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.     

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.     

Child maltreatment, non-suicidal self-injury, and the mediating role of self-criticism

We examined the relation between child maltreatment and non-suicidal self-injury (NSSI). Participants were 86 adolescents who completed measures of child maltreatment, self-criticism, perceived criticism, depression, and NSSI. Analyses revealed significant, small-to-medium associations between specific forms of child maltreatment (physical neglect, emotional abuse, and sexual abuse) and the presence of a recent history of NSSI. Emotional and sexual abuse had the strongest relations with NSSI, and the data supported a theoretical model in which self-criticism mediates the relation between emotional abuse and engagement in NSSI. Specificity for the mediating role of self-criticism was demonstrated by ruling out alternative mediation models. Taken together, these results indicate that several different forms of childhood maltreatment are associated with NSSI and illuminate one mechanism through which maltreatment may be associated with NSSI. Future research is needed to test the temporal relation between maltreatment and NSSI and should aim to identify additional pathways to engagement in NSSI.     

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.     

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.     

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.     

Child maltreatment types and risk behaviors: Associations with attachment style and emotion regulation dimensions

Child maltreatment is a robust psychosocial risk factor linked to the development of a wide range of risk behaviors among young adults. Adult attachment style and emotion dysregulation are two potential mechanisms through which maltreatment leads to risk behaviors. Yet, less is known about the specificity of the relations among different maltreatment types, attachment styles, emotion regulation strategies, and risk behaviors. The present study examined the relations among various forms of maltreatment and risk behaviors (e.g., substance use; risky sex) among 361 undergraduate students and tested whether attachment styles and emotion dysregulation might underlie these relations. Emotional, and sexual but not verbal abuse (although verbal abuse was directly related to alcohol use), were related to anxious and avoidant attachment styles, emotion dysregulation, and a variety of risk behaviors. Among the emotion regulation dimensions, impulsivity showed the strongest indirect effect from child maltreatment to risk behaviors. Results support a cross-sectional link between child maltreatment and risk behavior outcomes via attachment styles and emotion regulation. Implications for treatment and prevention of these risk behaviors in young adults are discussed.     

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.     

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.     

Religiosity of young adults: does childhood maltreatment make a difference?

Previous research on the association between maltreatment in childhood and later religious beliefs and behaviours suggests that maltreatment may have either negative or positive influences on religiosity. However, methodological limitations of previous studies may limit their generalisability. The present study attempted to address these limitations. We examined associations between childhood physical, sexual, and emotional abuse and several dimensions of adult religiosity in a large sample of college students (N = 763). Associations between child maltreatment and religiosity were weak (rs ≤ 0.09). After controlling for possible demographic confounds, the only significant association was between childhood emotional abuse and religious questing.     

The Relation Between Child Maltreatment and Adolescent Suicidal Behavior: A Systematic Review and Critical Examination of the Literature

A large body of research suggests that child maltreatment (CM) is associated with adolescent suicidal ideation and attempts. These studies, however, have not been critically examined and summarized in a manner that allows us to draw firm conclusions and make recommendations for future research and clinical work in this area. In this review, we evaluated all of the research literature to date examining the relationship between CM and adolescent suicidal ideation and attempts. Results generally suggest that childhood sexual abuse, physical abuse, emotional abuse, and neglect are associated with adolescent suicidal ideation and attempts across community, clinical, and high-risk samples, using cross-sectional and longitudinal research designs. In most studies, these associations remain significant when controlling for covariates such as youth demographics, mental health, family, and peer-related variables. When different forms of CM are examined in the same multivariate analysis, most research suggests that each form of CM maintains an independent association with adolescent suicidal ideation and suicide attempts. However, a subset of studies yielded evidence to suggest that sexual abuse and emotional abuse may be relatively more important in explaining suicidal behavior than physical abuse or neglect. Research also suggests an additive effect—each form of CM contributes unique variance to adolescent suicide attempts. We discuss the current limitations of this literature and offer recommendations for future research. We conclude with an overview of the clinical implications of this research, including careful, detailed screening of CM history, past suicidal behavior, and current suicidal ideation, as well as the need for integrated treatment approaches that effectively address both CM and adolescent suicidal ideation and suicide attempts.     

