Preface

Summary

Child victimization is a serious and on-going problem in the United States and throughout the world. In 2000, an estimated 900,000 children were victims of abuse and neglect in the United States. New and different responses to child maltreatment will have to be developed and implemented in response to the increasingly diverse contexts and situations within which maltreatment occurs. Emerging trends in adult-child boundary violations are explored within this volume from a cross-section of disciplines, including law, sociology, criminal justice, psychology, and health services. The selections analyze issues critical to child maltreatment and offer intriguingly different perspectives of present and future issues related to child abuse.     

Collaborating on Family Safety

Summary

The problems of child maltreatment and violence against women have traditionally been viewed and treated as two distinct issues. In response to these two forms of family violence, two separate service systems with different approaches to prevention, treatment and intervention have developed. This article outlines sources of conflicts between child protection workers and battered women's advocates, and elaborates on these conflicts using child protection workers' and battered women's advocates' own words elicited in a series of focus groups. Models of cross-system collaboration in the United States are then described, and recommendations are made for practice and policy which support collaboration across systems.     

Single versus Multi-Type Maltreatment

Abstract

The purpose of the present study was to identify the long-term impacts of different types of child abuse and to assess differential effects of single versus multi-type maltreatment. Three hundred and eighty-four college students completed measures of child abuse history (neglect, emotional, physical, and sexual abuse), depression, suicidality, self-esteem, sexual behavior, drug and alcohol use, and delinquent behavior. The results demonstrate the high rates of co-occurrence of different types of abuse, with few differential effects identified. Rather, all types of abuse were associated with symptoms. Experiencing multiple types of abuse was associated with greater symptoms than experiencing no abuse or a single type of abuse. The results highlight the importance of considering all types of abuse when studying child maltreatment.     

Prologue: Introduction and Overview to Special Volume

Abstract

The editors provide an overview of the obstacles that prevent us from ending child abuse in the United States and briefly summarize the various articles in this volume that address these obstacles from multiple points of view.     

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.     

Legal and Ethical Issues in the Treatment of Multiply Victimized Children

Abstract

The article discusses several common legal and ethical issues faced by clinicians when treating families where singular and multiple child victimization is an issue. The authors differentiate between legal requirements and ethical mandates, explore factors affecting reporting decisions, how dual relationships compromise treatment process, and clinicians' scope of competence and professional knowledge in child maltreatment cases. Each issue is addressed within the context of responding to cases where a child(ren) has been multiply victimized.     

RECENT TRENDS IN RESPONSE TO CHILD VICTIMIZATION

Abstract

This chapter serves as an introduction to the many roles of health care professionalsin the assessment, care, and treatment of child victimization. It concentrates on those professionals caring for the physical health of victims of child abuse and neglect, although there are many similarities between child maltreatment and other family violence victims. In reviewing the health impact of maltreatment and the historical contributions of health care professionals, it discusses the roles that health care disciplines play in clinical care, training, research, and advocacy and their interaction with the community's child welfare, legal, and criminal justice systems.     

Treatment of co-occurring child maltreatment and substance abuse

Despite high prevalence and severe negative consequences of child maltreatment (e.g., Brown, G. R., & Anderson, B., (1991). Psychiatric morbidity in adult inpatients with childhood histories of sexual and physical abuse. American Journal of Psychiatry, 148, 55–61; Jaudes, P. K., Ekwo, E., & Van Voorhis, J.V., (1995). Association of drug abuse and child abuse. Child Abuse and Neglect, 19, 1065–1075; Murphy, J. M., Jellinek, M., Quinn, D., Smith, G., & Goshkom, M., (1991). Substance abuse and serious child mistreatment: Prevalence, risk, and outcome in a court sample. Child Abuse and Neglect, 15, 197—211), the treatment of perpetrators and victims of child abuse and neglect remains grossly understudied (Behl, L. E., Conyngham, H. A., & May, P. F., (2003). Trends in child maltreatment literature. Child Abuse and Neglect, 27, 215–229). More than half of parentes founded for the abuse and neglect of their children have evidenced drug abuse, yet no treatments have been validated that concurrently address these problems. The reciprocal interaction between substance abuse and child maltreatment supports the need to concurrently treat these problems. This article illustrates the relationship between child maltreatment and parental substance abuse and proposes a behavioral model to explain the reciprocal influence of drug abuse and child maltreatment. A behavioral treatment plan that is designed to concurrently address drug abuse and child abuse is proposed and suggestions are made for future directions in this area.     

