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.     

Relationships between Parental Maltreatment and Adolescents’ School Adjustment: Mediating Roles of Self-Esteem and Peer Attachment

Parental maltreatment of children has been steadily increasing in Korea despite national efforts to curb it. Children and adolescents who experience maltreatment develop psychological and social maladjustment. Therefore, mediating variables alleviating the negative effects of parental maltreatment on child development should be investigated to develop effective intervention programs. We identified the direct effects of parental abuse and neglect on adolescents’ school adjustment and the mediating effects of adolescents’ self-esteem and peer attachment on the relationships between parental abuse and neglect and their school adjustment. We used data from 2351 middle school students who participated in the Korean Children and Youth Panel Survey. Structural equation modeling revealed the following: child neglect directly and negatively related with adolescents’ school adjustment, whereas child abuse did not. Further, while adolescents’ self-esteem and peer attachment mediated the relationship between child neglect and school adjustment, adolescents’ self-esteem alone mediated the relationship between child abuse and school adjustment. These findings imply that there is a need to develop different intervention programs based on child maltreatment types. Finally, we suggested that the negative effects of parental neglect on adolescents’ school adjustment could be alleviated by adolescents’ self-esteem recovery resulting from peer support. On the other hand, in the case of adolescents experiencing parental abuse, self-esteem recovery through education and counseling provided by teachers or respected adults could be prioritized.     

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.     

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.     

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.     

Braiding Two Evidence-Based Programs for Families At-Risk: Results of a Cluster Randomized Trial

Child maltreatment is a significant public health problem best addressed through evidence-based parent-support programs. There is a wide range of programs with different strengths offering a variety of options for families. Choosing one single evidence-based program often limits the range of services available to meet the unique needs of families. This paper presents findings from a study to examine the systematic braiding of two evidence-based programs, Parents as Teachers and SafeCare at Home (PATSCH), with the goal to provide a more robust intervention for higher risk families. A cluster randomized effectiveness trial was conducted to examine if PATSCH improved parenting behaviors known to decrease the risk for child maltreatment compared to Parents as Teachers (PAT) Alone. Parents (N?=?159; 92 PAT Alone; 67 PATSCH) were enrolled to complete a baseline, 6-month and 12-month assessment. Results indicate the groups did not differ on number of environmental hazards in the home, parents’ health care decision-making abilities, child abuse potential, and physical assault over time. However, with regard to the potential for child abuse, the PATSCH group showed a decrease in nonviolence discipline and increase in psychological aggression compared to the PAT group. Further research is needed to better examine this concept and its implications for the field.     

Using Multiple Informants to Assess Child Maltreatment: Concordance between Case File and Youth Self-Report

To understand the psychosocial implications of child maltreatment, methods used to document prevalence must be clear. Yet, rates of maltreatment found in child self-report are generally inconsistent with data found in case files from state social service agencies. Although it is known that self-reports and case file reports of abuse disagree on occurrence of specific events, it is unclear if reporters agree when overall categories of abuse are considered. This study investigated differences between case file and youth report of abuse by examining four types of abuse—physical, sexual, neglect, and psychological—in a within-subjects design using a sample of 97 youth in foster care aged 8 to 22. Case files were coded for the presence of any indication of each type of abuse. Self-report of abuse was also assessed for any indication of each type of abuse. Results indicated that, overall, youth reported more physical and psychological abuse, and younger youth reported more sexual abuse than documented in their file. Implications for research and service provision for maltreated youth are discussed.     

Clinical Assessment of Child Victims and Adult Survivors of Child Maltreatment

In the last 2 decades, various forms of child maltreatment, including physical abuse, sexual abuse, psychological abuse, and neglect, have gained the increased attention of the general public and mental health professionals. In this article, the authors review relevant literature to assist counselors in conducting quality clinical assessments of child victims and adult survivors of child maltreatment. Guidelines are discussed, and specific measures and procedures are recommended.     

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.     

Permanent Housing for Child Welfare‐Involved Families: Impact on Child Maltreatment Overview

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.     

Adult Psychological Distress and Self-Worth Following Child Verbal Abuse

Despite the proliferation of child maltreatment research over the last 30 years, there remains a dearth of research examining the long-term effects of child psychological maltreatment (CPM), particularly child verbal abuse (CVA). Using a college sample of 173 participants from a Southeastern university, this study examined the role of gender and perpetrator relationship in predicting psychological distress and self-worth of adults exposed to CVA. Maternal CVA emerged as a significant predictor of lower levels of self-worth in adult daughters and sons as well as greater psychological distress in adult daughters. Paternal CVA did not emerge as a significant predictor of greater psychological distress or lower levels of self-worth in either adult daughters or sons.     

