Profile Characteristics and Behavioral Change Trajectories of Young Residential Children

We aimed to identify profile characteristics for a recent sample of young residential children, examine the differential impact that profile characteristics have on behavior change, and describe the relationship between behavioral symptomatology and length of stay in residential treatment. A sample of 142 consecutively admitted residential treatment children were studied over a five-year period. Hierarchical Linear Modeling was the primary statistical method used to analyze behavioral rating data for a subset of 57 children assessed by teachers and treatment staff using the Devereux Scales of Mental Disorders. Younger age, female gender, and lower IQ were associated with increased levels of psychopathology. Residential length of stay was strongly linked to levels of behavioral symptomatology. HLM is a valuable analytic strategy that employs client profile characteristics to model behavioral change trajectories and help predict treatment responsiveness. System reform philosophies that promote expectations for rapid symptom improvement and removal of residential treatment from the continuum of care may exceed current treatment capacities.     

When soothing succeeds: Simulating a risk for repeated shaking in abusive head trauma in infants

PurposeTo investigate the observation that perpetrators of abusive head trauma engage in repeated shakings because shaking “works” to quiet the infant.MethodsSixty first-time parent couples individually cared for a programmable model infant in two consecutive 7-min trials. After six minutes of consolable followed by inconsolable crying, parents selected one of three soothing techniques. For trial one, parents were randomized to a “Successful” or “Failed” Soothing Condition. Whether the soothing technique was repeated after trial two was determined by the study investigators. Parents rated their frustration after each trial.ResultsAs hypothesized, parents were more likely to repeat a soothing technique that “worked” in trial one. Compared to fathers, mothers reported more frustration when soothing failed.ConclusionsThat caregivers were more likely to repeat a successful soothing technique converges with perpetrator confessions that crying cessation after shaking may be a reason why shaking is used repeatedly in response to crying.     

Associations between child physical abuse potential,observed maternal parenting,and young children's emotion regulation: Is participation in Early Head Start protective?

Clinicians working with Early Head Start (EHS) families consider family well-being and positive parent–child relationships as foundational to school readiness. Understanding the links between risk factors and these dimensions of family engagement can inform clinical decision-making, as risk assessments are used to tailoring program services. The current study examined the associations between high risk, or potential, for child physical abuse and both parenting quality and children's emotion regulation (ER) during toddlerhood; EHS participation was examined as a buffer. The sample included EHS-eligible mothers of infants (N = 80) drawn from one site of the EHS Research and Evaluation Project. Associations were tested between mothers’ potential for child physical abuse, measured during infancy, and observed maternal sensitivity, positive regard, harshness, and children's ER skills at child ages 1 and 2 years. Results indicated that high potential for child physical abuse was associated with lower positive regard at age 1 and lower ER skills at age 2. EHS participation operated as a buffer on each of these associations. Implications for screening for child physical abuse potential and the constructs it represents in clinical settings as well as how EHS can promote family engagement are discussed.     

The impact of hedged testimony on judgments of credibility

We tested whether people are attuned to critical memory factors, such as age at the timing of encoding and hedge words when judging the credibility of testimony. In two experiments, participants read a 19‐year‐old's testimony regarding a sexual assault. We manipulated whether participants learned that the assault occurred 4 years ago (when the claimant was 15 years old) or 15 years ago (when the claimant was 4 years old) and whether the claimant used hedge words in her testimony. In Experiment 2, we included a cross‐examination. Without the cross‐examination, participants rated the testimony as more credible when the assault had occurred 15 years ago. However, with the inclusion of a cross‐examination, participants rated the testimony more reliable when the event occurred 4 years ago and the claimant did not use hedge words. We discuss the implications our results have, particularly for historical cases, where memory is a key factor.     

Creating Structure in a Time of Intense Stress: Treating Intimate Partner Violence

Violence is an increasingly visible problem in the United States, with the news and other forms of media bringing this into the forefront of the public’s awareness. Violence comes in many different forms, including intimate partner violence (IPV), which occurs for about 36% of women and about 29% of men across the United States. Given the high incidence in the United States, it is imperative to consider the best ways for mental health professionals to treat violence in relationships. Some professionals in the field have developed and utilized conjoint treatment models for working with couples who have a history of violence. This article presents the application of attachment theory to a conjoint treatment model for couples that have experienced violence. A case study is included to demonstrate the implementation of an emotionally focused therapy framework and provide a sample outcome of this treatment approach. The framework of this article provides clinicians with insight into how to approach working with violent couples in a safe and productive way. Mental health professionals are at the front lines of implementing evidence-based interventions and creating lasting change for the clients whom they work with.     

Play Room as a psychological assessment method in cases of alleged child sexual abuse

This article presents an example of how psychoanalytic theory can be implemented in practice. The aim is to introduce and discuss the semi-projective material ‘Play Room’ which was originally developed to support prevention of sexual abuse among vulnerable children in Denmark. However, a recent study has shown that, when measured with a scale called Ability to Answer, children exposed to sexual abuse talked about the illustrations in Play Room in a significantly different way than did a clinical sample and a normal control group. The finding indicates the potential for expanding the scope of Play Room from prevention into clinical assessment, in cases of alleged child sexual abuse. Taking its starting point in the theory of Jean Laplanche, this article will discuss how psychoanalytic concepts such as seduction, translation, asymmetry, absence, and listening to listening can be used to describe the practice around Play Room. It is argued that, through the use of Play Room, the psychologist can encircle the lack of symbolization and inhibited creation of psychic representations that children exposed to sexual abuse typically convey. The discussion of Play Room’s assessment potential will be further fed by data from interviews with clinical child psychologists.     

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.     

Shame and Dissociation in Survivors of High and Low Betrayal Trauma

Shame and dissociation cooccur in trauma survivors. Bypassed shame theory posits that dissociation reduces pain by interrupting shame. We tested this theory by inducing dissociation. The hypothesis that higher baseline shame would predict larger increases in dissociation following the induction was marginally supported. However, in contrast to bypassed shame theory, shame scores increased rather than decreased following the induction. An alternative theory, betrayal trauma theory (BTT), proposes that dissociation reduces awareness of betrayal to protect a needed relationship. Shame might also serve this function. We aimed to replicate prior research indicating traumas higher in betrayal (HBT) are uniquely related to both shame and dissociation compared to traumas lower in betrayal (LBT). The hypothesis that HBT would relate to higher shame was supported. The results suggest that other explanations than bypassed shame theory, such as BTT, might better account for the relationship between shame and dissociation in trauma survivors.