Correlates of Multiple Forms of Victimization in Religion-Related Child Abuse Cases

Abstract

Abuse perpetrated under the guise of religion is a devastating form of child maltreatment that often involves multiple types of victimization. In a large-scale survey of clinicians, we investigated the nature and emotional sequelae of religion-related child sexual abuse cases. We predicted that there would be marked differences between cases involving multiple forms of abuse and those involving only sexual abuse. Our results indicate that as the number of abuses increases, so does the severity of the abusive experience and the seriousness of psychological consequences for the victim. Thus, religion-related abuse is best understood in light of the specific types and combinations of abuses suffered by victims.     

Child Maltreatment,Family Characteristics and Adult Adjustment

Abstract

Two alternate processes that may explain the relationship between child maltreatment, childhood family characteristics and adult adjustment (mediation and moderation) were tested using retrospective data from a community sample (N= 175). The levels of five different types of child maltreatment did not mediate the relationship between childhood family variables and adult adjustment. In contrast, family background played a mediating role in the relationship between mal-treatment and adjustment. Evidence of moderation was found in the interactions between different maltreatment types in predicting adjustment. Partial support was found for the moderating influence of family factors on the relationship of maltreatment to adjustment.     

Cumulative Risk and Protection Models of Child Maltreatment

Abstract

The often misused concepts of risk, vulnerability, protective factors, and resilience are clearly defined and existing models of child risk are presented. Research of risk and protective factors for child maltreatment is then discussed as it reflects on these models. A major conclusion is that child maltreatment exists within a complex context of cumulative risk and protection which needs to be considered in designing research of intervention programs. This article provides one of the clearest presentations and integrations in the literature of the conceptual bases and research findings relevant for considering child risk and resilience.     

Controversies in Family Preservation Programs

Summary

This paper examines the controversies over the use of family preservation policies to prevent and treat child abuse and neglect. Policies that aim to preserve families in which child maltreatment has occurred are at least a century old. However, there is renewed interest in such policies, given the dramatic rise in child abuse and neglect reports and a large number of children who spend time in out-of-home placements. New intensive family preservation services were advanced as able to assure the safety of children while working toward a lasting preservation of the family unit. The paper summarizes the research on intensive family preservation services and reports that such programs do not reduce placements nor do they appear to enhance child safety. The paper concludes by proposing that risk assessments and assessments of readiness to change could improve decision-making regarding which families might be aided by family preservation and which children should be protected by terminating their parents' rights.     

Child Protection and Psychology Education in Australian Universities

Child maltreatment is a significant problem in Australia. Psychologists in a wide range of occupations play an important role in the identification and prevention of child abuse and neglect, the provision of interventions to children and families, and the development and conduct of research in related areas. Psychology graduates must be adequately prepared to work in this field; however, little is known about the extent to which child abuse and neglect related contents are taught in current university curricula. A purpose‐developed curriculum‐mapping survey was used to examine Australian undergraduate, fourth year, and postgraduate Australian Psychology Accreditation Council‐accredited programmes available in 2008. Results showed that students in the majority of programmes were exposed to child protection‐related content; however, the extent of exposure was limited. Three postgraduate units specifically addressed the prevention, identification, and response to child abuse and neglect. Course coordinators reported that child maltreatment content was mostly integrated into general units throughout the programme, typically within developmental psychology units in the undergraduate curriculum and in ethics, research, or professional issues units in the fourth year and postgraduate programmes. Results suggest the need for child protection content to be included in minimum national standards and accreditation guidelines for universities.     

Where do we go from here? Moving toward an integrated approach to family violence

This article discusses patterns across reviews of the risk and protective factors for each of seven forms of family violence: partner physical, psychological, and sexual abuse; child physical, psychological, and sexual abuse and child neglect. We note that both child and partner literatures have large research bases on risk factors for physical abuse, but relatively few articles on psychological or sexual abuse (or child neglect). In addition, co-occurrence of forms of maltreatment within families is high, but little integrative work has been conducted. We argue that the overlap of both occurrence and risk factors across forms of maltreatment suggests that both etiological and intervention models would be improved by considering all forms of maltreatment more explicitly in a family (rather than dyadic) context.     

What We Know—and Don't Know—About Preventing Child Maltreatment

Abstract

Although child maltreatment is routinely acknowledged as a serious social problem, it remains widespread, raising questions about how prevention efforts can be improved. Following a review of theory and research relevant to prevention programming, the two dominant models of child abuse prevention-child empowerment and parent education-are examined, emphasizing both those factors that appear to contribute to program success (e.g., early intervention, sufficient time commitments, cultural sensitivity) and weaknesses in current efforts (e.g., poor implementation). Although underutilized, broader social and system-level reforms, including social policy and media initiatives, hold promise for prevention. Ways in which to leverage these tools are explored. Additional research is urged to explore assumptions on which programs are based, as well as to conduct more rigorous evaluation of current programs. The article concludes that a sustained commitment to prevention efforts aimed at child abuse and neglect is required.     

