within the Ambivalent Mode of parent-child relations and suggests the restaging of childhood trauma as the underlying dynamic in the march to civil war.
Brooks-Gunn, Jeanne; Schneider, William; Waldfogel, Jane
This study draws on the Fragile Families and Child Wellbeing Study (N=2,032), a birth cohort study of families with children from 20 U.S. cities. Interviews occurred between August 2007, and February 2010, when the children were approximately 9 years old. Macro-economic indicators of the Great Recession such as the Consumer Sentiment Index and unemployment and home foreclosure rates were matched to the data to estimate the links between different measures of the Great Recession and high frequency maternal spanking. We find that the large decline in consumer confidence during the Great Recession, as measured by the Consumer Sentiment Index, was associated with worse parenting behavior. In particular, lower levels of consumer confidence were associated with increased levels of high frequency spanking, a parenting behavior that is associated with greater likelihood of being contacted by child protective services. Copyright © 2013 Elsevier Ltd. All rights reserved.
Salazar, Amy M; Haggerty, Kevin P; de Haan, Benjamin; Catalano, Richard F; Vann, Terri; Vinson, Jean; Lansing, Michaele
The prevention of mental, emotional, and behavioral (MEB) disorders among children and adolescents is a national priority. One mode of implementing community-wide MEB prevention efforts is through evidence-based community mobilization approaches such as Communities That Care (CTC). This article provides an overview of the CTC framework and discusses the adaptation process of CTC to prevent development of MEBs through preventing child abuse and neglect and bolstering child well-being in children aged 0 to 10. Adaptations include those to the intervention itself as well as those to the evaluation approach. Preliminary findings from the Keeping Families Together pilot study of this evolving approach suggest that the implementation was manageable for sites, and community board functioning and community adoption of a science-based approach to prevention in pilot sites looks promising. Implications and next steps are outlined. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
Koizumi, Michiko; Takagishi, Haruto
Child abuse and neglect affect the development of social cognition in children and inhibit social adjustment. The purpose of this study was to compare the ability to identify the emotional states of others between abused and non-abused children. The participants, 129 children (44 abused and 85 non-abused children), completed a children’s version of the Reading the Mind in the Eyes Test (RMET). Results showed that the mean accuracy rate on the RMET for abused children was significantly lower than the rate of the non-abused children. In addition, the accuracy rates for positive emotion items (e.g., hoping, interested, happy) were significantly lower for the abused children, but negative emotion and neutral items were not different across the groups. This study found a negative relationship between child abuse and the ability to understand others’ emotions, especially positive emotions. PMID:24465891
Full Text Available Child abuse and neglect affect the development of social cognition in children and inhibit social adjustment. The purpose of this study was to compare the ability to identify the emotional states of others between abused and non-abused children. The participants, 129 children (44 abused and 85 non-abused children, completed a children's version of the Reading the Mind in the Eyes Test (RMET. Results showed that the mean accuracy rate on the RMET for abused children was significantly lower than the rate of the non-abused children. In addition, the accuracy rates for positive emotion items (e.g., hoping, interested, happy were significantly lower for the abused children, but negative emotion and neutral items were not different across the groups. This study found a negative relationship between child abuse and the ability to understand others' emotions, especially positive emotions.
Takeo Fujiwara M.D., Ph.D., MPH
Full Text Available Background The association between birth outcomes and child maltreatment remains controversial. The purpose of this study is to test whether infants without congenital or chronic disease who are low birth weight (LBW, preterm, or small for gestational age (SGA are at an increased risk of being maltreated. Methods A hospital-based case-control study of infants without congenital or chronic diseases who visited the National Center for Child Health and Development, Tokyo, between April 1, 2002 and March 31, 2005 was conducted. Cases (N = 35 and controls (N = 29 were compared on mean birth weight, gestational age, and z-score of birth weight. Results SGA was significantly associated with infant maltreatment after adjusting for other risk factors (adjusted odds ratio: 4.45, 95% CI: 1.29–15.3. LBW and preterm births were not associated with infant maltreatment. Conclusion Infants born as SGA are 4.5 times more at risk of maltreatment, even if they do not have a congenital or chronic disease. This may be because SGA infants tend to have poorer neurological development which leads them to be hard-to-soothe and places them at risk for maltreatment. Abbreviations SCAN, Suspected Child Abuse and Neglect; LBW, low birth weight; ZBW, z-score of birth weight adjusted for gestational age, sex, and parity; SGA, small for gestational age; SD, standard deviation; OR, odds ratio; aOR, adjusted odds ratio; CI, confidence interval; IPV, intimate partner violence.
Baglivio, Michael T; Wolff, Kevin T; Piquero, Alex R; Bilchik, Shay; Jackowski, Katherine; Greenwald, Mark A; Epps, Nathan
Although research has oft-documented a maltreatment-delinquency link, the effect of involvement in-and timing of-child welfare system involvement on offending has received less attention. We examine whether the timing of child welfare involvement has differential effects on recidivism of deep-end juvenile offenders (youth who have been adjudicated delinquent by the court and placed in juvenile justice residential programs). The current study uses a large, diverse sample of 12,955 youth completing juvenile justice residential programs between 1 January 2010 and 30 June 2013 in Florida (13 % female, 55 % Black, 11 % Hispanic). Additionally, we explore the direct effects of childhood traumatic events on delinquency, as well as their indirect effects through child welfare involvement using structural equation modeling. The findings indicate that adverse childhood experiences fail to exert a direct effect on recidivism, but do exhibit a significant indirect effect on recidivism through child welfare involvement, which is itself associated with recidivism. This means that while having exposures to more types of childhood traumatic events does not, in and of itself, increase the likelihood of re-offending, effects of such experiences operate through child welfare placement. Differences in the effects of maltreatment timing and of adverse childhood experiences are observed across sex and race/ethnicity subgroups. Across all racial subgroups, exposures to adverse childhood experiences have a significant effect on the likelihood of child welfare placement, yet child welfare placement exerts a significant effect on recidivism for White and Hispanic youth, but not for Black youth. Only Hispanic female and White male youth with overlapping child welfare and juvenile justice cases (open cases in both systems at the same time during the study period) were more likely to recidivate than their delinquent-only counterpart youth. Crossover status (child welfare and juvenile justice
Katz, Carmit; Hamama, Liat
Siblings share a common and unique bond. It is one of the most enduring relationships during an individual's life span. Thus, the impact of child maltreatment on sibling relationships is an important area of research to explore. The current article carries out a scoping review targeted at determining the existing knowledge and then identifying research priorities within the field of sibling relationship in the context of child maltreatment. The method elaborates on the various stages that were taken to perform the scoping review, and later, the article provides three results for the readers: The first result is a detailed mapping of the existing literature in the area of sibling relationship in the context of maltreatment. The second result is a thorough thematic analysis that was carried out on this literature that focused on several relevant domains: sibling exposure to intimate partner violence, sibling relationship and experiences in the context of child maltreatment, risk assessment for siblings following maltreatment, and sibling relationships and out-of-home placement. The third result is a set of conclusions targeted mainly at recommending future directions to researchers. © The Author(s) 2016.
Dileo, J F; Brewer, W; Northam, E; Yucel, M; Anderson, V
Maltreatment of children is a chronic community problem that increases the risk of future aggression. Despite several decades of research highlighting this relationship, few studies have explored the potential neuropsychological deficits that are likely to mediate it. This exploratory study aimed to examine how child maltreatment may be associated with aggression via impairment in the developing prefrontal-limbic-autonomic pathways that are implicated in neuropsychological models of aggression. Furthermore, it aimed to investigate the relationship between child maltreatment and both reactive and proactive aggression subtypes. To investigate this non-invasively in an at-risk population, children with a documented protective care history (n = 20) and a community control group (n = 30), aged between 6 and 12 years, were compared on measures of cardiovascular functioning, affect regulation and cognitive functioning aligned with this neuropsychological model. Whilst no group differences were found on cardiovascular functioning (i.e., resting heart rate, heart rate reactivity, heart rate variability), the protective care group performed significantly worse on measures of affect regulation and cognitive functioning (i.e., global intelligence, executive functioning, smell identification and social cognition). The relationship between child maltreatment and aggression was mediated by executive dysfunction and affect dysregulation but not global IQ, social cognition or olfactory identification. The results suggest that interventions targeting aggression in maltreated children will benefit from clinical assessment and psychological strategies that address the executive dysfunction and affect dysregulation that has been associated with this clinical outcome.
Cimino, Andrea N; Madden, Elissa E; Hohn, Kris; Cronley, Courtney M; Davis, Jaya B; Magruder, Karen; Kennedy, M Alexis
A risk for commercial sexual exploitation is childhood maltreatment. It's unknown whether juveniles in commercial sexual exploitation experience more childhood maltreatment than adults or how involved child protective services is in investigating maltreatment, a focus of this study. Women (N = 96) who sold sex commercially completed a cross-sectional questionnaire. Descriptive statistics, t tests, chi-squares, and odds ratios were used to examine differences in background, childhood maltreatment, and child protective services involvement by juvenile or adult entry. Although 93% of participants experienced child maltreatment, juveniles had increased odds of parent/caregiver sexual abuse, being left alone, being kicked out, and running away from a parent/caregiver. There were no differences in cumulative childhood maltreatment resulting in an investigation or removal, indicating that juveniles not investigated or removed by child protective services had as much childhood maltreatment as juveniles who were investigated or removed by child protective services. Results highlight the need for child welfare staff to recognize childhood maltreatment as risks for commercial sexual exploitation.
Cicchetti, Dante; Rogosch, Fred A.; Thibodeau, Eric
Gene-environment interaction effects in predicting antisocial behavior in late childhood were investigated among maltreated and nonmaltreated low-income children (N = 627, M age = 11.27). Variants in three genes, TPH1, 5-HTTLPR, and MAOA uVNTR, were examined. In addition to child maltreatment status, we also considered the impact of maltreatment subtypes, developmental timing of maltreatment, and chronicity. Indicators of antisocial behavior were obtained from self-, peer-, and adult counselor-reports. In a series of ANCOVAs, child maltreatment and its parameters demonstrated strong main effects on early antisocial behavior as assessed by all forms of report. Genetic effects operated primarily in the context of gene-environment interactions, moderating the impact of child maltreatment on outcomes. Across the three genes, among nonmaltreated children no differences in antisocial behavior were found based on genetic variation. In contrast, among maltreated children specific polymorphisms of TPH1, 5-HTTLPR, and MAOA were each related to heightened self-report of antisocial behavior; the interaction of 5-HTTLPR and developmental timing of maltreatment also indicated more severe antisocial outcomes for children with early onset and recurrent maltreatment based on genotype. TPH1 and 5-HTTLPR interacted with maltreatment subtype to predict peer-report of antisocial behavior; genetic variation contributed to larger differences in antisocial behavior among abused children. TPH1 and 5-HTTLPR polymorphisms also moderated the effects of maltreatment subtype on adult report of antisocial behavior; again genetic effects were strongest for children who were abused. Additionally, TPH1 moderated the effect of developmental timing of maltreatment and chronicity on adult report of antisocial behavior. The findings elucidate how genetic variation contributes to identifying which maltreated children are most vulnerable to antisocial development. PMID:22781862
Laskey, Antoinette L
Cognitive errors have been studied in a broad array of fields, including medicine. The more that is understood about how the human mind processes complex information, the more it becomes clear that certain situations are particularly susceptible to less than optimal outcomes because of these errors. This article explores how some of the known cognitive errors may influence the diagnosis of child abuse, resulting in both false-negative and false-positive diagnoses. Suggested remedies for these errors are offered. Copyright © 2014 Elsevier Inc. All rights reserved.
Horikawa, Hiroyuki; Suguimoto, S Pilar; Musumari, Patou Masika; Techasrivichien, Teeranee; Ono-Kihara, Masako; Kihara, Masahiro
To develop a prediction model for the first recurrence of child maltreatment within the first year after the initial report, we carried out a historical cohort study using administrative data from 716 incident cases of child maltreatment (physical abuse, psychological abuse, or neglect) not receiving support services, reported between April 1, 1996 through March 31, 2011 to Shiga Central Child Guidance Center, Japan. In total, 23 items related to characteristics of the child, the maltreatment, the offender, household, and other related factors were selected as predictive variables and analyzed by multivariate logistic regression model for association with first recurrence of maltreatment. According to the stepwise selection procedure six factors were identified that include 9-13year age of child (AOR=3.43/95%CI=1.52-7.72), maltreatment during childhood (AOR=2.56/95%CI=1.31-4.99), household financial instability or poverty (AOR=1.64/95%CI=1.10-2.45), absence of someone in the community who could watch over the child (AOR=1.68/95%CI=1.16-2.44), and the organization as the referral source (AOR=2.21/95%CI=1.24-3.93). Using these six predictors, we generated a linear prediction model with a sensitivity and specificity of 45.2% and 82.4%, respectively. The model may be useful to assess the risk of further maltreatment and help the child and family welfare administrations to develop preventive strategies for recurrence. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.
Hurren, Emily; Stewart, Anna; Dennison, Susan
Administrative data are crucial to the "big data" revolution of social science and have played an important role in the development of child maltreatment research. These data are also of value to administrators, policy makers, and clinicians. The focus of this paper is the use of administrative data to produce and replicate longitudinal studies of child maltreatment. Child protection administrative data have several advantages. They are often population-based, and allow longitudinal examination of child maltreatment and complex multi-level analyses. They also allow comparison across subgroups and minority groups, remove burden from individuals to disclose traumatic experiences, and can be less biased than retrospective recall. Finally, they can be linked to data from other agencies to explore comorbidity and outcomes, and are comparatively cost and time effective. The benefits and challenges associated with the use of administrative data for longitudinal child maltreatment research become magnified when these data are used to produce replications. Techniques to address challenges and support future replication efforts include developing a biographical understanding of the systems from which the data are drawn, using multiple data sources to contextualize the data and research results, recognizing and adopting various approaches to replication, and documenting all data coding and manipulation processes. These techniques are illustrated in this paper via a case study of previous replication work.
Potthast, Nadine; Neuner, Frank; Catani, Claudia
Recent research indicates that there is a link between emotional maltreatment and alcohol dependence (AD), but the underlying mechanisms still need to be clarified. There is reason to assume that maltreatment related cues automatically activate an associative memory network comprising cues eliciting craving as well as alcohol-related responses. The current study aimed to examine this network in AD patients who experienced emotional abuse using a priming paradigm. A specific priming effect in emotionally abused AD subjects was hypothesized for maltreatment related words that preceded alcohol related words. 49 AD subjects (n=14 with emotional abuse vs. n=35 without emotional abuse) and 34 control subjects performed a priming task with maltreatment related and neutral prime words combined with alcohol related and neutral target words. Maltreatment related words consisted of socially and physically threatening words. As hypothesized, a specific priming effect for socially threatening and physically threatening cues was found only in AD subjects with emotional abuse. The present data are the first to provide evidence that child maltreatment related cues automatically activate an associative memory network in alcoholics with emotional abuse experiences. Copyright © 2015 Elsevier Ltd. All rights reserved.
Fuller, Tamara; Zhang, Saijun
Despite decades of debate about the most effective ways to intervene with families reported to child protective services (CPS), little evidence exists regarding the types of services or approach that reduce children's risk of additional maltreatment. The current study used data collected during a statewide experimental evaluation of CPS to examine the impact of numerous service variables, family engagement, and family characteristics on the risk of maltreatment re-reports and substantiated re-reports among families initially reported for neglect and risk of harm. The sample included 4,868 families with screened-in reports that were randomly assigned to receive either an investigation or an assessment. The results of the Cox regression analyses found that service duration, intensity, and breadth were unrelated to maltreatment re-report or substantiated re-reports, but caseworker ratings of the service-need match were associated with both. The provision of domestic violence services was related to decreased risk of maltreatment re-reports. Increased levels of family engagement were associated with lowered risk of both maltreatment re-reports and substantiated re-reports. Once the effects of services, engagement, and family characteristics were taken into account, CPS response pathway (investigation or assessment) had no relationship to maltreatment re-reports or substantiated re-reports.
Fowler, Patrick J.; Motley, Darnell; Zhang, Jinjin; Rolls-Reutz, Jennifer; Landsverk, John
In this longitudinal study, we tested whether adolescent maltreatment and out-of-home placement as a response to maltreatment altered developmental patterns of sexual risk behaviors in a nationally representative sample of youth involved in the child welfare system. Participants included adolescents aged 13 to 17 (M=15.5, SD=1.49) at baseline (n=714), followed over 18 months. Computer-assisted interviews were used to collect self-reported sexual practices and experiences of physical and psychological abuse at both time points. Latent transition analyses were used to identify three patterns of sexual risk behaviors: abstainers, safe sex with multiple partners, and unsafe sex with multiple partners. Most adolescents transitioned to safer sexual behavior patterns over time. Adolescents exhibiting the riskiest sexual practices at baseline were most likely to report subsequent abuse and less likely to be placed into out-of-home care. Findings provide a more nuanced understanding of sexual risk among child welfare–involved adolescents and inform practices to promote positive transitions within the system. PMID:25155702
Betts, T; Ahmed, S; Maguire, S; Watts, P
PurposeTo identify the spectrum of non-vitreoretinal ocular injury due to child maltreatment.MethodsAll language search of MEDLINE, PsychINFO, EMBASE, AMED, Web of Science, and CINAHL databases, 1950-2015, was conducted. explicit confirmation of injury aetiology, age children that had suffered physical abuse with ocular injury had subconjunctival haemorrhages. Children presenting with abusive ocular injuries had a mean age of 13.9 months (range 1-68), while those who suffered violent corporal punishment were considerably older (mean 96 months). All cases, apart from severe corporal punishment, underwent screening for occult fractures, but neuroimaging only apparent in 2/5 eligible cases.ConclusionAlthough, the face is the most common site of abusive injury, there is a paucity of high-quality data on non-vitreoretinal ocular abusive injury. Thus, while subconjunctival haemorrhages are a potential sentinel injury of maltreatment, and may warrant further evaluation, the lack of large-scale published data limits our ability to highlight further specific characteristics of non-vitreoretinal ocular injury indicative of child abuse.
