The social cognitive development of abused children.

Previous research on the impact of parental abuse on child development has typically been skewed to the more seriously injured or most socially disadvantaged families. The few studies attending to psychological consequences of abuse have further been limited by a failure to control for potentially confounding intellectual or demographic factors and have been too general in approach to provide effective guidelines for differential diagnosis, treatment, or theory building. The present study compared the social cognitive styles of 17 abused children and 16 controls (mean age 7 yrs 6 mo) and found differences in perceived locus of control of social events and social role comprehensions. Similar trends emerged in perspective-taking skills and social sensitivity. These alternative social cognitions could not be attributed to IQ or class disparities between groups. Implications for treatment and as a theoretical model for understanding the intergenerational nature of abuse are discussed. (46 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Emotional, cognitive, and family systems mediators of children's adjustment to interparental conflict.

Emotional, cognitive, and family systems processes have been identified as mediators of the association between interparental conflict and children's adjustment. However, little is known about how they function in relation to one another because they have not all been assessed in the same study. This investigation examined the relations among children's exposure to parental conflict, their appraisals of threat and blame, their emotional reaction, and triangulation into parental disagreements. One hundred fifty ethnically diverse 8- to 12-year-old children and both of their parents participated in the study. Comparisons of 3 models proposing different relations among these processes indicated that they function as parallel and independent mediators of children's adjustment. Specifically, children's self-blaming attributions and emotional distress were uniquely associated with both internalizing and externalizing problems, whereas perceived threat uniquely predicted internalizing problems and triangulation uniquely predicted externalizing problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Gender differences in abused children with and without disabilities

OBJECTIVE: Two questions were posed: (1) What are the proportions of boys and girls in various categories of substantiated child abuse? (2) Do the gender proportions differ for children with and without disabilities? METHOD: Data collected by previous researchers from a demographically representative sample of U.S. child abuse reporting districts was analyzed. This included 1,249 case files involving 1,834 children. The number of girls and boys who did and did not have disabilities was identified for three age categories and for several categories of abuse. Chi-square analyses were used to determine whether there was a relationship between disability and gender for the various age and abuse categories. RESULTS: More boys were physically abused and neglected, but more girls were sexually abused. Boys with disabilities, however, were over-represented in all categories of abuse. Moreover, gender proportions among abused children with disabilities differed significantly from those found among other abused children. Although slightly more than half of abused children without disabilities were girls, 65% of abused children with disabilities were boys. CONCLUSIONS: Boys represented a significantly larger proportion of physically abused, sexually abused, and neglected children with disabilities than would be expected from their respective proportion of abused and neglected children without disabilities. Several possible explanations for the observed gender and disability status interaction are discussed.     

Treatment of sexually abused children and adolescents.

The authors review research demonstrating the variable effects of childhood sexual abuse, the need for intervention, and the effectiveness of available treatment models. The well-controlled treatment-outcome studies reviewed do not focus on sensationalistic fringe treatments that treat sexually abused children as a special class of patients. Instead, studies demonstrate empirical evidence for extending and modifying treatment models from mainstream clinical child psychology to sexually abused children. The authors propose a continuum of interventions to meet the needs of this heterogeneous group. Interventions range from psychoeducation, prevention, and screening, to short-term, abuse focused cognitive-behavioral therapy with family involvement, to more comprehensive long-term plans for multiproblem cases. Last discussed are gaps in the research and suggestions for future research to address the pressing dilemmas faced by clinicians and policymakers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Antisocial personality disorder in abused and neglected children grown up

OBJECTIVE: the authors' goal in this study was to examine the extent to which having been abused and/or neglected in childhood raises a person's risk for having an adult DSM-III-R diagnosis of antisocial personality disorder. METHOD: Children who had experienced substantiated child abuse and/or neglect from 1967 to 1971 in a Midwestern metropolitan county area were matched on the basis of age, race, sex, and approximate family social class with a group of nonabused and nonneglected children and followed prospectively into young adulthood. Subjects were located and participated in a 2-hour interview consisting of a series of structured and semistructured questions, rating scales, and a psychiatric assessment using the National Institute of Mental Health Diagnostic Interview Schedule. Interviews were completed with 699 young adult subjects (416 abused and/or neglected and 283 comparison subjects). RESULTS: Childhood victimization was a significant predictor of the number of lifetime symptoms of antisocial personality disorder and of a diagnosis of antisocial personality disorder, despite the fact that controls for demographic characteristics and arrest history were introduced. CONCLUSIONS: These findings suggest the importance of inquiring about a patient's childhood history of abuse and/or neglect when antisocial symptoms are evident. In addition to speculation about a possible saturation model for the consequences of childhood victimization, these findings also reinforce a multiple causation model of antisocial personality disorder.     

