A Latent Class Analysis of Childhood Maltreatment: Identifying Abuse Typologies

Multiple forms of abuse may co-occur, resulting in specific abuse typologies. A stratified random probability survey was conducted in Denmark with 4,718 participants, aged 24, from the 1984 birth cohort. A total of 2,980 interviews were successfully conducted. Latent class analysis was implemented using 20 categorical abuse experience items across four domains of childhood maltreatment. Logistic regression was conducted to ascertain whether abuse typologies could be differentiated by child protection status and gender. Four distinct abuse typologies were revealed: a non-abused group, a psychologically maltreated group, a sexually abused group, and a group experiencing multiple abuse types. Child protection status and female gender were predictive of group membership in certain abused groups compared to a non-abused group.     

This is a Tricky Situation: Situationism and Reasons-Responsiveness

Situations are powerful: the evidence from experimental social psychology suggests that agents are hugely influenced by the situations they find themselves in, often without their knowing it (this, roughly-speaking, is the thesis of situationism). In our paper, we evaluate how situational factors affect our reasons-responsiveness, as conceived of by John Fischer and Mark Ravizza, and, through this, how they also affect moral responsibility. We argue that the situationist experiments suggest that situational factors impair, among other things, our moderate reasons-responsiveness, which is plausibly required for moral responsibility. However, even though we argue that situational factors lower the degree of our reasons-responsiveness, we propose that agents remain moderately reasons-responsive to the degree required for moral responsibility. Nonetheless, those (adversely) affected by situational factors are arguably less morally responsible than those who are not subject to similar situational factors. We further evaluate an understanding of reasons-responsiveness (developed by Manuel Vargas in the light of situationist data) which relativizes reasons-responsiveness to agents’ circumstances. We argue that the situationist data do not warrant this kind of divergence from Fischer’s and Ravizza’s account. We conclude by discussing what situationist experiments tell us about our relationship to non-reasons.     

Identifying Children in Middle Childhood Who Are at Risk for Reading Problems

The purpose of this study was to identify and evaluate a universal screening battery for reading that is appropriate for older elementary students in a response to intervention model. Multiple measures of reading and reading correlates were administered to 230 fourth-grade children. Teachers rated children's reading skills, academic competence, and attention. Children were classified as not-at-risk or at-risk readers based on a three-factor model reflecting reading comprehension, word recognition/decoding, and word fluency. Predictors of reading status included group-administered tests of reading comprehension, silent word reading fluency, and teacher ratings of reading problems. Inclusion of individually administered tests and growth estimates did not add substantial variance. The receiver-operator characteristic curve analysis yielded an area under the curve index of 0.90, suggesting this model may both accurately and efficiently screen older elementary students with reading problems.     

Identifying Children at Risk of Problematic Development: Latent Clusters Among Childhood Arrestees

The presence of clusters characterized by distinct profiles of individual, family and peer characteristics among childhood arrestees was investigated and cluster membership stability after 2 years was determined. Identification of such clusters in this heterogeneous at-risk group can extend insight into the presence and severity of children’s co-occurring problems and guide intervention and prevention efforts. Latent class analysis (LCA) was used to detect clusters among 308 childhood arrestees (mean age 10.7 years), based on dichotomous dynamic correlates of offending present at the time of first arrest. Correlates in the individual, peer and family domains were assessed at baseline and 2-year follow-up, using standardized instruments. This resulted in identification of a low problem group characterized by few problems across all domains (40.2 %), an externalizing intermediate problem group characterized by mainly externalizing problems on the individual and peer domains (39.4 %), and a pervasive high problem group characterized by numerous problems across all domains (20.4 %). Cluster membership was most stable for the low problem group (71.4 %), followed by the externalizing intermediate problem group (49.5 %). Transition was highest in the pervasive high problem group (63.0 %), with the majority of children progressing to the externalizing intermediate problem group. The identification of such distinct clusters among childhood arrestees, differing in the presence of co-occurring problems, stresses the importance of a first police arrest as an opportunity for early recognition of children in need of care. As problems present at the time of first arrest do not persist in every child, careful periodic monitoring is needed.     

