COGNITIVE AND SOCIOEMOTIONAL FUNCTIONING AT 4½ YEARS IN CHILDREN BORN TO MOTHERS WHO HAVE RECEIVED TREATMENT FOR SUBSTANCE‐ABUSE PROBLEMS WHILE PREGNANT

Cognitive and socioemotional functioning at 4½ years of age were examined in children born to mothers with substance‐abuse problems (n = 22) recruited from residential treatment institutions while pregnant, and then compared to children born to mothers with mental health problems (n = 18) and children from a low‐risk group (n = 26). No significant group differences in cognitive functioning were found, but the children born to mothers with substance‐abuse problems showed more caregiver‐reported socioemotional problems than did the low‐risk children, like the children born to mothers with mental health problems. Birth weight had an effect on internalizing problems at 4½ years and mediated the relation between group and socioemotional problems, although not when controlling for caregiver education, single parenthood, and anxiety and depression. At 4½ years, 7 children born to mothers with substance‐abuse problems were placed in foster care. These children had lower birth weight and higher caregiver‐rated internalizing problems. In addition to emphasizing the importance of the quality of the prenatal environment, this study suggests that families with previous substance abuse are in need of long‐term follow‐up to address socioemotional problems and enhance further positive child cognitive development. The foster‐placed children may be in particular need of long‐term follow‐up.     

Fathers for Change for Substance Use and Intimate Partner Violence: Initial Community Pilot

The lack of focus on the role of men as fathers within intervention programs for men with histories of Intimate Partner Violence (IPV) or substance abuse is of significant concern given the large numbers of these men who are actively parenting and coparenting children. Fathers for Change is a new intervention designed to fill this gap. Eighteen fathers with co‐occurring IPV and substance abuse were randomly assigned to Fathers for Change or Individual Drug Counseling (IDC). They were assessed at baseline, post‐intervention and 3 months following the 16‐week intervention period. Men in the Fathers for Change group: (1) were more likely to complete treatment; (2) reported significantly greater satisfaction with the program; (3) reported a trend toward less IPV; and (4) exhibited significantly less intrusiveness in coded play interactions with their children following treatment than fathers in the IDC group. Results indicate further evaluation of this intervention in a larger sample is warranted. Limitations and directions for future research are discussed.     

Child witness statements about sexual abuse in day‐care: reports from a case with confessions from the suspect

Evaluation of alleged sexual abuse at day‐care centres usually has to be based mainly on child statements about their own victimisation. This study points at other possible sources of information. Thus, the child may give contributions to the investigative procedure also as a witness of abuse of other children, as a participator of group interaction related to abuse and as a receiver of a disclosure about abuse from another child. Data are presented from a case where the suspect had confessed. A quarter of the children at the day‐care centre had given information about other children's exposure. For more than half of the children, there were witness statements that reflected what these particular children might have been exposed to. Context and statement characteristics seemed to make an evaluation of some of these statements possible. Information about interaction between children and about disclosures between children was strikingly scarce which was probably due to the lack of questions from parents and investigators in these areas. Witness statements from children about other children's exposure to abuse stand out as an interesting complementary source of information in investigations of abuse at day‐care centres and may also provide a basis for interpretations at a group level. Copyright © 2005 John Wiley & Sons, Ltd.     

Evaluation of a Sexual Abuse Prevention Program for Children with Intellectual Disabilities

The present study evaluated the effectiveness of a sexual abuse prevention program for children with intellectual disabilities. Three children with mild to moderate intellectual disabilities participated in the study. They were taught skills relative to identifying body parts and discrimination between appropriate and inappropriate situations, refusal skills (verbal refusing and leaving situations), and reporting skills through this program. A multiple probe across participants design was used to determine the effects of the program. Results demonstrated that the program was effective for teaching the skills to all three children with intellectual disabilities. In addition, these skills generalized in probes conducted in real‐life settings and maintained at 10‐week follow‐up probes. Copyright © 2015 John Wiley & Sons, Ltd.     

