A critical assessment of the research related to batterer programs with recommendations for heightened engagement of men, ongoing risk management, and better coordination of courts and services
...Batterer programs are at a critical juncture, with a handful of experimental program evaluations showing little or no effect from the prevailing program approach. This finding has prompted calls to overhaul or replace such programs. Edward W. Gondolf examines batterer research in light of the push for “evidence-based practice” and advocates a progressive evolution of batterer intervention as it currently stands. Cautioning against the call for programs based on a “new psychology,” he argues that current cognitive-behavioral approaches are appropriate for most cases, with the addition of ongoing risk management for severely violent men. Overall, he promotes a broader picture of batterer intervention and advocates better implementation of the basic principles established in the criminal justice field.
Despite the high prevalence, evidence-based treatments for abuse-related posttraumatic stress disorder (PTSD) in adolescents have rarely been studied.
To examine whether developmentally adapted ...cognitive processing therapy (D-CPT) is more effective than a wait-list condition with treatment advice (WL/TA) among adolescents with PTSD related to childhood abuse.
This rater-blinded, multicenter, randomized clinical trial (stratified by center) enrolled treatment-seeking adolescents and young adults (aged 14-21 years) with childhood abuse-related PTSD at 3 university outpatient clinics in Germany from July 2013 to June 2015, with the last follow-up interview conducted by May 2016. Of 194 patients, 88 were eligible for randomization.
Participants received D-CPT or WL/TA. Cognitive processing therapy was enhanced by a motivational and alliance-building phase, by including emotion regulation and consideration of typical developmental tasks, and by higher session frequency in the trauma-focused core CPT phase. In WL/TA, participants received treatment advice with respective recommendations of clinicians and were offered D-CPT after 7 months.
All outcomes were assessed before treatment (baseline), approximately 8 weeks after the start of treatment, after the end of treatment (posttreatment), and at the 3-month follow-up. The primary outcome, PTSD symptom severity, was assessed in clinical interview (Clinician-Administered PTSD Scale for Children and Adolescents for DSM-IV CAPS-CA). Secondary outcomes were self-reported PTSD severity, depression, borderline symptoms, behavior problems, and dissociation.
The 88 participants (75 85% female) had a mean age of 18.1 years (95% CI, 17.6-18.6 years). In the intention-to-treat analysis, the 44 participants receiving D-CPT (39 89% female) demonstrated greater improvement than the 44 WL/TA participants (36 82% female) in terms of PTSD severity (mean CAPS-CA scores, 24.7 95% CI, 16.6-32.7 vs 47.5 95% CI, 37.9-57.1; Hedges g = 0.90). This difference was maintained through the follow-up (mean CAPS-CA scores, 25.9 95% CI, 16.2-35.6 vs 47.3 95% CI, 37.8-56.8; Hedges g = 0.80). Treatment success was greatest during the trauma-focused core phase. The D-CPT participants also showed greater and stable improvement in all secondary outcomes, with between-groups effect sizes ranging from 0.65 to 1.08 at the posttreatment assessment (eg, for borderline symptoms, 14.1 95% CI, 8.0-20.2 vs 32.0 95% CI, 23.8-40.2; Hedges g = 0.91).
Adolescents and young adults with abuse-related PTSD benefited more from D-CPT than from WL/TA. Treatment success was stable at the follow-up and generalized to borderline symptoms and other comorbidities.
German Clinical Trials Register identifier: DRKS00004787.
Background: The relationship of health risk behavior and disease in adulthood to the breadth of exposure to childhood emotional, physical, or sexual abuse, and household dysfunction during childhood ...has not previously been described. Methods: A questionnaire about adverse childhood experiences was mailed to 13,494 adults who had completed a standardized medical evaluation at a large HMO; 9,508 (70.5%) responded. Seven categories of adverse childhood experiences were studied: psychological, physical, or sexual abuse; violence against mother; or living with household members who were substance abusers, mentally ill or suicidal, or ever imprisoned. The number of categories of these adverse childhood experiences was then compared to measures of adult risk behavior, health status, and disease. Logistic regression was used to adjust for effects of demographic factors on the association between the cumulative number of categories of childhood exposures (range: 0–7) and risk factors for the leading causes of death in adult life. Results: More than half of respondents reported at least one, and one-fourth reported ≥2 categories of childhood exposures. We found a graded relationship between the number of categories of childhood exposure and each of the adult health risk behaviors and diseases that were studied (P < .001). Persons who had experienced four or more categories of childhood exposure, compared to those who had experienced none, had 4- to 12-fold increased health risks for alcoholism, drug abuse, depression, and suicide attempt; a 2- to 4-fold increase in smoking, poor self-rated health, ≥50 sexual intercourse partners, and sexually transmitted disease; and a 1.4- to 1.6-fold increase in physical inactivity and severe obesity. The number of categories of adverse childhood exposures showed a graded relationship to the presence of adult diseases including ischemic heart disease, cancer, chronic lung disease, skeletal fractures, and liver disease. The seven categories of adverse childhood experiences were strongly interrelated and persons with multiple categories of childhood exposure were likely to have multiple health risk factors later in life. Conclusions: We found a strong graded relationship between the breadth of exposure to abuse or household dysfunction during childhood and multiple risk factors for several of the leading causes of death in adults.
