A longitudinal analysis of risk factors for child maltreatment: findings of a 17-year prospective study of officially recorded and self-reported child abuse and neglect

OBJECTIVE: To identify demographic, family, parent, and child factors prospectively associated with risk for child abuse and neglect among families in the community, using data on child maltreatment obtained from both official records and youth self-reports. METHOD: Surveys assessing demographic variables, family relationships, parental behavior, and characteristics of parents and children were administered to a representative sample of 644 families in upstate New York on four occasions between 1975 and 1992. Data on child abuse and neglect were obtained from New York State records and retrospective self-report instruments administered when youths were > or = 18 years old. RESULTS: Logistic regression analyses indicated that different patterns of risk factors predicted the occurrence of physical abuse, sexual abuse, and neglect, although maternal youth and maternal sociopathy predicted the occurrence of all three forms of child maltreatment. In addition, the prevalence of child abuse or neglect increased from 3% when no risk factors were present to 24% when > or = 4 risk factors were present. State records and self-reports of child maltreatment did not correspond in most cases when maltreatment was reported through at least one data source, underlining the importance of obtaining data from both official records and self-reports. CONCLUSIONS: Assessment of a number of risk factors may permit health professionals to identify parents and children who are at high risk for child maltreatment, facilitating appropriate implementation of prevention and treatment interventions.     

Child maltreatment history among newlywed couples: A longitudinal study of marital outcomes and mediating pathways.

Participants included 202 newlywed couples who reported retrospectively about child maltreatment experiences (sexual abuse, physical abuse, psychological abuse, and neglect) and whose marital functioning was assessed 3 times over a 2-year period. Decreased marital satisfaction at T1 was predicted by childhood physical abuse, psychological abuse, and neglect for husbands; only neglect predicted lower satisfaction for wives. Increased maltreatment of various types was also related to T1 difficulties with marital trust and partner aggression. Dyadic growth curve analyses showed that the marital difficulties reported at T1 tended to remain over the course of the study. Further, in several instances, maltreatment exerted an increasingly detrimental influence on marital functioning over time, particularly for husbands. Examination of possible mediators between maltreatment and reductions in marital satisfaction revealed pathways through decreased sexual activity, increased psychological aggression, and increased trauma symptoms reported by husbands. These findings suggest that clinicians should consider how an adult’s history of child maltreatment may contribute to current marital dysfunction. The authors also identify possible targets for intervention when working with this population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Association of insulin resistance to electrocardiographic changes in non obese Asian Indian subjects with hypertension

Although it is well documented that child maltreatment exerts a deleterious impact on child adaptation, much less is known about the precise etiological pathways that eventuate in child abuse and neglect. This paper reports on a multimethod ecological study of the relationship between neighborhood structural factors and child maltreatment reports in African American and European American census tracts. The study had two major components. First, in an aggregate analysis, the effects of four measures of community structure (impoverishment, child care burden, instability, and geographic isolation) on child maltreatment report rates were examined separately for predominantly African American (n = 94) and predominantly European American (n = 189) census tracts. Impoverishment in particular had a significantly weaker effect on maltreatment rates in African American than in European American neighborhoods. Second, focused ethnographies were conducted in four selected census tracts with child maltreatment report rates in the highest and lowest quartiles. Ethnographic data point to the importance of the social fabric in accounting for differences in child maltreatment report rates by predominant neighborhood ethnicity.     

Stress, social support, and substantiated maltreatment in the second and third years of life

OBJECTIVE: The purpose of this research was to determine whether risk factors for a maltreatment report in the first year of life, especially the interaction of life event stress and social support, persist into the second and third years of life. METHOD: Predominantly low income mothers who had been interviewed shortly after the birth of infants in a longitudinal cohort were re-interviewed around the infants' first birthdays, and reports to North Carolina's Central Registry of Child Abuse and Neglect were tracked for substantiated maltreatment reports. RESULTS: Variables significantly associated with a substantiated maltreatment report in the second or third year of life (p < .01) were first year maltreatment reports and participation in Medicaid. Three interactions between a stressful life event indicator variable and a social support indicator variable were significant predictors of substantiated second or third year reports (p < .05). CONCLUSIONS: Even in the presence of significant risk factors from the first year of life, life event stress can increase the risk of a substantiated maltreatment report in the second or third years of life, but social support may moderate the effect of life events.     