McLeigh, Jill D; Katz, Carmit; Davidson-Arad, Bilha; Ben-Arieh, Asher
A unique primary prevention effort, Strong Communities for Children (Strong Communities), focuses on changing attitudes and expectations regarding communities' collective responsibilities for the safety of children. Findings from a 6-year pilot of the initiative in South Carolina have shown promise in reducing child maltreatment, but efforts to adapt the initiative to different cultural contexts have been lacking. No models exist for adapting an initiative that takes a community-level approach to ensuring children's safety. Thus, this article addresses the gap by providing an overview of the original initiative, how the initiative was adapted to the Israeli context, and lessons learned from the experience. Building on conceptualizations of cultural adaptation by Castro et al. (Prevention Science, 5, 2004, 41) and Resnicow et al. (Ethnicity and Disease, 9, 1999, 11), sources of nonfit (i.e., sociodemographic traits, political conflict, government services, and the presence and role of community organizations) were identified and deep and surface structure modifications were made to the content and delivery. Ultimately, this article describes the adaption and dissemination of a community-based child maltreatment prevention initiative in Tel Aviv, Israel, and addresses researchers' calls for more publications describing the adaptation of interventions and the procedures that need to be implemented to achieve cultural relevance. © 2015 Family Process Institute.
Boeck, Christina; Koenig, Alexandra Maria; Schury, Katharina; Geiger, Martha Leonie; Karabatsiakis, Alexander; Wilker, Sarah; Waller, Christiane; Gündel, Harald; Fegert, Jörg Michael; Calzia, Enrico; Kolassa, Iris-Tatjana
The experience of maltreatment during childhood is associated with chronic low-grade inflammation in adulthood. However, the molecular mechanisms underlying this pro-inflammatory phenotype remain unclear. Mitochondria were recently found to principally coordinate inflammatory processes via both inflammasome activation and inflammasome-independent pathways. To this end, we hypothesized that alterations in immune cell mitochondrial functioning and oxidative stress might be at the interface between the association of maltreatment experiences during childhood and inflammation. We analyzed pro-inflammatory biomarkers (levels of C-reactive protein, cytokine secretion by peripheral blood mononuclear cells (PBMC) in vitro, PBMC composition, lysophosphatidylcholine levels), serum oxidative stress levels (arginine:citrulline ratio, l-carnitine and acetylcarnitine levels) and mitochondrial functioning (respiratory activity and density of mitochondria in PBMC) in peripheral blood samples collected from 30 women (aged 22-44years) with varying degrees of maltreatment experiences in form of abuse and neglect during childhood. Exposure to maltreatment during childhood was associated with an increased ROS production, higher levels of oxidative stress and an increased mitochondrial activity in a dose-response relationship. Moreover, the increase in mitochondrial activity and ROS production were positively associated with the release of pro-inflammatory cytokines by PBMC. Decreased serum levels of lysophosphatidylcholines suggested higher inflammasome activation with increasing severity of child maltreatment experiences. Together these findings offer preliminary evidence for the association of alterations in immune cell mitochondrial functioning, oxidative stress and the pro-inflammatory phenotype observed in individuals with a history of maltreatment during childhood. The results emphasize that the early prevention of child abuse and neglect warrants more attention, as the
Farrell, Anne F; Dibble, Kate E; Randall, Kellie G; Britner, Preston A
This paper reports results of mixed methods, population survey of housing instability, and homelessness. Child welfare personnel conducted the Quick Risks and Assets for Family Triage (QRAFT), a three-question screening tool intended to identify housing instability and homelessness. The QRAFT requires users to assess family housing history, current housing arrangement, and current housing condition, on a four-point scale from "asset/not a risk" to "severe risk." The QRAFT was completed among 6828 families undergoing new child maltreatment investigations. Approximately 5.4% of families demonstrated significant to severe housing problems; approximately one-third exhibited moderate housing risk. Housing problems and homelessness were significantly associated with the outcome of child welfare investigations; among families with substantiated child welfare determinations, 21% demonstrated significant to severe housing risk, a significantly higher proportion than among families where the investigation outcome was unsubstantiated or differential response (i.e., voluntary services). Of significant to severe housing risk families, 15.7% later met eligibility criteria for a supportive housing intervention, suggesting that housing concerns combined with substantial parent and child functional difficulties. Qualitative data indicated the QRAFT was perceived as easy to administer, effective as a screening tool, and useful to "apply the housing lens" early in child welfare involvement. © Society for Community Research and Action 2017.
Bartelink, Cora; van Yperen, Tom A; ten Berge, Ingrid J
Assessment and decision-making in child maltreatment cases is difficult. Practitioners face many uncertainties and obstacles during their assessment and decision-making process. Research exhibits shortcomings in this decision-making process. The purpose of this literature review is to identify and discuss methods to overcome these shortcomings. We conducted a systematic review of the published literature on decision-making using PsychINFO and MEDLINE from 2000 through May 2014. We included reviews and quantitative research studies that investigated methods aimed at improving professional decision-making on child abuse and neglect in child welfare and child protection. Although many researchers have published articles on decision-making including ideas and theories to improve professional decision-making, empirical research on these improvements is scarce. Available studies have shown promising results. Structured decision-making has created a greater child-centred and holistic approach that takes the child's family and environment into account, which has made practitioners work more systematically and improved the analysis of complex situations. However, this approach has not improved inter-rater agreement on decisions made. Shared decision-making may improve the participation of parents and children and the quality of decisions by taking client treatment preferences into account in addition to scientific evidence and clinical experience. A number of interesting developments appear in recent research literature; however, child welfare and child protection must find additional inspiration from other areas, e.g., mental health services, because research on decision-making processes in child welfare and child protection is still rare. Copyright © 2015 Elsevier Ltd. All rights reserved.
Yoon, Dalhee; Yoon, Susan; Park, Jiho; Yoon, Miyoung
The purpose of this study was to identify the pathways from childhood physical and sexual abuse to adolescent physical and sexual victimization by assessing behavior symptoms (both internalizing and externalizing) and peer popularity as potential mediating variables. The data derive from Longitudinal Studies of Child Abuse and Neglect (LONGSCAN), which tracks the consequences of child abuse and neglect using five study sites across the US. Child physical and sexual abuse was measured at age 12 using self-reports of life-time maltreatment experiences. Internalizing and externalizing symptoms were assessed at age 12 using the Child Behavior Checklist (CBCL). Peer popularity was assessed at age 14 by teachers. Peer victimization was assessed at age 16 using the modified version of the Juvenile Victimization Questionnaire. The results indicated that physical abuse had no direct effect on either physical or sexual peer victimization, whereas sexual abuse had significant direct effect on both physical and sexual victimization. Assessed at age 12, children who had been physically or sexually maltreated were found to have higher levels of internalizing and externalizing symptoms. These increased symptoms are associated with lower peer popularity at age 14, which in turn is associated with greater physical and sexual peer victimization at age 16. The findings suggest that multiple points for interventions may exist to disrupt the cycle of victimization. Early assessment and treatment for externalizing symptoms and for low peer popularity may be helpful in preventing physical peer victimization among adolescents who have been physically and/or sexually abused. Copyright © 2018 Elsevier Ltd. All rights reserved.
Kepple, Nancy J; Freisthler, Bridget; Johnson-Motoyama, Michelle
Few methods estimate the prevalence of child maltreatment in the general population due to concerns about socially desirable responding and mandated reporting laws. Innovative methods, such as interactive voice response (IVR), may obtain better estimates that address these concerns. This study examined the utility of interactive voice response (IVR) for child maltreatment behaviors by assessing differences between respondents who completed and did not complete a survey using IVR technology. A mixed-mode telephone survey was conducted in English and Spanish in 50 cities in California during 2009. Caregivers (n=3,023) self-reported abusive and neglectful parenting behaviors for a focal child under the age of 13 using computer-assisted telephone interviewing and IVR. We used hierarchical generalized linear models to compare survey completion by caregivers nested within cities for the full sample and age-specific ranges. For demographic characteristics, caregivers born in the United States were more likely to complete the survey when controlling for covariates. Parenting stress, provision of physical needs, and provision of supervisory needs were not associated with survey completion in the full multivariate model. For caregivers of children 0-4 years (n=838), those reporting they could often or always hear their child from another room had a higher likelihood of survey completion. The findings suggest IVR could prove to be useful for future surveys that aim to estimate abusive and/or neglectful parenting behaviors given the limited bias observed for demographic characteristics and problematic parenting behaviors. Further research should expand upon its utility to advance estimation rates. Copyright © 2014 Elsevier Ltd. All rights reserved.
Atiqul Haque, M; Janson, S; Moniruzzaman, S; Rahman, A K M F; Mashreky, S R; Eriksson, U-B
Child maltreatment (CM) is a public health problem and is recognized as a huge barrier for child development. Most of the research and definitions on CM are from the perspective of high-income western countries. Because no major studies have been conducted on CM in Bangladesh, the aim of the current study was to explore the experiences of and perceptions on CM in school-age children in rural and urban Bangladesh in order to understand maltreatment in a local context and from a child perspective. Semistructured individual interviews with 24 children (13 boys and 11 girls), between the ages of 9 and 13 years of which 11 were schoolgoing and 13 non-schoolgoing, were conducted during July 2013 and analysed according to qualitative content analysis. CM was a common and painful experience with serious physical and emotional consequences but highly accepted by the society. Vulnerable groups were especially young children, girls, and poor children. The children's voices were not heard due to their low status and low position in their families, schools, and working places. The main theme that emerged in the analysis was children's subordination, which permeated the five categories: (a) perception of children's situation in society, (b) understanding children's development and needs, (c) CM associated to school achievement, (d) negative impact of CM, and (e) emotional responses. Different kinds of abuse are obviously common in Bangladesh, and the schools do not follow the law from 2011 prohibiting corporal punishment at school. The society has to take further steps to live up to the UN Convention on the Rights of the Child, which was ratified already in 1990, to protect the Bangladeshi children from CM. © 2017 John Wiley & Sons Ltd.
Longman-Mills, S.; Gonzalez, W. Y.; Melendez, M. O.; Garcia, M. R.; Gomez, J. D.; Juarez, C. G.; Martinez, E. A.; Penalba, S. J.; Pizzanelli, E. M.; Solorzano, L. I.; Wright, M. G. M.; Cumsille, F.; De La Haye, W.; Sapag, J. C.; Khenti, A.; Hamilton, H. A.; Erickson, P. G.; Brands, B.; Flam-Zalcman, R.; Simpson, S.; Wekerle, C.; Mann, R. E.
Objectives: Research from developed countries shows that child maltreatment increases the risk for substance use and problems. However, little evidence on this relationship is available from developing countries, and recognition of this relationship may have important implications for substance demand reduction strategies, including efforts to…
Steen, Julie A.
The purpose of this study is to examine domestic violence shelter workers' perceptions of child maltreatment reporting. A sample of 82 professionals from domestic violence shelters across the United States participated in a survey focusing on a variety of different types of reports and the frequency of both positive and negative outcomes arising…
Walsh, Kate; Gonsalves, Valerie M.; Scalora, Mario J.; King, Steve; Hardyman, Patricia L.
Despite data indicating that child maltreatment (CM) in various forms is associated with adult sexual victimization among community women, few studies have explicitly explored how types of CM might relate to prison sexual victimization. Because little is known about "how" CM might give rise to prison sexual victimization, the present…
Shen, April Chiung-Tao
This study examined the joint impact of experiencing both interparental violence and child physical maltreatment on young adults' self-esteem. It also tested the hypothesis of parental and peer relationship qualities as mediators in the relationship between childhood histories of family violence and adult self-esteem. Data were collected from a…
Admon Livny, Karen; Katz, Carmit
Child maltreatment is a worldwide social problem that receives considerable attention. However, prevention efforts remain rare, allowing the phenomenon to continue and spread. The aim of the current article is to systematically review evidence-based prevention efforts that address schools and families as key stakeholders for preventing child maltreatment. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a thorough literature review revealed that only five programs matched the inclusion criteria for the current article. These programs were analyzed for several domains, including level of prevention, target population, participants, and the programs' outcomes. The current review highlights the urgent needs to develop, modify, and further evaluate prevention programs for child maltreatment in the context of the ecological model. More specifically, it illuminates the need to create and champion programs that enhance the collaboration between families and schools, both of which are key stakeholders within the phenomenon of child maltreatment. Collaboration between policymakers, researchers, and practitioners should guide future efforts by promoting cultural adaptation to such programs and by integrating children's perceptions to improve these efforts and to benefit everyone involved.
Topitzes, James; Mersky, Joshua P.; Reynolds, Arthur J.
Research suggests that child maltreatment predicts juvenile violence, but it is uncertain whether the effects of victimization persist into adulthood or differ across gender. Furthermore, we know little about the mechanisms underlying the victim-perpetrator cycle for males and females. Consequently, this study analyzed associations between child…
Chan, Ko Ling
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…
Aron, Sarah B.; McCrowell, Jean; Moon, Alyson; Yamano, Ryoichi; Roark, Duston A.; Simmons, Monica; Tatanashvili, Zurab; Drake, Brett
The purpose of this article is to compare four different levels of aggregation to assess their utility as areal units in child maltreatment research. The units examined are county, zip code, tract, and block group levels. Each of the four levels is analyzed to determine which show the strongest effects in modeling the correlation between poverty…
Toth, Sheree L.; Manly, Jody Todd
Child maltreatment has been associated with a wide range of negative developmental outcomes for children and families as well as significant economic consequences. While efficacious intervention strategies have been demonstrated to reduce symptoms of trauma and to improve behavioral and emotional functioning, these models have not been widely…
Miller, Adam B.; Esposito-Smythers, Christianne; Weismoore, Julie T.; Renshaw, Keith D.
A large body of research suggests that child maltreatment (CM) is associated with adolescent suicidal ideation and attempts. These studies, however, have not been critically examined and summarized in a manner that allows us to draw firm conclusions and make recommendations for future research and clinical work in this area. In this review, we…
Mbagaya, Catherine Vuhya
Child maltreatment is a global phenomenon affecting a significant number of the world’s children. The purpose of this study was to compare the prevalence of self-reported childhood maltreatment among university students in Kenya, Zambia, and The Netherlands. We also sought to compare the
Raman, Shanti; Hotton, Paul Rex
Child maltreatment (CM) is a major public health problem globally. While there is evidence for the value of medical examination in the assessment of CM, little is known about the quality of clinical assessments for CM. South Western Sydney (SWS) has a large metropolitan population with many vulnerable subgroups. We aimed to describe acute presentations of CM in SWS over a 3-year period-with a focus on the quality of the clinical assessments. We wanted to determine whether the cases assessed fulfilled established minimum standards for clinical assessment of CM and whether the assessments were performed in a child-friendly manner. We gathered data from the acute child protection database on all children forensic doctors were better at identifying these health concerns than solo assessments. Most assessments were multidisciplinary and used protocols; half were not followed up; a third were performed after-hours and a third had no carer present during assessments. We identified strengths and weaknesses in current CM assessments in our service. Locally relevant standards for CM assessments are achievable in the acute setting, more challenging is addressing appropriate medical and psychosocial follow-up for these children. While we have established baseline domains for measuring a child-friendly approach to CM assessments, more should be done to ensure these vulnerable children are assessed in a timely, child-friendly manner, with appropriate follow-up.
Full Text Available Child maltreatment (CM is common worldwide, and can take many forms. It may even endanger the child’s life, especially when younger children are the victims. CM affects the child’s quality of life and consequently leads to long term issues to be dealt with by the child, family and community. This case series discusses six children who have been subjected to CM, and diagnosed by the child protection team of the departments of Child Health and Behavioural Medicine at Sultan Qaboos University Hospital (SQUH, Oman. The aim of this case series is to increase the level of awareness of CM among Oman’s medical professionals and to highlight the difficulties encountered in diagnosing and providing optimal care for these children. Although treatment is provided in Oman’s health care system, it is clear that there are gaps in the existing system which affect the quality of child protection services provided to the children and their families.
Afifi, Tracie O; Sareen, Jitender; Fortier, Janique; Taillieu, Tamara; Turner, Sarah; Cheung, Kristene; Henriksen, Christine A
Child maltreatment is associated with an increased likelihood of having mood disorders, anxiety disorders, post-traumatic stress disorder, substance use disorders, and personality disorders, but far less is known about eating disorders. The objective of the current study was to examine the associations between child maltreatment, including harsh physical punishment, physical abuse, sexual abuse, emotional abuse, emotional neglect, physical neglect, and exposure to intimate partner violence, and eating disorders in adulthood among men and women. Data were from the National Epidemiologic Survey on Alcohol and Related Conditions wave 3 (NESARC-III) collected in 2012-2013. The sample was nationally representative of the United States adult population (N = 36,309). Lifetime eating disorders (anorexia nervosa [AN], bulimia nervosa [BN], and binge-eating disorder [BED]) were assessed using diagnostic and statistical manual of mental disorders, fifth edition (DSM-5) criteria and the alcohol use disorder and associated disabilities interview schedule-5 (AUDADIS-5). The prevalence of any lifetime eating disorder was 1.7% (0.8% among men and 2.7% among women). All child maltreatment types were associated with AN, BN, and BED with notable differences among men and women. Overall, the types of child maltreatment with the strongest relationships with any eating disorder were sexual abuse and physical neglect among men and sexual abuse and emotional abuse among women. Clinicians should be mindful that child maltreatment experiences are associated with increased odds of eating disorders including AN, BED, and BN. Such relationships are significant among men and women although notable gender differences in these relationships exist. Abstract word count = 248. © 2017 The Authors International Journal of Eating Disorders Published by Wiley Periodicals, Inc.
van der Put, Claudia E; Lanctôt, Nadine; de Ruiter, Corine; van Vugt, Eveline
This study examined differences in offending behavior and psychosocial problems between juvenile offenders who have been sexually abused (n=231), physically abused (n=1,568), neglected (n=1,555), exposed to multiple forms of maltreatment (n=1,767), and non-victims (n=8,492). In addition, the moderating effect of gender in the association between type of maltreatment and offending behavior/psychosocial problems was examined. Results showed that violent offenses were more common in victims of physical abuse and victims of multiple forms of abuse than in non-victims, both in boys and girls. In boys, sexual offenses were far more common in victims of sexual abuse than in victims of other or multiple forms of maltreatment or in non-victims. In girls, no group differences were found in sexual offending behavior. For both boys and girls, externalizing problems were relatively common in victims of physical abuse and neglect whereas internalizing problems were relatively common in victims of sexual abuse. In victims of multiple forms of maltreatment, both internalizing and externalizing problems were relatively common. Implications for clinical practice are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.
van der Put, C.E.; Lanctot, N.; de Ruiter, C.; van Vugt, E.
