The child abusing family: I. Methodological issues and parent-related characteristics of abusing families

Abstract

The physical abuse of children by their parents is a family matter and should be viewed within the context of the family unit. Unfortunately, few child abuse studies have directly examined the family unit. Rather, most studies focus on characteristics of individual members of abusing families or on dyadic relationships within abusing families. Therefore, the present paper examines the family-related variables that might contribute to child abuse. This review is divided into two parts. Part I discusses methodological considerations and parent-related aspects of abusing families, including: characteristics of abusing parents, childhood experiences of abusing parents, marital relationships of abusing parents and the perceptions and expectations that abusing parents have of their abused children. Part II of this review, which will appear in a later issue, will cover child-related aspects of abusing families, parent-child interactions in these families, environmental conditions associated with child abuse and typologies of abusing families.     

Variables Associated with Therapy Attendance in Runaway Substance Abusing Youth: Preliminary Findings

Service providers and researchers note that youth with substance abuse problems are difficult to engage in treatment and, when engaged, often drop out early. Estimates of the alcohol and drug abuse rate of runaway youth range from 70% to 95%. This study evaluated predictors of therapy attendance in a sample of substance abusing youth recruited through two southwestern runaway shelters. Runaway youth and their families (N = 36) were engaged into a 15-session ecologically-based family therapy (EBFT) intervention. Fewer days between the pretreatment assessment and the first therapy session, as well as less perceived parental care, predicted more therapy sessions attended. No relationship was found between level of substance use and treatment attendance. The findings highlight the importance of engaging families in therapy soon after the youth's arrival to the shelter, as treatment motivation may decrease as the crisis lessens.     

Couple Therapy and Addictions

Abstract

Therapies for alcoholism, substance abuse, and other addictions traditionally focus on characteristics of individuals such as behaviors, thoughts, and emotions. These kinds of programs tend to target problems inside the abusing person rather than a relational system. Treatments that are more recent locate the problems within systems of people. Regardless of the locus or cause of the abuse or addiction, seen as arising from disease processes, systemic dynamics, or other mechanisms that lead to unfortunate habits and behaviors, utilizing the individual's partner or family in therapy has become an important part of successful treatment. This article reviews models of couple treatment for alcoholics and substance abusers in terms of initiation into treatment, primary treatment, and relapse prevention.     

Testing Underlying Assumptions of the Family Empowerment Perspective

We examined two underlying assumptions of the family empowerment perspective. The first assumption is that a well-validated family-based treatment that explicitly aims to empower caregivers can do so. The second assumption is that increased caregiver empowerment should be associated with improved youth and family functioning. The data used to examine these assumptions are based on a randomized trial of multisystemic therapy versus usual community services for 118 substance abusing and dependent juvenile offenders. Results provided partial support for the underlying assumptions of the family empowerment perspective. The family-based treatment in comparison with usual services increased caregiver perceptions of empowerment at the service system level, but not at the family level. In addition, increased empowerment at the family and service system levels were associated with improved family relations, but not with decreased youth behavior problems. The conceptual implications and limitations of the findings are discussed.     

The Effect of Strain,Affect, and Personal/Social Resources on Problem Substance Use among Incarcerated and Non-Incarcerated Youth

ABSTRACT

We explore the applicability of General Strain Theory to juvenile substance use. In doing so, we offer three advances over prior work. First, we put forward the concept of “problem substance use” to move beyond frequency-based and more medicalized conceptions of the phenomenon toward a conceptualization that views substance use as problematic when it disrupts social relationships and expectations and when it reflects a loss of self-control. Second, we employ a dataset that permits us to explore how strains originating in different life domains influence problem substance use as well as how negative emotions and personal coping resources mediate the relationship between strain and problem substance use. Third, we move beyond prior work by comparing how strain and strain mediators operate differently in schools, alternative learning centers, and juvenile correctional facilities. We find strong effects of the strain variables and strain mediators indicated by General Strain Theory and evidence that alternative learning centers and juvenile correction facilities are associated with especially high odds of problem substance use even when strain and other variables are controlled. We conclude by discussing the limitations of current work and the implications for next steps in the strain-substance use research literature.     