Depression and maltreatment as predictors of social competence and social problem-solving skills in school-age children

Childhood depression and child maltreatment have been shown to be important predictors of childhood adjustment problems, including difficulties in the spheres of home, school, and peer relationships. In this study, depression and maltreatment were used to predict social competence and social problem-solving skills, as rated by self, parent, and teacher. The total sample contained 68 children (35 girls, 33 boys), most of whom were at high-risk either due to poverty, physical abuse and neglect (as determined by substantiated Protective Services reports), or exposure to negative life events. Hierarchical multivariate regression analyses were used to identify the contribution of depression and maltreatment to social competence and social problem-solving skills. Depression predicted parents' and teachers' ratings of social competence and parents' ratings of peer rejection. Additionally, depression predicted children's ratings of social competence and both measures of social problem-solving skills. Maltreatment predicted parents' and teachers' ratings of social competence. Gender predicted teachers' ratings of peer rejection and social competence. An additive effect of depression and maltreatment was found such that children who are depressed and maltreated have the lowest social competence as rated by parents and teachers. These children are, therefore, doubly at risk for problems in future relationships.     

Predicting personality pathology among adult patients with substance use disorders: effects of childhood maltreatment

The purpose of this study was to examine predictive relationships between types of childhood maltreatment and personality disorders in a substance-abusing population. Three hundred thirty-nine drug- or alcohol-dependent patients completed a reliable and valid retrospective measure of childhood trauma, the CTQ, and a self-report inventory that assesses the entire range of DSM-III-R personality disorders, the PDQ-R. As a preliminary step, factor analyses were used to group personality disorders into the three DSM-III-R Axis II clusters (Clusters A, B, and C), although some diagnostic subclusters were also found. Structural equation modeling analyses revealed several significant paths between types of maltreatment and personality disorder clusters (and subclusters). Physical abuse and physical neglect were related to a subcluster of "psychopathic" personality disorders consisting of childhood and adult antisocial personality traits and sadistic traits. Emotional abuse emerged as a broad risk factor for personality disorders in Clusters A, B, and C. Emotional neglect was related to the traits of schizoid personality disorder, which formed its own subcluster. Finally, sexual abuse, which had been expected to predict borderline personality disorder traits, was unrelated to any personality disorder cluster. These findings support the view that child maltreatment contributes to the high prevalence of co-morbid personality disorders in addicted populations.     

Reliability of family maltreatment diagnostic criteria: 41 site dissemination field trial.

R. E. Heyman and A. M. S. Slep (see record 2006-10939-007) developed and conducted an effectiveness trial of a diagnostic system for child and partner maltreatment. The current investigation tested the widespread dissemination of the diagnostic system at 41 child and partner maltreatment services sites (n = 549 partner maltreatment cases and n = 342 child maltreatment cases). Agreement between field and master reviewers’ decisions was good for partner physical and emotional abuse (κ = 0.83–0.84). Agreement was also good for child physical, emotional, and sexual abuse (κ = 0.73–0.89) but lagged slightly for child neglect (κ = 0.66). Thus, multifaceted and content valid family maltreatment diagnostic criteria can be disseminated reliably. Replication studies of interrater agreement of the diagnostic system in typical clinical and agency settings are necessary; however, the high levels of agreement in myriad field sites imply that consistency of maltreatment determinations is achievable in widespread use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Child abuse and neglect: Usefulness of the animal data.