This study examined differences in offending behavior and psychosocial problems between juvenile offenders who have been sexually abused (n = 231), physically abused (n = 1,568), neglected (n = 1,555), exposed to multiple forms of maltreatment (n = 1,767), and non-victims (n = 8,492). In addition,
Miller, Adam B.; Adams, Leah M.; Esposito-Smythers, Christianne; Thompson, Richard; Proctor, Laura J.
This study examined parental relationship quality, friendship quality, and depression as mediators of the association between child maltreatment (CM) and adolescent suicidal ideation (SI). Participants were 674 adolescents (46% female; 55% African American) involved in the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). Data were collected via youth self-report at ages 12, 16, and 18. CM before age 12 predicted poor parental relationships and depression, but not poor friendships, ...
Full Text Available This study uses observations of team meetings and interviews with 17 primary care professionals in four GP practices in England to generate hypotheses about how “vulnerable family” team meetings might support responses by GPs to maltreatment-related concerns and joint working with other professionals. These meetings are also called “safeguarding meetings”. The study found that vulnerable family meetings were used as a way of monitoring children or young people and their families and supporting risk assessment by information gathering. Four factors facilitated the meetings: meaningful information flow into the meetings from other agencies, systematic ways of identifying cases for discussion, limiting attendance to core members of the primary care team and locating the meeting as part of routine clinical practice. Our results generate hypotheses about a model of care that can be tested for effectiveness in terms of service measures, child and family outcomes, and as a potential mechanism for other professionals to engage and support GPs in their everyday responses to vulnerable and maltreated children. The potential for adverse as well as beneficial effects should be considered from involving professionals outside the core primary care team (e.g., police, children’s social care, education and mental health services.
Woodman, Jenny; Gilbert, Ruth; Allister, Janice; Glaser, Danya; Brandon, Marian
Objectives To provide a rich description of current responses to concerns related to child maltreatment among a sample of English general practitioners (GPs). Design In-depth, face-to-face interviews (November 2010 to September 2011). Participants selected and discussed families who had prompted ‘maltreatment-related concerns’. Thematic analysis of data. Setting 4 general practices in England. Participants 14 GPs, 2 practice nurses and 2 health visitors from practices with at least 1 ‘expert’ GP (expertise in child safeguarding/protection). Results The concerns about neglect and emotional abuse dominated the interviews. GPs described intense and long-term involvement with families with multiple social and medical problems. Narratives were distilled into seven possible actions that GPs took in response to maltreatment-related concerns. These were orientated towards whole families (monitoring and advocating), the parents (coaching) and children (opportune healthcare), and included referral to or working with other services and recording concerns. Facilitators of the seven actions were: trusting relationships between GPs and parents, good working relationships with health visitors and framing the problem/response as ‘medical’. Narratives indicated significant time and energy spent building facilitating relationships with parents with the aim of improving the child's well-being. Conclusions These GPs used core general practice skills for on-going management of families who prompted concerns about neglect and emotional abuse. Policy and research focus should be broadened to include strategies for direct intervention and on-going involvement by GPs, such as using their core skills during consultations and practice systems for monitoring families and encouraging presentation to general practice. Exemplars of current practice, such as those identified in our study, should be evaluated for feasibility and acceptability in representative general practice settings
Shenk, Chad E; Griffin, Amanda M; O'Donnell, Kieran J
Major depressive disorder (MDD) is a prevalent psychiatric condition in the child maltreatment population. However, not all children who have been maltreated will develop MDD or MDD symptoms, suggesting the presence of unique risk pathways that explain how certain children develop MDD symptoms when others do not. The current study tested several candidate risk pathways to MDD symptoms following child maltreatment: neuroendocrine, autonomic, affective, and emotion regulation. Female adolescents (N = 110; age range = 14-19) were recruited into a substantiated child maltreatment or comparison condition and completed a laboratory stressor, saliva samples, and measures of emotion regulation, negative affect, and MDD symptoms. MDD symptoms were reassessed 18 months later. Mediational modeling revealed that emotion regulation was the only significant indirect effect of the relationship between child maltreatment and subsequent MDD symptoms, demonstrating that children exposed to maltreatment had greater difficulties managing affective states that in turn led to more severe MDD symptoms. These results highlight the importance of emotion dysregulation as a central risk pathway to MDD following child maltreatment. Areas of future research and implications for optimizing prevention and clinical intervention through the direct targeting of transdiagnostic risk pathways are discussed.
Shenk, Chad E.; Griffin, Amanda M.; O’Donnell, Kieran J.
Major depressive disorder (MDD) is a prevalent psychiatric condition in the child maltreatment population. However, not all children who have been maltreated will develop MDD or MDD symptoms, suggesting the presence of unique risk pathways that explain how certain children develop MDD symptoms when others do not. The current study tested several candidate risk pathways to MDD symptoms following child maltreatment: 1) neuroendocrine, 2) autonomic, 3) affective, and 4) emotion regulation. Female adolescents (N=110; Age range: 14–19) were recruited into a substantiated child maltreatment or comparison condition and completed a laboratory stressor, saliva samples, and measures of emotion regulation, negative affect, and MDD symptoms. MDD symptoms were reassessed eighteen months later. Mediational modeling revealed that emotion regulation was the only significant indirect effect of the relationship between child maltreatment and subsequent MDD symptoms, demonstrating that children exposed to maltreatment had greater difficulties managing affective states that in turn led to more severe MDD symptoms. These results highlight the importance of emotion dysregulation as a central risk pathway to MDD following child maltreatment. Areas of future research and implications for optimizing prevention and clinical intervention through the direct targeting of transdiagnostic risk pathways are discussed. PMID:26535940
Thibodeau, Eric L.; Cicchetti, Dante; Rogosch, Fred A.
A model examining the effects of an increasing number of maltreatment subtypes experienced on antisocial behavior, as mediated by impulsivity and moderated by a polygenic index of dopaminergic genotypes, was investigated. An African American sample of children (N = 1012, M age = 10.07) with and without maltreatment histories participated. Indicators of aggression, delinquency, and disruptive peer behavior were obtained from peer and counselor rated measures to form a latent variable of antisocial behavior; impulsivity was assessed by counselor report. Five genotypes in four dopaminergic genes (DRD4, DRD2, DAT1, and COMT) conferring heightened environmental sensitivity were combined into one polygenic index. Using SEM, a first-stage, moderated-mediation model was evaluated. Age and sex were entered as covariates, both as main effects and in interaction with maltreatment and the gene index. The model had excellent fit: χ2(32, N =1012) = 86..51, pmaltreatment subtypes on antisocial behavior was partially mediated by impulsivity (β= 0.173, pmaltreatment and impulsivity was stronger as children evinced more differentiating genotypes, thereby strengthening the mediational effect of impulsivity on antisocial behavior. These findings elucidate the manner by which maltreated children develop early signs of antisocial behavior, and the genetic mechanisms involved in greater vulnerability for maladaptation in impulse-control within context of child maltreatment. PMID:26535948
Purpose/Objective Child abuse imaging differs from general musculoskeletal imaging in the demands for low noise. The consequences of misdiagnosis are serious. The images are directly involved in legal processes and the child and the family faces major consequences if the images are not adequate. ...
Chaplin, Tara M.; Sinha, Rajita; Tebes, Jacob K.; Mayes, Linda C.
Experience with and management of stress has implications for adolescents’ behavioral and socioemotional development. This study examined the relationship between adolescents’ physiological response to an acute laboratory stressor (i.e., Trier Social Stress Test; TSST) and anger regulation and interpersonal competence in a sample of 175 low-income urban adolescents (51.8% girls). Findings suggested that heightened reactivity as indicated by cortisol, heart rate, and blood pressure was associated with increased interpersonal competence and anger regulation. However, these findings were context dependent such that, for youth high in self-reported child maltreatment, heightened reactivity was associated with decreased interpersonal competence and anger regulation. Results highlight the importance of considering how context may condition the effect of stress reactivity on functioning during adolescence. PMID:22359225
Eckenrode, John; Campa, Mary I; Morris, Pamela A; Henderson, Charles R; Bolger, Kerry E; Kitzman, Harriet; Olds, David L
We examine maternal life-course mediators of the impact of a nurse home visitation program on reducing child maltreatment among participants in the Elmira trial of the Nurse Family Partnership program from the first child's birth through age 15. For women having experienced low to moderate levels of domestic violence, program effects on the number of confirmed maltreatment reports were mediated by reductions in numbers of subsequent children born to mothers and their reported use of public assistance. Together, the two mediators explained nearly one half of the total effect of nurse home visiting on child maltreatment. The long-term success of this program on reducing child maltreatment can be explained, at least in part, by its positive effect on pregnancy planning and economic self-sufficiency.
Chemtob, Claude M; Gudiño, Omar G; Laraque, Danielle
Maternal posttraumatic stress disorder (PTSD) may be associated with increased risk for child maltreatment and child exposure to traumatic events. Exposure to multiple traumatic events is associated with a wide range of adverse health and social outcomes in children. To examine the association of probable maternal depression, PTSD, and comorbid PTSD and depression with the risk for child maltreatment and parenting stress and with the number of traumatic events to which preschool children are exposed. Cross-sectional observational design. We used analysis of variance to determine whether probable maternal psychopathology groups differed on child maltreatment, parenting stress, and children's exposure to traumatic events. Hierarchical regression analyses were used to examine the unique and interactive effects of depression and PTSD severity scores on these outcomes. Urban pediatric primary care outpatient clinic. Ninety-seven mothers of children aged 3 to 5 years. Pediatric primary care visit. Probable maternal depression and/or PTSD, parenting stress, child exposure to traumatic events, and child maltreatment. Mothers with probable comorbid PTSD and depression reported greater child-directed psychological aggression and physical assault and greater parenting stress. The children of mothers with PTSD (mean number of events the child was exposed to, 5.0) or with comorbid PTSD and depression (3.5 events) experienced more traumatic events than those of mothers with depression (1.2 events) or neither disorder (1.4 events). Severity of depressive symptoms uniquely predicted physical assault and neglect. Symptom scores for PTSD and depression interacted to predict psychological aggression and child exposure to traumatic events. When PTSD symptom severity scores were high, psychological aggression and the number of traumatic events children experienced rose. Depressive symptom severity scores predicted the risk for psychological aggression and exposure to traumatic events
Skowron, Elizabeth A.; Loke, Eric; Gatzke-Kopp, Lisa M.; Cipriano-Essel, Elizabeth A.; Woehrle, Petra L.; Van Epps, John J.; Gowda, Anjali; Ammerman, Robert T.
Child maltreatment (CM) lies on an extreme end of the continuum of parenting-at-risk, and while CM has been linked with a variety of behavioral indicators of dysregulation in children, less is known about how physiological markers of regulatory capacity contribute to this association. The present study examined patterns of mother and child physiological regulation and their relations with observed differences in parenting processes during a structured interaction. Abusing, neglecting, and non-CM mothers and their 3- to 5-year-old children completed a resting baseline and moderately challenging joint task. The structural analysis of social behavior was used to code mother–child interactions while simultaneous measures of respiratory sinus arrhythmia were obtained. Results indicated that physically abusive mothers were more likely to react to children’s positive bids for autonomy with strict and hostile control, than either neglecting or non-CM mothers. CM exposure and quality of maternal responding to children’s autonomous bids were uniquely associated with lower parasympathetic tone in children. Results provide evidence of neurodevelopmental associations between early CM exposure, the immediate interactive context of parenting, and children’s autonomic physiology. PMID:21842991
Dion, Jacinthe; Matte-Gagné, Célia; Daigneault, Isabelle; Blackburn, Marie-Eve; Hébert, Martine; McDuff, Pierre; Auclair, Julie; Veillette, Suzanne; Perron, Michel
Transition into adulthood is a critical developmental period that may be influenced by adverse life events as well as by protective factors. This study aimed at investigating the effect of different forms of child maltreatment experienced prior to age 14 (i.e., sexual abuse, physical abuse and exposure to intimate partner violence), and of friend support at age 14 on the psychological distress trajectory from age 14 to 24. Participants were 605 adolescents from the general population involved in a 10-year longitudinal study. Psychological distress was evaluated at ages 14, 16, 18 and 24. Child maltreatment prior to 14 years was retrospectively assessed at 14 and 24 years while perception of support from friends was evaluated at age 14. Multilevel growth modeling indicated that psychological distress followed a significant decreasing curvilinear trajectory, with participants reporting fewer distressing psychological symptoms after 18 years. All three forms of child maltreatment, as well as their cumulative effect, predicted more psychological distress over 10 years above and beyond the protective effect of support from friends. Higher support from friends at age 14 was related to lower distress at baseline andover 10 years, beyond the effect of child maltreatment. Self-report nature of all measures, attrition, and measures of child maltreatment forms. Psychological distress decreased during the transition from adolescence to emerging adulthood. Results also revealed the detrimental impact of child maltreatment and the promotive role of friend support, which underscore the importance of early intervention. Copyright © 2015 Elsevier B.V. All rights reserved.
Dixon, Louise; Hamilton-Giachritsis, Catherine; Browne, Kevin
This study extends previous research (Dixon, Browne, & Hamilton-Giachritsis, 2004) by exploring the mediational properties of parenting styles and their relation to risk factors in the intergenerational cycle of child maltreatment. Families with newborns where at least one of the parents was physically and/or sexually abused as a child (AP families) were compared, in terms of parents' attributions and behaviour, to families where the parents had no childhood history of victimization (NAP families). Information was collected from 4351 families (135 AP families) by community nurses as part of the 'health visiting' service. The same health visitor visited each family twice at home when the child was 4 to 6 weeks and 3 to 5 months of age, to assess behavioural indicators of positive parenting. Within 13 months after birth, 9 (6.7%) AP families were referred for maltreating their own child in comparison to 18 (.4%) NAP families. Assessments found a significantly higher number of risk factors and measures indicating poor parenting for AP families. Mediational analysis found that intergenerational continuity of child maltreatment was explained to a larger extent (62% of the total effect) by the presence of poor parenting styles together with the three significant risk factors (parenting under 21 years, history of mental illness or depression, residing with a violent adult). The three risk factors alone were less explanatory (53% of the total effect). This study provides an explanation for why a minority of parents abused in childhood go on to maltreat their own infant, evidencing poor parenting styles and mediating risk factors. Hence, prevention may be enhanced in AP families by the promotion of 'positive parenting' in addition to providing additional support to young parents, tackling mental illness/depression and domestic violence problems.
Maloney, Tim; Jiang, Nan; Putnam-Hornstein, Emily; Dalton, Erin; Vaithianathan, Rhema
Introduction Official statistics have confirmed that relative to their presence in the population and relative to white children, black children have consistently higher rates of contact with child protective services (CPS). We used linked administrative data and statistical decomposition techniques to generate new insights into black and white differences in child maltreatment reports and foster care placements. Methods Birth records for all children born in Allegheny County, Pennsylvania, between 2008 and 2010 were linked to administrative service records originating in multiple county data systems. Differences in rates of involvement with child protective services between black and white children by age 4 were decomposed using nonlinear regression techniques. Results Black children had rates of CPS involvement that were 3 times higher than white children. Racial differences were explained solely by parental marital status (i.e., being unmarried) and age at birth (i.e., predominantly teenage mothers). Adding other covariates did not capture any further racial differences in maltreatment reporting or foster care placement rates, they simply shifted differences already explained by marital status and age to these other variables. Discussion Racial differences in rates of maltreatment reports and foster care placements can be explained by a basic model that adjusts only for parental marital status and age at the time of birth. Increasing access to early prevention services for vulnerable families may reduce disparities in child protective service involvement. Using birth records linked to other administrative data sources provides an important means to developing population-based research.
Full Text Available Background: Experiencing abuse during childhood affects the psychological well-being of individuals throughout their lives and may even influence their offspring by enhancing the likelihood of an intergenerational transmission of violence. Understanding the effects of childhood maltreatment on child-rearing practices and intimate partner violence might be of particular importance to overcome the consequences of violent conflicts in African societies. Objective: Using Burundi as an example, we aimed to explore the associations between childhood maltreatment, intimate partner violence, perceived partner intimidation, gender and the probability of violently acting out against one's own children or romantic partner. Methods: Amongst a sample of 141 men and 141 women in the capital of Burundi, we identified those who had biological children and those who lived or had lived in relationships. Using culturally appropriate instruments, we enquired about their exposure to childhood maltreatment and partner violence as well as their inclinations to act out violently. Results: We found that childhood maltreatment and perceived partner intimidation were strong predictors for the perpetration of violence against children. Moreover, we found that women were more likely to use violence against children if they experienced partner violence and less likely to resort to violence if they felt intimidated. Men were more likely to perpetrate violence against their partner. Childhood maltreatment was again a strong predictor. The more women experienced partner violence, the more they fought back. Conclusions: Childhood maltreatment is a strong predictor for domestic violence and has to be addressed to interrupt the cycle of violence in post-conflict countries.
