Resisting Abuse at What Cost? The Impact of Mandated Reporting Laws on the Process and Content of Therapy

Child abuse reporting is mandatory for family therapists. Little is written regarding the impact of mandated reporting and its impact on the family therapy systemic processes. This paper reviews literature on the impact on therapy of mandated reporting, and shares the results of a study designed to assess the impact of mandated reporting on family therapist's attention to systemic issues. The study demonstrates that MFTs shift their focus when the question of a mandated report arises to the detriment of systemic considerations. The institutional split between investigation and treatment of child abuse is discussed.     

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.

     

Unto the Third Generation

Abstract

It is possible to significantly reduce, even eliminate child abuse if we address five obstacles: (1) many mandated reporters fail to comply with the law; (2) most child abuse reports are not investigated; (3) frontline child protection professionals are inadequately trained; (4) we do not address child abuse at the youngest ages; and (5) maltreated children receive an inadequate share of financial resources. Accordingly, we must reform our higher education system to ensure that all child protection professionals have the skills necessary to recognize and respond to abuse. We must provide ongoing training to professionals in the field, have at least one forensic interview-training program in each state, develop prevention programs at the local level, and teach frontline professionals to advocate for children. Finally, we must recruit a second generation that will build on these successes and continue to improve our response until child abuse no longer exists.     

Index of suspicion: feeling not believing

Throughout the U.S., state laws require professionals who work with children to report cases of suspected child abuse to child protection services. Both practically and conceptually, however, significant problems arise from a lack of clarity regarding the threshold that has been set for reporting. Specifically, there is no consensus as to what constitutes reasonable suspicion, and little direction for how mandated reporters should gauge their legal and professional responsibilities when they harbor suspicion. In this paper we outline the context of the problem, discuss the nature and scope of its conceptual underpinnings, and offer recommendations for moving towards a concrete, practical solution.     

Between Subjugation and Survival: Women, Borderline Personality Disorder and High Security Mental Hospitals

Women in high security mental health care are frequently diagnosed with borderline personality disorder. Such women commonly report histories of child abuse, in particular child sexual abuse, and the vast majority also self-harm. In this paper, we draw on social constructionist theory to develop a framework for understanding these women, the effects of abuse and the reasons they self-harm. We demonstrate how a social model of intervention provides a comprehensive framework for identifying and exploring relevant factors within therapy. We argue that diagnostic categorisation has limited utility in directing therapeutic work with this particular group of women, because it directs attention away from the social world to internal pathology. We demonstrate that it is with reference to women's past and current relationships that borderline behaviour can be understood to be meaningful and partially adaptive. We conclude that treatment is more usefully organised around and directed towards those factors, such as abuse and self-harm, that are implicated in women's ongoing relationship difficulties.     

Long-term consequences of childhood physical and psychological maltreatment

This study assessed whether some of the correlates of learned helplessness—depression, low self-esteem, and a maladaptive attributional style—are long-term consequences of child abused. In this study, 260 subjects were identified as physically abused, psychologically abused, both physically and psychologically abused, or nonabused, based on responses to the Child Abuse Questionnaire (CAQ). Subjects were tested for levels of nonclinical depression via the Beck Depression Inventory (BDI), for levels of self-esteem via the Rosenberg Self-Esteem Scale (RSE), and for the adaptiveness of attributional style via the Attributional Style Questionnaire (ASQ). It was hypothesized that each of the three abuse groups would differ from the control group on the three dependent measures; differences among the three abuse groups were also explored. Three one-way analyses of variance indicated that (1) BDI scores reflected a greater tendency toward depression in subjects reporting both types of abuse than in nonabused subjects or in subjects reporting either psychological or physical abuse, (2) subjects reporting psychological abuse only or both psychological and physical abuse showed lower self-esteem than did nonabused subjects, and (3) abused subjects did not seem to exhibit a more maladaptive attributional style than that of nonabused subjects. In addition, multiple linear regression analyses pointed to psychological abuse as a critical variable in predicting levels of depression, self-esteem, and attributional style, when physical abuse effects were controlled. Controlling for the effects of psychological abuse, however, indicated that physical abuse did not significantly contribute to the variance in these variables. Implications for the learned helplessness model and for future research are discussed. © 1992 Wiley-Liss, Inc.     