This article reviews and critically discusses the relevance of animal data to research on child abuse and neglect. Although parental investment theory can be useful in investigating the adaptiveness, if any, of child abuse and neglect, the evolutionary approach also has some limitations. The most suitable animal models for investigating the psychosocial processes underlying child abuse and neglect are probably found among the nonhuman primates. Whereas the heuristic value of social deprivation paradigms may be limited, recent studies suggest that the spontaneous occurrence of infant maltreatment in monkeys may be the closest approximation to child maltreatment provided by nonhuman animals. The investigation of adaptive and maladaptive processes in the parenting behavior of socially living nonhuman primates can inform research on child abuse and neglect and allow investigators to conduct studies that would be difficult or impossible in humans. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Childhood maltreatment, object relations, and suicidal behavior in women.

Findings from a study examining object relations (OR) as a mediator of the link between childhood maltreatment and suicidal behavior in a sample of predominantly low-income, African American women (suicide attempters: n?=?53; nonattempters: n?=?106) revealed that each OR dimension fully, yet differentially, mediated specific links between 5 types of childhood maltreatment (sexual, physical, and emotional abuse, and emotional and physical neglect) and suicide attempt status. The alienation subscale of 1 of the 2 OR measures used was the most robust mediator, fully mediating the links between all types of childhood maltreatment and suicide attempt status. For both childhood sexual abuse and physical neglect, the links with suicide attempt status were fully mediated by 5 of 6 OR dimensions measured, whereas the other childhood maltreatment types (physical abuse, emotional abuse, and emotional neglect) were fully mediated by just 1 or 2 OR dimensions. Research directions and clinical implications of the findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A survey of health care and child protective services provider knowledge regarding the toe tourniquet syndrome

Recent efforts to increase public awareness of child abuse may result in an increased number of inappropriate reports of suspected child abuse. The authors believe that digital hair strangulation should be included among the conditions that may be confused with child abuse. Digital hair strangulation (toe tourniquet syndrome) occurs primarily in infants and is characterized by a constricting band of foreign material that becomes tightly wrapped around a digit or digits (most often the toes). The consensus in the medical literature is that this condition is not the result of intentional injury. As no reference to the toe tourniquet syndrome exists in the child abuse literature, it was hypothesized that child welfare workers would be more likely than physicians and public health nurses to misinterpret this condition as resulting from intentional injury. A survey was conducted to test this hypothesis. Professionals from the fields of medicine, nursing, and child welfare were provided with a history and photographic findings of a child with a typical case of the toe tourniquet syndrome. Participants were surveyed regarding their interpretation of the described injuries. More than 50% of all respondents indicated that they would report this case as suspected abuse. Child welfare workers responded that the injuries were suggestive of abuse (83%), significantly more often than public health nurses did (45%), (chi 2 = 4.55, p = .03).(ABSTRACT TRUNCATED AT 250 WORDS)     

Decisions and attitudes concerning child sexual abuse: does the gender of the perpetrator make a difference to child protection professionals?

OBJECTIVE: An investigation was conducted into whether child protection investigators, specifically social workers and the police, are as likely to take seriously a case of child sexual abuse if it had been perpetrated by a female rather than a male. Also, to examine whether the decisions relating to female-perpetrated abuse were predicted by participants' sex role perceptions of women and their attitudes concerning women's sexualized behavior towards children. METHOD: Participants advocated decisions in response to four hypothetical case of child sexual abuse in which the perpetrator was either male or female. The female perpetrators were then rated on femininity and masculinity characteristics and attitudes concerning women's sexualized behavior toward children were assessed. RESULTS: Following male--rather than female--perpetrated sexual abuse, case registration and imprisonment of the perpetrator was considered more appropriate by all participant groups; male social workers also considered social services involvement and investigation as more appropriate. A substantial number of decisions concerning female perpetrated abuse were predicted by participants' attitudes. CONCLUSION: While child protection professionals considered child sexual abuse perpetrated by females to be a serious issue warranting intervention, a number of advocated decisions suggested that they did not consider female-perpetrated abuse to be as serious as male-perpetrated abuse. The implication is that victims of sexual abuse perpetrated by a woman may be less likely to receive the protection afforded victims of male-perpetrated abuse. Furthermore, professionals' practices may be inadvertently perpetuating the view that female child sexual abuse is rare or less harmful than abuse carried out by males.     