Dittrich, Katja; Boedeker, Katja; Kluczniok, Dorothea; Jaite, Charlotte; Hindi Attar, Catherine; Fuehrer, Daniel; Herpertz, Sabine C; Brunner, Romuald; Winter, Sibylle Maria; Heinz, Andreas; Roepke, Stefan; Heim, Christine; Bermpohl, Felix
Early life maltreatment (ELM), borderline personality disorder (BPD) and major depressive disorder (MDD) have been shown to increase the potential of abuse. Emotion regulation is an identified mediator for the association of ELM and BPD with abuse potential. Until now, there has been no study to account for the co-occurrence of these risk factors in one analysis, although BPD and MDD are known as common sequelae of ELM. This is paired with a lack of studies investigating the effects of abuse potential on child well-being.AimsOur study aims at (a) disentangling the effects of maternal ELM, MDD and BPD on abuse potential; (b) exploring the role of emotion regulation as a mediator; and (c) testing for intergenerational effects of abuse potential on child psychopathology. The research design included 114 mothers with/without ELM, BPD and MDD in remission and their children, all of which were between 5 and 12 years of age. A path analysis was conducted to investigate the multiple associations between our variables. ELM, MDD and BPD were all associated with abuse potential, with emotion regulation acting as a mediator for BPD and MDD. Furthermore, an elevated abuse potential was related to higher psychopathology in the child. History of ELM as well as the common sequelae, BPD and MDD, pose risks for child abuse. Our findings suggest improvement of emotion regulation as a potential target for intervention programs. These programs should also aim at non-substantiated cases because even an elevated abuse potential affected child mental health.Declaration of interestNone.
Full Text Available Mandatory reporting laws have been created in many jurisdictions as a way of identifying cases of severe child maltreatment on the basis that cases will otherwise remain hidden. These laws usually apply to all four maltreatment types. Other jurisdictions have narrower approaches supplemented by differential response systems, and others still have chosen not to enact mandatory reporting laws for any type of maltreatment. In scholarly research and normative debates about mandatory reporting laws and their effects, the four major forms of child maltreatment—physical abuse, sexual abuse, emotional abuse, and neglect—are often grouped together as if they are homogenous in nature, cause, and consequence. Yet, the heterogeneity of maltreatment types, and different reporting practices regarding them, must be acknowledged and explored when considering what legal and policy frameworks are best suited to identify and respond to cases. A related question which is often conjectured upon but seldom empirically explored, is whether reporting laws make a difference in case identification. This article first considers different types of child abuse and neglect, before exploring the nature and operation of mandatory reporting laws in different contexts. It then posits a differentiation thesis, arguing that different patterns of reporting between both reporter groups and maltreatment types must be acknowledged and analysed, and should inform discussions and assessments of optimal approaches in law, policy and practice. Finally, to contribute to the evidence base required to inform discussion, this article conducts an empirical cross-jurisdictional comparison of the reporting and identification of child sexual abuse in jurisdictions with and without mandatory reporting, and concludes that mandatory reporting laws appear to be associated with better case identification.
Lakhdir, Maryam Pyar Ali; Farooq, Salima; Khan, Uzma Rahim; Parpio, Yasmin; Azam, Syed Iqbal; Razzak, Junaid; Laljee, Anjiya Aslam; Kadir, Muhammad Masood
Child maltreatment is considered as a global social issue and results as combined effect of parental background, socioeconomic environment, family structure, and child characteristics. The aim of this study was to determine factors associated with child maltreatment among children aged 11 to 17 years in Karachi, Pakistan. A cross-sectional survey of 800 pairs (children ranging from 11 to 17 years old and their parents) was randomly selected from 32 clusters of Karachi, using multistage cluster sampling. A structured questionnaire was adopted from the International Society for the Prevention of Child Abuse and Neglect (International Child Abuse Screening Tool for Parent [ICAST-P] and for Child [ICAST-C]). Multiple linear regression technique was used to assess the association of factors with child maltreatment score, by using STATA software. Our study found that children who always get bullied and mistreated by their siblings are at increased risk of getting maltreatment by parents (adjusted β: 10.78, 95% CI = [8.5, 13.05]).The mean estimated ICAST-C score increases by 9.86 (95% CI = [6.17, 13.55]) for children with exposure of verbal abuse and quarrel within family members. The mean estimated ICAST-C score increases by 5.09 among male children as compared with female children (95% CI = [3.65, 6.52]). Among children whose family always fight with each other and whose parents have exposure to childhood maltreatment, the mean estimated ICAST-C score increases by 22.25 (95% CI = [16.53, 27.98]). This study reflects the potential factors of child maltreatment in Karachi. Our findings provide evidence to raise awareness about child maltreatment.
Lynch, Michael; Manly, Jody Todd; Cicchetti, Dante
Physiological response to stress has been linked to variety of healthy and pathological conditions. The current study conducted a multilevel examination of interactions among environmental toxins – i.e., neighborhood crime and child maltreatment – and specific genetic polymorphisms of eNOS and GABRA6. A total of 186 children were recruited at age 4. At this time, the presence or absence of child maltreatment was determined, as was the amount of crime that occurred in their neighborhood during the previous year. At age 9, the children were brought to the lab where their physiological response to a cognitive challenge – i.e., change in the amplitude of RSA – was assessed and DNA samples were collected for subsequent genotyping. Results confirmed that complex G x G, E x E, and G x E interactions were associated with different patterns of RSA reactivity. The implications for future research and evidence-based intervention are discussed. PMID:26535938
Crombach, Anselm; Bambonyé, Manassé
Background: Experiencing abuse during childhood affects the psychological well-being of individuals throughout their lives and may even influence their offspring by enhancing the likelihood of an intergenerational transmission of violence. Understanding the effects of childhood maltreatment on child-rearing practices and intimate partner violence might be of particular importance to overcome the consequences of violent conflicts in African societies.Objective: Using Burundi as an example, we ...
Merritt, Darcey H; Klein, Sacha
Young children under 6 years old are over-represented in the U.S. child welfare system (CWS). Due to their exposure to early deprivation and trauma, they are also highly vulnerable to developmental problems, including language delays. High quality early care and education (ECE) programs (e.g. preschool, Head Start) can improve children's development and so policymakers have begun calling for increased enrollment of CWS-supervised children in these programs. However, it is not a given that ECE will benefit all children who experience maltreatment. Some types of maltreatment may result in trauma-related learning and behavior challenges or developmental deficits that cause children to respond to ECE settings differently. The current study uses data from a nationally representative survey of children in the U.S. child welfare system, the National Survey of Child and Adolescent Well-Being II, to assess whether young CWS-supervised children (N=1,652) who were enrolled in ECE had better language development outcomes 18 months later than those not enrolled in ECE. We also explore whether the type of maltreatment that brought children to the CWS' attention moderates the relationship between ECE and children's language development. After controlling for children's initial scores on the Preschool Language Scale (PLS-3), type(s) of maltreatment experienced, and child and caregiver demographics, we found that ECE participation predicted better PLS-3 scores at follow-up, with a positive interaction between ECE participation and supervisory neglect. ECE seems to be beneficial for CWS-involved children's early language development, especially for children referred to the CWS because they lack appropriate parent supervision at home. Copyright © 2014 Elsevier Ltd. All rights reserved.
Ferrari, Anne M
The aim of the present study was to assess the relationship between a childhood history of abuse that a parent may have experienced and the cultural beliefs/factors that an individual may subscribe to with current parenting behaviors and attitudes. It was hypothesized that cultural factors would be more predictive of parenting behaviors and attitudes than ethnicity as a demographic label. Using a survey design, 150 parents of Hispanic, African American and European American descent participated. Participants completed the Conflict Tactics Scale, a Familism Scale, a Machismo Scale, a Valuing Children Scale, the Childhood Trauma Questionnaire, and assigned seriousness ratings to vignettes depicting child maltreatment. A history of childhood abuse was found to be predictive of the use of both physical and verbal punishment by mothers, but not for fathers. Cultural factors/beliefs were predictive of fathers' parenting behaviors, but not mothers'. Ethnicity, as a demographic variable, continued to be a significant predictor of parenting behaviors and attitudes for all parents, controlling for cultural factors. The present study adds to our understanding of diverse parenting styles, of definitions of child abuse and neglect, and of ethnicity. The findings indicate that ethnicity is a complex factor, one demanding further examination with regard to its components.
Geoffroy, Marie-Claude; Pinto Pereira, Snehal; Li, Leah; Power, Chris
Life-long adverse effects of childhood maltreatment on mental health are well established, but effects on child-to-adulthood cognition and related educational attainment have yet to be examined in the general population. We aimed to establish whether different forms of child maltreatment are associated with poorer cognition and educational qualifications in childhood/adolescence and whether associations persist to midlife, parallel to associations for mental health. Cognitive abilities at ages 7, 11, and 16 years (math, reading, and general intellectual ability) and 50 years (immediate/delayed memory, verbal fluency, processing speed) were assessed using standardized tests, and qualifications by age 42 were self-reported. Information on childhood maltreatment (neglect and abuse: sexual, physical, psychological, witnessed), cognition, and mental health was available for 8,928 participants in the 1958 British Birth Cohort. We found a strong association of child neglect with cognitive deficits from childhood to adulthood. To illustrate, the most neglected 6% of the population (score ≥4) had a 0.60 (95% CI = 0.56-0.68) SD lower cognitive score at age 16 and a 0.28 (95% CI = 0.20-0.36) SD deficit at age 50 years relative to the non-neglected participants (score = 0) after adjustment for confounding factors and mental health, and they also had increased risk of poor qualifications (i.e., none/low versus degree-level). Childhood neglect and all forms of abuse were associated with poorer child-to-adulthood mental health, but abuse was mostly unrelated to cognitive abilities. The study provides novel data that child neglect is associated with cognitive deficits in childhood/adolescence and decades later in adulthood, independent of mental health, and highlights the lifelong burden of child neglect on cognitive abilities and mental health. Copyright © 2016 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.
Schwab-Reese, Laura M; Hovdestad, Wendy; Tonmyr, Lil; Fluke, John
Collecting child maltreatment data is a complicated undertaking for many reasons. As a result, there is an interest by child maltreatment researchers to develop methodologies that allow for the triangulation of data sources. To better understand how social media and internet-based technologies could contribute to these approaches, we conducted a scoping review to provide an overview of social media and internet-based methodologies for health research, to report results of evaluation and validation research on these methods, and to highlight studies with potential relevance to child maltreatment research and surveillance. Many approaches were identified in the broad health literature; however, there has been limited application of these approaches to child maltreatment. The most common use was recruiting participants or engaging existing participants using online methods. From the broad health literature, social media and internet-based approaches to surveillance and epidemiologic research appear promising. Many of the approaches are relatively low cost and easy to implement without extensive infrastructure, but there are also a range of limitations for each method. Several methods have a mixed record of validation and sources of error in estimation are not yet understood or predictable. In addition to the problems relevant to other health outcomes, child maltreatment researchers face additional challenges, including the complex ethical issues associated with both internet-based and child maltreatment research. If these issues are adequately addressed, social media and internet-based technologies may be a promising approach to reducing some of the limitations in existing child maltreatment data. Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.
Edelson, Jeffrey L.
This commentary identifies critical issues regarding social interventions with families in which both child maltreatment and woman battering are suspected. Addresses several common assumptions of service providers and suggests changes in current practice. (Author)
Leiter, Jeffrey; Johnsen, Matthew C.
Presents a longitudinal analysis of school performance declines among neglected and abused children, using the maltreatment and school histories of 1,369 children in Mecklenburg County, North Carolina. Significant relationships between maltreatment and declines in performance were found in diverse school outcomes. (SLD)
Sikes, April; Remley, Theodore P., Jr.; Hays, Danica G.
The purpose of this study was to explore the experiences of school counselors during and after making suspected child abuse and neglect reports. A total of 847 school counselors who were members of the American School Counselor Association (ASCA) participated in this study. Results showed that professional school counselors encountered some…
Murray-Close, Dianna; Han, Georges; Cicchetti, Dante; Crick, Nicki R.; Rogosch, Fred A.
The purpose of the present investigation was to examine the association between circadian rhythms of cortisol and physical and relational aggression. Morning arrival, pre-lunch, and afternoon pre-departure salivary cortisol were assessed among 418 maltreated and nonmaltreated children (52% maltreated; 49% female) attending a summer day camp. Counselors and peers rated participants' involvement in physically and relationally aggressive behaviors. Results indicated that physical aggression was associated with heightened cortisol following morning arrival and relatively steep declines in cortisol over the day whereas relational aggression was associated with low cortisol following morning arrival and blunted diurnal change in cortisol. Moreover, maltreatment was a significant moderator of this relationship such that aggression was related to greater cortisol dysregulation among nonmaltreated than maltreated children. The findings suggest that physiological correlates of aggression may differ for physical and relational forms of aggression and among maltreated versus nonmaltreated populations. PMID:18605842
Yampolskaya, Svetlana; Greenbaum, Paul E.; Brown, C. Hendricks; Armstrong, Mary I.
This study examined the trajectories of maltreatment severity and substantiation over a 24-month period among children (N = 82,396) with repeated maltreatment reports. Findings revealed two different longitudinal patterns. The first pattern, Elevated Severity, showed a higher level of maltreatment during the initial incident and increased maltreatment severity during subsequent incidents but the substantiation rates for this class decreased over time. The second pattern, Lowered Severity, showed a much lower level of severity, but the likelihood of substantiation increased over time. The Elevated Severity class was comprised of children with an elevated risk profile due to both individual and contextual risk factors including older age, female gender, caregivers’ substance use problems, and a higher number of previous maltreatment reports. Implications of the findings are discussed. PMID:26300381
Weibel, Sébastien; Vidal, Sonia; Olié, Emilie; Hasler, Roland; Torriani, Catherine; Prada, Paco; Courtet, Philippe; Guillaume, Sébastien; Perroud, Nader; Huguelet, Philippe
Child maltreatment (CM) worsens prognosis and quality of life in several psychiatric conditions. Meaning in life is a construct which relates to the sense of purpose that one can perceive in life, and is a key aspect of recovery in psychiatric patients. The lasting impact of CM on meaning in life and its mediating variables have not been studied in patients with chronic persistent psychiatric conditions. One hundred and sixty-six patients with bipolar disorder (N=35), psychotic disorder (N=73), anorexia nervosa (N=30) or borderline personality disorder (N=28) were assessed for meaning in life (revised version of the Life Regard Index (LRI-R)), for CM (Childhood Trauma Questionnaire (CTQ)) and for internalized/externalized psychopathology. CM was associated with a lower LRI score. Structural Equation Modeling showed that internalized psychopathology (depression, hopelessness and low self-esteem) was the main mediator of the impact of CM on meaning in life. The direct effect of CM on meaning in life was not significant. Having suffered from negligence or abuse during childhood is associated with lower meaning in life in adults with persistent and pervasive psychiatric disorders. Treating depressive symptoms and improving self-esteem may improve meaning in life in patients with severe mental disorders who were affected by CM. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.
Full Text Available Background: Child maltreatment (CM and attachment experiences are closely linked to alterations in the human oxytocin (OXT system. However, human data about oxytocin receptor (OXTR protein levels are lacking. Therefore, we investigated oxytocin receptor (OXTR protein levels in circulating immune cells and related them to circulating levels of OXT in peripheral blood. We hypothesized reduced OXTR protein levels, associated with both, experiences of CM and an insecure attachment representation.Methods: OXTR protein expressions were analyzed by western blot analyses in peripheral blood mononuclear cells (PBMC and plasma OXT levels were determined by radioimmunoassay (RIA in 49 mothers. We used the Childhood Trauma Questionnaire (CTQ to assess adverse childhood experiences. Attachment representations (secure vs. insecure were classified using the Adult Attachment Projective Picture System (AAP and levels of anxiety and depression were assessed with the German version of the Hospital Depression and Anxiety scale (HADS-D.Results: CM-affected women showed significantly lower OXTR protein expression with significantly negative correlations between the OXTR protein expression and the CTQ sum score, whereas plasma OXT levels showed no significant differences in association with CM. Lower OXTR protein expression in PBMC were particularly pronounced in the group of insecurely attached mothers compared to the securely attached group. Anxiety levels were significantly higher in CM-affected women.Conclusion: This study demonstrated a significant association between CM and an alteration of OXTR protein expression in human blood cells as a sign for chronic, long-lasting alterations in this attachment-related neurobiological system.
Krause, Sabrina; Boeck, Christina; Gumpp, Anja M; Rottler, Edit; Schury, Katharina; Karabatsiakis, Alexander; Buchheim, Anna; Gündel, Harald; Kolassa, Iris-Tatjana; Waller, Christiane
Background: Child maltreatment (CM) and attachment experiences are closely linked to alterations in the human oxytocin (OXT) system. However, human data about oxytocin receptor (OXTR) protein levels are lacking. Therefore, we investigated oxytocin receptor (OXTR) protein levels in circulating immune cells and related them to circulating levels of OXT in peripheral blood. We hypothesized reduced OXTR protein levels, associated with both, experiences of CM and an insecure attachment representation. Methods: OXTR protein expressions were analyzed by western blot analyses in peripheral blood mononuclear cells (PBMC) and plasma OXT levels were determined by radioimmunoassay (RIA) in 49 mothers. We used the Childhood Trauma Questionnaire (CTQ) to assess adverse childhood experiences. Attachment representations (secure vs. insecure) were classified using the Adult Attachment Projective Picture System (AAP) and levels of anxiety and depression were assessed with the German version of the Hospital Depression and Anxiety scale (HADS-D). Results: CM-affected women showed significantly lower OXTR protein expression with significantly negative correlations between the OXTR protein expression and the CTQ sum score, whereas plasma OXT levels showed no significant differences in association with CM. Lower OXTR protein expression in PBMC were particularly pronounced in the group of insecurely attached mothers compared to the securely attached group. Anxiety levels were significantly higher in CM-affected women. Conclusion: This study demonstrated a significant association between CM and an alteration of OXTR protein expression in human blood cells as a sign for chronic, long-lasting alterations in this attachment-related neurobiological system.
