A comparison of child abuse and child neglect.

Compared data from the child welfare and the hospital files for each of 422 children identified from a hospital list as abused. The children fell into 4 categories: 62 (mean age 2.1 yrs) who were neglected, 243 (mean age 5.2 yrs) who were abused, 83 who were abused and neglected, and 34 for whom evidence of abuse or neglect was not established. Significant differences were found between the families who abused their children and those who neglected them, including differences in maternal age and socioeconomic status (SES). Abuse was more prevalent in children who had been previously separated from their parents, while children of teenaged mothers were most likely to be neglected. Data relating to the difficulties in decision making support the notion that interdisciplinary community teams might have much to offer in the development of more stringent guides for determining the nature of mistreatment and the probability of further risk to the child. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The federal response to child abuse and neglect.

Addressing the problem of child maltreatment is a high priority for the Clinton administration. Guided by the principles of safety, permanency, and the child's well-being, the Administration on Children and Families (ACF) has made great strides in improving the lives of maltreated children. Critical programs administered by ACF include the Adoption and Safe Families Act, Community-Based Family Resource and Support Program grants, Children's Justice Act programs, and Child Abuse Prevention and Treatment Act research and demonstration projects. Projects serve both to expand existing programs and to develop innovative approaches. ACF has also sponsored several multidisciplinary national conferences designed to generate a sense of shared responsibility and a renewed commitment to solving problems of child abuse and neglect. (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)     

The worst combinations of child abuse and neglect

We have studied the impact of various kinds of abuse and neglect on the child's perception of himself and his future. We found, when considering physical abuse, physical neglect, verbal abuse, emotional neglect, and sexual abuse, that less than 5% of these mistreatments occurred in isolation. Since the vast majority of mistreated children are subject to more than one kind of abuse or neglect, it was important to delineate which combinations have the greatest effect. We found that a combination of physical neglect, physical abuse, and verbal abuse had the greatest impact on children, affecting such things as their enjoyment of living and hopes for the future. An early age of onset for verbal abuse and emotional neglect was significantly associated with greater severity and frequency of mistreatment. Neglect appears to be a precursor to abuse in many cases.     

Substantiation of child abuse and neglect reports.

A representative sample of 796 sexual abuse, 198 physical abuse, and 880 child neglect reports in New York State in 1985 was examined to identify case factors that predict the substantiation of the reports following an investigation by child protective services. This issue has taken on added significance as the number of child maltreatment reports continues to rise, whereas the percentage of those being substantiated declines. Regression analyses revealed that reports from professionals were substantiated at a significantly higher rate than reports from nonprofessionals for all types of maltreatment. These analyses further revealed that part of the effect of source of report was due to differences between professional and nonprofessional reports in the types of actions taken after the report was received. The most important predictors of substantiation, after source of report, were the variables that reflected the case investigatory process. The data also showed that background characteristics, such as the child's ethnicity or the number of children in the household, had some impact on the outcome of the investigation and that this varied as a function of the type of maltreatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Child extrafamilial sexual abuse: predicting parent and child functioning

OBJECTIVE: This study evaluated the emotional and behavioral adjustment of parents and children within 3 months and 1 year after the discovery of child extrafamilial sexual abuse. METHOD: Ninety-two case parents (63 mothers, 29 fathers) and 56 children were compared to a nonclinical comparison group of 136 parents (74 mothers, 62 fathers) and 75 children. Parent adjustment was assessed using self-report measures while child functioning was assessed using a combination of child-, parent- and teacher-report measures. RESULTS: Mothers, fathers and sexually abused children experienced clinically significant effects both initially and at 12 months post-disclosure. Children's perceptions of self-blame and guilt for the abuse and the extent of traumatization predicted their self-reported symtomatology at 3 months and 1 year post-disclosure. Child age and gender also significantly contributed to the prediction of many of the child outcome measures. No abuse-related variable was related to any child self-report measure. Mothers' satisfaction in the parenting role, perceived support and intrusive symptoms predicted their initial emotional functioning. Avoidant symptoms, child's internalizing behavior and mothers' initial emotional functioning were significant predictors of longer-term emotional functioning. CONCLUSIONS: Results emphasize the need to address children's abuse-related attributions and underscore the need to expand our focus beyond the child victims to the traumatized families.     