Optimal Items for Assessing Parental Involvement across Different Groups During Middle Childhood

Various definitions and different approaches for assessing the complex construct of parental involvement (PI) have led to inconsistent findings regarding the impact of PI on child development. To date, limited information is available regarding the measurement invariance of PI measures across time and groups (e.g., children’s gender, ethnicity, and socio-economic status), leaving a concern that group differences in PI might reflect item bias instead of true differences in PI. The present study aimed to obtain a set of optimal items for measuring PI from kindergarten through the elementary school years and investigate whether they could be used for parents from different groups. A Rasch measurement model was implemented to investigate item difficulty, step calibrations, and measurement invariance (differential item functioning; DIF, here). The results from the Early Childhood Longitudinal Study, Kindergarten Class of 1998–1999 data set showed that 20 items can be used to measure three dimensions of PI—namely school/home involvement, family educational investment, and family routines—across four time points. Administrative time, children’s gender, ethnicity, and social economic status showed different levels of effect on item difficulty for half of these items. Practitioners and researchers should be cautious when using these items and are suggested to freely estimate the item parameters of DIF items as well as add more items to the PI scale to improve reliability.     

The Importance of Assessing for Childhood Abuse and Lifetime PTSD in Bariatric Surgery Candidates

For bariatric surgery candidates, history of child abuse and PTSD may be under-recognized or under-reported at pre-surgical evaluation. On a range of clinically relevant factors, we studied 3045 candidates for bariatric surgery: (1) those with a history of childhood abuse compared to those without such history; and (2) among candidates with a history of abuse, those with a lifetime diagnosis of PTSD compared to those without that diagnosis. We compared them on current and lifetime eating disorders, physical health problems, health behaviors, physical functioning, psychosocial functioning, psychiatric disorders, emotional wellness, body satisfaction, and self-esteem. We hypothesized that patients with a history of childhood abuse, and within that group, those with a lifetime PTSD diagnosis, would display greater overall impairment. Patients were interviewed with semi-structured interviews and completed self-report questionnaires. Results showed that (1) patients with a history of childhood abuse exhibited significantly greater impairment than those without abuse; and (2) among candidates with a history of abuse, those with a lifetime history of PTSD displayed significantly greater impairment than those without a PTSD diagnosis. The findings suggest that a history of both childhood abuse and lifetime PTSD should be thoroughly assessed for at pre-surgical evaluation, and that greater attention be paid to the experience of PTSD symptoms in abuse survivors presenting for bariatric surgery.     

Identifying Risk for Self‐Harm: Rumination and Negative Affectivity in the Prospective Prediction of Nonsuicidal Self‐Injury

Research suggests nonsuicidal self‐injury (NSSI) may function as a maladaptive strategy to regulate negative emotions, and individuals high in trait negative affectivity (NA) may be particularly at risk. Rumination, a cognitive emotion regulation strategy, may amplify negative affect, increasing the likelihood of NSSI. The current study found that high NA and high rumination interacted to predict both likelihood of engagement in NSSI and frequency of NSSI. This study provides support for the joint contribution of cognitive and temperamental factors impacting the relationship between NA and NSSI and suggests that interventions targeted at maladaptive emotion regulation strategies may help inform individualized treatment.     

Identifying the Developmental Strengths of Juvenile Offenders: Assessing Four Life‐Skills Dimensions

The authors describe the development of the Life‐Skills Development Scale Juvenile Form, a brief self‐report instrument for assessing the life‐skills development of juvenile offenders. Reliability and validity findings are presented, implications for treatment planning are provided, and recommendations for further research are discussed.     

A Tricky Object to Classify: Evidence,Postpartum Depression and the DSM‐IV

The concept of evidence has become central in Western healthcare systems; however, few investigations have studied how the shift toward specific definitions of evidence actually occurred in practice. This paper examines a historical case in psychiatry where the debate about how to define evidence was of central importance to nosological decision making. During the fourth revision of the Diagnostic andStatistical Manual of Mental Disorders a controversial decision was made to exclude postpartum depression (PPD) as a distinct disorder from the manual. On the basis of archival and interview data, I argue that the fundamental issues driving this decision were related to questions about what constituted suitable hierarchies of evidence and appropriate definitions of evidence. Further, although potentially buttressed by the evidence‐based medicine movement, this shift toward a reliance on particular kinds of empirical evidence occurred when the dominant paradigm in A merican psychiatry changed from a psychodynamic approach to a research‐based medical model.     

Assessing Biobehavioural Self‐Regulation and Coregulation in Early Childhood: The Parent‐Child Challenge Task

Researchers have argued for more dynamic and contextually relevant measures of regulatory processes in interpersonal interactions. In response, we introduce and examine the effectiveness of a new task, the Parent–Child Challenge Task, designed to assess the self‐regulation and coregulation of affect, goal‐directed behaviour, and physiology in parents and their preschoolers in response to an experimental perturbation. Concurrent and predictive validity was examined via relations with children's externalizing behaviours. Mothers used only their words to guide their 3‐year‐old children to complete increasingly difficult puzzles in order to win a prize (N = 96). A challenge condition was initiated midway through the task with a newly introduced time limit. The challenge produced decreases in parental teaching and dyadic behavioural variability and increases in child negative affect and dyadic affective variability, measured by dynamic systems‐based methods. Children rated lower on externalizing showed respiratory sinus arrhythmia (RSA) suppression in response to challenge, whereas those rated higher on externalizing showed RSA augmentation. Additionally, select task changes in affect, behaviour, and physiology predicted teacher‐rated externalizing behaviours four months later. Findings indicate that the Parent–Child Challenge Task was effective in producing regulatory changes and suggest its utility in assessing biobehavioural self‐regulation and coregulation in parents and their preschoolers. Copyright © 2016 John Wiley & Sons, Ltd.     