Child abuse reporting in British Columbia: Psychologists' knowledge of and compliance with the reporting law.

Despite mandatory reporting laws, research suggests that psychologists still commonly fail to report suspected child abuse. Psychologists from British Columbia completed a survey concerning their knowledge of, compliance with, and attitudes about reporting laws. Participants also responded to vignettes that varied the type of child abuse presented (i.e., physical, emotional, sexual, and neglect). Results showed that psychologists have a high level of knowledge of the reporting law; however, their knowledge did not influence their reporting behavior. Intention to report differed as a function of type of abuse, with the neglect and sexual abuse vignettes being most likely to be reported. Degree of certainty that abuse was occurring accounted for a substantial amount of the variance in reporting intention. Lack of evidence in detecting maltreatment was indicated as a significant barrier against the reporting of suspected child abuse. Implications for professional training, research, and legislative reform are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Father and mother physical abuse and child aggressive behaviour in two generations.

Research in developmental psychopathology has not adequately examined the role of fathers in abuse, nor has it adequately examined the effects of abuse on girls. This study was an investigation of physical child abuse from fathers and mothers in the prediction of aggressive behavior among boys as well as girls. The participants consisted of 1,536 parents and their 983 college-age children. A parallel 2-generation, cross-sectional design was utilized. Results indicated that physical abuse from fathers and from mothers emerged as significant and additive predictors of aggressive behavior among boys as well as girls. The results point to the important role fathers appear to play in the adaptive and maladaptive functioning of their children. The results also suggest that child maltreatment should be examined within the context of the family unit or microsystem. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A retrospective study of risk to siblings in abusing families.

Relatively little research has considered the risk to siblings within maltreating families. The sample in the present study consisted of the 795 siblings from a cohort of 400 "index" children who had been referred to police child protection units in England for abuse and/or neglect. In 44% of families (valid cases), the index child was scapegoated, in 37% maltreatment was nonspecific to all siblings, and in 20% maltreatment was specifically directed at some but not all siblings. Scapegoated children were more likely to be older and to experience physical or sexual abuse, whereas younger children and index child referrals for neglect, emotional abuse, or mixed abuse were associated with risk to some or all siblings. Parental difficulties and family stressors increased the risk of maltreatment to all siblings. There was no evidence of increased risk to stepsiblings or children with difficulties, suggesting that the special victim model has limited application. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Improving parenting in families referred for child maltreatment: A randomized controlled trial examining effects of Project Support.

Project Support is an intervention designed to decrease coercive patterns of aggressive discipline and increase positive parenting. This research evaluates Project Support in a sample of families reported to Children's Protective Services (CPS) for allegations of physical abuse or neglect; 35 families with a child between 3- and 8-years-old participated. In all families, CPS allowed the children to remain in the family home while the family received services. Families were randomly assigned to receive either Project Support or services as usual, which were provided by CPS or CPS-contracted service providers. To evaluate intervention effects, a multimethod, multi-informant assessment strategy was used that included data from mothers' reports, direct observation of parents' behavior, and review of CPS records for re-referrals for child maltreatment. Families who received Project Support services showed greater decreases than families who received services as usual in the following areas: mothers' perceived inability to manage childrearing responsibilities, mothers' reports of harsh parenting, and observations of ineffective parenting practices. Only 5.9% of families in the Project Support condition had a subsequent referral to CPS for child maltreatment, compared with 27.7% of families in the comparison condition. The results suggest that Project Support may be a promising intervention for reducing child maltreatment among families in which it has occurred. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Science, policy, and the protection of children.