Potential liability in cases of child abuse and neglect

Effects of thyrotropin hormone (TSH) and anti-TSH receptor antibodies on the plasma membrane potential of polymorphonuclear granulocytes (PMN) were analyzed by means of flow cytometry. Both TSH and the autoantibody caused a rapid, dose-dependent hyperpolarization of the plasma membrane of PMNs. TSH was also able to mask (revert) the depolarizing effect of a chemotactic peptide, fMLP, on PMNs. No detectable rise in the cytosolic free calcium level accompanied the observed hyperpolarization. Quinine, a blocker of Ca(2+)-activated and voltage-gated K+ channels did not affect the hyperpolarization by TSH and antibodies. Decreasing the [K+] gradient across the plasma membrane by valinomycin, however, blocked the hyperpolarizing effect. Peptide362-376 (derived from the extracellular domain of TSH receptor) also blocked the hyperpolarization induced by both TSH and anti-TSHR antibodies. These data suggest that the observed hyperpolarization is a specific, receptor-mediated early signal during interaction of PMNs with TSH or anti-TSHR antibodies.     

Incidence of child neglect and child abuse in the region of Copenhagen

The aim of the study was to evaluate the incidence of physical violence, neglect and sexual abuse against children as reported to the local authorities, in the county of Copenhagen during the year 1993. A questionnaire was mailed to the local authorities in the 18 districts in the county and to 18 schools and 18 general practitioners (GP's). They were asked whether, and how many new, verified and suspected cases of physical, emotional and sexual abuse had come to their attention in 1993. A total of 300 cases of child abuse were identified in the area with a total population of 675.000 i.e. a total incidence of 2.7 cases per 1000 children aged 0-17 years (2.7%), with 0.7% for physical violence, 0.5% for sexual abuse and 1.5% for emotional neglect. Some 180 cases were considered verified and 120 cases were suspected. A considerable variation between the different districts was noted, i.e. the local incidence varied from 0-5.4%. A statistically significant inverse correlation between the average local tax-income and the incidence of child abuse and neglect was found. There were several examples of schools having knowledge of more cases than the local authorities. Very few cases came to be attention of the GP.     

Estimates of fatal child abuse and neglect, United States, 1979 through 1988

The results of recent surveys in the United States have suggested a rising tide of fatalities due to child abuse or neglect (CAN). Because these surveys lack consistency in case definition and are incomplete in coverage, the use of death certificate data to estimate the number of CAN deaths was explored. To estimate these deaths among children 0 through 17 years old for 1979 through 1988, three models were formulated, each comprising six coding categories: (1) deaths coded explicitly as due to CAN, (2) homicides, (3) injury deaths of undetermined intentionality, (4) accidental injury deaths, (5) sudden infant death syndrome fatalities, and (6) natural-cause deaths. Research studies and crime data were relied on to estimate the proportions of deaths in categories 2 through 6 that were actually due to CAN, and other assumptions were varied to create a range of estimates. For the 10-year period, the estimated mean annual CAN fatalities ranged from 861 to 1814 for ages 0 through 4, and from 949 to 2022 for ages 0 through 17. Child abuse and neglect death rates did not increase over the period; in fact, they were relatively stable for ages 0 through 17 and showed a modest decline for 0 through 4. Ninety percent of fatal CAN occurs among children younger than 5 years old, and 41% occurs among infants. About 85% of CAN deaths are recorded as due to other causes.(ABSTRACT TRUNCATED AT 250 WORDS)     

Recognizing emotion in faces: Developmental effects of child abuse and neglect.

