Marital violence: Characteristics of abusive couples.

The Short Marital Adjustment Test, short form of the Attitudes Toward Women Scale, Short Michigan Alcoholism Screening Test, and measures of assertion were administerd to 52 abused wives (AWs) and 20 abusive husbands (AHs) who were seen at a center that specializes in domestic violence problems. Comparison data were collected from 20 couples with satisfactory marriages and 20 maritally dysfunctional nonviolent couples. Results show that although AWs and AHs were differentiated from satisfactorily married couples on almost every measure, when comparisons were made with nonabused wives in marital therapy, no measures yielded significant between-group differences. Three variables differentiated AHs from nonabusive husbands with marital difficulties: (a) AHs were less assertive with their wives, (b) they were more likely to have been abused children, and (c) they were more likely to have witnessed parental spouse abuse in their families of origin. Alcoholism and conservatism characterized the men who would not come for therapy with their AWs. (43 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A longitudinal study assessing trauma symptoms in sexually abused children engaged in play therapy.

Children who have been sexually abused exhibit a variety of emotional, sexual, behavioral, and psychological problems. A great deal of interest has been generated in the use of play therapy as a clinical approach to intervention with sexually abused children. This study explores the effect of play therapy as a primary treatment modality with sexually abused children. The impact of specific traumatic symptoms and overall treatment is examined. Findings indicate that, overall, trauma symptom severity in children decreased after 6 months of play therapy. In addition, anxiety, depression, post-traumatic stress, and sexual distress scores indicated a significant decrease. Additional research is recommended to develop evaluative and systematic guidelines that will further validate the use of play therapy as an empirically supported assessment and treatment tool. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Physically abused preschoolers' responses to peers' distress.

Response to peers' distress for which they were (target-caused) or were not (bystander) the cause were coded for 11 abused and nonabused preschoolers between the ages of 35 and 67 months. Each child was observed on a playground for an average of 115 min. Consistent with results of research with toddlers, abused preschoolers exhibited more inappropriate responses (aggression and withdrawal) toward distressed peers (bystander incidents) than did nonabused preschoolers. Also, abused children were more likely to cause distress of peers. These findings suggest that even among abused children who have had opportunities to interact with nonabusive caregivers and peers (i.e., regularly attended day care), differences in responses to peers' distress are obtained. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The concept of family: perceptions of adults who were in long-term out-of-home care as children

The author presents findings from a study in which adults fostered as children identified current family members. Those who included biological parents among their family members reported conflicted relationships, but also spoke of love. In contrast, those who omitted their biological parents seemed angrier, were more likely to have been abused, and were visited less by their biological parents. Those who included their foster parents described feeling loved, said they were not discriminated against, and received ongoing support after leaving care. Those who omitted members of their foster families overwhelmingly described feeling unloved and uncared for; said they were abused, devalued, and discriminated against; and received no continuing support.     

The abuser and the abused: Sources of resistance to resolving splits in the countertransference in the treatment of adults who were sexually abused as children.

A primary challenge encountered in treating adult patients who were sexually abused as children is the experience of being divided between feelings of empathy for the patient as an abused person versus feelings that this person is sometimes being abusive and foiling or hurting us. This article examines some of the sources of what is seen as the collective difficulty of therapists in resolving the recurrent conflict between identifications with the abused and the abuser in countertransference toward these patients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Introduction.

This introduction discusses how play therapy is used by professionals who work with abused children, as well as adolescents and adults. The final article in the current issue describes how to modify traditional, Eurocentric play therapy to better meet the needs of children from other cultural backgrounds, to ensure that their symbols, actions, and languages are accurately heard and accepted. Also included is a poem written by a former student of a member of the editorial board of the current issue, which seems fitting for the topics discussed in the current issue. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Characteristics of women physically abused by their spouses and who seek treatment regarding marital conflict.