Depression, developmental level and disclosure in sexually abused children

OBJECTIVE: To investigate the relationship between sexual abuse disclosure, developmental level and psychopathology in children. DESIGN: A retrospective analysis of case records, using chi-square and t-tests for statistical significance. SETTING: Child and Adolescent Unit, Midlands Hospital, Pietermaritzburg. SUBJECTS: One hundred children consecutively admitted for all types of mental health problems. OUTCOME MEASURES: Diagnostic evaluations were made using the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (3rd edition, revised). RESULTS: Forty of the 100 children had been sexually abused, but 14 (35%) of the abused children did not disclose their abuse until after admission. The post-admission disclosure group had a significantly higher mean age (13.71 years) than the pre-admission disclosure group (10.96 years). Also, significantly more post-admission disclosure children received a diagnosis of major depressive disorder than their pre-admission disclosure counterparts. CONCLUSION: The study highlights the issue of sexual abuse disclosure and its relationship to depression and developmental level. Internal psychological and developmental mechanisms appear to influence the disclosure/non-disclosure of sexual abuse.     

Cognitive and behavioral characteristics of physically abused children.

Compared 11 physically abused males (aged 3 yrs 11 mo to 5 yrs 8 mo) on the McCarthy Scales of Children's Abilities (MSCA) and the Wide Range Achievement Test with 10 nonabused males matched on age, family income, and maternal age and education. In addition, behavioral observations of their performance on a persistence task were coded. Significant differences were found on the Verbal and Memory Scales and the General Cognitive Index of the MSCA. No behavioral differences were noted. (2 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Emotional adjustment in terminal patients: A quantitative approach.

Used a quantitative approach to identify factors relating to emotional adjustment in 84 13-82 yr old dying patients. 11 hospital chaplains collected data by interviewing the patients. Results indicate that emotional adjustment to the awareness of a limited life expectancy was not related principally to religious orientation, although this was an important factor. Emotional adjustment was influenced more by the patient's physical condition (level of discomfort), by previous experiences with dying persons, and by interpersonal relationships. The most important aspect of the religious variable was the quality of religious orientation rather than mere religious affiliation or verbal acceptance of religious beliefs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attribution-based treatment of self-blame and helplessness in sexually abused children.

Reviews a number of attributional distinctions within the concepts of self-blame and helplessness that can be utilized in treatment planning for sexually abused children to make possible simultaneous reduction of guilt and powerlessness. Adaptive and maladaptive subtypes of self-blame and helplessness are separated, often based on their implications for past vs future control. Recommendations are presented for phrasing attributional interventions in language understandable to young children. The formulation is also applied to work on children's ambivalent feelings toward perpetrators and non-offending parents. The role of client education as a therapeutic technique is emphasized. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Serotonergic functioning in depressed abused children: clinical and familial correlates

BACKGROUND: The goal of this study was to examine serotonergic functioning and concomitant clinical and familial correlates in depressed abused children. METHODS: L-5-Hydroxytryptophan (L-5-HTP) (0.8 mg/kg) was administered intravenously to 10 depressed abused (MDD-AB), 10 depressed nonabused (MDD-NA), and 10 normal control nonabused (NC-NA) children. The children in the two nonabused cohorts represent a small matched subset of children from a larger interlocking study of the psychobiology of depression. Blood samples for prolactin and cortisol were collected from 30 min before to 2.5 hours after L-5-HTP infusion. RESULTS: The MDD-AB children secreted significantly more prolactin post-L-5-HTP than the children in the other two groups. There were no differences in baseline prolactin or any of the cortisol measures. Total prolactin post-L-5-HTP was significantly correlated with clinical ratings of aggressive behavior (rho = .48). In addition, children with a family history positive for suicide attempt (MDD-AB: n = 7; MDD-NA: n = 5; NC-NA: n = 2) secreted significantly more prolactin post-L-5-HTP than children with no family history of suicide. CONCLUSIONS: Dysregulation in the serotonergic system in abused children appears to be related to both familial and experiential factors.     

Play therapy behaviors of sexually abused children.

Examined the question of whether there are specific play therapy behaviors associated with children who have been sexually abused, and whether these behaviors differ by sex and age of the children. A survey instrument was developed which listed 140 play therapy behaviors. 21 play therapists participated in a field test to establish external validity. 249 play therapists were also surveyed to identify professionals who provide play therapy. Analysis identified highly interrelated play therapy behaviors of sexually abused girls and boys from ages 3–10 yrs. Suggested use of the play therapy behaviors include assessments to detect sexual abuse and recommendations for child placement and/or court testimony. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depressive symptoms among physically abused and psychiatrically disturbed children.