Internalizing and externalizing characteristics of sexually and/or physically abused children

This study evaluates the behavioral consequences of childhood abuse (sexual, physical, or both), with particular focus on prevalence of posttraumatic stress disorder (PTSD). Three abuse type groups and nonabused controls were contrasted on behavioral rating scales and on structured psychiatric interview data. The participants (109 abused children and 16 normal control children) were recruited from Arkansas Children’s Hospital and local agencies for abused children. As expected, proportionately more females than males were sexually abused. Overall, males were rated as more disturbed than females. Type of abuse did not consistently influence behavioral ratings. Externalizing scores were significantly higher than internalizing scores in all abused groups. PTSD was diagnosed in 50% of the abused children, with a higher rate for boys who had been sexually abused as opposed to physically abused only (58% versus 13%). The most frequent comorbid condition with PTSD was Separation Anxiety. Sexually abused boys were hospitalized for psychiatric treatment at a higher rate than were other abused children.     

Adjustment following sexual abuse discovery: the role of shame and attributional style.

This study examined adjustment following sexual abuse as a function of shame and attributional style. One hundred forty-seven participants (83 children and 64 adolescents) were seen at the time of abuse discovery and again 1 year later. Once adjustment at abuse discovery was accounted for, shame and attribution style explained additional variation in subsequent adjustment, whereas abuse severity did not. A pessimistic attribution style at abuse discovery moderated the relation between severity of abuse and subsequent depressive symptoms and self-esteem. The relations between abuse severity and these outcomes were significant only at high levels of pessimistic attribution style. Of note, patterns of change in shame and attribution predicted which children remained at risk or improved in adjustment. In addition, age and gender differences were found in adjustment over time.     

Physical Abuse and Childhood Disability

SUMMARY

Several authors have hypothesized that children with disabilities are at increased risk for physical abuse. Such a finding would be consistent with current ecological models, which posit that certain child characteristics (e.g., behavior problems) in combination with other risk factors can lead to abuse. The paucity of research in this area makes it difficult to draw firm conclusions at this time. However, the few studies conducted suggest that child characteristics play a minor role in the etiology of abuse. Despite the lack of evidence indicating that children with disabilities are at significantly greater risk for abuse than their nondisabled peers, the presence of a disability raises some unique issues in the identification, assessment, and treatment of special needs children. This article reviews the literature linking abuse and disability as a risk factor. In addition, impediments encountered in the assessment and treatment of abused children with disabilities and their families are discussed and guidelines for practice are presented.     

Post-traumatic stress symptoms in mothers of children with leukaemia undergoing the first 12 months of therapy: Predictive models

The aim of this study consists in the measurement of psychological health and adaptation in mothers of children during the first 12 months of treatment for leukaemia and in the identification of possible early predictors. Ninety-four mothers were followed longitudinally at one week (T1), one month (T2), six months (T3) and 12 months (T4) post-diagnosis. The instruments used were: PTSD symptom checklist, BSI-18, Problem Scale, Ladder of life and an in-depth interview (EFI-C). Couple connectedness, family routine reorganisation, parental communication around the child's illness and trust in the medical care significantly increased from T1 to T4. Two models are proposed concerning possible predictors of mothers’ PTSS at T2 and at T3. Clinical suggestions are proposed on the basis of our empirical findings in order to plan informative, clinical and practical interventions for mothers of children under treatment for leukaemia.     

The case against the routine provision of psychotherapy to children/adolescents labeled “sexually abused”

Whether symptomatic or asymptomatic, children labeled sexually abused are routinely offered treatment at considerable financial cost. One result of this is that mental health professionals are being charged with exploiting the problem of child sexual abuse (CSA). Is the routine provision of psychotherapy for children and adolescents labeled sexually abused warranted? In this paper, it is argued that the evidence indicates it is not warranted. Further, its provision is not in the best interests of either the children or mental health professionals. A number of recommendations are given which follow from the evidence.     