Childhood maltreatment, emotional distress, and early adolescent sexual intercourse: multi-informant perspectives on parental monitoring

This prospective investigation used multi-informant models to examine whether parental monitoring moderated associations between child maltreatment and either emotional distress or sexual intercourse. Data included 637 youth in the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). Child maltreatment was determined by lifetime Child Protective Service records and youth self-report and included sexual, physical, psychological abuse, and neglect (age 12). The moderating variable was youth- and caregiver-reported parental monitoring (age 12). Outcome variables were emotional distress (age 12) and sexual intercourse (age 14). Analyses included multi- and individual-informant models, adjusting for age, ethnicity/race, family income, and study site. Rates of parental monitoring did not differ by gender, but gender-specific analyses found that among girls, but not boys, youth-reported parental monitoring buffered the effect of maltreatment on emotional distress. Subtype analyses found that the buffering effects of monitoring on emotional distress were strongest for sexual and physical abuse and when youth experienced multiple subtypes of maltreatment. Caregiver-reported monitoring was not associated with reduced emotional distress. Youth and caregiver reports of parental monitoring were inversely associated with sexual intercourse, regardless of maltreatment history. Findings suggest that promoting parental monitoring among caregivers, and perceptions of monitoring among youth, may prevent early sexual intercourse regardless of maltreatment history. Promoting parental monitoring among youth with a history of maltreatment, especially girls or those who have experienced sexual or physical abuse or multiple subtypes of abuse, may reduce the likelihood of emotional distress.     

儿童心理虐待与忽视和自杀意念的关系：有调节的中介模型

采用问卷法对988名初中生进行调查,探究儿童心理虐待与忽视和自杀意念的关系,应对方式的中介作用以及友谊质量的调节作用。结果表明：（1）儿童心理虐待与忽视正向预测自杀意念;（2）应对方式是儿童心理虐待与忽视和自杀意念之间的中介变量;（3）儿童心理虐待与忽视对自杀意念的直接效应受到友谊质量的调节,直接效应对于友谊质量低的青少年更显著;（4）儿童心理虐待与忽视通过应对方式对自杀意念的间接效应的后半段受到友谊质量的调节,友谊质量高的青少年的自杀意念水平相对更低。因此,儿童心理虐待与忽视和自杀意念之间是有调节的中介关系,儿童心理虐待与忽视通过应对方式影响自杀意念,友谊质量在直接路径和间接路径中起调节作用。     

Reductions of intimate partner violence resulting from supplementing children with omega‐3 fatty acids: A randomized,double‐blind,placebo‐controlled,stratified, parallel‐group trial

Omega‐3 supplementation has been found to reduce externalizing behavior in children. Reciprocal models of parent‐child behavior suggest that improving child behavior could lead to improvements in parent behavior, however no study has examined whether omega‐3 supplementation in children could reduce intimate partner violence or child maltreatment by their adult caregivers. In this randomized, double‐blind, placebo‐controlled, stratified, parallel group trial, a community sample of children were randomized to receive either a fruit drink containing 1 gm of omega‐3 fats (Smartfish Recharge; Omega‐3 group, n = 100) or the same fruit drink without omega‐3's (Placebo group, n = 100). Child participants, adult caregivers, and research staff were blinded to group assignment. Adult caregivers reported inter‐partner and child‐directed physical assault and psychological aggression at baseline, 6 months (end of treatment) and 12 months (6 months post‐treatment) using the Conflicts Tactics Scale. Caregivers of children in the omega‐3 group reported long‐term reductions in psychological aggression in a group × time interaction. Improvements in adult psychological aggression were correlated with improvements in child externalizing behavior scores. No differences were reported for child maltreatment. This study is the first to show that omega‐3 supplementation in children can reduce inter‐partner psychological aggression among adult caregivers not receiving supplements. Findings suggest that improving child behavior through omega‐3 supplementation could have long‐term benefits to the family system as a whole.

