Depressive characteristics of physically abused children

Physically abused and nonabused children were compared on child-completed measures of depression, hopelessness, self-esteem, and locus of control. Results indicated that, in comparison with nonabused controls, abused children evidenced more depressive symptoms, heightened externality, lower self-esteem, and greater hopelessness about the future. Group differences in depressive symptomatology were not accounted for on the basis of differences in age, sex, race, gender, IQ, or socioeconomic status. Results replicate the results of Kazdin, Moser, Colbus, and Bell (1985) derived from a sample of physically abused psychiatric inpatients and extend the generality of these findings to abused children of nonpatient status. Implications of the findings for clinical interventions, theoretical models of child depression, and future research are discussed.The authors wish to thank Alvin Hadley and the staff of Franklin County Children Services.Appreciation is also extended to Dr. Charles Wenar.     

Assessment of depression and diagnosis of depressive disorder among psychiatrically disturbed children

This study examined the relations between performance on alternative measures of childhood depression and diagnosis of depressive disorder. Hospitalized inpatient children (N=770, ages 7–13) with a diagnosis of depressive disorder (Research Diagnostic Criteria) were compared with a matched sample of patients whose diagnoses excluded depression. Children and parents completed four standardized depression scales plus measures designed to assess associated features including hopelessness, selfesteem, and internalizing symptoms. The results indicated that (1) alternative depression measures, whether completed by children or parents, yielded scores that were significantly higher for children with a diagnosis of depression; (2) parent ratings of severity of depression were consistently higher among the measures than the child ratings; (3) optimal cutoff scores derived for each measure correctly classified approximately 60% of depressed and nondepressed cases; (4) different cutoff scores were required for the same measure, depending on whether children or parents were the raters; and (5) using a battery of measures and combining these in a stepwise discriminant function yielded over 80% classification accuracy. The implications of the results for selection of cases for clinical research are discussed.Completion of this research was supported by a Research Scientist Development Award (MH00353) and by a Clinical Research Center Grant for the Study of Affective Disorders (MH30915) from the National Institute of Mental Health. The authors are grateful to members of the clinical research team of the Child Psychiatric Treatment Service, who greatly facilitated this research.     

Inpatient intervention for chronic functional encopresis in psychiatrically disturbed children

Twelve children referred for short-term inpatient psychiatric treatment also received intervention for Functional Encopresis. Treatment consisted of an initial regimen of cathartic medication (CATH MED) followed by prompted toileting trips after meals for bowel retraining (TRIPS). Maintenance medications were given throughout both conditions. Staff records were used to document the integrity and impact of treatment. Compared to baseline, CATH MED was associated with an increase in independent toileting but no reduction in accidents. Significant improvements were obtained on both of these measures during the subsequent TRIPS condition. Some association among demographic, integrity, and outcome measures was detected. There was modest evidence for maintenance of improvements at one-year follow-up. Implications for the delivery and evaluation of inpatient treatment for encopretic children are discussed.     

Selective attention to facial emotion in physically abused children

The ability to allocate attention to emotional cues in the environment is an important feature of adaptive self-regulation. Existing data suggest that physically abused children overattend to angry expressions, but the attentional mechanisms underlying such behavior are unknown. The authors tested 8-11-year-old physically abused children to determine whether they displayed specific information-processing problems in a selective attention paradigm using emotional faces as cues. Physically abused children demonstrated delayed disengagement when angry faces served as invalid cues. Abused children also demonstrated increased attentional benefits on valid angry trials. Results are discussed in terms of the influence of early adverse experience on children's selective attention to threat-related signals as a mechanism in the development of psychopathology.     

Differentiating psychiatrically disturbed children on the basis of a structured interview

A structured psychiatric interview designed for both clinical assessment and data collection was given to 50 pairs of well-matched pediatrie and psychiatric clinic children and their mothers. The two groups were shown to be dearly distinguished on the basis of numbers of symptoms. Behavior and school symptoms gave the sharpest distinction between the two groups. Neurotic and somatic symptoms were the poorest discriminators. The psychiatric children showed significantly more antisocial symptoms than their matched pediatrie peers. Age differences showed the expected trends with the widest divergence in the number of symptoms being in the oldest age group.This study was supported in part by NIMH Grant 05938.     

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.     