Risk Factors for the Occurrence of Child Abuse and Neglect

SUMMARY

A large, nationally representative database of child abuse and neglect cases was analyzed to identify demographic risk factors for the occurrence of different types of abuse and neglect. The analyses used the data collected in the second National Incidence Study of Child Abuse and Neglect (the NIS-2) concerning children who were harmed by abuse or neglect. Multiple-factor logistic models were developed to identify risk factors for the occurrence of abuse or neglect in six categories of maltreatment: physical abuse, sexual abuse, emotional maltreatment, physical neglect, educational neglect, and multiple maltreatment. A key finding was that children in families with incomes under $15,000 per year were at far greater risk in every category of maltreatment. Also, older children were generally at greater risk in every category, and risk was related to family structure, family size, child's sex and race/ethnicity, and metropolitan status of the county. However, these relationships applied to only certain types of abuse or neglect or took different forms in different maltreatment categories. Interactions among risk factors were the rule rather than the exception. Findings emphasize the need for better coordination between human services and income support services to families. The results imply that risk assessment would be appreciably advanced by going beyond simple matrix approaches that independently consider different factors by developing assessment models that include interactions between different risk factors.     

Factors leading to orphans and vulnerable children living in community-based homes

This study explored the influences on living arrangements of orphans and vulnerable children (OVC) housed at a community-based home in Johannesburg, South Africa. A total of 50 OVC (males = 36%, females = 64%; age range 11 to 18 years) completed an open-ended questionnaire, while some of them also participated in individual interviews and focus group discussions on how they became residents of the community-based home. The data were thematically analysed. Findings suggest their choice to live in a community-based care setting to have been influenced by homelessness with accompanying poverty, health issues, experiences of child abuse and neglect, discrimination, and domestic violence. School psychologists working with OVC from community-based homes should consider pathways by which the children could be provided with needed support for resilient health and wellness.     

A theoretical framework for evaluation and treatment of the victims of child sexual assault by a nonfamily member

Thirty-seven families whose children were victims of sexual abuse by a nonfamily member were evaluated and treated during a nine-month period. The average age of the children was 5.36 years. The youngest children were boys, and all the adolescents were girls. A theoretical framework adapted from Ferreira's and Byng-Hall's work was developed to assess and treat child victims of sexual molestation and their families. The format consists of three concepts. First, the trauma from sexual abuse, being outside the realm of usual human experience, creates a breach in the family's adaptive and protective shield, including its shared values and beliefs. Second, the trauma has a "derailing" effect on the child's and family's predicted passage through their world. And third, issues that arise as a consequence of disclosure are intimately tied to preexisting family myths and beliefs. Evaluation, treatment, and short-term outcomes are discussed.     

Obscene telephone calls to children: a retrospective field study

Studied a sample of 24 Danish children selected from a larger group of 56 children who had received obscene telephone calls from a single adult offender to ascertain the psychological consequences of this form of sexual abuse. The sample is unusual in that the source of the abuse was the same for all of the children, and none of them had records of prior or concurrent abuse from other sources. Almost all children suffered significant psychological consequences from these calls, those who obeyed the caller's demands experiencing more serious consequences than those who did not. A comparison was made with the consequences suffered by an additional group of 7 children who had experienced direct physical sexual abuse by the same offender.     

Forensic sexual abuse evaluations of older children: Disclosures and symptomatology

This study examines the results of forensic evaluations of 399 children between the ages of 8 and 15 who were seen at an urban evaluation center regarding allegations of sexual abuse. Data collected included demographic, family environment, and abuse variables, outcome of a multidisciplinary forensic evaluation, and psychological distress as measured by the Trauma Symptom Checklist for Children (TSCC Briere, in press). Children were grouped according to the outcome of the evaluation: nonabused, abused-disclosing, and abused-nondisclosing (composed of children for whom there was external evidence of abuse but who denied being abused). A number of variables predicted group membership, including subject race, sex, cognitive delays, mother's belief or disbelief in the allegation, and psychological distress. Sexually abused children who disclosed abuse reported particularly high levels of distress, abused but nondisclosing children reported the lowest levels, and nonabused children reported intermediate symptom levels. The data are discussed in terms of the role of denial, maternal support, and symptomatology in forensic evaluations.     

Validity of a short measure of child sexual abuse for use in adult mental health surveys

An 18-yr. follow-up of 49 children for whom presence or apparent absence of sexual abuse was independently verified by social service reports in childhood, indicated partial validity for a recently developed measure of sexual abuse. Of 19 subjects known to have been sexually abused in childhood, 74% recalled details of such abuse when young adults.     