Initial Reliability and Validity of the Life Satisfaction Scale for Problem Youth in a Sample of Drug Abusing and Conduct Disordered Youth

Responses to Life Satisfaction Scale for Problem Youth (LSSPY) items were examined in a sample of 193 substance abusing and conduct disordered adolescents. In responding to the LSSPY, youth endorse their percentage of happiness (0 to 100%) in twelve domains (i.e., friendships, family, school, employment/work, fun activities, appearance, sex life/dating, use of drugs, use of alcohol, money/material possessions, transportation, control of one's life). Results indicated that the LSSPY yielded three factor structures (i.e., Social Satisfaction, External Obligations Satisfaction, Substance Use Satisfaction), demonstrated good initial psychometric properties, and appears to be a useful instrument in the evaluation of treatment outcome in problem youth. Males were more satisfied in the Social and External Obligations domains than females, although no gender differences were indicated in Substance Use Satisfaction. Caucasian, African-American, and Hispanic youths responded to LSSPY items similarly. Future directions are discussed in light of these results.     

Transformation of Narcissism and the Intersubjective Therapeutic Exchange

Abstract

Clinicians and researchers have redefined adolescence and depression in adolescence and no longer consider depression as typical of “normal” adolescence. Depression during the teenage period is differentiated from a depressed mood, replete with misery and anguish, and depression proper, i.e., a real illness with specific symptoms which are depressive equivalents. These symptoms often include aggressivity, substance abuse, school refusal, and delinquency. A detailed case presentation is offered of a 17-year-old depressed, substance abusing adolescent who shares his lyrics and heavy metal rock music in sessions, thereby transforming his aggression and narcissism. Use of self psychology and intersubjectivity theory stimulated the formation of a therapeutic alliance and a corrective selfobject relationship, with this young patient's subsequent gains in self-regulation, decreased temper eruptions, and school involvement.     

Predictors of treatment attendance among adolescent substance abusing runaways: a comparison of family and individual therapy modalities

This study explored and compared predictors of session attendance among substance abusing runaway adolescents and their parents using three manual‐driven interventions: ecologically‐based family therapy (EBFT), motivational enhancement therapy (MET), and the community reinforcement approach (CRA). Individual and family‐level variables, as well as time between intake and first session were used as predictors of session attendance. Adolescents (N=179) between the ages of 12–17 years old were recruited from the only runaway shelter in Columbus, Ohio. The findings showed that adolescents assigned to EBFT were more likely to attend at least one therapy session than those assigned to either CRA or MET. Fewer days between intake and the first therapy session were associated with higher family therapy attendance. Overall, individual and family factors predicted therapy attendance but these factors differed depending upon the treatment modality.     

Co‐Occurring Trajectory of Mothers’ Substance Use and Psychological Control and Children's Behavior Problems: The Effects of a Family Systems Intervention

This study examined the effects of a family systems therapy (Ecologically‐Based Family Therapy [EBFT]) on the co‐occurring trajectory of mothers’ substance use and psychological control, and its association with children's problem behaviors. Participants included 183 mothers with a substance use disorder who had at least one biological child in their care. Mothers were randomly assigned to one of the three intervention conditions: EBFT—home, n = 62; EBFT—office, n = 61; or Women's Health Education, n = 60. Participants were assessed at baseline, 3, 6, 12, and 18 months post‐baseline. A dual‐trajectory class growth analysis identified three groups of mothers in regard to their change trajectories. The majority of the mothers exhibited a synchronous decrease in substance use and psychological control (n = 107). In all, 46 mothers exhibited a synchronous increase in substance use and psychological control. For the remaining 30 mothers, substance use and psychological control remained stable. Mothers in the family therapy condition were more likely to show reduced substance use and psychological control compared to mothers in the control condition. Moreover, children with mothers who showed decreased substance use and psychological control exhibited lower levels of problem behaviors compared to children with mothers showing increased substance use and psychological control. The findings provide evidence for the effectiveness of family systems therapy, EBFT, in treating mothers’ substance use, improving parenting behaviors, and subsequently improving child behavioral outcomes.     

The Family FIRO Model: Exploring Relationship Needs of “At-Risk” Families

This research investigates the conceptualization and application of the family fundamental interpersonal relations orientation(FIRO) model to an at-risk family population. The relationships between the family FIRO domains of inclusion, control, and intimacy and family functioning indices, as measured by the Family Assessment Device (FAD) subscales, were explored. An at-risk family population ( N = 43 primary caretakers) was assessed at four time intervals, using an ex post facto design with multiple linear regression model testing. The results indicated significant relationships between FIRO model domains and FAD subscales. A case example further explored the application of the family FIRO model with at-risk families.     

Acculturative Hassles and Immigrant Adolescents: A Life-Domain Assessment for Soviet Jewish Refugees

Abstract

In a sample of 146 adolescents, the authors developed and validated a measure of acculturative hassles for Soviet Jewish refugees. They based the measure on an ecological perspective, which focuses on hassles involving person-environment transactions occurring in life domains of school, family, peers, and language. The authors reviewed conceptual and methodological issues in existing instruments and incorporated efforts to address current limitations into instrument development. The measure was correlated with psychological distress, level of acculturation to Russian and U.S. cultures, and outcomes in life domains; it contributed to outcomes over and above effects of nonacculturative hassles. Implications for measurement of acculturative hassles are discussed.     