Abused women (23 physically vs 25 marital discordant nonabused) reported significantly more fear of their spouses and reported that their spouses were significantly more coercive and psychologically aggressive than women in the 2 matched nonabused groups. Abused women did not report higher rates of abuse as a child, nor did they report higher rates of past psychopathology than women in the nonabused groups. However, abused women and nonabused discordant women reported higher rates of emotional abuse in childhood than maritally satisfied nonabused women. Result suggests that childhood abuse and a history of depression may be risk factors for women in abusive and nonabusive discordant relationships. Abused women reported higher rates of posttraumatic stress disorder than women in the discordant-only and community control groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Close contact with tuberculosis in childhood

In a 1-year prospective study 83 children, who had been in close contact with 52 adults who had tuberculosis, were examined. Thirty-six of the index cases had culture positive tuberculosis and 16 of these had smear positive tuberculosis. All the children had been BCG-vaccinated at birth. Forty-one (49%) of the children were PPD negative on examination with the Mantoux test. Of these 83 children, one 14-year-old boy was diagnosed as having primary tuberculosis and was treated. Twenty-one children received INH therapy, 12 because of their age (under 2 years of age or at puberty), nine because of a strong positive reaction to the first Mantoux test or because of the conversion of a negative test result to positive during the follow-up period. Seven of the latter nine children had been in contact with persons whose disease was culture- and smear-positive. It is concluded that as the frequency of tuberculosis declines, the practice of examining all children who have been in close contact with tuberculous adults is possible. The children who have been in contact with smear-positive index cases are at special risk of contracting tuberculosis.     

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)     

Impact of sexual abuse on children: A review and synthesis of recent empirical studies.

A review of 45 studies clearly demonstrates that sexually abused children have more symptoms than nonabused children, with abuse accounting for 15–45% of the variance. Fears, posttraumatic stress disorder (PTSD), behavior problems, sexualized behaviors, and poor self-esteem occurred most frequently among a long list of symptoms noted, but no one symptom characterized a majority of sexually abused children. Some symptoms were specific to certain ages, and approximately one-third of victims had no symptoms. Penetration, the duration and frequency of the abuse, force, the relationship of the perpetrator to the child, and maternal support affected the degree of symptomatology. About two-thirds of the victimized children showed recovery during the 1st 12–28 mo. The findings suggest the absence of any specific syndrome in children who have been sexually abused and no single traumatizing process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Child-Centered Play Therapy with Children who are Homeless: Perspective and Procedures.

Children who are homeless are one of the fastest growing populations. However, the literature on play therapy with children who are homeless is sparse. This article provides play therapists with needed perspective of prevalence, causes, and mental health impact of homelessness. A Child-Centered Play Therapy approach, which emphasizes a safe relationship based on the core conditions, is recommended. Procedures to meet the needs of children who are homeless and to enlarge the meaning of their unique play themes, such as eviction and "I'm rich," are discussed. Play therapists are encouraged to fulfill their social responsibility by providing play therapy for children who are homeless. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Filial therapy with nonoffending parents of children who have been sexually abused.

Examined the effectiveness of a 10 wk filial therapy training model as a method of intervention for nonoffending parents (24–56 yrs old) and their children (4–10 yrs old) who have experienced sexual abuse. Ss were assigned to either an experimental or control group and were given pretraining sessions and assessments. The parents in the experimental group then conducted weekly 30 min special play sessions with their children, as recommended by Landreth (1991). One session was videotaped. The parents received constructive feedback and support from the facilitator and group members during meetings. A posttest battery of instruments was administered to parents and children following the training sessions. Analyses of covariance revealed that the nonoffending parents in the experimental group significantly increased their level of empathy in their interactions with their children, significantly increased their attitude of acceptance toward their children, and significantly reduced their level of stress. Measures of the children's behavior, anxiety, emotional adjustment, and self-concept indicated positive trends. The authors maintain that this study supports filial therapy as an effective intervention for nonoffending parents and their children who have experienced sexual abuse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Early maternal rejection affects the development of monoaminergic systems and adult abusive parenting in rhesus macaques (Macaca mulatta).

This study investigated the effects of early exposure to variable parenting style and infant abuse on cerebrospinal fluid (CSF) concentrations of monoamine metabolites and examined the role of monoaminergic function in the intergenerational transmission of infant abuse in rhesus monkeys (Macaca mulatta). Forty-three infants reared by their biological mothers and 15 infants that were cross-fostered at birth and reared by unrelated mothers were followed longitudinally through their first 3 years of life or longer. Approximately half of the infants were reared by abusive mothers and half by nonabusive controls. Abused infants did not differ from controls in CSF concentrations of 5-hydroxyindoleacetic acid (5-HIAA), homovanillic acid (HVA), or 3-methoxy-4-hydroxyphenylgycol (MHPG). Abused infants, however, were exposed to higher rates of maternal rejection, and highly rejected infants had lower CSF 5-HIAA and HVA than low-rejection infants. The abused females who became abusive mothers in adulthood had lower CSF 5-HIAA than the abused females who did not. A similar trend was also observed among the cross-fostered females, suggesting that low serotonergic function resulting from early exposure to high rates of maternal rejection plays a role in the intergenerational transmission of infant abuse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adverse events after school leavers received combined tetanus and low dose diphtheria vaccine