     

Identity and Emotional Competence as Mediators of the Relation between Childhood Psychological Maltreatment and Adult Love Relationships

This study tested whether identity formation and emotional competence mediated the relationship between childhood psychological maltreatment and adult attachment styles, and tested the differential long-term effects of psychological abuse and neglect. The sample included 187 undergraduates in romantic relationships. Measures assessed the extent of childhood trauma, family expressiveness, alexithymia, self-esteem, self-concept, and adult attachment style. Results of path analysis showed that emotional competence, but not self-identity, mediated the relationship between psychological maltreatment and adult attachment styles. Self-identity mediated the relationship between psychological maltreatment and emotional competence. Emotional abuse and neglect both were associated with lack of contentment, sense of worthiness and significance, alexithymia, and fearful adult attachment style. Results support the importance of emotional competence for forming adult romantic relationships.     

Differentiating corporal punishment from physical abuse in the prediction of lifetime aggression

Corporal punishment and parental physical abuse often co‐occur during upbringing, making it difficult to differentiate their selective impacts on psychological functioning. Associations between corporal punishment and a number of lifetime aggression indicators were examined in this study after efforts to control the potential influence of various forms of co‐occurring maltreatment (parental physical abuse, childhood sexual abuse, sibling abuse, peer bullying, and observed parental violence). College students (N = 1,136) provided retrospective self‐reports regarding their history of aggression and levels of exposure to childhood corporal punishment and maltreatment experiences. Analyses focused on three hypotheses: 1) The odds of experiencing childhood physical abuse would be higher among respondents reporting frequent corporal punishment during upbringing; 2) Corporal punishment scores would predict the criterion aggression indices after control of variance associated with childhood maltreatment; 3) Aggression scores would be higher among respondents classified in the moderate and elevated corporal punishment risk groups. Strong support was found for the first hypothesis since the odds of childhood physical abuse recollections were higher (OR = 65.3) among respondents who experienced frequent (>60 total disciplinary acts) corporal punishment during upbringing. Partial support was found for the second and third hypotheses. Dimensional and categorical corporal punishment scores were associated significantly with half of the criterion measures. These findings support efforts to dissuade reliance on corporal punishment to manage child behavior.

     

The Role of Children��s Appraisals on Adjustment Following Psychological Maltreatment: A Pilot Study

Little is known about the cognitive mechanisms involved in the development of psychopathology following psychological maltreatment in children. This study therefore examined the role of thinking styles on children's outcomes following this subtype of maltreatment. Children who had experienced past maltreatment (n?=?24) and a control group (n?=?26) were assessed using self-report questionnaires. Maltreatment history, cognitive styles and psychological outcomes, such as depression, posttraumatic stress disorder (PTSD) and self-esteem were assessed. Parents/caregivers also completed a measure of child internalizing and externalizing behaviours. Psychological maltreatment made a significant contribution to children's self-reported depression and low self-esteem, and parent reported internalizing and externalizing problems, even after controlling for other abusive experiences. This was not the case for PTSD symptoms. Further, children's cognitive styles were associated with self-reported depression, self-esteem and PTSD. They did not, however, predict parent-rated emotional and behavioural problems. This study provides preliminary support for a cognitive model of adjustment following psychological maltreatment. The results indicate the need for enhanced community awareness about the impact of psychological maltreatment, and suggest a direction for therapeutic intervention.     

Sex with children is abuse: Comment on Rind, Tromovitch, and Bauserman (1998).

B. Rind, P. Tromovitch, and R. Bauserman (1998) reported a meta-analysis of the relation between sexual abuse in childhood and adolescence and psychological functioning among college students. Several aspects of their work have proven to be highly controversial, including their assertion that the relation between child sexual abuse and adjustment is quite small and their questioning of whether child sexual abuse should be labeled abuse in scientific inquiry. In this commentary, the authors summarize the controversy that has ensued, place it in a historical context, discuss the limitations of B. Rind et al.'s findings, and critique the manner in which those findings are presented. The authors also argue for the appropriateness of the term abuse and for scientific terminology that reflects rather than contradicts consensual public morality.     

An assessment of the extent of child maltreatment using administrative databases

This study examined the extent of violence toward children and factors associated with child maltreatment in Florida using a cohort of children (N=499,330) who were adjudged to be victims of maltreatment between July 1, 1996, and June 30, 2003. To assess the extent of maltreatment, five indicators were proposed and examined. Multivariate analyses found that prior referral, having more than one type of maltreatment during an initial incident, and caregiver absence best predicted the recurrence of maltreatment. Caregivers' alcohol and substance use were strong predictors of neglect and threatened harm but not of abuse. Finally, multilevel analyses found that older, nonminority girls with histories of prior referrals were significantly (psuedo-zs>2.00) more likely to experience high degrees of incident severity. Caregivers' substance use, excluding alcohol, also was significantly linked to incident severity. Implications of the findings are discussed.