Tracie O. Afifi
Full Text Available Abstract Background Physical punishment of children is an important public health concern. Yet, few studies have examined how physical punishment is related to other types of child maltreatment and violence across the lifespan. Therefore, the objective of the current study was to examine if harsh physical punishment (i.e., being pushed, grabbed, shoved, hit, and/or slapped without causing marks, bruises, or injury is associated with an increased likelihood of more severe childhood maltreatment (i.e., physical abuse, emotional abuse, sexual abuse, physical neglect, emotional neglect, and exposure to intimate partner violence (IPV in childhood and perpetration or victimization of IPV in adulthood. Methods Data were drawn from the National Epidemiologic Survey on Alcohol and Related Conditions collected in 2004 to 2005 (n = 34,402, response rate = 86.7%, a representative United States adult sample. Results Harsh physical punishment was associated with increased odds of childhood maltreatment, including emotional abuse, sexual abuse, physical abuse, physical neglect, emotional neglect, and exposure to IPV after adjusting for sociodemographic factors, family history of dysfunction, and other child maltreatment types (range 1.6 to 26.6. Harsh physical punishment was also related to increased odds of experiencing IPV in adulthood (range 1.4 to 1.7. Conclusions It is important for parents and professionals working with children to be aware that pushing, grabbing, shoving, hitting, or slapping children may increase the likelihood of emotional abuse, sexual abuse, physical abuse, physical neglect, emotional neglect, and exposure to IPV in childhood and also experiencing IPV victimization and/or perpetration in later adulthood.
Afifi, Tracie O; Mota, Natalie; Sareen, Jitender; MacMillan, Harriet L
Physical punishment of children is an important public health concern. Yet, few studies have examined how physical punishment is related to other types of child maltreatment and violence across the lifespan. Therefore, the objective of the current study was to examine if harsh physical punishment (i.e., being pushed, grabbed, shoved, hit, and/or slapped without causing marks, bruises, or injury) is associated with an increased likelihood of more severe childhood maltreatment (i.e., physical abuse, emotional abuse, sexual abuse, physical neglect, emotional neglect, and exposure to intimate partner violence (IPV)) in childhood and perpetration or victimization of IPV in adulthood. Data were drawn from the National Epidemiologic Survey on Alcohol and Related Conditions collected in 2004 to 2005 (n = 34,402, response rate = 86.7%), a representative United States adult sample. Harsh physical punishment was associated with increased odds of childhood maltreatment, including emotional abuse, sexual abuse, physical abuse, physical neglect, emotional neglect, and exposure to IPV after adjusting for sociodemographic factors, family history of dysfunction, and other child maltreatment types (range 1.6 to 26.6). Harsh physical punishment was also related to increased odds of experiencing IPV in adulthood (range 1.4 to 1.7). It is important for parents and professionals working with children to be aware that pushing, grabbing, shoving, hitting, or slapping children may increase the likelihood of emotional abuse, sexual abuse, physical abuse, physical neglect, emotional neglect, and exposure to IPV in childhood and also experiencing IPV victimization and/or perpetration in later adulthood.
Examination of Life Satisfaction, Child Maltreatment Potential and Substance Use in Mothers Referred for Treatment by Child Protective Services for Child Neglect and Substance Abuse: Implications for Intervention Planning
Plant, Christopher P.; Donohue, Brad; Holland, Jason M.
There is evidence to suggest mothers who are served by child protective service agencies are relatively dissatisfied in their lives, leading some investigators to conclude life dissatisfaction may be associated with child maltreatment. To assist in better understanding this relationship the Life Satisfaction Scale for Caregivers (LSSC) was psychometrically developed in a sample of 72 mothers who were referred for behavioral treatment for child neglect and substance abuse by caseworkers from a...
Dackis, Melissa N.; Rogosch, Fred A.; Cicchetti, Dante
Child maltreatment is associated with disruptions in physiological arousal, emotion regulation, and defensive responses to cues of threat and distress, as well as increased risk for callous unemotional (CU) traits and externalizing behavior. Developmental models of callous unemotional (CU) traits have focused on biological and genetic risk factors that contribute to hypoarousal and antisocial behavior, but have focused less on environmental influences (Blair, 2004; Daversa, 2010; Hare, Frazell, & Cox, 1978; Krueger, 2000; Shirtcliff et al., 2009; Viding, Fontaine, & McCrory, 2012). The aim of the present investigation was to measure the independent and combined effects of child maltreatment and high CU trait on emotion-modulated startle (EMS) response in children. Participants consisted of 132 low-income maltreated (n = 60) and nonmaltreated (n = 72) children between 8–12 years old who attended a summer camp program. Acoustic startle response (ASR) was elicited in response to a 110-dB 50-ms probe while children viewed a slideshow of pleasant, neutral, and unpleasant IAPS images. Maltreatment status was assessed through examination of Department of Human Services records. CU traits were measured using counselor reports from the Inventory of Callous and Unemotional Traits (ICU; Frick, 2004), and conduct problems were measured using counselor and child self-report. We found no significant differences in emotion-modulated startle in the overall sample. However, significant differences in ASR by maltreatment status, maltreatment subtype, and level of CU traits were apparent. Results indicated differential physiological responses for maltreated and nonmaltreated children based on CU traits, including a pathway of hypoarousal for nonmaltreated/high CU children that differed markedly from a more normative physiological trajectory for maltreated/high CU children. Further, we found heightened ASR for emotionally and physically neglected children with high CU and elevated
Cammack, Alison L; Hogue, Carol J; Drews-Botsch, Carolyn D; Kramer, Michael R; Pearce, Brad D; Knight, Bettina; Stowe, Zachary N; Newport, D Jeffrey
Childhood maltreatment is common and has been increasingly studied in relation to perinatal outcomes. While retrospective self-report is convenient to use in studies assessing the impact of maltreatment on perinatal outcomes, it may be vulnerable to bias. We assessed bias in reporting of maltreatment with respect to women's experiences of adverse perinatal outcomes in a cohort of 230 women enrolled in studies of maternal mental illness. Each woman provided a self-reported history of childhood maltreatment via the Childhood Trauma Questionnaire at two time points: 1) the preconception or prenatal period and 2) the postpartum period. While most women's reports of maltreatment agreed, there was less agreement for physical neglect among women experiencing adverse perinatal outcomes. Further, among women who discrepantly reported maltreatment, those experiencing adverse pregnancy outcomes tended to report physical neglect after delivery but not before, and associations between physical neglect measured after delivery and adverse pregnancy outcomes were larger than associations that assessed physical neglect before delivery. There were larger associations between post-delivery measured maltreatment and perinatal outcomes among women who had not previously been pregnant and in those with higher postpartum depressive symptoms. Although additional larger studies in the general population are necessary to replicate these findings, they suggest retrospective reporting of childhood maltreatment, namely physical neglect, may be prone to systematic differential recall bias with respect to perinatal outcomes. Measures of childhood maltreatment reported before delivery may be needed to validly estimate associations between maternal exposure to childhood physical neglect and perinatal outcomes. Copyright © 2018 Elsevier Ltd. All rights reserved.
Jud, Andreas; Fluke, John; Alink, Lenneke R A; Allan, Kate; Fallon, Barbara; Kindler, Heinz; Lee, Bong Joo; Mansell, James; van Puyenbroek, Hubert
Although high-income countries share and value the goal of protecting children from harm, national data on child maltreatment and the involvement of social services, the judiciary and health services remain relatively scarce. To explore potential reasons for this, a number of high-income countries across the world (Belgium, Canada, Germany, the Netherlands, New Zealand, South Korea, Switzerland and the United States) were compared. Amongst other aspects, the impact of service orientation (child protection-vs-family-services-orientated), the complexity of systems, and the role of social work as a lead profession in child welfare are discussed. Special consideration is given to indigenous and minority populations. The call for high-income countries to collect national data on child maltreatment is to promote research to better understand the risks to children. Its remit ranges well beyond these issues and reflects a major gap in a critical resource to increase prevention and intervention in these complex social situations. Fortunately, initiatives to close this gap are increasing.
Reijneveld, S.A.; de Meer, G.; Wiefferink, C.H.; Crone, M.R.
Abstract Objective Child maltreatment (i.e., abuse and neglect) is a major cause of child morbidity and death. It is a principal topic in community child-healthcare services yet little is known about the actual detection of suspected cases. We examined trends in this detection, as well as the
Doom, Jenalee R; Hazzard, Vivienne M; Bauer, Katherine W; Clark, Cari Jo; Miller, Alison L
While striving to succeed in the face of adversity may provide individuals with outward benefits, it may come at a cost to individuals' physical health. The current study examines whether striving predicts greater physiological or psychosocial costs among those who experienced child maltreatment, a stressor that disrupts the caregiving environment and threatens relationship security. Using data from the National Longitudinal Study of Adolescent to Adult Health, we tested whether greater striving after childhood maltreatment would come at a cost, increasing underlying cardiovascular disease (CVD) risk and depressive symptoms despite showing outward success via income and college degree attainment. The study included 13,341 Black, Hispanic, and White adolescents who self-reported striving and their experiences of childhood neglect, physical abuse, and sexual abuse. As young adults, participants reported depressive symptoms, income, and college degree attainment and completed a health assessment from which a 30-year Framingham-based CVD risk score was calculated. Higher striving was associated with lower CVD risk and depressive symptoms, and higher income and college degree attainment, regardless of maltreatment history. These findings highlight the potential for striving as a target for interventions and support the need to examine multiple biological and behavioral outcomes to understand the multifaceted nature of resilience.
Hoffmann, Ferdinand; Puetz, Vanessa B; Viding, Essi; Sethi, Arjun; Palmer, Amy; McCrory, Eamon J
Maltreatment is associated with increased risk of a range of psychiatric disorders, many of which are characterized by altered risk-taking propensity. Currently, little is known about the neural correlates of risk-taking in children exposed to maltreatment, nor whether their risk-taking is atypically modulated by peer influence. Seventy-five 10- to 14-year-old children [maltreated (MT) group: N = 41; non-maltreated Group (NMT): N = 34] performed a Balloon Analogue Risk Task (BART), under three different peer influence conditions: while alone, while being observed by a peer and while being encouraged by a peer to take risks. The MT group engaged in less risk-taking irrespective of peer influence. There was no differential effect of peer influence on risk-taking behaviour across groups. At the neural level, the right anterior insula (rAI) exhibited altered risk sensitivity across conditions in the MT group. Across groups and conditions, rAI risk sensitivity was negatively associated with risk-taking and within the MT group greater rAI risk sensitivity was related to more anxiety symptoms. These findings suggest that children with a history of maltreatment show reduced risk-taking but typical responses to peer influence. Abnormal rAI functioning contributes to the pattern of reduced risk-taking and may predispose children exposed to maltreatment to develop future psychopathology. © The Author (2017). Published by Oxford University Press.
Hoffmann, Ferdinand; Puetz, Vanessa B; Viding, Essi; Sethi, Arjun; Palmer, Amy
Abstract Maltreatment is associated with increased risk of a range of psychiatric disorders, many of which are characterized by altered risk-taking propensity. Currently, little is known about the neural correlates of risk-taking in children exposed to maltreatment, nor whether their risk-taking is atypically modulated by peer influence. Seventy-five 10- to 14-year-old children [maltreated (MT) group: N = 41; non-maltreated Group (NMT): N = 34] performed a Balloon Analogue Risk Task (BART), under three different peer influence conditions: while alone, while being observed by a peer and while being encouraged by a peer to take risks. The MT group engaged in less risk-taking irrespective of peer influence. There was no differential effect of peer influence on risk-taking behaviour across groups. At the neural level, the right anterior insula (rAI) exhibited altered risk sensitivity across conditions in the MT group. Across groups and conditions, rAI risk sensitivity was negatively associated with risk-taking and within the MT group greater rAI risk sensitivity was related to more anxiety symptoms. These findings suggest that children with a history of maltreatment show reduced risk-taking but typical responses to peer influence. Abnormal rAI functioning contributes to the pattern of reduced risk-taking and may predispose children exposed to maltreatment to develop future psychopathology. PMID:29069467
Kim, Jungmeen; Cicchetti, Dante; Rogosch, Fred A; Manly, Jody Todd
This study investigated the longitudinal impact of maltreatment parameters on personality processes and maladjustment and prospective relationships between personality trajectory classes and subsequent maladjustment outcomes. The sample involved maltreated (n = 249) and nonmaltreated (n = 200) children followed longitudinally between ages 6 and 10. Growth mixture modeling indicated multifinality in personality development depending on the risk status (i.e., maltreated vs. nonmaltreated). Two trajectory classes of ego resiliency were identified for maltreated children: those who showed a declining trajectory exhibited greater maladjustment. In contrast, three trajectory classes of ego control were identified for nonmaltreated children; the subgroups showing increases in ego undercontrol or dramatic changes from high ego undercontrol to high ego overcontrol exhibited poor adjustment. Experiencing multiple maltreatment subtypes and physical/sexual abuse were related to higher levels of ego undercontrol and externalizing symptomatology, whereas early onset of maltreatment was associated with the low and decreasing trajectory of ego resiliency and higher levels of internalizing symptomatology. The findings suggest that ego resiliency and ego control, personality processes related to self-regulation, may be important factors in identifying distinct pathways to later personality disorders as well as pathways to resilient functioning.
Huffhines, Lindsay; Tunno, Angela M.; Cho, Bridget; Hambrick, Erin P.; Campos, Ilse; Lichty, Brittany; Jackson, Yo
State social service agency case files are a common mechanism for obtaining information about a child’s maltreatment history, yet these documents are often challenging for researchers to access, and then to process in a manner consistent with the requirements of social science research designs. Specifically, accessing and navigating case files is an extensive undertaking, and a task that many researchers have had to maneuver with little guidance. Even after the files are in hand and the research questions and relevant variables have been clarified, case file information about a child’s maltreatment exposure can be idiosyncratic, vague, inconsistent, and incomplete, making coding such information into useful variables for statistical analyses difficult. The Modified Maltreatment Classification System (MMCS) is a popular tool used to guide the process, and though comprehensive, this coding system cannot cover all idiosyncrasies found in case files. It is not clear from the literature how researchers implement this system while accounting for issues outside of the purview of the MMCS or that arise during MMCS use. Finally, a large yet reliable file coding team is essential to the process, however, the literature lacks training guidelines and methods for establishing reliability between coders. In an effort to move the field toward a common approach, the purpose of the present discussion is to detail the process used by one large-scale study of child maltreatment, the Studying Pathways to Adjustment and Resilience in Kids (SPARK) project, a longitudinal study of resilience in youth in foster care. The article addresses each phase of case file coding, from accessing case files, to identifying how to measure constructs of interest, to dealing with exceptions to the coding system, to coding variables reliably, to training large teams of coders and monitoring for fidelity. Implications for a comprehensive and efficient approach to case file coding are discussed. PMID
Does the impact of child sexual abuse differ from maltreated but non-sexually abused children? A prospective examination of the impact of child sexual abuse on internalizing and externalizing behavior problems.
Lewis, Terri; McElroy, Erika; Harlaar, Nicole; Runyan, Desmond
Child sexual abuse (CSA) continues to be a significant problem with significant short and long term consequences. However, extant literature is limited by the reliance on retrospective recall of adult samples, single-time assessments, and lack of longitudinal data during the childhood and adolescent years. The purpose of this study was to compare internalizing and externalizing behavior problems of those with a history of sexual abuse to those with a history of maltreatment, but not sexual abuse. We examined whether gender moderated problems over time. Data were drawn from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) at ages 4, 6, 8, 10, 12, 14, and 16 (N=977). The Child Behavior Checklist was used to assess internalizing and externalizing problems. Maltreatment history and types were obtained from official Child Protective Services (CPS) records. Generalized Estimating Equations (GEE) were used to assess behavior problems over time by maltreatment group. Findings indicated significantly more problems in the CSA group than the maltreated group without CSA over time. Internalizing problems were higher for sexually abused boys compared to girls. For sexually abused girls internalizing problems, but not externalizing problems increased with age relative to boys. This pattern was similar among maltreated but not sexually abused youth. Further efforts are needed to examine the psychological effects of maltreatment, particularly CSA longitudinally as well as better understand possible gender differences in order to best guide treatment efforts. Copyright © 2015 Elsevier Ltd. All rights reserved.
Kim, Jinah; Kim, Kwanghyuk
A preliminary survey was conducted on primary school aged children (N=302) between seven to twelve years of age, who attend the local Community Child Centers (CCC) in the economically deprived areas of Jeollabukdo in South Korea for the purpose of identifying the children who have been exposed to on-going child maltreatment and poverty, and their needs. Both standardized and non-standardized self-report types of surveys were carried out and completed by both the children and the teachers of the CCC. As would be expected, emotional and behavioral problems are more pronounced by the children who are exposed to child maltreatment and poverty compared to the children who were not exposed to these adversities, or who were not poor. The more severely abused children in terms of frequency and co-occurrence of different abuses appear to display more behavioral problems than less severely abused children. Teachers reported that the children who were able to play a musical instrument and had arts therapy experiences appear to have less behavioral problems, particularly delinquent and aggressive behavior in comparison to the children who did not have such ability and experiences. Through the survey, it was possible to identify the children in need of therapeutic intervention and discover clinically relevant information. Clinical implications will be discussed further. Copyright © 2014 Elsevier Ltd. All rights reserved.
