Trauma-Informed Care for Infant and Early Childhood Abuse

ABSTRACT

Trauma-informed care for those who experienced early childhood maltreatment is being developed to meet the needs of infant, toddler, and preschool victims of child abuse and neglect. This age group experiences a disproportionate amount of abuse, and the resultant toxic stress during this rapid developmental stage is more damaging than it is in later years. The concept of trauma-informed care in general is presented, followed by a focus on trauma care for early childhood abuse. Trauma-informed care for younger children is united by common principles and is seen as developmental, relational, sensory oriented, and evidence based in nature. Dissemination of knowledge about this unique population to every system that encounters survivors of any age has begun, although it must be broadened and increased. Evidence-based treatment programs for young children are available and effective but limited, especially for age 0–2. Home visiting programs for mothers and babies are effective and cost efficient. Major funding by U.S. Department of Health and Human Services to each state has significant potential for success because it targets mother-child attachment and care, as well as the disproportionate amount of damage resulting from early childhood abuse. Infants and preschoolers are in some ways comparable to children with disabilities due to their developmental limitations. The nature of this population requires a more rigorous and proactive awareness and identification process because these children are physically dependent on surrounding adults. Addressing child abuse in the first years of life offers an excellent opportunity to assist the most vulnerable victims and effectively reduce the impact to families and communities in the ensuing years.     

Benchmarking the “Question,Persuade, Refer” Program Against Evaluations of Established Suicide Prevention Gatekeeper Trainings

Gatekeeper training is a common approach for aiding suicidal youth. This study utilizes comparative effectiveness “benchmarks” from established programs to evaluate the Question, Persuade, Refer (QPR) program. The QPR program was implemented with adults (N = 2,389) working in youth‐serving community agencies. Questionnaires assessed suicide prevention knowledge, attitudes, subjective norms, perceived behavioral control, and behaviors. Consistent with benchmarked studies, participants in QPR demonstrated knowledge and suicide prevention behavior gains compared with control groups. Future research should utilize benchmarking methods as a measure of effectiveness, and more thoroughly assess mechanisms that promote behavior change.     

SIMILARITIES AND DIFFERENCES IN WOMEN'S SEXUAL ASSAULT EXPERIENCES BASED ON TACTICS USED BY THE PERPETRATOR

Only a few studies have examined the characteristics of sexual assault based on the tactics used by the perpetrator. In this study we compared the experiences of women who were forced to engage in vaginal, anal, or oral intercourse due to verbal coercion, physical force, or intoxication. Random-digit dialing was used to obtain a sample of 272 single African American and Caucasian women between the ages of 18 and 49 from the Detroit metropolitan area. Participants completed a computer-assisted self-interview that asked detailed questions about a past sexual assault and their reactions to it. Among the 139 women who were forced to engage in vaginal, anal, or oral intercourse, sexual assaults that involved physical force produced the most severe negative outcomes. Situations that involved the woman being too intoxicated to resist differed from others primarily in terms of how much alcohol the man and woman consumed. Although all types of sexual assault were perceived as being at least moderately serious, verbally coerced assaults were on average perceived as being least serious. These findings suggest that the perpetrators' tactics affect women's responses to sexual assault.     

Self–Objectification and its Psychological Outcomes for College Women

The objectification of women by our society can become internalized by women, resulting in negative psychological outcomes. Using Fredrickson and Roberts' (1997) objectification theory, we tested a model of the relationships between self–objectification and disordered eating and depressive symptoms in a sample of undergraduate women ( n = 384). One postulate of self–objectification theory is that self–objectification can lead to a lack of internal awareness, which may mediate the relationship between self–objectification and restrictive eating, bulimic, and depressive symptoms. Results of structural equation modeling suggest that self–objectification has a direct relationship to restrictive eating, bulimic, and depressive symptoms. The mediational role of internal awareness was relevant for depressive symptoms but not for restrictive eating or bulimic symptoms. Depressive symptoms did, however, mediate the relationship between self–objectification and bulimic symptoms. The relevance of our findings to the understanding of objectification theory are discussed and future areas of research recommended.