Depressive symptoms among women employed outside the home

Researchers who attempt to explain why paid employment is a source of psychological distress for some women must consider how a number of factors in the work and nonoccupational environments influence a woman's reaction to employment outside the home. We examined four aspects of the job that may be a source of distress for working women: job dissatisfaction, pay dissatisfaction, commitment to the work role, and full versus part-time employment. Of these, pay dissatisfaction and commitment to the work role emerged as significant predictors of depressive symptoms. With regard to home-related roles, neither help with housework nor the presence of young children in the home exerted a significant direct effect on psychological distress. Young children at home did, however, have a significant interaction effect with a woman's sex role beliefs. Finally, the presence of a conflict between the work and home roles was also a significant predictor of depression.     

Object relations and referential activity in physically abused adolescents

This study compared the object relations and language functions of 15 physically abused and 15 nonabused adolescents. The adolescents provided a 5-minute narrative about their mothers, which was scored for referential activity and object relations. As predicted, the abused adolescents tended to have lower levels of affect tone, indicating more malevolent relationship paradigms. Contrary to what was predicted, however, there were no significant differences between groups on overall measures of referential activity and object relations. Further, the abused adolescents tended to have higher levels of two elements of referential activity (concreteness, imagery), indicating increased verbal ability to express emotional experience. While predicted correlations were found between object relations and referential activity for the nonabused group, the abused group showed higher symbolizing and verbalizing capacity, associated with more malevolent representations of relationships. The findings do not support the view that physically abused adolescents experience developmental lags, instead suggesting that they organize and use emotional and symbolizing processes differently from nonabused adolescents. The implications for treatment are discussed.     

An event-related brain potential investigation of PTSD and PTSD symptoms in abused children

We tested 186 children ranging in age from 6 years, 10 months to 13 years, 7 months; 174 suffered either physical and/or sexual abuse, and 12 were nonabused children. Abused subjects were grouped in four different ways. The primary grouping was based on whether subjects satisfied the DSM III-R criteria for posttraumatic stress disorder (PTSD). Secondary groupings were based upon the three symptom clusters used to make the PTSD diagnosis (arousal, avaidance, and reexperiencing). In each of these groupings three separate subgroups were formed with approximately 25 percent in the high and low symptom count subgroups and the remaining 50 percent in the middle symptom count subgroup. Subjects listened to four different intensity levels (65, 80, 95, and 102 dB) of a 1 KHz tone, pseudo-randomly ordered, while event-related brain potentials (ERPs) were recorded. Two separate blocks were used, one with short intervals (4±1 sec) between tones and the other with longer intervals (17±2 sec). PTSD subjects presented a greater P2-N2 ERP intensity gradient (i.e., a larger increase in the P2-N2 ERP component as tone intensity increased) than did abused subjects without PTSD. Abused subjects with the highest number of reexperiencing symptoms showed a similar P2-N2 augmenting effect when compared to those with the lowest number of reexperiencing symptoms. Subjects with the highest number of arousal symptoms showed a shallower intensity gradient for the N1-P2 ERP component than did those with fewer arousal symptoms. The results are discussed in relation to previous results reported on adults with PTSD and in terms of CNS processing of stimulus intensity information.     

Depressive symptoms and conspiracy beliefs

Conspiratorial beliefs can endanger individuals and societies by increasing the likelihood of harmful behaviors such as the flouting of public health guidelines. While scholars have identified various correlates of conspiracy beliefs, one factor that has received scant attention is depressive symptoms. We use three large surveys to explore the connection between depression and conspiracy beliefs. We find a consistent association, with the extent of the relationship depending on individual and situational factors. Interestingly, those from relatively advantaged demographic groups (i.e., White, male, high income, educated) exhibit a stronger relationship between depression and conspiracy beliefs than those not from such groups. Furthermore, situational variables that ostensibly increase stress—such as having COVID-19 or parenting during COVID-19—exacerbate the relationship while those that seem to decrease stress, such as social support, vitiate it. The results provide insight about the development of targeted interventions and accentuate the need for theorizing about the mechanisms that lead depression to correlate with conspiracy beliefs.     

Problem-solving deficits and depressive symptoms among children

Depressive symptoms among 40 fourth- and fifth-grade students as measured by the Children's Depression Inventory, correlated highly with impaired problem solving at block designs (r = .64) and anagrams (r = .67). Similar impairments have been found among depressed adults, suggesting that depression among children may be continuous with depression among adults.     

