Child Maltreatment in DSM‐5 and ICD‐11

Child maltreatment is widespread and has a tremendous impact on child victims and their families. Over the past decade, definitions of child maltreatment have been developed that are operationalized, face valid, and can be reliably applied in clinical settings. These definitions have informed the revised Diagnostic and Statistical Manual (American Psychiatric Association, 2013) and are being considered for the International Classification of Disease–11 (World Health Organization). Now that these definitions are available in major diagnostic systems, primary healthcare providers and clinicians who see children and families are poised to help screen for, identify, prevent, and treat child maltreatment. This article reviews the definitions of maltreatment in these diagnostic systems, along with assessment and screening tools, and empirically supported prevention and intervention approaches.     

Cognitive distortions in sexual aggressors against children: An examination of the Abel and Becker Cognition Scale (ABCS)

IntroductionCognitive distortions are generally considered a key factor in the evaluation and treatment of sexual aggressors against children.AimThe aim of this study was to examine the discriminant properties of the Abel and Becker Cognition Scale.Method and resultsThe results of analyses of covariance, in a sample of 265 aggressors against children, do not support ABCS's discriminating properties.ConclusionLimits and implications for future researches are discussed.     

Therapeutic Assessment with couples

Therapeutic Assessment can be helpful to many types of couples, including (1) those who are considering marriage and wish to know each other more deeply, (2) long-term couples who are in distress and considering separating, and (3) couples who have decided to separate but wish to better understand why they were unable to stay together. This article comprises the first complete case study of Therapeutic Assessment (TA) with couples. I describe how those steps common to all forms of TA (initial sessions, extended inquiries, assessment intervention sessions, and summary/discussion sessions) differ when applied to couples. I also discuss the use of the Consensus Rorschach as an assessment intervention with long-term distressed couples engaged in problematic projective identification. The case example involves a young heterosexual couple married for 12 years who were at an impasse in couples therapy. The assessment helped the partners explore mutual conflicts around the expression of anger and dependency needs, and to resolve a power imbalance within the couple. Long-term follow-up showed that the Therapeutic Assessment helped the couple have more compassion for each other and move beyond the destructive role-lock they had fallen into. Also, the referring therapist reported that the TA helped resolve the impasse in the couples’ therapy.     

Parent Perspectives on the Use of Group Well-Child Care to Address Toxic Stress in Early Childhood

We sought to understand the experiences of parents who participated in Group Well-Child Care (GWCC) and Trauma-Informed GWCC (TI-GWCC). Three focus groups and design sessions with parents from either standard GWCC or TI-GWCC (N = 17) were conducted and synthesized into common themes using thematic analysis. Focus group themes included: (1) GWCC can empower parents to recognize toxic stress; (2) Parents identify ways that they role model behaviors for their child(ren); (3) Activities that facilitate reflection on attachment and anger management encourage intentional parenting practices. Our qualitative findings suggest that TI-GWCC supports the prevention of childhood adversity by creating connections between parents, helping families understand and identify toxic stress, and teaching parenting practices that mitigate stressors.     

Early—but modest—gender differences in focal aspects of childhood temperament

The best evidence for gender differences in child temperament is in the broad areas of effortful control and surgency, and to an extent negative affectivity, domains that encompass temperament dimensions of inhibitory control, activity level, and shyness. We examined the influence of child gender in a methodologically comprehensively assessed twin sample. We used mother, father, and Laboratory Temperament Assessment Battery (Lab-TAB) ratings to assess temperament in 3 year-olds. Boys had higher levels of activity level and lower levels of shyness and inhibitory control than girls across all methods of assessment. Then, more rigorous testing showed that patterns of mean gender differences for opposite-sex twin pairs in our sample were very consistent with overall sample gender differences and the magnitude of these gender differences was consistent across assessment methodology. We then asked: are these more gendered dimensions of temperament associated with one another, and are associations different across gender? The answer to both questions is, yes. Shyer children have lower activity level and higher inhibitory control, and those with higher inhibitory control are less active. Gender differences did appear in the intercorrelations between parent ratings of shyness and inhibitory control with only girls showing significant associations within and across these dimensions.     

Step Three: Assessing Readiness for OAM (Older Adult Ministry)

SUMMARY

Assessing existing programs as well as the readiness of the congregation to receive new programs in the area of older adult ministry is an essential building block. An assessment of existing ministries is essential to discovering what needs to be developed. At the same time, the strengths and challenges of a congregation to develop and maintain an expanded older adult ministry is also important to assess so that starting points can be identified and needs filled. Often, the secondary gain of any congregational assessment is the ability to hear all of the voices within the congregation, help congregants to feel like they have participated in the process and to prepare them to expect something new. Tools for assessing existing programs as well as the readiness of the congregation are shared and explained.     

Feared consequences of panic attacks in panic disorder: A qualitative and quantitative analysis

Cognitions are hypothesized to play a central role in panic disorder (PD). Previous studies have used questionnaires to assess cognitive content, focusing on prototypical cognitions associated with PD; however, few studies have qualitatively examined cognitions associated with the feared consequences of panic attacks. The purpose of this study was to conduct a qualitative and quantitative analysis of feared consequences of panic attacks. The initial, qualitative analysis resulted in the development of 32 categories of feared consequences. The categories were derived from participant responses to a standardized, semi-structured question (n?=?207). Five expert-derived categories were then utilized to quantitatively examine the relationship between cognitions and indicators of PD severity. Cognitions did not predict PD severity; however, correlational analyses indicated some predictive validity to the expert-derived categories. The qualitative analysis identified additional areas of patient-reported concern not included in previous research that may be important in the assessment and treatment of PD.     

Confirmatory Factor Analysis of Arnold et al.’s Parenting Scale Across Race, Age, and Sex

We used confirmatory factor analysis (CFA) to investigate the factor structure of several models of Arnold et al.’s Parenting Scale [Arnold et al. (1993). Psychological Assessment, 5, 137–144] across children from various age groups and races. Participants were parents of children (ages 2–16 years) presenting to four community-based pediatric practices for routine care. Parents completed questionnaires pertaining to various aspects of parenting and child behavior problems. Results indicated that a two-factor revision proposed by Reitman et al. [(2001). Journal of Clinical Child Psychology, 30, 514–524] represented the data well and better than the original three-factor structure and other two-factor models. Results from multigroup CFA analyses indicated that this factor structure did not vary across child sex, child age, and parental race. Results of validity analyses indicated that scores on both factors were related to reports of children’s behavior and parental affect and cognitions. This study was the first to use multigroup CFA procedures to demonstrate that relationships between individual items and factors of the Parenting Scale are similar for parents of children across various age groups.     

Family Influences on Treatment Refusal in School-linked Mental Health Services

This study analyzed family influences on treatment refusal in school-linked mental health services (SLMHS). Specifically, it assessed whether levels of family cohesion, conflict, and organization were related to whether a family refused to initiate recommended treatment. Children (N = 133) referred for emotional and behavioral problems and their families participated. Results indicated that (1) family environment factors explained a significant amount of variance in treatment refusal after controlling for demographic factors, (2) families of children with predominantly internalizing symptoms were at greater risk for refusing treatment than families of children with predominantly externalizing symptoms, and (3) lower level of family cohesion was an individual risk factor for refusing treatment. Incorporating an evaluation of family environment within SLMHS assessments may aid in the identification of areas wherein intervention may be beneficial in preventing treatment refusal.