Examined the relation of physical abuse and depressive symptoms among 79 6–13 yr old child psychiatric inpatients. Childhood depression, hopelessness, and self-esteem were assessed through questionnaire or interview measures administered to the children. 79 25–52 yr old mothers or maternal guardians also completed measures to evaluate their children's dysfunction. As predicted, the 33 physically abused children, compared with the 46 nonphysically abused patient controls, evinced significantly lower self-esteem and greater depression and negative expectations toward their futures. Among abused children, those with both past and current abuse showed more severe symptoms of depression that did those with either past or current abuse only. The differences in depressive symptoms between abused and nonabused children could not be accounted for by differences in child psychiatric diagnosis, age, race, gender, IQ, or severity of psychopathology or parent psychiatric diagnoses, marital, or SES. Results suggest that physical abuse, at least for a psychiatric patient sample, is related to symptoms of depression. The possible basis for this relation and the treatment implications are discussed. (36 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prior childhood sexual abuse in mothers of sexually abused children

OBJECTIVE: To study extensively the therapeutic approach of gastroesophageal reflux disease in intellectually disabled children. DESIGN: We studied the effect of omeprazole sodium on healing and symptom relief in 52 institutionalized intellectually disabled children (male-female, 21:31; mean age, 15.4 years; range, 4-19 years). INTERVENTION: Endoscopically proven esophagitis (grades I-IV, Savary-Miller classification) was treated with omeprazole sodium, 40 mg/d (20 mg/d for children weighing <20 kg) as healing dose for 3 months, and 20 mg/d (10 mg/d for children weighing <20 kg) as maintenance dose for another 3 months. After 3 and 6 months, results of treatment were evaluated using symptom scoring and/or endoscopy. For patients with relapse, the dose was increased. RESULTS: At first endoscopy, 19 patients (36%) of 52 showed grade I esophagitis; 20 (38%), grade II; 6 (12%), grade III; and 7 (13%), grade IV. In 44 (86%) of 51 patients, treatment was effective in healing esophagitis and keeping patients in remission, independent of the severity of esophagitis. In 7 patients (14%), a symptomatic relapse was observed after decreasing the dose. However, these patients became symptom free again after increasing the dose and showed healing on endoscopy at the end of the study. One child did not finish the study for reasons not related to therapy. Marked improvement of persistent vomiting, regurgitation, food refusal, iron deficiency anemia, and signs of depression was seen at the end. CONCLUSIONS: Omeprazole is highly effective for all grades of esophagitis in intellectually disabled children, without adverse effects. The dose needed to maintain the remission can be titrated according to the reflux symptoms. One disadvantage of medical therapy is that it is open ended, in contrast to operation, but surgery in this population has high mortality and complication rates.     

Selective attention to facial emotion in physically abused children.

The ability to allocate attention to emotional cues in the enviromnent is an important feature of adaptive self-regulation. Existing data suggest that physically abused children overattend to angry expressions, but the attentional mechanisms underlying such behavior are unknown. The authors tested 8-11-year-old physically abused children to determine whether they displayed specific information-processing problems in a selective attention paradigm using emotional faces as cues. Physically abused children demonstrated delayed disengagement when angry faces served as invalid cues. Abused children also demonstrated increased attentional benefits on valid angry trials. Results are discussed in terms of the influence of early adverse experience on children's selective attention to threat-related signals as a mechanism in the development of psychopathology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Course of psychological symptoms in sexually abused young children.

Assessed 8 sexually abused (SA) children (aged 3–7 yrs) repeatedly with the Child Behavior Checklist during a 10–18 mo period to explore the course of psychological symptoms that emerged in response to the abuse. Their individual courses were linked to whether treatment was provided and pathology in the parents. In some Ss, symptoms reflected a similar pattern of resolution. Symptomatology included depression and somatic complaints, aggressiveness, and the emergence of sexualized behavior. Parent–child interactions and the impact of therapy are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

School performance and disciplinary problems among abused and neglected children.

Investigated the relationship of child abuse and neglect to academic achievement and discipline problems in a school-age population. A representative community sample of 420 maltreated children in kindergarten through Grade 12 were matched with 420 nonmaltreated children in the same community. Using social service and school records as the sources of data, the authors found maltreated children performed significantly below their nonmaltreated peers in standardized tests and grades and were more likely to repeat a grade. Maltreated children also had significantly more discipline referrals and suspensions. Of the maltreated children, neglected children showed the poorest outcomes on academic performance, and physically abused children showed the most discipline problems. Variations in maltreatment effects by grade level, public assistance status, and gender are also described. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Conceptual sorting and personality adjustment in children.

24 relatively well adjusted and 24 relatively poorly adjusted children, selected from 150 normal 6th-grade children, were compared on the Gelb-Goldstein-Weigl-Scheerer Object Sorting Test. Poorly adjusted children made significantly more inadequate sortings than well adjusted children, confirming the prediction of this study. High and average intelligence children were more adequate in their object sortings than low intelligence children. Relatively poorly adjusted children, because of lack of appropriate categories, may not be as able to reduce environmental complexity and assign meaning to events as relatively well adjusted children. High and average intelligence, at this age level, contributes to the ability to abstract and use shared properties as a grouping principle. (PsycINFO Database Record (c) 2010 APA, all rights reserved)