Scott, Kate M; Smith, Don A R; Ellis, Pete M
Despite growing evidence from longitudinal studies of a link between early-life stress and the development of asthma, very few of these examine one of the most severe types of early-life stress: childhood maltreatment. Cross-sectional studies on this topic have relied on retrospective self-reports of maltreatment. This study investigates associations between childhood maltreatment indicated by child protection agency records versus self-reports and lifetime asthma diagnosis in young adults, adjusting for socioeconomic status and mental disorders. A nationally representative general population survey of DSM-IV mental disorders in New Zealand (n = 12,992) obtained information on lifetime diagnoses of chronic physical conditions. Information from a subsample of survey respondents aged 16 to 27 years (n = 1413) was linked with a national child protection database to identify respondents with a history of agency involvement, which was used as a proxy for childhood maltreatment. Retrospective reports of maltreatment were also obtained. Child protection agency history was associated with elevated odds (odds ratio = 2.88 [95% confidence interval = 1.7-4.74]) of a lifetime diagnosis of asthma. After adjusting for a variety of indicators of socioeconomic status, lifetime mental disorders, lifetime smoking, and body mass index, this association remained significantly elevated (odds ratio = 2.26 [95% confidence interval = 1.33-3.83]). Retrospectively self-reported maltreatment in childhood was not associated with asthma. Childhood maltreatment was associated with elevated odds of asthma diagnosis. These findings are consistent with the possibility that early-life stress may be one of the environmental factors that increase the risk of asthma in genetically vulnerable individuals.
This dissertation comprises an empirical study and a meta-analytical study on autonomic nervous system (ANS) functioning and attachment representations in maltreating parents. For the empirical study we recruited a sample of 45 mothers with substantiated abuse and neglect and 45 non-maltreating
Rahman, Gisel; Ocampo, Dolores; Rubinstein, Anahí; Risso, Paula
The presence of sexually transmitted infections (STIs) in patients with suspected sexual abuse is uncommon in the field of pediatrics. To establish the prevalence of anogenital findings and their relation to the presence of STIs in girls referred for suspected child sexual abuse. Retrospective study conducted between January 1st, 2003 and December 31st, 2013. Physical findings and detection of STIs in girls with suspected child sexual abuse were analyzed. One thousand thirty-four patients were included. Their median age was 7.9 years old. Anogenital findings were classified as class I (normal):38.4%, class II (nonspecific):38.1%, class III (specific):19.9% and class IV (definitive):3.6%. STIs were observed in 42 patients (4.1%). A relation was established between STIs and the classification of physical findings: 10 (class II: 9; class III: 1) Neisseria gonorrhoeae, 17 (class I: 2; class II: 8; class III: 7) Chlamydia trachomatis, 15 (class I: 2; class II: 10; class III: 3) Trichomonas vaginalis. Statistically significant differences for Trichomonas vaginalis (p= 0.01) and Neisseria gonorrhoeae (p < 0.0001) were observed, with predominance of nonspecific clinical signs. Both nonspecific and specific findings were similarly observed for Chlamydia trachomatis (p= 0.03). Most cases of girls with suspected child sexual abuse had normal or nonspecific anogenital findings. The prevalence of STIs in these girls is low. Trichomonas vaginalis and Neisseria gonorrhoeae were related to nonspecific findings, while both nonspecific and specific findings were observed for Chlamydia trachomatis.
Roderick A. Rose
Full Text Available The child welfare system is an access point for children’s mental health services. Psychiatric residential treatment facilities (PRTFs are the most restrictive, and most expensive setting for children to receive long-term care. Given the high rates of behavioral health concerns among maltreated children in out-of-home care, research is needed to examine the factors that predict entry in PRTFs among children investigated for maltreatment. This exploratory study used cross-sector administrative records linked across multiple systems, including child welfare records and Medicaid claims, from a single state over a five-year period (n = 105,982. Cox proportional hazards modeling was used to predict entry into a PRTF. After controlling for many factors, PRTF entry was predicted by diagnosis code indicating a trauma-related condition, antipsychotic medication prescriptions, and entry into lower levels of out-of-home care, supporting the view that youth are admitted to PRTFs largely due to clinical need. However, PRTF admission is also associated with characteristics of their experiences with the social service system, primarily foster care placement stability and permanency. Implications for practice and research are discussed.
Casillas, Katherine L; Fauchier, Angèle; Derkash, Bridget T; Garrido, Edward F
In recent years there has been an increase in the popularity of home visitation programs as a means of addressing risk factors for child maltreatment. The evidence supporting the effectiveness of these programs from several meta-analyses, however, is mixed. One potential explanation for this inconsistency explored in the current study involves the manner in which these programs were implemented. In the current study we reviewed 156 studies associated with 9 different home visitation program models targeted to caregivers of children between the ages of 0 and 5. Meta-analytic techniques were used to determine the impact of 18 implementation factors (e.g., staff selection, training, supervision, fidelity monitoring, etc.) and four study characteristics (publication type, target population, study design, comparison group) in predicting program outcomes. Results from analyses revealed that several implementation factors, including training, supervision, and fidelity monitoring, had a significant effect on program outcomes, particularly child maltreatment outcomes. Study characteristics, including the program's target population and the comparison group employed, also had a significant effect on program outcomes. Implications of the study's results for those interested in implementing home visitation programs are discussed. A careful consideration and monitoring of program implementation is advised as a means of achieving optimal study results. Copyright © 2015 Elsevier Ltd. All rights reserved.
Greger, Hanne Klæboe; Myhre, Arne Kristian; Lydersen, Stian; Jozefiak, Thomas
Childhood maltreatment is an important risk factor for mental and physical health problems. Adolescents living in residential youth care (RYC) have experienced a high rate of childhood maltreatment and are a high-risk group for psychiatric disorders. Quality of life (QoL) is a subjective, multidimensional concept that goes beyond medical diagnoses. There is a lack of research regarding the associations between childhood maltreatment and QoL. In the present study, we compare self-reported QoL between adolescents in RYC in Norway with and without maltreatment histories, and adolescents from the general population. We also study the impact of number of types of adversities on QoL. Adolescents aged 12-23 years living in RYC in Norway were invited to participate in the study; 400 participated, yielding a response rate of 67 %. Maltreatment histories were assessed through interviews with trained research assistants, and completed by 335 adolescents. Previous exposure to maltreatment was reported by 237 adolescents. The Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents (KINDL-R) was used. Nonexposed peers in RYC (n = 98) and a sample of adolescents from the general population (n = 1017) were used for comparison. General linear model analyses (ANCOVA) were conducted with five KINDL-R life domains as dependent variables. Linear regression was used to study the effect of number of types of adversities. Exposed adolescents in RYC reported poorer QoL than peers in control groups. Compared with nonexposed peers in RYC, the 95 % confidence intervals for mean score differences on the KINDL-R subdomains (0-100 scale) were 1.9-11.4 (Physical Well-being), 2.2-11.1 (Emotional Well-being), -0.7-10.0 (Self-esteem), and 1.8-10.9 (Friends). Compared with the general population sample, the 95 % confidence intervals for mean score differences were 9.7-17.6 (Physical Well-being), 7.9-15.3 (Emotional Well-being), 3.6-12.5 (Self-esteem), and 5
McKinney, Cliff; Stearns, Melanie; Szkody, Erica
The current study examined the indirect effect of maternal and paternal emotional and physical maltreatment on affective and behavioral symptoms of oppositional defiant disorder (ODD) through parent-child relationship quality; gender and overall ODD symptoms were examined as moderators. Participants included 2,362 emerging adults who completed questionnaires about parental emotional and physical maltreatment, parent-child relationship quality, and affective and behavioral ODD symptoms. These characteristics were compared across parent and child gender (i.e., maternal and paternal effects as well as male and female differences) as well as participants reporting high and low ODD symptoms. In the low ODD group, indirect effects of emotional maltreatment occurred in all parent-child dyads except the mother-son dyad, whereas in the high ODD group, indirect effects occurred only in the father-son dyad. Indirect effects of physical maltreatment occurred only in the father-son dyad in the low ODD group, and only in the mother-daughter dyad on behavioral ODD symptoms in the high ODD group. The results suggest that specific parent-child gender dyads respond differently, warranting further investigation of gender effects. Moreover, emerging adults in the low ODD symptoms group demonstrated a positive association between parental maltreatment and ODD symptoms and a negative association between parent-child relationship quality and ODD symptoms, whereas those high in the high ODD symptoms group did not demonstrate these associations. That is, emerging adults reporting high ODD symptoms demonstrated no relationship between their ODD symptoms and harsh parenting, suggesting an ineffective coercive process.
Jud, A.; Fluke, J.; Alink, L.R.A.; Allan, K.; Fallon, B.; Kindler, H.; Lee, B.J.; Mansell, J.; van Puyenbroek, H.
Although high-income countries share and value the goal of protecting children from harm, national data on child maltreatment and the involvement of social services, the judiciary and health services remain relatively scarce. To explore potential reasons for this, a number of high-income countries
Hahm, Hyeouk Chris; Lee, Yoona; Ozonoff, Al; Van Wert, Michael J.
The purpose of this study was to investigate how different types of child maltreatment, independently and collectively, impact a wide range of risk behaviors that fall into three domains: sexual risk behaviors, delinquency, and suicidality. Cumulative classification and Expanded Hierarchical Type (EHT) classification approaches were used to…
Dos Santos Dias, A.M.; Sales, L.; Mooren, G.T.M.; Mota Cardoso, R.; Kleber, R.J.
Background/Objective: Childhood maltreatment (CM) has been associated with revictimization and post-traumatic stress disorder (PTSD). However, this relation is hardly examined in South European countries, and in community samples. We tested these associations in a convenience sample of 1,200
Rhodes, Anne E.; Boyle, Michael H.; Bethell, Jennifer; Wekerle, Christine; Goodman, Deborah; Tonmyr, Lil; Leslie, Bruce; Lam, Kelvin; Manion, Ian
Objectives: To determine whether the rates of a first presentation to the emergency department (ED) for suicide-related behavior (SRB) are higher among children/youth permanently removed from their parental home because of substantiated maltreatment than their peers. To describe the health care settings accessed by these children/youth before a…
McEvoy, M M
Child abuse is a particularly difficult subject to teach at both undergraduate and postgraduate level. Most doctors are dissatisfied with their training in child abuse recognition and management. We developed an interactive video based Virtual Patient to provide formal training for paediatric Basic Specialist Trainees in the recognition of suspected child abuse. The Virtual Patient case revolves around the management of suspected physical abuse in a seven month old child, who initially presents to the Emergency Department with viral upper respiratory tract symptoms. This Virtual Patient was used to facilitate a case discussion with Basic Specialist Trainees. A questionnaire was developed to determine their perception of the value of the Virtual Patient as an educational tool. Twenty five Basic Specialist Trainees completed the questionnaire. Upon completion of the case, 23\\/25 (92%) participants reported greater self confidence in their ability to recognize cases of suspected child abuse and 24\\/25 (96%) of participants reported greater self confidence in their ability to report cases of suspected child abuse. Basic Specialist Trainees perceived the Virtual Patient to be a useful educational tool. Virtual Patients may have a role to play in enhancing postgraduate training in the recognition of suspected child abuse.
Full Text Available Experts in the area of treatment and intervention for autism spectrum disorders provide parents with recommenda¬tions for situations when their children are suspected to have autism or have been diagnosed. These recommenda¬tions are universal and are appropriate for raising a child with any spectrum disorder. Following these recommenda¬tions will allow parents to comprehend the situation with the child’s development, access approaches, that are used by professionals, and will help them to not waste precious time on finding primary information after the diagnosis.
Koenig, A M; Schury, K; Reister, F; Köhler-Dauner, F; Schauer, M; Ruf-Leuschner, M; Gündel, H; Ziegenhain, U; Fegert, J M; Kolassa, I-T
Background: Childhood maltreatment (CM) can increase the risk of psychosocial risk factors in adulthood (e. g. intimate partner violence, financial problems, substance abuse or medical problems). The transition to parenthood presents those affected by CM with particular challenges, in addition to usual birth-related stressors. Methods: In this cross-sectional study a total of 240 women were interviewed in the puerperium with respect to CM experiences, using the German version of the Childhood Trauma Questionnaire (CTQ). Current psychosocial risk factors (e. g. financial concerns, maternal mental illness, single parent) were assessed using the Constance Index (KINDEX) for early childhood risk factors. Associations between CM experience and psychosocial risk factors were calculated using simple correlation. Results: The average age of participants was 33 years. On the CTQ 13.8 % of participants reported emotional abuse, 6.7 % physical abuse and 12.5 % sexual abuse, while 32.1 % reported emotional neglect and 7.5 % physical neglect during childhood. With rising severity of CM, more psychosocial risk factors (KINDEX) were present. Conclusions: This study shows a clear association between experiences of maltreatment during childhood and the presence of psychosocial stressors among women in the puerperium. Regular screening for a history of CM and parental psychosocial stressors should be conducted early, i.e. during pregnancy, to avoid negative consequences for the child.
Faulkner, Breanne; Goldstein, Abby L; Wekerle, Christine
Longitudinal survey data were used to examine the relationship between two types of childhood maltreatment, abuse/neglect and exposure to intimate partner violence (IPV), and two outcomes, substance use and dating violence, within the past year. Participants were youth (N = 158, aged 16-19 at Time 3) involved with child protective services (CPS). A parallel multiple mediator model was used to test the hypothesis that trauma symptoms would mediate the relationship between both types of maltreatment and dating violence, marijuana, and alcohol use outcomes. Although both types of maltreatment were not directly associated with dating violence and substance use outcomes, the indirect effects of anxiety, anger, and dissociation on the relationship between maltreatment and substance use/dating violence were significant. Direct effects of both types of maltreatment on past year use of dating violence + alcohol use and dating violence + marijuana use were not significant, but results demonstrated a significant indirect effect for anger on the relationship between exposure to IPV and past year dating violence + marijuana use. No other indirect effects were significant. Findings highlight the negative effects of exposure to IPV and have implications for the development of prevention programming for youth transitioning out of CPS. © The Author(s) 2014.
Baiden, Philip; Tarshis, Sarah; Antwi-Boasiako, Kofi; den Dunnen, Wendy
The purpose of this study was to examine the independent protective effect of subjective well-being on severe psychological distress among adult Canadians with a history of child maltreatment. Data for this study were obtained from the 2012 Canadian Community Health Survey-Mental Health (CCHS-MH). A sample of 8126 respondents aged 20-69 years old who experienced at least one child maltreatment event was analyzed using binary logistic regression with severe psychological distress as the outcome variable. Of the 8126 respondents with a history of child maltreatment, 3.9% experienced severe psychological distress within the past month. Results from the multivariate logistic regression revealed that emotional and psychological well-being each had a significant effect on severe psychological distress. For each unit increase in emotional well-being, the odds of a respondent having severe psychological distress were predicted to decrease by a factor of 28% and for each unit increase in psychological well-being, the odds of a respondent having severe psychological distress were predicted to decrease by a factor of 10%, net the effect of demographic, socioeconomic, and health factors. Other factors associated with psychological distress included: younger age, poor self-perceived physical health, and chronic condition. Having post-secondary education, having a higher income, and being non-White predicted lower odds of severe psychological distress. Although, child maltreatment is associated with stressful life events later in adulthood, subjective well-being could serve as a protective factor against severe psychological distress among adults who experienced maltreatment when they were children. Copyright © 2016 Elsevier Ltd. All rights reserved.
McElearney, Aisling; Brennan-Wilson, Aoibheann; Murphy, Christina; Stephenson, Phyllis; Bunting, Brendan
Child maltreatment has a pervasive, detrimental impact on children's wellbeing. Despite a growing focus on prevention through school based education, few programmes adopt a whole- school approach, are multi-component, seek to address all forms of maltreatment, or indeed have been robustly evaluated. This paper describes a cluster randomised controlled trial designed to evaluate a school based child maltreatment prevention programme: 'Keeping Safe' in primary schools in Northern Ireland. The intervention has been designed by a non-profit agency. Programme resources include 63 lessons taught incrementally to children between four and 11 years old, and is premised on three core themes: healthy relationships, my body, and being safe. There are programme resources to engage parents and to build the capacity and skills of school staff. A cluster Randomised Controlled Trial (RCT) will be conducted with children in 80 schools over a two-year period. The unit of randomisation is the school. Schools will be allocated to intervention or wait-list control groups using a computer-generated list. Data will be collected at three time points: baseline, end of year one, and end of year two of programme implementation. Primary outcomes will include: children's understanding of key programme concepts, self-efficacy to keep safe in situations of maltreatment, anxiety arising from programme participation, and disclosure of maltreatment. Secondary outcomes include teachers' comfort and confidence in teaching the programme and parents' confidence in talking to their children about programme concepts. This RCT will address gaps in current practice and evidence regarding school based child maltreatment prevention programmes. This includes the use of a whole- school approach and multi-component programme that addresses all maltreatment concepts, a two-year period of programme implementation, and the tracking of outcomes for children, parents, and teachers. Methodologically, it will extend
Nikulina, Valentina; Widom, Cathy Spatz
Objective There is extensive evidence of negative consequences of childhood maltreatment for IQ, academic achievement, and post-traumatic stress disorder (PTSD) and increased attention to neurobiological consequences. However, few prospective studies have assessed the long-term effects of abuse and neglect on executive functioning. The current study examines whether childhood abuse and neglect predicts components of executive functioning and nonverbal reasoning ability in middle adulthood and whether PTSD moderates this relationship. Method Using a prospective cohort design, a large sample (N = 792) of court-substantiated cases of childhood physical and sexual abuse and neglect (ages 0-11) and matched controls were followed into adulthood (mean age = 41). Executive functioning was assessed with the Trail Making B test and non-verbal reasoning with Matrix Reasoning. PTSD (DSM-III-R lifetime diagnosis) was assessed at age 29. Data were analyzed using ordinary least squares regressions, controlling for age, sex, and race and possible confounds of IQ, depression, and excessive alcohol use. Results In multivariate analyses, childhood maltreatment overall and childhood neglect predicted poorer executive functioning and non-verbal reasoning at age 41, whereas physical and sexual abuse did not. A past history of PTSD did not mediate or moderate these relations. Conclusions Childhood maltreatment and neglect specifically have a significant long-term impact on important aspects of adult neuropsychological functioning. These findings suggest the need for targeted efforts dedicated to interventions for neglected children. PMID:23876115
Villodas, Miguel T; Litrownik, Alan J; Thompson, Richard; Jones, Deborah; Roesch, Scott C; Hussey, Jon M; Block, Stephanie; English, Diana J; Dubowitz, Howard
The present study examined the impact of children's maltreatment experiences on the emergence of externalizing problem presentations among children during different developmental periods. The sample included 788 youth and their caregivers who participated in a multisite, prospective study of youth at-risk for maltreatment. Externalizing problems were assessed at ages 4, 8, and 12, and symptoms and diagnoses of attention-deficit/hyperactivity disorder, oppositional defiant disorder, and conduct disorder were assessed at age 14, during interviews with youth and caregivers. Information about maltreatment allegations was coded from official records. Latent transition analysis identified three groups of youth with similar presentations of externalizing problems ("well adjusted," "hyperactive/oppositional," and "aggressive/rule-breaking") and transitions between groups from ages 4, 8, and 12. A "defiant/deceitful" group also emerged at age 12. Girls were generally more likely to present as well adjusted than boys. Children with recent physical abuse allegations had an increased risk for aggressive/rule-breaking presentations during the preschool and preadolescent years, while children with sexual abuse or neglect allegations had lower probabilities of having well-adjusted presentations during middle childhood. These findings indicate that persistently severe aggressive conduct problems, which are related to the most concerning outcomes, can be identified early, particularly among neglected and physically and sexually abused children.