The contributions to the recognition of emotional signals of (a) experience and learning versus (b) internal predispositions are difficult to investigate because children are virtually always exposed to complex emotional experiences from birth. The recognition of emotion among physically abused and physically neglected preschoolers was assessed in order to examine the effects of atypical experience on emotional development. In Experiment 1, children matched a facial expression to an emotional situation. Neglected children had more difficulty discriminating emotional expressions than did control or physically abused children. Physically abused children displayed a response bias for angry facial expressions. In Experiment 2, children rated the similarity of facial expressions. Control children viewed discrete emotions as dissimilar, neglected children saw fewer distinctions between emotions, and physically abused children showed the most variance across emotions. These results suggest that to the extent that children's experience with the world varies, so too will their interpretation and understanding of emotional signals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Multisystemic therapy for child abuse and neglect: A randomized effectiveness trial.

The primary purpose of this study was to conduct a randomized effectiveness trial of Multisystemic Therapy for Child Abuse and Neglect (MST-CAN) for physically abused youth (mean age = 13.88 years, 55.8% female, 68.6% Black) and their families. Eighty-six families being followed by Child Protective Services due to physical abuse were randomly assigned to MST-CAN or Enhanced Outpatient Treatment (EOT), with both interventions delivered by therapists employed at a community mental health center. Across five assessments extending 16 months post baseline, intent-to-treat analyses showed that MST-CAN was significantly more effective than EOT in reducing youth mental health symptoms, parent psychiatric distress, parenting behaviors associated with maltreatment, youth out-of-home placements, and changes in youth placement. Also, MST-CAN was significantly more effective at improving natural social support for parents. Effect sizes were in the medium to large range for most outcomes examined. Although fewer children in the MST-CAN condition experienced an incident of reabuse than did counterparts in the EOT condition, base rates were low and this difference was not statistically significant. The findings of this study demonstrate the potential for broad-based treatments of child physical abuse to be effectively transported and implemented in community treatment settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychologists' knowledge, opinions, and decision-making processes regarding child abuse and neglect reporting laws.

Mandated child abuse reporting laws have been in effect in the United States for more than 20 years, yet practitioners vary in their understanding and opinions of these laws. A sample of licensed psychologists were surveyed and reported being relatively well-informed. However, their performance on a knowledge measure suggests knowledge deficits and a tendency to overreport. Legal considerations encourage reporting, whereas beliefs that one can provide client treatment deter reporting. Opinions of the laws were generally favorable, with some concerns about child protection systems and the impact of reporting on the therapeutic alliance. Practice and policy implications are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Tensions in the parent and adult child relationship: Links to solidarity and ambivalence.

Tensions are normative in the parent and adult child relationship, but there is little research on the topics that cause the most tension or whether tensions are associated with overall relationship quality. In this study, adult sons and daughters, age 22 to 49, and their mothers and fathers (N = 158 families, 474 individuals) reported the intensity of different tension topics and relationship quality (solidarity and ambivalence) with one another. Tensions varied between and within families by generation, gender, and age of offspring. Compared to tensions regarding individual issues, tensions regarding the relationship were associated with lower affective solidarity and greater ambivalence. Findings are consistent with the developmental schism hypothesis, which indicates that parent–child tensions are common and are the result of discrepancies in developmental needs that vary by generation, gender, and age. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The drug abuse problem in Peninsular Malaysia: parent and child differences in knowledge, attitudes and perceptions

Neural crest cell migration in the gut and the growth of the mid- and hindgut of avian embryos was investigated by a combination of whole-mount immunofluorescence of the HNK-1 neural crest marker epitope, chorioallantoic membrane grafting and morphometry. HNK-1-labelled cells advanced rostrocaudally in the gut of quail embryos (to the duodenum by stage HH 21, to the umbilicus by HH 25, to the ceca by HH 27, to the cloaca by HH 33). The timetable in chick embryos appeared to be slightly slower, but neural cells were obscured by background fluorescence in this species. More rostral regions of the gut commenced rapid growth earlier than more caudal regions (preumbilical small intestine after HH 26, postumbilical small intestine after HH 27 and colorectum after HH 28), and the small intestine and ceca grew most rapidly in length while the colorectum grew most rapidly in diameter. The rates of growth of the gut were low prior to the stage when HNK-1-labelled cells normally arrive in the small intestine, ceca and rostral colorectum, but increased dramatically after arrival. In the caudal colorectum rapid growth had commenced at the time of arrival of these cells. These data are consistent with the idea that a delay in arrival of vagal neural crest cells at any point in the intestine could jeopardize the ability of the cells to fully populate the remainder of the gut, due to the normal growth spurt causing the migration end-point to recede faster than the rate of neural crest cell migration. Thus, a mismatch in timing of neural crest cell migration and gut growth could play a role in the etiology of some forms of Hirschsprung's disease.     