Childhood depression: A place for psychotherapy

Pharmacotherapy and psychotherapy are the two dominant mental health treatment modalities, but they are often taught and practised very separately leading to polarisation which may fragment treatment delivery. This paper presents results from a small qualitative study of interfaces between these modalities as described by medical and non-medical professionals practising in the National Health Service (NHS) and explores whether this polarisation maps to the Kleinian ‘P/S’ (paranoid/schizoid) and ‘D’ (depressive) positions, the ‘P/S’ position of omnipotence and dominance of one model over the other shifting the attention away from a more realistic ‘D’ position of integration and concern for the patient. The challenges to the integration of pharmacology and psychotherapy are examined in reference to cultural, organisational, relational and intrapsychic issues. Finally, clinical implications of an integrative approach are considered.     

On Microaggressions: Cumulative Harm and Individual Responsibility

Microaggressions are a new moral category that refers to the subtle yet harmful forms of discriminatory behavior experienced by members of oppressed groups. Such behavior often results from implicit bias, leaving individual perpetrators unaware of the harm they have caused. Moreover, microaggressions are often dismissed on the grounds that they do not constitute a real or morally significant harm. My goal is therefore to explain why microaggressions are morally significant and argue that we are responsible for their harms. I offer a conceptual framework for microaggressions, exploring the central mechanisms used for identification and the empirical research concerning their harm. The cumulative harm of microaggressions presents a unique case for understanding disaggregation models for contributed harms, blame allocation, and individual responsibility within structural oppression. Our standard moral model for addressing cumulative harm is to hold all individual contributors blameworthy for their particular contributions. However, if we aim to hold people responsible for their unconscious microaggressions and address cumulative harm holistically, this model is inadequate. Drawing on Iris Marion Young's social connection model, I argue that we, as individual perpetrators of microaggressions, have a responsibility to respond to the cumulative harm to which we have individually contributed.     

Assessing offenders: dying for reprieve

As is true for those who face death, the trauma of arrest and conviction for a crime and subsequent imprisonment takes the individual through a series of psychological stages, In the offender, these defenses are to some extent prescribed by the culture. The nature of and the person's adaptation to this process has not been previously recognized and argues for an assessment approach that emphasizes developmental rather than static formulations. Examination and treatment implications are discussed.     

The Harm Principle Cannot Replace the Best Interest Standard: Problems With Using the Harm Principle for Medical Decision Making for Children

For many years the prevailing paradigm for medical decision making for children has been the best interest standard. Recently, some authors have proposed that Mill’s “harm principle” should be used to mediate or to replace the best interest standard. This article critically examines the harm principle movement and identifies serious defects within the project of using Mill’s harm principle for medical decision making for children. While the harm principle proponents successfully highlight some difficulties in present-day use of the best interest standard, the use of the harm principle suffers substantial normative and conceptual problems. A medical decision-making framework for children is suggested, grounded in the four principles. It draws on the best interest standard, incorporates concepts of harm, and provides two questions that can act as guide and limit in medical decision making for children.     

Moving Beyond an Exclusive Focus on Harm Avoidance in Obsessive-Compulsive Disorder: Behavioral Validation for the Separability of Harm Avoidance and Incompleteness

There is increasing recognition that symptoms of obsessive-compulsive disorder (OCD) may be associated not only with harm avoidance, but also with sensations of things being incomplete or not “just right.” Although preliminary research supports the presence of both harm avoidance and incompleteness in OCD, their validity as separate constructs has not been tested beyond the use of self-report measures. Therefore, the aim of the current study was to behaviorally validate the separability of harm avoidance and incompleteness using an unselected student sample. Consistent with hypotheses, self-reported levels of incompleteness and harm avoidance uniquely predicted participants' ratings of their experiences while performing OCD-relevant behavioral tasks (e.g., washing dirty dishes, arranging books on a bookshelf). Results suggest that harm avoidance is associated with anxiety/nervousness and a desire to prevent harm, whereas incompleteness is linked to feelings of tension/discomfort and a desire to perform tasks perfectly or just right. Theoretical and clinical implications are discussed.