Depressive symptoms and attribute type moderate effects of partner feedback among college couples

Previous findings on the effects of partner feedback (about the self) have been mixed, potentially due to moderating roles of individuals' prior well‐being and the type of attributes appraised. This experimental study of 118 college‐student couples examined whether depressive symptoms moderated responses to partner feedback that was either enhancing or verifying of either social (communion‐related) or personal (agency‐related) attributes. Results showed that individuals with fewer depressive symptoms reported higher relationship quality after receiving partner feedback (particularly when it was enhancing) on their personal (vs. social) attributes. Conversely, individuals with more depressive symptoms reported higher relationship quality after receiving social partner feedback (particularly when it was enhancing). Thus, individuals' prior well‐being and communion‐related versus agency‐related attributes should be considered in studies of interpersonal feedback.     

Depressive symptoms in Swedish adolescents

This study examined the prevalence of self-reported depressive symptoms in a Swedish urban school sample (n=547) aged 13 to 18 years using the Beck Depression Inventory (BDI). The data obtained were examined with respect to sex and age differences and compared with a clinical sample of adolescents hospitalized because of psychiatric disturbances. The results indicated a strong preponderance of depressive symptoms among girls in the school sample, in particular for the severe symptom level. Eight percent of subjects reported depressive symptoms sufficiently high to be classified as a moderate, and 2% as a severe, level of depression. Factor analysis yielded four factors representing dysphoric mood, social activity, relationship, and food-related dimensions. The BDI showed a high internal consistency, and test-retest reliability calculated for a 2-week and a 2-month interval revealed strong correlations. The means of total scores on the BDI for the clinical sample were significantly higher than for those in the school sample.     

Parent,teacher, and peer ratings of physically abused and nonmaltreated Children's behavior

Behavior ratings by parents, teachers, and classmates of physically abused fourth to sixth graders, identified from the New York City Maltreatment Register, and case-matched classroom controls, showed substantial concurrence among informants: Parents and teachers both rated significantly more behavioral disturbance in the abused children, and peers' ratings were significantly correlated with adults' ratings, especially those by teachers. Children's exposure to spouse or partner physical abuse, which had a substantial prevalence among both child-abusing and control families, reduced the difference in disturbance ratings between children who were themselves physically abused and those who were not. Overall, we conclude that physically abused children show pervasive behavioral disturbance, in that parents, teachers, and classmates all see higher levels of behavior problems and lower levels of socially desirable behavior in them compared to their nonmaltreated peers.This research was supported in part by research grant R01MH38814 and Clinical Research Center grant MH30906 from the National Institute of Mental Health. The authors thank the New York City Child Welfare Administration, especially Terry Weiss, for facilitating access to the Maltreatment Register; the NYC Board of Education for access to schools; and the many participating superintendents, principals, and teachers. Some preliminary data were presented as a poster at the Meetings of the American Academy of Child Psychiatry, New York, 1989.     

Correlates of loneliness in nonreferred and psychiatrically hospitalized children

We investigated psychosocial correlates of loneliness using self- and caretaker-reports in 6–12 year old nonreferred and psychiatrically hospitalized children. In Phase 1, 109 nonreferred children completed self-report measures of internalizing problems, mothers completed the Child Behavior Checklist (CBCL), and teachers completed the CBCL-Teacher's Report Form. In Phase 2, a similar assessment battery was completed for 109 psychiatrically hospitalized children. Results indicated a moderate to strong relationship between loneliness and self-reported depression, hopelessness, low self-esteem, and anxiety. Children reporting high and low levels of loneliness were not differentiated by parent or teacher reports. Lonely children had lower IQs than their non-lonely peers.     

The Children's Firesetting Interview with psychiatrically referred and nonreferred children

This study evaluated the Children's Firesetting Interview (CFI). The measure was developed to operationalize multiple domains of functioning derived from a riskfactor model of firesetting. The model poses that child, parent, and family characteristics promote firesetting and continuation of a pattern of firesetting. Major factors include curiosity about fire, involvement in and exposure to firerelated activities, and knowledge about first safety The CFI, consisting of 46 questions reflecting six a prioridimensions, was administered to 519 children (ages 6–13) recruited from nonpatient, outpatient, and inpatient samples. Internal consistency and testretest reliability of the measure were satisfactory. Criterion validity was supported by the findings that firesetters showed greater curiosity about fire, involvement in firerelated activities, exposure to models/materials, and knowledge about things that burn than did nonfiresetters. These findings did not vary as a function of the child's patient status or level of antisocial behavior. Implications for the evaluation of firesetting risk are discussed.This study was supported by grant MH-39976 from the Antisocial and Violent Behavior Branch of the National Institute of Mental Health and by a Research Scientist Development Award (MH00353) from the National Institute of Mental Health. The authors acknowledge the constructive suggestions of two anonymous reviewers.