Child maltreatment is a particular concern for many researchers, practitioners, and policymakers. The articles in this Child Sexual Abuse: Science, Practice, and Policy Issues section, edited by Jeffrey Haugaard, address the issue from several perspectives. Haugaard articulates the difficulties of defining certain types of abuse and of researching ambiguous variables. Karen Saywitz and her coauthors provide an overview of current treatments for child sexual abuse victims. Recent national statistics on child maltreatment and federal efforts to address the problem are described by Olivia Golden. Tom DeLay highlights current problems in the child welfare system and the federal government's role in responding to them. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Child Maltreatment, Parent Alcohol- and Drug-Related Problems, Polydrug Problems, and Parenting Practices: A Test of Gender Differences and Four Theoretical Perspectives.

The authors tested how adverse childhood experiences (child maltreatment and parent alcohol- and drug-related problems) and adult polydrug use (as a mediator) predict poor parenting in a community sample (237 mothers and 81 fathers). These relationships were framed within several theoretical perspectives, including observational learning, impaired functioning, self-medication, and parentification-pseudomaturity. Structural models revealed that child maltreatment predicted poor parenting practices among mothers. Parent alcohol- and drug-related problems had an indirect detrimental influence on mothers' parenting and practices through self-drug problems. Among fathers, emotional neglect experienced as a child predicted lack of parental warmth more parental neglect, and sexual abuse experienced as a child predicted a rejecting style of parenting. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparison of multisystemic therapy and parent training in the brief treatment of child abuse and neglect.

This study evaluated the relative efficacy of two promising treatments of child abuse and child neglect: parent training and multisystemic therapy. Subjects included 18 abusive families and 15 neglectful families who were randomly assigned to the treatment conditions. Self-report and observational measures were used to evaluate the effects of treatment at three levels that have been associated with child maltreatment: individual functioning, family relations, and stress/social support. Statistical analyses revealed that families who received either treatment showed decreased parental psychiatric symptomology, reduced overall stress, and a reduction in the severity of identified problems. Analyses of sequential observational measures revealed that multisystemic therapy was more effective than parent training at restructuring parent–child relations. Parent training was more effective than multisystemic therapy at reducing identified social problems. The differential influences of the two treatments were probably associated with differences in their respective treatment contexts and epistemologies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predictive validity of the Child Abuse Potential Inventory.

200 predominantly female parents (average age 22.4 yrs) who were participants in an at-risk parent–child program were administered the Child Abuse Potential Inventory (CAPI) to determine the degree of correspondence between Ss' CAPI scores and subsequent confirmed reports of abuse, neglect, or failure to thrive. It was found that 42 parents were reported to a suspected child abuse and neglect team, confirmed for maltreatment, and referred to a human resources department; 11 Ss were reported for abuse, 15 for neglect, and 16 for failure to thrive. Although all abusive Ss earned scores above the CAPI cutoff score for abuse, the majority of Ss earning elevated scores did not abuse. A significant relationship was found between CAPI abuse scores and subsequent abuse and between abuse scores and later neglect. No relationship was found between abuse scores and subsequent failure to thrive. Findings support the predictive validity of the CAPI. (23 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differentiation, self–other representations, and rupture–repair processes: Predicting child maltreatment risk.

This set of studies was designed to examine the relational underpinnings of child abuse potential in a sample of 51 urban families. In Study 1, lower maternal differentiation of self—most notably, greater emotional reactivity and greater emotional cutoff—along with self-attacking introjects distinguished mothers at higher risk (vs. lower risk) for child maltreatment. In Study 2, patterns of interactive rupture and repair were examined in a subsample of 15 families and found to vary as a function of risk for child maltreatment. Specifically, Structural Analysis of Social Behavior coding (SASB; Benjamin, 1996, 2003) of mother–children interactions during 2 moderately stressful lab tasks revealed higher rates of interactive mismatch and mother-initiated ruptures and fewer successful repairs in families at higher risk for child maltreatment, relative to families at lower risk. Implications for counseling and directions for further translational research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)