The Association of Child Abuse and Eating Disorder Symptomatology

Abstract

Using self-report questionnaires, symptoms of eating disorders were examined in relation to child sexual (CSA), physical (CPA), and emotional abuse (CEA), and adult rape among 301 college women. CPA and adult rape were associated with fear of fatness and bulimic behavior. CEA, family cohesion and expressiveness, and adult rape were related to difficulties recognizing emotional states and satiety. Individuals who reported multiple forms of child abuse or who were revictimized exhibited the highest levels of symptoms. Revictimized women were more likely to report clinical levels of symptoms compared with individuals reporting adult rape without child abuse or child abuse without adult rape. Findings support the assumption that negative experiences in addition to CSA, such as adult rape and other forms of child abuse, influence eating pathology, and suggest a cumulative impact of abuse.     

Cultural–geographical differences in the occurrence of child physical abuse? A meta‐analysis of global prevalence

Our comprehensive meta‐analysis combined prevalence figures of child physical abuse reported in 111 studies, including 168 independent samples with a total of 9,698,801 participants. The overall estimated prevalence was 3/1000 for studies using informants and 226/1000 for studies using self‐report measures of child physical abuse, with no apparent gender differences. Methodological factors partly explained the vast variation of self‐reported prevalence rates in individual studies. The highest prevalence rates were found for studies using a broad definition of child physical abuse, studies measuring physical abuse over the longest period of 0–18 years, studies using college samples, studies in which adults served as respondents, and studies using more questions on physical abuse. Cultural–geographical factors did not seem to affect prevalence rates of physical abuse, which may be partly due to procedural factors. More crosscultural research on physical abuse is badly needed, especially in Africa and South America. We conclude that child physical abuse is a widespread, global phenomenon affecting the lives of millions of children all over the world, which is in sharp contrast with the United Nation's Convention on the Rights of the Child.     

Growing Up with Child Sexual Abuse in an Experimental Commune: Making Sense of Narrative Variation

The legitimacy of adult's accounts of child sexual abuse depends on the consistency of the story they tell about this experience. But there are a variety of influences that conspire to create dynamic variation in retrospective accounts of child sexual abuse. In a study of an experimental New Zealand commune called Centrepoint, participants showed considerable variation in accounting for the child sexual abuse that was known to have occurred there. We used a narrative methodology to show the variation between stories that highlighted abuse and suffering and others that represented an idyllic childhood within which sex between children and adults was normalised. There was also considerable variation within individual participant's accounts. The variation within and between accounts was shaped by features such exposure to contradictory experiences, different social positioning in relation to child sexual abuse, shifts in memory and interpretation over time, differences between insider and outsider perspectives on child sexual activity at the commune and alternative perspectives on victimhood. This research challenges the mythology that accounts of child sexual abuse should be expected to be clear and consistent. Instead, variation should be treated the rule rather than the exception in these accounts. Copyright © 2012 John Wiley & Sons, Ltd.     

Child Sexual Abuse

Summary

Children who are recent victims of sexual abuse may initially present to their primary care health provider. Often, the outward manifestations of sexual abuse are somatic complaints or nonspecific behavioral changes. Retrospective reports of adults suggest that about 20-30% of women were sexually abused as children, with figures for men ranging from 10-15%. Interview guidelines for children and adolescents emphasize the need for sensitivity to cognitive development and emotional issues while simultaneously being focused on eliciting specific behavioral data. The use of anatomically detailed dolls, in the context of a comprehensive assessment, is discussed. Health care providers are mandated reporters and must disclose suspected child sexual abuse to the state's child protective service department. Guidelines for reporting as well as addressing this issue with parents are discussed.     

The School Functioning of Individuals with Childhood Experiences of Sexual Abuse: Results and Implications of a South African Study

This study investigated the school functioning of individuals with childhood sexual experiences in South Africa. The nature of the study was qualitative, and employed two data collection strategies: in-depth individual interviews with 22 survivors of child sexual abuse and focus interviews with two groups of teachers. The study revealed that participants' emotional reaction to the abuse affected three broad areas of school functioning: concentration, interest in school-related activities and school adjustment. The intensity of these problems varied across participants. The findings are consistent with Finkelhor and Browne's (1986) traumagenic model, which suggests that the experience of child sexual abuse often results in feelings that interfere with one's cognitive development and emotional orientations to the world and causes trauma by distorting the victim's self concept and worldview.     