Coping style and memory specificity in adolescents and adults with histories of child sexual abuse

Individuals with histories of childhood trauma may adopt a nonspecific memory retrieval strategy to avoid unpleasant and intrusive memories. In a sample of 93 adolescents and adults with or without histories of child sexual abuse (CSA), we tested the hypothesis that nonspecific memory retrieval is related to an individual's general tendency to use avoidant (i.e., distancing) coping as a personal problem-solving or coping strategy, especially in victims of CSA. We also examined age differences and other individual differences (e.g., trauma-related psychopathology) as predictors of nonspecific memories. Distancing coping was significantly associated with less specific autobiographical memory. Younger age, lower vocabulary scores, and non-CSA childhood maltreatment (i.e., physical and emotional abuse) also uniquely predicted less autobiographical memory specificity, whereas trauma-related psychopathology was associated with more specific memory. Implications for the development of autobiographical memory retrieval in the context of coping with childhood maltreatment are discussed.     

Maltreatment of adolescents: the relationship to a predisposition toward violent behavior and delinquency

This discussion reviews the literature concerning the association between the maltreatment, abuse and exploitation of adolescents and the predisposition to violent and other offending behavior. We review the importance and family dynamics of abuse which bear a relationship to antisocial behavior. The distinction is made between child abuse and adolescent abuse, and controversies regarding the sequelae of various maltreatments are discussed. Recent work in sexual abuse and its relationship to male sexual offenders and male prostitutes is detailed. Adolescents who commit various offenses or are in contact with juvenile justice system may be or have been the victims of various forms of maltreatment and exploitation. Helping professionals caring for these youths should have an understanding of these factors and the underlying dynamics.     

The environment of child maltreatment: contextual factors and the development of psychopathology

Some professionals have hypothesized that the observed problems in children who have been maltreated may actually be a result of the combination of risk factors surrounding the child, including but not limited to direct results of the abuse itself. This article examines the complexity of hypothesized pathways to poor adjustment after physical and sexual abuse. The literature on the impact of major risk factors associated with maltreatment is reviewed in an attempt to clarify the potential contributions of these contextual variables on the development of psychopathology in physically and sexually abused children. The implications this analysis may yield for prevention, intervention, and research in this field are also discussed.     

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.     

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.     

The Role of Parenting Programmes in the Prevention of Child Maltreatment

Child maltreatment is a major worldwide concern and continuing high rates of abuse demand action. This article examines the role of parenting programmes as a strategy to prevent child maltreatment in the population as a whole and also as a targeted intervention for parents who have abused, or are at risk of abusing, their children. We argue that a blend of universal and targeted interventions is needed to reduce the prevalence of child maltreatment. Parenting interventions that concurrently target positive parenting and effective child management skills, dysfunctional parental attributions, and increasing parents' capacity to regulate their emotions are particularly useful. A variant of the Triple P—Positive Parenting Program, known as Pathways Triple P, is discussed to illustrate the value of this approach. Contextual factors that need to be addressed in working with child protection cases are also discussed. The role of training and supervision is discussed in the context of disseminating evidence‐based parenting programmes, and future directions for research are presented.     

Child Maltreatment,Emotion Regulation,and Posttraumatic Stress: The Impact of Emotional Abuse

This study examined the relationship of emotion regulation to multiple forms of child abuse and subsequent posttraumatic stress. Particular consideration was given to emotional abuse, which has received less attention in the literature. Results from a survey of 912 female college students revealed that women who reported a history of sexual, physical, or emotional abuse endorsed greater emotion regulation difficulties compared to women without abuse histories. Notably, emotional abuse was the strongest predictor of emotion deregulation. Mediation analyses indicated that emotion dysregulation partially explained the relationship between physical and emotional abuse and symptoms of posttraumatic stress, suggesting that intervention efforts aimed at improving emotion regulation strategies might be beneficial in decreasing posttraumatic stress among women with child maltreatment histories.     

Intervention in child neglect: an applied behavioral perspective

Child maltreatment in the forms of abuse and neglect is a serious social problem, affecting over 1.5 million children in the US annually. Abuse has generally received more public and professional attention than other forms of child maltreatment. Given that more than one type of child maltreatment frequently occurs in families, there are few behavioral studies that have specifically addressed techniques for the reduction of child neglect. Only recently have researchers begun to regard child neglect as a phenomenon that may be conceptually different from other forms of child maltreatment, thereby warranting specific attention. Described here are intervention strategies for parents at-risk for or referred for child neglect. We review these strategies, along with commentary on the difficulties of conducting applied research in this field. Suggestions are offered for improved intervention research in child neglect.