Mother–child interactional style in abuse, neglect, and control groups: Naturalistic observations in the home.

Examined mother–child interactional patterns in an urban environment. Three groups of mothers (n?=?12/group) were included in the study: (a) Ss with a known history of child abuse, (b) Ss with a known history of child neglect, and (c) Ss with no known history of child maltreatment. Ss and their children were observed in their homes on 3 consecutive days for 90 min each day. Interactions were described via a coding system of 11 major interactional patterns; dependent variables included verbal and nonverbal behaviors as well as measures of total interaction. Results indicate that the groups differed on several variables. Dysfunctional Ss showed significantly fewer positive behaviors than did the controls on verbal and nonverbal measures. Also, the abusive Ss showed significantly higher rates of verbal and physical aggression; the neglectful mothers had the lowest overall rates of interaction. The maltreated children also exhibited fewer positive behaviors and more aggressive behaviors. Results are discussed in terms of current theories of child maltreatment and of the treatment of dysfunctional families. (24 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Early intervention for parents at risk of child abuse and neglect: A preliminary investigation.

An early intervention program for young parents and children who have been identified as being at risk of child maltreatment was evaluated. Thirty mother–child dyads were randomly assigned to one of two conditions: (a) an information group offered by the child protection agency (which served as a control condition) or (b) a special program of behavioral parent training in addition to the agency group. Self-report measures indicated that significant improvements in parenting risk and child behavior problems at posttest and at 3-month follow-up were evident only for mothers who received parent training in addition to information groups. Home observation data were inconclusive, possibly due to the limited opportunities to observe behaviors of interest. Both groups showed improvements in their child-rearing environments and in their children's adaptive behaviors at follow-up. Caseworker ratings of clients' risks of maltreatment and abilities to manage their families at 1-year follow-up significantly favored the families who received parent training in addition to information. Methodological and treatment issues arising from this preliminary investigation of early intervention with diverse population of high-risk parents and children are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mothers' and fathers' perceptions of child deviance: Roles of parent and child behaviors and parent adjustment.

The mothers (n?=?120) and fathers (n?=?85) of children with conduct problems (ages?=?3–8 years) completed two measures of child adjustment (Child Behavior Checklist, Eyberg Child Behavior Inventory), three personal adjustment measures (Beck Depression Inventory, Marital Adjustment Test, Parenting Stress Index), and a Life Experience Survey and were observed at home interacting with their children. In addition, teachers (n?=?107) completed the Behar Preschool Questionnaire. Fathers' perceptions of their children's behaviors were significantly correlated with teachers' ratings, but mothers' ratings were not. Correlations showed that mothers who were depressed or stressed due to marital problems perceived more child deviant behaviors and interacted with their children with more commands and criticisms. Fathers' perceptions and behaviors were relatively unaffected by personal adjustment measures. Differences in these perceptions and behaviors between mothers and fathers are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Munchausen syndrome by proxy: a different kind of child abuse

Munchausen syndrome by proxy (MSBP) continues to mystify health care professionals, law enforcement officials and the judicial system. Even though the first cases were described in 1977, it remains puzzling why a parent would want to induce fictitious symptoms and illnesses in a child. Many professionals do not consider MSBP as a diagnosis because the parent, usually the mother, is so convincing that she is a "good" mother, cares about and wants the best for her child. This article is offered to further educate physicians that MSBP exists, can present in the form of anything and should be considered as a diagnosis in cases that do not make medical sense. Case examples are provided, along with common and not so common presentations. MSBP is a form of severe child abuse that must be reported to Child Protection Service when a child is endangered. Physicians play a critical role in identifying these children and recommending the best course of action to the rest of the system.