Reviews

Abstract

The sixth annual banff conference on behavior modification looks at families: Perspectives, polemics, and promises, Cole Barton, James F. Alexander

Behavior Modification and Families. Mash, E.J., Hammerlynck, L.A., and Handy, L.C. (Eds.), New York: Brunner/Mazel Publishers, 1976, $13.50, 362 pages.

Behavior Modification Approaches to Parenting. Mash, E.J. Hammerlynck, L.A., and Handy, L.C. (Eds.), New York: Brunner/Mazel Publishers, 1976, $13.50, 254 pages.

The abusing family, Blair, Rita Justice, William Friedrich, Human Sciences Press, 1976, $14.95, 288 pages     

Concurrent Validity of the Schwartz Outcome Scale With a Chemically Dependent Population

Clients (N = 151) completed the Schwartz Outcome Scale (SOS‐10; M. A. Blais et al., 1999) and the Substance Abuse Subtle Screening Inventory‐3 (F. G. Miller & L. E. Lazowski, 1999). The results show a negative relationship between substance use symptoms and SOS‐10 scores and a positive relationship between defensiveness and SOS‐10 scores.     

The role of workaholism in the job demands-resources model

Background and Objectives: The present study tries to gain more insight in workaholism by investigating its antecedents and consequences using the job demands-resources model. Design: We hypothesized that job demands would be positively related to workaholism, particularly when job resources are low. In addition, we hypothesized that workaholism would be positively related to negative outcomes in three important life domains: health, family, and work. Methods: The research involved 617 Italian workers (employees and self-employed). To test the hypotheses we applied structural equation modeling (SEM) and moderated structural equation modeling (MSEM) using Mplus 6. Results: The results of SEM showed a good model where workload, cognitive demands, emotional demands, and customer-related social stressors were positively related to workaholism and work–family conflict (WFC) (partial mediation). Additionally, workaholism was indirectly related to exhaustion and intentions to change jobs through WFC. Moreover, MSEM analyses confirmed that job resources (job security and opportunities for development) buffered the relationship between job demands and workaholism. Particularly, the interaction effects were statistically significant in five out of eight combinations. Conclusions: These findings suggest that workaholism is a function of a suboptimal work environment and predicts unfavorable employee outcomes. We discuss the theoretical and practical implications of these findings.     

Unilateral family therapy for alcohol abuse: A working conception

Abstract

Unilateral family therapy is presented as a new mode of family therapy in which intervention is directed toward changing the behavior of an uncooperative family member through working with a cooperative member as mediator. In this initial exposition of the unilateral approach, it is applied to the problem of endeavoring to reach and change an uncooperative alcohol abuser through giving therapeutic assistance to a cooperating spouse. A working conception of this mode of therapy is presented based upon the authors' current clinical research in this area. Directions for further research and development are identified.     

Stability of developmental status and risk of impairment at 24 and 36 months in late preterm infants

BackgroundFew studies investigated whether late preterm infants might have developmental delays in several domains in early life and how stable the lag in developmental status might be.AimWe aimed to examine the stability of potential delays across developmental domains at 24 and 36 months of age in late preterm (34°-36⁶ weeks) and term (≥37 weeks) children and whether the risk of delays remained high at 36 months.Study design, subjects, and outcome measureWe conducted a prospective cohort analysis of the children of pregnant women participating in the Vitamin Antenatal Asthma Reduction Trial (VDAART). 652 children who were prospectively followed up and had parent-completed Ages Stages Questionnaires (ASQ-3) questionnaires at both 24 and 36 months were analyzed to assess their domain-specific developmental status.Results6.61 % (42/635) of children had a late preterm birth. Developmental delays were stable between 24 and 36 months on all 5 domains for the children born preterm and on 4/5 domains for those born at term. The developmental domains with the status stability at 24 and 36 months in both late preterm and term children were the gross motor, communication, personal-social skills, and problem-solving. Late preterm children compared with term children remained at higher risk of delays at 36 months for gross motor, communication, and problem-solving skills (aOR = 4.54, 95 %CI: 1.81−10.79; aOR = 8.60, 95 %CI: 3.10−23.28 and aOR = 3.80, 95 %CI: 1.58−8.73, respectively).ConclusionLate preterm birth is associated with suboptimal development and stability in several domains at both 24 and 36 months and compared with term birth, requiring early monitoring and assessment of the developmental lag to avoid potential long-term implications.