Examination of Life Satisfaction, Child Maltreatment Potential and Substance Use in Mothers Referred for Treatment by Child Protective Services for Child Neglect and Substance Abuse: Implications for Intervention Planning
Plant, Christopher P.; Donohue, Brad; Holland, Jason M.
There is evidence to suggest mothers who are served by child protective service agencies are relatively dissatisfied in their lives, leading some investigators to conclude life dissatisfaction may be associated with child maltreatment. To assist in better understanding this relationship the Life Satisfaction Scale for Caregivers (LSSC) was psychometrically developed in a sample of 72 mothers who were referred for behavioral treatment for child neglect and substance abuse by caseworkers from a local child protective service agency. The LSSC was developed to assess mothers’ happiness in nine domains (family, friendships, employment/work, spirituality/religion, safety, sex life/dating, ability to avoid drugs, ability to avoid alcohol, control over one’s own life). Results indicated two factors that appeared to be relevant to Social Satisfaction and Safety and Control Satisfaction. Higher satisfaction scores on both of these scales were negatively associated with child maltreatment potential and substance use at baseline (i.e., positive urinalysis test). Mothers who exposed their children to substances in utero or in infancy (a distinct type of child neglect) were found to report higher satisfaction scores on the LSSC than other types of child neglect. Hispanic-American, African-American, and Caucasian women reported similar levels of life satisfaction. Application of the LSSC as a non-stigmatizing, wellness-focused instrument is discussed within the context of intervention planning. PMID:27617042
Byrne, S; Rodrigo, M J; Máiquez, M L
In the area of child maltreatment prevention, little is known about the typology of changes that individuals undergo in response to parent-training interventions. In this study, we examined the patterns of change observed in parents immediately after their completion of the Apoyo Personal y Familiar (APF, Personal and Family Support) parenting program. We identified five clusters and classified 496 parents according to two criteria: (a) the amount of pre-post changes (total or partial) as reflected in their self-reports on implicit theories, parental agency and childrearing practices, and (b) the positive, negative or mixed character of these changes. The study also included a follow-up of a subset of 95 participants intended to examine the extent to which the patterns of change identified in the first part of the study might predict the quality of the childrearing environment at home and the successful integration of the APF program into social services structures one year on. In this follow-up study, external evaluators observed families' home environments and collected the parenting program facilitators' self-reports on changes to their work environment. The evaluators found higher-quality childrearing environments and more positive appraisals of the changes to the teams' work with families in those cases where participants had experienced partial or total positive changes as a result of the APF. This approach offers insights into processes of individual change that have practical implications for the successful implementation of parenting programs in child maltreatment prevention services. Copyright © 2014 Elsevier Ltd. All rights reserved.
Janßen, Katharina; Greif, Dominik; Rothschild, Markus A; Banaschak, Sibylle
If a case of physical child abuse is suspected in Germany, the general feeling is often that "it does not matter whether you make a report or not" because, generally, no conviction is made anyway. This study investigates the juridical analysis of complaint cases of physical child abuse [criminal complaint parag. 225 StGB (German penal code) with filial victim]. It focuses on the doctor's role and the impact of their practice in relation to a later conviction. It is based on the analysis of 302 files of the enquiry from 2004-2009 from the department of public prosecution in Cologne, Germany. Besides general epidemiological data on the reporting person, the affected child and the presumed offender, the documents were reassessed for the relevance of medical reports for successful convictions. Only 7% (n = 21) of 302 complaints led to a conviction. In 38.1% (n = 8) of those cases, a medical report was mentioned as a piece of evidence, and just in two cases a (legal) medical report was quoted and mentioned as relevant for the conviction. 50% of the complaint cases with legal medical expertise led to a trial. In contrast, only 30.2% with a common medical report and 7.3% without a report led to a trial. The results show how a medical report existed in only a few cases. In those cases, the rate of performed trials was higher than for those without a medical report, but the report played a minor part when reasoning a verdict.
Wulf-Andersen, Trine Østergaard; Ranning, Anne
Children of parents with acute symptoms of schizophrenia are at high risk of being exposed to adverse environmental circumstances known to predict future mental and physical illness. To ensure a healthy development of children human services must address the needs of children of patients...... with schizophrenia. In this study, notifications of suspected child abuse and neglect was used to elicit difficulties in parental role functioning in schizophrenia patients. Qualitative text analysis was used to elicit common themes in 49 written documents from social workers at mental health centres expressing...... concerns about the wellbeing of children of patients with schizophrenia. We found the most recurring themes to be “parents’ delusions”, “parents being absorbed in their private reality”, “parents’ distress as a result of symptoms”, “fierce or violent scenes in the home” and “burden on other caretakers...
Cicchetti, Dante; Rogosch, Fred A; Sturge-Apple, Melissa; Toth, Sheree L
To investigate whether genotypic variation of the serotonin transporter gene-linked promoter region (5-HTTLPR) moderates the effect of maltreatment on suicidal ideation in school-aged children. Eight hundred and fifty low-income children (478 maltreated; 372 non-maltreated) provided DNA samples and self-reported depressive and suicidal symptoms. Genotypes of 5-HTTLPR (s/s or s/l vs. l/l) were determined by fragment analyses. Higher suicidal ideation was found among maltreated than non-maltreated children; the groups did not differ in 5-HTTLPR genotype frequencies. Children with one to two maltreatment subtypes and s/s or s/l genotypes had higher suicidal ideation than those with the l/l genotype; suicidal ideation did not differ in non-maltreated children or children with three to four maltreatment subtypes based on 5-HTTLPR variation. The results were applicable to emotionally maltreated/neglected and to physically/sexually abused children. Gene-environment interaction was not found for depressive symptoms. The protective effect of the 5-HTTLPR l/l genotype on suicidal ideation was limited to maltreated children experiencing fewer subtypes.
Davies, Ffion C; Lecky, Fiona E; Fisher, Ross; Fragoso-Iiguez, Marisol; Coats, Tim J
Networked organised systems of care for patients with major trauma now exist in many countries, designed around the needs of the majority of patients (90% adults). Non-accidental injury is a significant cause of paediatric major trauma and has a different injury and age profile from accidental injury (AI). This paper compares the prehospital and inhospital phases of the patient pathway for children with suspected abuse, with those accidentally injured. The paediatric database of the national trauma registry of England and Wales, Trauma Audit and Research Network, was interrogated from April 2012 (the launch of the major trauma networks) to June 2015, comparing the patient pathway for cases of suspected child abuse (SCA) with AI. In the study population of 7825 children, 7344 (94%) were classified as AI and 481 (6%) as SCA. SCA cases were younger (median 0.4 years vs 7 years for AI), had a higher Injury Severity Score (median 16vs9 for AI), and had nearly three times higher mortality (5.7%vs2.2% for AI). Other differences included presentation to hospital evenly throughout the day and year, arrival by non-ambulance means to hospital (74%) and delayed presentation to hospital from the time of injury (median 8 hours vs 1.8 hours for AI). Despite more severe injuries, these infants were less likely to receive key interventions in a timely manner. Only 20% arrived to a designated paediatric-capable major trauma centre. Secondary transfer to specialist care, if needed, took a median of 21.6 hours from injury(vs 13.8 hours for AI). These data show that children with major trauma that is inflicted rather than accidental follow a different pathway through the trauma system. The current model of major trauma care is not a good fit for the way in which child victims of suspected abuse present to healthcare. To achieve better care, awareness of this patient profile needs to increase, and trauma networks should adjust their conventional responses. © Article author
Smith, Lucia Rojas; Gibbs, Deborah; Wetterhall, Scott; Schnitzer, Patricia G; Farris, Tonya; Crosby, Alex E; Leeb, Rebecca T
Reducing the number of largely preventable and tragic deaths due to child maltreatment (CM) requires an understanding of the magnitude of and risk factors for fatal CM and targeted research, policy, and prevention efforts. Public health surveillance offers an opportunity to improve our understanding of the problem of CM. In 2006, the Centers for Disease Control and Prevention (CDC) funded state public health agencies in California, Michigan, and Oregon to implement a model approach for routine and sustainable CM surveillance and evaluated the experience of those efforts. We describe the experiences of 3 state health agencies in building collaborations and partnerships with multiple stakeholders for CM surveillance. Qualitative, structured key informant interviews were carried out during site visits as part of an evaluation of a CDC-funded project to implement a model approach to CM surveillance. Key informants included system stakeholders from state health agencies, law enforcement, child protective services, the medical community, and child welfare advocacy groups in the 3 funded states. Factors that facilitated stakeholder engagement for CM surveillance included the following: streamlining and coordinating the work of Child Death Review Teams (CDRTs); demonstrating the value of surveillance to non-public health partners; codifying relationships with participating agencies; and securing the commitment of decision-makers. Legislative mandates were helpful in bringing key stakeholders together, but it was not sufficient to ensure sustained engagement. The engagement process yielded multiple benefits for the stakeholders including a deeper appreciation of the complexity of defining CM; a greater understanding of risk factors for CM; and enhanced guidance for prevention and control efforts. States considering or currently undertaking CM surveillance can glean useful insights from the experiences of these 3 states and apply them to their own efforts to engage
Leung, R.S.; Nwachuckwu, C.; Pervaiz, A.; Wallace, C.; Landes, C.; Offiah, A.C.
Aim: To determine current practice and perceptions of the adequacy of training and support received for the reporting of skeletal surveys in suspected physical child abuse. Materials and methods: A list of telephone numbers of UK hospitals with a radiology department was obtained from Royal College of Radiologists. One hundred hospitals were then randomly selected for inclusion in the survey. An 18-item questionnaire was successfully administered to consultant radiologists from 84 departments. Results: Sixty-one percent of departments had a named radiologist to report their skeletal surveys, 16% assigned surveys to a random radiologist, and 23% referred them elsewhere. Only 52% of departments had a dedicated paediatric radiologist, thus in a significant proportion of departments (25%) initial reports on skeletal surveys for physical abuse were provided by non-paediatric radiologists. Fifteen percent did not have ready access to a paediatric radiology opinion. Sixty-one percent thought that the service could be improved. Expert evidence was provided by 5% of respondents. Seventy-three percent would never consider providing expert evidence, even if given adequate radiology and/or legal training. Conclusion: The survey shows significant dissatisfaction amongst consultant radiologists with the current service, confirms a low number of paediatric radiologists taking on this work, and suggests the potential to increase numbers of radiology child abuse experts by 27% if given improved training and support. Appropriate service and education strategies should be implemented.
Leung, R.S. [Department of Radiology, Great Ormond Street Hospital for Children, London (United Kingdom); Nwachuckwu, C. [Department of Paediatrics, Whipps Cross Hospital, London (United Kingdom); Pervaiz, A. [Department of Radiology, Great Ormond Street Hospital for Children, London (United Kingdom); Wallace, C.; Landes, C. [Department of Radiology, Royal Liverpool Childrens NHS Trust, Liverpool (United Kingdom); Offiah, A.C. [Department of Radiology, Great Ormond Street Hospital for Children, London (United Kingdom)], E-mail: OffiaA@gosh.nhs.uk
Aim: To determine current practice and perceptions of the adequacy of training and support received for the reporting of skeletal surveys in suspected physical child abuse. Materials and methods: A list of telephone numbers of UK hospitals with a radiology department was obtained from Royal College of Radiologists. One hundred hospitals were then randomly selected for inclusion in the survey. An 18-item questionnaire was successfully administered to consultant radiologists from 84 departments. Results: Sixty-one percent of departments had a named radiologist to report their skeletal surveys, 16% assigned surveys to a random radiologist, and 23% referred them elsewhere. Only 52% of departments had a dedicated paediatric radiologist, thus in a significant proportion of departments (25%) initial reports on skeletal surveys for physical abuse were provided by non-paediatric radiologists. Fifteen percent did not have ready access to a paediatric radiology opinion. Sixty-one percent thought that the service could be improved. Expert evidence was provided by 5% of respondents. Seventy-three percent would never consider providing expert evidence, even if given adequate radiology and/or legal training. Conclusion: The survey shows significant dissatisfaction amongst consultant radiologists with the current service, confirms a low number of paediatric radiologists taking on this work, and suggests the potential to increase numbers of radiology child abuse experts by 27% if given improved training and support. Appropriate service and education strategies should be implemented.
Li, Longfeng; Lin, Xiuyun; Chi, Peilian; Heath, Melissa Allen; Fang, Xiaoyi; Du, Hongfei; Wang, Zhonghui
Maltreatment has negative effects on the parent-child relationship and the emotional and behavioral development of children. The current study aimed to examine the associations among maltreatment, parent-child relationship, and emotional and behavioral problems in Chinese children with or without oppositional defiant disorder (ODD). Participants in the study included 259 children with ODD and their 269 non-ODD counterparts from northern, eastern, and southwestern China. We also collected data from their teachers and fathers or mothers. The results showed that ODD children suffered more maltreatment and had more emotional and behavioral problems than their non-ODD peers. For all children (both ODD and non-ODD children), emotional abuse predicted emotional problems but not behavioral problems. Physical abuse predicted behavioral problems but not emotional problems. Parent-child relationship mediated the effects of emotional abuse and physical abuse on emotional problems among ODD children but not among non-ODD children. Implications for prevention of emotional and physical abuse and ODD in the Chinese cultural context are discussed. © The Author(s) 2016.
Weiss, Jonathan A.; MacMullin, Jennifer; Waechter, Randall; Wekerle, Christine
One of the most salient developmental tasks of adolescence is the entry into romantic relationship, which often involves developing attachments to partners. Adolescents with a history of maltreatment have been found to be at greater risk of insecure attachments to romantic partners than non-maltreated adolescents, and the interaction of…
Hong, Jun Sung; Espelage, Dorothy L.; Grogan-Kaylor, Andrew; Allen-Meares, Paula
A growing body of literature is demonstrating associations between childhood maltreatment and bullying involvement at school. In this literature review, four potential mediators (explanatory) and three potential moderators (mitigates or exacerbates) of the association between childhood maltreatment and school bullying are proposed. Mediators…
Corso, Phaedra S.; Ingels, Justin B.; Roldos, M. Isabel
Estimating the benefits of preventing child maltreatment (CM) is essential for policy makers to determine whether there are significant returns on investment from interventions to prevent CM. The aim of this study was to estimate the benefits of preventing CM deaths in an Ecuadorian population, and to compare the results to a similar study in a US population. The study used the contingent valuation method to elicit respondents’ willingness to pay (WTP) for a 1 in 100,000 reduction in the risk of CM mortality. After adjusting for differences in purchasing power, the WTP to prevent the CM mortality risk reduction in the Ecuador population was $237 and the WTP for the same risk reduction in the US population was $175. In the pooled analysis, WTP for a reduction in CM mortality was significantly impacted by country (p = 0.03), history of CM (p = 0.007), payment mechanism (p Ecuador, may be better served by developing their own benefits estimates for use in future benefit-cost analyses of interventions designed to prevent CM. PMID:23538730
Wilgus, Sam J; Packer, Mary M; Lile-King, Rachel; Miller-Perrin, Cindy L; Brand, Bethany L
Abnormal psychology courses introduce undergraduate students to the range, causes, and treatments of psychological disorders. These courses present important opportunities to instruct students about disorders and treatments associated with childhood maltreatment (CM) as well as its prevalence. Little research has examined the adequacy with which abnormal psychology textbooks present information about CM. The present study reviewed the CM content of 10 abnormal psychology textbooks. The content was assessed in terms of the number of times CM was mentioned, the number of psychological disorders linked to CM, and the number of CM-related research citations. In addition, the authors conducted a content analysis to examine the significance, depth of detail, and organizational structure of the information provided within the sections of text addressing CM. There were significant differences in scores and the accuracy of coverage of CM across textbooks. Most of the textbooks lack key information on CM. The information presented in many textbooks is not consistent with current research and is overly focused on controversies. These findings are concerning because research has linked many psychological disorders and problematic outcomes to CM, but this information is not adequately conveyed to students via abnormal psychology textbooks. The authors make recommendations for improving the coverage of CM in abnormal psychology textbooks. (c) 2016 APA, all rights reserved).