Multiple forms of child abuse and neglect: adult retrospective reports

There are few research reports of the experience of multiple forms of child abuse and neglect (multi-type maltreatment). A critical review is presented of 29 studies in which adult retrospective reports of more than one form of child maltreatment (sexual abuse, physical abuse, psychological maltreatment, neglect, or witnessing family violence) are assessed. Empirical investigations of the extent and impact of multi-type maltreatment are identified. Data on the relationship between the different forms of maltreatment and the adjustment problems associated with each type of maltreatment are critiqued. As well as using dichotomous measures of maltreatment, an important methodological problem was the failure of researchers to assess all child maltreatment types, the relationship between multi-type maltreatment and adjustment, and the role of variables influencing the occurrence or impact of maltreatment. Considerable overlap was found in the occurrence of maltreatment types. The compounding or interacting effects of experiencing multi-type maltreatment were ignored in many studies. Where an assessment was made of the specific impact of multi-type maltreatment, it was associated with greater impairment than single forms of abuse or neglect. A multi-dimensional approach to prevention and treatment of child abuse and neglect is required in which children's vulnerability to multi-type maltreatment is addressed.     

Child Maltreatment in Vietnam: Prevalence and Cross-Cultural Comparison

This Vietnam prevalence study on child maltreatment (VPM-2014) was designed to examine the prevalence of child maltreatment in Vietnam and to compare it with the child maltreatment prevalence in the Netherlands using the same measures and procedure. Questionnaires were filled out by 1,851 students aged 12 to 17 years (47.3% were boys). Results indicated that half of the students (49.9%) reported at least 1 event of child maltreatment in the past year. Emotional abuse was most frequently reported (31.8%), followed by physical abuse, neglect, and witnessing parental conflict. Sexual abuse was the least prevalent (2.6%). Compared with the Netherlands, the prevalence rates of most types of child maltreatment were higher in Vietnam: The largest difference was with emotional abuse, followed by neglect, physical abuse, and witnessing parental conflict. Only the past-year sexual abuse prevalence in Vietnam was lower. These findings highlight the alarming problem of child maltreatment in Vietnam.     

A Differentiated Legal Approach to the Effects of Spousal Abuse on Children

Summary

In the past decade judges have started to recognize the destructive effects of spousal violence on children, but too many judges and justice system professionals still fail to take adequate account of spousal abuse when dealing with child related issues. Courts need to take a “differentiated” approach to spousal abuse, one that recognizes its different forms, nature and effects on adults and children, with a continuum of responses ranging from ordinary visitation, through supervision of exchanges or visitation, to termination of visitation. Canada should enact legislation that explicitly recognizes spousal abuse as a factor in child related disputes, increase education about domestic violence for judges and other justice system professionals, and provide more support for services such as supervised visitations programs. While this article focuses on Canadian developments and case law, there are similar issues in other countries.     

Emotion Dysregulation Mediates the Relationship Between Child Maltreatment and Non-Suicidal Self-Injury

One risk factor for non-suicidal self-injury (NSSI) in adolescents is exposure to traumatic experiences, particularly child maltreatment. However, the mechanisms through which childhood maltreatment predicts NSSI are largely unknown. Emotion dysregulation (ED) is likely an important mechanism in this relationship. Therefore, this study examined the relationship between childhood maltreatment, ED, and NSSI in a sample of adolescent inpatients (n = 53). Results demonstrated that child physical and emotional maltreatment, but not child sexual abuse, was significantly associated with NSSI frequency. More specifically, ED mediated the relationship between child physical and emotional maltreatment and NSSI frequency. Findings support the importance of ED as a mediating factor in the relationship between childhood maltreatment and NSSI behaviors and highlight the need for teaching emotion regulation skills to youth affected by trauma.     

Examination of the Extent to which Employment Factors are Associated with Reduced Child Maltreatment Potential and Drug Use

Job assistance programs are commonly recommended for parents of children who have been victimized by child maltreatment, particularly when illicit drugs are indicated. However, the relationship between employment factors, substance abuse, and risk of child maltreatment has received limited empirical attention. Therefore, the current study examines employment factors in a sample of 72 mothers, who were referred by child protective services for treatment of substance abuse and child neglect. Child maltreatment potential was found to be negatively associated with number of hours employed and self-reported happiness with employment. The association between child abuse potential and personal income of participants approached significance (p?=?.057), and the results were not influenced by social desirability. Employment satisfaction significantly contributed to the prediction of child maltreatment potential over and above other employment factors and control variables. These findings suggest that when mothers are involved in child protective services their risk of perpetrating child maltreatment may be reduced when they are assisted in gainful employment that is personally satisfying. Happiness with employment was the only employment factor correlated (inversely) with substance use (biological testing, self-report of participants). Future directions are discussed in light of the results, including the importance of considering employment satisfaction when conducting vocational assistance programs in this population.