Since October 1994, children in the United Kingdom have been offered tetanus vaccine combined with a low dose of diphtheria vaccine (Td) at the age of 15 to 18 years. It is recommended that schoolchildren who have already received a booster of tetanus vaccine at the time of an injury should be given low dose diphtheria vaccine alone. When this vaccine is not available, however, it is recommended that Td vaccine should be given to all children. This study was performed to compare the frequency of adverse events after Td vaccine in 15 year old children with and without a history of an additional tetanus booster in the preceding 10 years. Two hundred and sixty-five children were followed up-52 pupils (20%) with a history of an additional tetanus booster, 157 (59%) with no such history, and 56 (21%) whose history was unclear. Mild local reactions were common and occurred more commonly in children with a history of an additional tetanus booster. Twenty-three pupils (44%) who had received an additional tetanus booster had swelling over 2 cm diameter at the injection site, compared with only 39 (25%) of those with no such history (p < 0.013). Systemic symptoms were equally unusual in both groups. Only three children experienced symptoms attributed to vaccine that were severe enough for them to miss school or attend a doctor; and none of these had received an additional tetanus booster. We conclude that, in the absence of a supply of low dose diphtheria vaccine, offering Td vaccine to children with a history of additional tetanus booster is an acceptable policy.     

A paradigm for working with child survivors of sexual abuse who exhibit sexualized behaviors during play therapy.

Discusses how play therapists cope with sexually abused children who display sexual behaviors during play therapy. The author briefly reviews the literature regarding how to handle this problem. Three types of sexualized play observed during play therapy are described: abuse reactive play, re-enactment, and symbolic sexualized play. The author discusses possible therapist reactions to, and useful therapeutic interventions for, each type of play described, including limit-setting, witnessing/active listening, and active participation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Physical abuse of preschoolers: identification and intervention through occupational therapy

Child abuse is a major public health concern in the United States, one that has negative consequences on abused persons' productivity and mental health throughout their lives. Occupational therapists who work with preschool-aged children are in a strategic position to screen for physical abuse and aid in the rehabilitation of children and families engaged in abuse. This article provides a review of the literature and accounts of clinical experience with children and families in a variety of settings. It offers an overview of behavioral risk factors that have been shown to correlate with physical abuse, including how these factors can be observed within the context of an occupational therapy evaluation. Guidelines for interacting with child protective services via reporting suspected cases of child abuse and working collaboratively with such agencies are provided. Strategies for occupational therapy intervention with abused children and their parents are described. These strategies include using activities to facilitate positive parent-child interaction, educating parents regarding child development and management techniques, and facilitating children's psychosocial development.     

A group therapist's (analyst's) lament.

Comments on the article by D. Daskovsky (see record 1997-38798-001) on issues in resistance and countertransference in the treatment of adults who were sexually abused as children. The article adds weight to the perception among uninformed psychologists and psychoanalysts that analytic group psychotherapy (analytically informed) is the unrecognized offspring of psychoanalysis in the US. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Considerations in the psychoanalytic treatment of men who were sexually abused as children.

Examines the literature on sexually abused men and illustrates with clinical examples from individual and group psychoanalytic practice the themes that emerge in working with them. Sexual abuse situations with boys are considered in 3 groups: those involving penetration, those involving inappropriate tactile contact, and those involving noncontact seduction and excitation. The boundary violation inherent in all of these situations is crucial in the treatment of the man who has been abused, as is the familial context of the abuse. Sexual orientation and gender identity, abuse in a familial context, love and sexuality, and transference and countertransference are discussed. For the analyst treating men who were sexually abused, there may be feelings of being overwhelmed by the seductive energy in the analytic relationship and also wishes to reel back and deny the horror of the material being discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sexually abused children's perceptions: How they may change treatment focus.

The purpose of this study was to assess differences in sexually abused children's self-concept and experiences of traumatic symptoms and to qualitatively examine the manner in which standardized assessment instruments could be used by therapists for treatment planning and case management. The results of this study suggest that not all sexually abused children have the same perceived level of self-concept, social support, or traumatic symptoms. Sexually abused children who had high self concept had higher perceived levels of social support. Use of the formal assessments assisted therapists in developing individualized treatment plans. Implications of this study are discussed. (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)