Dias, Aida; Sales, Luísa; Hessen, David J; Kleber, Rolf J
Child maltreatment (CM) is associated with poor long-term health outcomes. However, knowledge about CM prevalence and related consequences is scarce among adults in South European countries. We examined the self-reported prevalence of five different forms of CM in a community sample of 1,200 Portuguese adults; we compared the results with similar samples from three other countries, using the same instrument. We also explored the relationship between CM and psychological symptoms. Cross-sectional data using the Childhood Trauma Questionnaire-Short Form and the Brief Symptom Inventory were analyzed. Moderate or severe CM exposure was self-reported by 14.7% of the sample, and 67% was exposed to more than one form of CM. Emotional neglect was the most endorsed experience, with women reporting greater emotional abuse and men reporting larger physical abuse. Physical and sexual abuse was less self-reported by Portuguese than by American or German subjects. CM exposure predicted 12.8% of the psychological distress. Emotional abuse was the strongest predictor for psychological symptoms, namely for paranoid ideation, depression, and interpersonal sensitivity. Emotional abuse overlapped with the exposure to all other CM forms, and interacted with physical abuse, physical neglect, and emotional neglect to predict psychological distress. Low exposure to emotional abuse was directly associated with the effects of physical abuse, physical neglect, and emotional neglect to predict adult psychological distress. Verbal abuse experiences were frequently reported and had the highest correlations with adult psychological distress. Our results underline the potential hurtful effects of child emotional abuse among Portuguese adults in the community. They also highlight the need to improve prevention and intervention actions to reduce exposure and consequences of CM, particularly emotional abuse.
Duran, Bonnie; Malcoe, Lorraine Halinka; Sanders, Margaret; Waitzkin, Howard; Skipper, Betty; Yager, Joel
Objective: To examine (1) the prevalence, types, and severity of child abuse and neglect (CAN) and (2) the relationship between CAN and lifetime psychiatric disorders among American Indian women using primary care services. Methods: A cross-sectional study was conducted among 234 American Indian women, age 18-45 who presented for outpatient…
Berger, Lawrence M; Font, Sarah A; Slack, Kristen S; Waldfogel, Jane
This study estimates the associations of income with both (self-reported) child protective services (CPS) involvement and parenting behaviors that proxy for child abuse and neglect risk among unmarried families. Our primary strategy follows the instrumental variables (IV) approach employed by Dahl and Lochner (2012), which leverages variation between states and over time in the generosity of the total state and federal Earned Income Tax Credit for which a family is eligible to identify exogenous variation in family income. As a robustness check, we also estimate standard OLS regressions (linear probability models), reduced form OLS regressions, and OLS regressions with the inclusion of a control function (each with and without family-specific fixed effects). Our micro-level data are drawn from the Fragile Families and Child Wellbeing Study, a longitudinal birth-cohort of relatively disadvantaged urban children who have been followed from birth to age nine. Results suggest that an exogenous increase in income is associated with reductions in behaviorally-approximated child neglect and CPS involvement, particularly among low-income single-mother families.
Sanders, Barbara; Becker-Lausen, Evvie
The Child Abuse and Trauma Scale, a self-report measure yielding a quantitative index of the frequency and extent of negative experiences in childhood and adolescence, was administered to 1,198 college students and 17 subjects with Multiple Personality Disorder. Results revealed the scale's strong internal consistency, test-retest reliability, and…
Larson, Oscar W., III; And Others
Responses of 1,328 educational personnel in 14 states along the Atlantic coastal region who work with migrant children indicated that the incidence of child abuse among migrant families was perceived to be substantially higher than for the general population or nonmigrant families of the same socioeconomic status. (Author/DB)
Skowron, Elizabeth A.; Kozlowski, JoEllen M.; Pincus, Aaron L.
This set of studies was designed to examine the relational underpinnings of child abuse potential in a sample of 51 urban families. In Study 1, lower maternal differentiation of self--most notably, greater emotional reactivity and greater emotional cutoff--along with self-attacking introjects distinguished mothers at higher risk (vs. lower risk)…
Ju, Soyoung; Lee, Yanghee
The purpose of this study is to identify the developmental trajectories of peer attachment, self-esteem, depression, and child maltreatment, and to understand the longitudinal mediation effects that peer attachment and self-esteem have on the influence of perceived abuse on early adolescent depression. This study uses Year 1 to Year 5 data of the 4th grader panel of the Korea Youth Panel Survey (KYPS) and utilizes a multivariate latent growth model to analyze the main variables in the applicable data between 5th (i.e., Year 2) and 8th (i.e., Year 5) grades. The results indicate that from the 5th to the 8th grade, the degree of abuse and depression increases while self-esteem gradually decreases with slowly lowering peer attachment. A significant distribution of the initial values and the rate of change were present for all main variables of the study, confirming individual differences in time wise changes. Further, more exposure to abuse correlated with a decrease in self-esteem, while an increase in self-esteem greatly reduced depression. The initial value of self-esteem showed a partial mediation effect, whereas the rate of change indicated a full mediation effect with a significant longitudinal mediation effect. More experience of abuse during early adolescence indicated a lower degree of peer attachment, and a higher peer attachment was related to decreased depression. A significant partial mediation effect was present for both the initial value and the rate of change of peer attachment, and a longitudinal mediation effect was present. This study confirmed that self-esteem in early adolescents is an important protective factor that can greatly reduce the degree of depression, and suggests continuous interventions conducted to increase self-esteem in adolescence. Furthermore, by determining that peer attachment decreases the degree of depression in children at risk, the study emphasizes the healing aspect of adolescent peer attachment. Copyright © 2017 Elsevier
Esposito-Smythers, Christianne; Weismoore, Julie T.; Renshaw, Keith D.
A large body of research suggests that child maltreatment (CM) is associated with adolescent suicidal ideation and attempts. These studies, however, have not been critically examined and summarized in a manner that allows us to draw firm conclusions and make recommendations for future research and clinical work in this area. In this review, we evaluated all of the research literature to date examining the relationship between CM and adolescent suicidal ideation and attempts. Results generally suggest that childhood sexual abuse, physical abuse, emotional abuse, and neglect are associated with adolescent suicidal ideation and attempts across community, clinical, and high-risk samples, using cross-sectional and longitudinal research designs. In most studies, these associations remain significant when controlling for covariates such as youth demographics, mental health, family, and peer-related variables. When different forms of CM are examined in the same multivariate analysis, most research suggests that each form of CM maintains an independent association with adolescent suicidal ideation and suicide attempts. However, a subset of studies yielded evidence to suggest that sexual abuse and emotional abuse may be relatively more important in explaining suicidal behavior than physical abuse or neglect. Research also suggests an additive effect—each form of CM contributes unique variance to adolescent suicide attempts. We discuss the current limitations of this literature and offer recommendations for future research. We conclude with an overview of the clinical implications of this research, including careful, detailed screening of CM history, past suicidal behavior, and current suicidal ideation, as well as the need for integrated treatment approaches that effectively address both CM and adolescent suicidal ideation and suicide attempts. PMID:23568617
Altamimi, Dana; Almuneef, Maha; Albuhairan, Fadia; Saleheen, Hassan
The aim of this study was to examine the relationship between child maltreatment (CM) and school performance among adolescents in Saudi Arabia. A cross-sectional study was conducted in Riyadh, Saudi Arabia, in 2014. The enrolment criteria included both male and female Saudi students ( n=674; 52.7% male) aged 12-19 years ( M age =15.6±1.6 years), attending intermediate and secondary schools belonging to the Ministry of National Guard. A self-administered questionnaire was used to gather information on different forms of abuse that had occurred in the past or were currently occurring. Poor school performance was more likely in students who lived among substance-use family members or guardians compared with those who did not (33.3% vs. 11.4%; p<0.01), those with an imprisoned family member compared with those without (26.5% vs. 11.2%; p<0.01), those who were psychologically abused compared with those who were not abused (21.0% vs. 10.1%; p<0.01), those who were physically abused compared with those who were not abused (18.9% vs. 9.3%; p<0.01), and those suffering multiple forms of abuse compared with those not abused (23.4% vs. 9.7%; p<0.01). Logistic regression analysis showed that household dysfunction was the most predisposing factor to poor performance in school, and included living among substance-use family members or guardians (odds ratio=4.0; 95% confidence interval=1.7-9.5) and living with imprisoned family member (odds ratio=3.1, 95% confidence interval=1.5-6.3). CM, along with family structure and dynamics, has an adverse relationship with students' school performance. These findings highlight the importance of increasing awareness of the impact of CM on school performance among families, schools and the community.
Al-Eissa, Majid A; AlBuhairan, Fadia S; Qayad, Mohammed; Saleheen, Hassan; Runyan, Desmond; Almuneef, Maha
Studies in other countries, including countries with mandated reporting by professionals and a long history of recognition of the problem, have found child abuse to be seriously under reported. This population-based pilot study was conducted to determine the magnitude of adolescents' exposure to CAN at home, and to identify ethical and methodological challenges to conducting a survey on a culturally sensitive subject. This cross-sectional study was carried out in Al-Kharj city in 2011-2012. Through a stratified multistage cluster random sampling of schools, a sample of adolescents (15-18 years) were identified and invited to participate. The ISPCAN Child Abuse Screening Tool-Child: Home version (ICAST-CH) was used for data collection. The previous year's incidence of physical, psychological, and sexual abuse, neglect, and exposure to violence were assessed. A total of 2,043 students participated in the study (mean age, 16.6 years; 58%, female). The incidence of psychological abuse, physical abuse, exposure to violence, neglect, and sexual abuse were 74.9%, 57.5%, 50.7%, 50.2%, and 14.0%, respectively. Female participants were at higher risk for psychological and physical abuse, exposure to violence, and neglect, but not for sexual abuse. The rates and gender distribution of CAN at home differ from findings of health-based records. Our results are comparable to other regional population-based studies. Thus, population-based data are necessary to inform and guide professionals and decision makers for prevention policies and resource allocation. Insights to ethical and methodological challenges surrounding the sensitive nature of this type of study are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.
Sty, J.R.; Starshak, R.J.
A comparison was made of the radiographic and scintigraphic skeletal surveys of 261 children who were suspected victims of abuse. Radiography was positive in 105 children and produced false-negative results in 32; scintigraphy was positive in 120 children and produced false-negative results in two. Although radiography has traditionally been used to assess the skeletal injuries of battered children, the authors conclude that scintigraphy should be the screening procedure of choice for children suspected of having been abused
Appleyard, Karen; Yang, Chongming; Runyan, Desmond K.
The current study investigated concurrent and longitudinal mediated and mediated moderation pathways among maltreatment, self perception (i.e., loneliness and self esteem), social support, and internalizing and externalizing behavior problems. For both genders, early childhood maltreatment (i.e., ages 0–6) was related directly to internalizing and externalizing behavior problems at age 6, and later maltreatment (i.e., ages 6–8) was directly related to internalizing and externalizing behavior problems at age 8. Results of concurrent mediation and mediated moderation indicated that early maltreatment was significantly related to internalizing and externalizing behavior problems at age 6 indirectly both through age 6 loneliness and self esteem for boys and through age 6 loneliness for girls. Significant moderation of the pathway from early maltreatment to self esteem, and, for boys, significant mediated moderation to emotional and behavioral problems were found, such that the mediated effect through self esteem varied across levels of social support, though in an unexpected direction. No significant longitudinal mediation or mediated moderation was found, however, between the age 6 mediators and moderator and internalizing or externalizing problems at age 8. The roles of the hypothesized mediating and moderating mechanisms are discussed, with implications for designing intervention and prevention programs. PMID:20423545
Romano, Elisa; Babchishin, Lyzon; Marquis, Robyn; Fréchette, Sabrina
Children (0-18 years) with maltreatment histories are vulnerable to experiencing difficulties across multiple domains of functioning, including educational outcomes that encompass not only academic achievement but also mental well-being. The current literature review adopted Slade and Wissow's model to examine (1) the link between childhood maltreatment and academic achievement, (2) the link between childhood maltreatment and mental health outcomes (i.e., emotional and behavioral difficulties), and (3) the bidirectional relationship between childhood academic achievement and mental health. In addition, we reviewed variables that might influence or help explain the link between childhood maltreatment and educational outcomes, drawing on developmental perspectives and Bronfenbrenner's ecological model. Finally, whenever possible, we presented findings specific to maltreated children in out-of-home care to highlight the unique challenges experienced by this population. Results indicated that children with maltreatment histories often experience impairments in both their academic performance (e.g., special education, grade retention, lower grades) and mental well-being (e.g., anxiety, low mood, aggression, social skills deficits, poor interpersonal relationships). These impairments appeared to be particularly pronounced among maltreated children in out-of-home care. Findings, albeit sparse, also indicated that mental health difficulties are negatively associated with children's academic achievement and, similarly, that academic achievement deficits are linked with mental health problems. The link between childhood maltreatment and educational outcomes may be partly explained through the disruption of key developmental processes in children, such as attachment, emotion regulation, and sense of agency. As well, maltreatment characteristics and the functioning of various systems in which children are embedded (e.g., family, school, child welfare) can serve to positively
Full Text Available We present data on maltreatment profiles and psychopathology of 358 children and adolescents (4–17 years. Data on maltreatment profiles has been categorized into six major maltreatment types: physical abuse, emotional abuse, sexual abuse, sexual abuse with penetration, exposure to intimate partner violence and neglect. The data on history of maltreatment is based on the interview version of the Juvenile Victimization Questionnaire (JVQ. Additionally data on psychopathology in general as well as specific disorders according to DSM-IV based on K-SADS-PL is presented. The data was used to examine patterns of co-occurrences of maltreatment and associated clinical outcome variables using latent class analysis (LCA, “Experience by children and adolescents of more than one type of maltreatment: association of different classes of maltreatment profiles with clinical outcome variables” (Witt et al., . Keywords: Child maltreatment, Latent class analysis, Child abuse and neglect, Psychopathology
Jones, Deborah J.; Runyan, Desmond K.; Lewis, Terri; Litrownik, Alan J.; Black, Maureen M.; Wiley, Tisha; English, Diana E.; Proctor, Laura J.; Jones, Bobby L.; Nagin, Daniel S.
Childhood sexual abuse (CSA) has been associated with HIV/AIDS risk behavior; however, much of this work is retrospective and focuses on women. The current study used semiparametric mixture modeling with youth (n = 844; 48.8% boys) from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) to examine the link between trajectories of CSA (2 to 12 y.o.) and HIV/AIDS risk behavior at age 14 (i.e., sexual intercourse & alcohol use). Trajectory analyses revealed a link between a history of CSA and the development of risky behavior. In addition, trajectories for physical and emotional abuse, but not neglect or witnessed violence, contributed to risky behavior over and above the role of CSA. Child gender did not moderate the findings. Findings highlight the signficance of CSA histories, as well as the broader context of maltreatment, for better understanding the development of risk behaviors in both girls and boys. PMID:20706919
Mitchell, Kimberly J; Finkelhor, David; Wolak, Janis
Two studies were conducted to identify the incidence (Study 1) and characteristics (Study 2) of juvenile prostitution cases known to law enforcement agencies in the United States. Study 1 revealed a national estimate of 1,450 arrests or detentions (95% confidence interval [CI]: 1,287-1,614) in cases involving juvenile prostitution during a 1-year period. In Study 2, exploratory data were collected from a subsample of 138 cases from police records in 2005. The cases are broadly categorized into three main types: (a) third-party exploiters, (b) solo prostitution, and (c) conventional child sexual abuse (CSA) with payment. Cases were classified into three initial categories based on police orientation toward the juvenile: (a) juveniles as victims (53%), (b) juveniles as delinquents (31%), and (c) juvenile as both victims and delinquents (16%). When examining the status of the juveniles by case type, the authors found that all the juveniles in CSA with payment cases were treated as victims, 66% in third-party exploiters cases, and 11% in solo cases. Findings indicate law enforcement responses to juvenile prostitution are influential in determining whether such youth are viewed as victims of commercial sexual exploitation or as delinquents.
van der Put, Claudia E; Bouwmeester-Landweer, Merian B R; Landsmeer-Beker, Eleonore A; Wit, Jan M; Dekker, Friedo W; Kousemaker, N Pieter J; Baartman, Herman E M
For preventive purposes it is important to be able to identify families with a high risk of child maltreatment at an early stage. Therefore we developed an actuarial instrument for screening families with a newborn baby, the Instrument for identification of Parents At Risk for child Abuse and Neglect (IPARAN). The aim of this study was to assess the predictive validity of the IPARAN and to examine whether combining actuarial and clinical methods leads to an improvement of the predictive validity. We examined the predictive validity by calculating several performance indicators (i.e., sensitivity, specificity and the Area Under the receiver operating characteristic Curve [AUC]) in a sample of 4692 Dutch families with newborns. The outcome measure was a report of child maltreatment at Child Protection Services during a follow-up of 3 years. For 17 children (.4%) a report of maltreatment was registered. The predictive validity of the IPARAN was significantly better than chance (AUC=.700, 95% CI [.567-.832]), in contrast to a low value for clinical judgement of nurses of the Youth Health Care Centers (AUC=.591, 95% CI [.422-.759]). The combination of the IPARAN and clinical judgement resulted in the highest predictive validity (AUC=.720, 95% CI [.593-.847]), however, the difference between the methods did not reach statistical significance. The good predictive validity of the IPARAN in combination with clinical judgment of the nurse enables professionals to assess risks at an early stage and to make referrals to early intervention programs. Copyright © 2017 Elsevier Ltd. All rights reserved.
Arnott, Janine; Hesselgreaves, Hannah; Nunn, Anthony J; Peak, Matthew; Pirmohamed, Munir; Smyth, Rosalind L; Turner, Mark A; Young, Bridget
There is little research on parents' experiences of suspected adve