The Role of Race and Severity of Abuse in Teachers' Recognition or Reporting of Child Abuse

In the United States, reported child abuse rates vary dramatically with race. We employed a scenario methodology to examine whether teachers, whose professional obligations include reporting suspected instances of abuse, exhibit bias in evaluating a possibly abused child. Each teacher (180 White, 180 Black, and 180 Hispanic) read one of six profiles about a hypothetical elementary school student and then expressed extent of agreement with either a statement that the child is being physically abused or a statement that the child should be reported as being physically abused. Within the set of profiles, race of the child and severity of abuse were manipulated. When the child in the profile was severely abused, responses for the two judgmental tasks were comparable. However, when the child was moderately abused, teachers asked whether the child was abused gave higher responses than their counterparts who were asked whether the child should be reported. No effects of race of the child or race of the teacher were observed.     

Why do child sexual abuse victims not tell anyone about their abuse? An exploration of factors that prevent and promote disclosure

Disclosure rates of child sexual abuse (CSA) to both social supports and law enforcement are concerningly low, although more research is needed to understand factors that impact disclosure. Thus, the present study examined rates of informal (i.e., to a social support) and formal (i.e., to law enforcement) disclosure of CSA, as well as victims' self-reported experiences with telling others about their own abuse and their perceptions of the overall advantages and disadvantages of disclosure. In all, 76 undergraduate women (who collectively experienced 105 instances of abuse) participated in a semi-structured interview regarding their history of CSA. Results revealed that approximately 50% of cases involved the victim informally disclosing, and only 10% of cases being formally disclosed to authorities. The quantitative and qualitative data shed light on a number of factors that lead victims to not disclose, as well as the identification of factors that may promote a victim to share their abuse with others. The implications for improved prevention and responses to CSA disclosure are discussed.     

Nature and Prevalence of Childhood Sexual Abuse Among High School Girls and College Students in Zimbabwe

The study investigated the nature and prevalence of self-reported childhood sexual abuse (CSA) among a sample of Zimbabwean girls and college students. A total of 1059 high school girls and college students with a mean age (M = 18.31, SD = 3.66) participated in study. Overall, a CSA prevalence rate of 41.26% was found. The highest CSA prevalence rate was found among respondents who resided on commercial farms and mines (53%). Respondents who lived with their biological parents during childhood were significantly less likely to be sexually abused than were respondents who lived with non-parents such as uncles and brothers-in-law. Only 7.22% of the perpetrators were strangers. This study shows that sexual abuse of children in Zimbabwe is rampant, multifaceted, and linked to cultural factors that must be addressed as part of efforts to confront this scourge.     

Child abuse: is there a mandate for researchers to report?

During the past 20 years, states have increasingly expanded the lists of individuals who are obligated to report their suspicions of child abuse and neglect. These legal requirements are juxtaposed with ethical considerations in research and professional practice. The ethical issues include the obligation to maintain both confidentiality of information provided by human participants and the safety and protection of these participants. This article reviews the types of state child abuse reporting statutes and outlines the categories of mandated reporters. I develop a model of how individual researchers should approach deciding whether they are mandated reporters of child abuse and neglect.     

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.     

The relationship between parental physical availability and child sexual,physical and emotional abuse: a study among a sample of university students in South Africa

The relationship between perceived parental physical availability and child sexual, physical and emotional abuse was investigated. The sample comprised 722 undergraduate students of psychology at the University of the North, South Africa. Participants filled in a retrospective self-rated questionnaire in a classroom setting. The questionnaire asked about perceived parental physical availability during childhood, and childhood sexual, physical and emotional abuse. Logistic regression analysis showed that, among all the participants, the factors "the participant not living with the natural (biological) mother until he or she was at least 16 years old" and "have ever had a stepfather or adoptive father until he or she was at least 16 years old" predicted child sexual abuse; and "have ever had a stepfather or adoptive father until he or she was at least 16 years old" predicted child emotional abuse. None of the other aspects of parental availability considered predicted child physical abuse. Mental health and social workers, educators and law enforcement agencies dealing with prevention and protection against child abuse should take note of the above identified predictors while designing programs for the eradication of child sexual, physical and emotional abuse.     

Researching Child Sexual Abuse in South Africa: Complexities in the Field

This study reports on my fieldwork experiences applying qualitative research strategies to study child sexual abuse in South Africa. It considers the challenges associated with, at three stages of data collection: ethical clearance, recruitment and data collection, followed by possible solutions. The study also considers the challenges from ethical and epistemological perspectives. I used a reflective self-study to analyse my experiences. My experiences revealed the following challenges: ethical process due to reasons not linked to the content of the research process would cause delays to the field-work. In addition, the use of [formal institutions] welfare institutions as sole research sites would result in a homogenous sample that does not permit comparison of experiences among the abuse cases. The costs to the researcher in terms of emotional and physical investment can be significant.