Factors Related to Outcome in a School-based Intensive Mental Health Program: An Examination of Nonresponders

We examined factors related to treatment responders (n = 35) and nonresponders (n = 16) in a group of 51 children admitted to the Intensive Mental Health Program (IMHP). Children’s response to treatment was coded based on their functioning at intake and discharge using total CAFAS scores. Demographic variables, length of treatment, number of diagnoses and medications, and history of physical/emotional abuse or neglect did not significantly distinguish between responders and nonresponders. Nonresponders were more likely to present with a history of suspected or confirmed sexual abuse, internalizing diagnoses, or comorbid internalizing and externalizing diagnoses. Although the small sample size may limit interpretations, our findings indicate treatment programs need augmentation when children with serious emotional disturbances (SED) may be at risk for not responding to interventions.     

虐待与流动儿童对立违抗症状的关系:亲密度和冲突性的作用

以来自北京10所小学的369名有对立违抗障碍症状的流动儿童,349名无ODD症状的对照组流动儿童和94名有ODD症状的北京儿童为被试,探究了有ODD症状流动儿童的症状严重程度及影响因素,并进一步探讨了ODD症状流动儿童在家庭中所受情感虐待、躯体虐待对其情绪方面的ODD症状和行为方面的ODD症状的影响,以及亲子关系(包括亲密度和冲突性)在其中起的作用。研究结果发现:(1)对比ODD症状北京儿童和对照组流动儿童,ODD症状流动儿童受到更严重的虐待,亲子关系亲密度更差,冲突性更高;(2)对ODD症状流动儿童,虐待和亲密度显著负相关,虐待和冲突性显著正相关,躯体虐待、冲突性均和行为方面ODD症状显著正相关;(3)躯体虐待能直接预测ODD症状流动儿童的行为方面ODD症状,但无法直接预测其情绪方面ODD症状;(4)在躯体虐待对ODD症状的影响中,冲突性起着显著的中介作用,躯体虐待通过影响亲子关系冲突性,对流动儿童的行为方面ODD症状产生影响,而亲密度则显著调节了躯体虐待对流动儿童情绪方面ODD症状的影响。     

Childhood abuse and depressive vulnerability in clients with gender dysphoria

Background: Childhood abuse in the early lives of gender variant people has been under‐reported, although higher psychiatric morbidity, particularly depression and suicidality, than in the general population is more widely recognised. There are increasing numbers of people seeking advice and treatment for gender dysphoria (GD) some of whose experiences of depression and childhood abuse may be additional treatment considerations. Aim: To illuminate the issues relating to childhood abuse, depression and GD via case examples underpinned by a summary review of the relevant literature, for their combined relevance to therapeutic practice and service provision. Methods: A review of relevant online literature was conducted and two case examples were developed subsequently to capture the core review themes from a practice perspective. Results: Nine studies met the inclusion criteria. Gender variant children and adolescents may experience abuse by peers and teachers, as well as parents and caregivers. Emotional abuse and neglect may have more adverse consequences than more active forms of abuse. Conclusions: This is an under‐researched area, and inconsistencies of design, definition, measurement and controls were evident in the literature. While no clear association between depressive vulnerability and childhood abuse could be found, prevalence of such abuse was high. A case is made for clients with GD to have the opportunity to explore the influence and meaning of their adverse childhood experiences on their social and psychological development, and for additional training and education for practitioners.     

Secret-Keeping Behaviors in Black and White Children as a Function of Interviewer Race,Racial Identity,and Risk for Abuse

Summary

The tendency for children to keep the secret of child abuse is an important practical impediment to adequate research, prevention, assessment, and treatment. While some studies have established that children will readily keep adult secrets, few have investigated the predictors of ease of disclosure. In this research, race of the interviewer requesting the secret strongly affected disclosure, with Black children particularly showing an unwillingness to disclose a negative secret to a different race interviewer. Children at high risk for sexual abuse (as assessed by the Finkelhor checklist) also were more likely to keep the secret.