Preventing Child Maltreatment: Multicultural Considerations in
the United States is the first book in a concentrated series
that examines child maltreatment across minoritized, cultural
groups. ...Specifically, this volume examines core multicultural
concepts (e.g., intersectionality, acculturation, spirituality,
oppression) as they relate to child maltreatment in the United
States, while the other books take a closer look at particular
ethnic or racial communities in this country. Additionally, this
book examines child maltreatment through the intersection of
feminist, multicultural, and prevention/wellness promotion lenses.
Recommendations for treatment in each book build on a foundation of
prevention and wellness promotion, along with multicultural and
feminist theories. Throughout this book, five case studies, which
are introduced in Chapter One, are revisited to help the readers
make important and meaningful connections between theory and
practice.
Ecologically valid typologies of adverse child experiences (ACEs) were identified to investigate the link between ACEs and adult incarceration. In a nationally representative sample (N = 34,653, age ...20+), latent class analysis (LCA) was conducted with childhood maltreatment (physical, sexual, and emotional abuse, interpersonal violence IPV exposure, physical neglect) and caregiver maladjustment (substance use, incarceration, mental illness, and suicidal behavior) indicators. LCA identified a 5-typology model (1. Low Adversity Risk; 2. Caregiver Substance Use, and Maltreatment Acts of Omission; 3. Physical and Emotional Maltreatment; 4. Severe Cross-Subtype Maltreatment and Caregiver Substance Use; and 5. Caregiver Maladjustment). Controlling for sociodemographics and substance use problems, logistic regression analyses determined that, compared with the Low Adversity Risk typology, all typologies (except Caregiver Maladjustment) had elevated incarceration risk (adjusted odds ratios: 1.76-4.18). Maltreatment experiences were more predictive of incarceration for women versus men. Childhood maltreatment confers risk for incarceration beyond established risk factors, but caregiver maladjustment, alone, does not. Preventative efforts should focus on understanding and targeting pathways to delinquency for individuals with childhood maltreatment.
•Job loss increases risk for psychological and physical abuse during the pandemic.•Positive cognitive reframing mitigates risk of job loss on physical abuse.•Interventions targeting reframing may ...decrease risk for abuse during COVID-19.
Job loss resulting from the COVID-19 pandemic presents significant risk for child abuse. Protective factors, such as reframing coping, may mitigate the risk of job loss on child maltreatment.
The current study investigated factors associated with child maltreatment during the COVID-19 pandemic, including parental job loss, and whether cognitive reframing moderated associations between job loss and child maltreatment.
A community sample of 342 parents (62% mothers) of 4- to 10-year-olds (M = 7.38, SD = 2.01; 57.3% male) living in the United States completed online questionnaires regarding experiences with COVID-19, the Parent-Child Conflict Tactics Scale, and the Family Crisis Oriented Personal Evaluation Scales.
Two logistic regression analyses evaluated predictors of whether parents psychologically maltreated or physically abused their children during the pandemic controlling for maltreating history, parental depressive symptoms, financial stability, parent age, parent gender, child age, and child gender. Parents who lost their jobs (OR = 4.86, 95% CI 1.19, 19.91, p = .03), were more depressed (OR = 1.05, 95% CI 1.02, 1.08, p < .01), and previously psychologically maltreated their children (OR = 111.94, 95% CI 28.54, 439.01, p < .001) were more likely to psychologically maltreat during the pandemic. Regarding physical abuse, a significant interaction between job loss and reframing coping emerged (OR = 0.76, 95% CI 0.59, 0.99, p = .04). Among parents who lost their jobs, the probability of physical abuse decreased as reframing coping increased.
Job loss during the COVID-19 pandemic is a significant risk factor for child maltreatment. Reframing coping may be an important buffer of this association on physical abuse and presents implications for maltreatment prevention.
The literature has been contradictory regarding whether parents who were abused as children have a greater tendency to abuse their own children. A prospective 30-year follow-up study interviewed ...individuals with documented histories of childhood abuse and neglect and matched comparisons and a subset of their children. The study assessed maltreatment based on child protective service (CPS) agency records and reports by parents, nonparents, and offspring. The extent of the intergenerational transmission of abuse and neglect depended in large part on the source of the information used. Individuals with histories of childhood abuse and neglect have higher rates of being reported to CPS for child maltreatment but do not self-report more physical and sexual abuse than matched comparisons. Offspring of parents with histories of childhood abuse and neglect are more likely to report sexual abuse and neglect and that CPS was concerned about them at some point in their lives. The strongest evidence for the intergenerational transmission of maltreatment indicates that offspring are at risk for childhood neglect and sexual abuse, but detection or surveillance bias may account for the greater likelihood of CPS reports.
Since the early twentieth century, the United States has led a global prohibition effort against certain drugs in which production restriction and criminalization are emphasized over prevention and ...treatment as means to reduce problematic usage. This “war on drugs” is widely seen to have failed, and periodically decriminalization and legalization movements arise. Debates continue over whether the problems of addiction and crime associated with illicit use of drugs stem from their illegal status or the nature of the drugs themselves. In The Long War on Drugs Anne L. Foster explores the origin of the punitive approach to drugs and its continued appeal despite its obvious flaws. She provides a comprehensive overview, focusing not only on a political history of policy developments but also on changes in medical practices and understanding of drugs. Foster also outlines the social and cultural changes prompting different attitudes about drugs; the racial, environmental, and social justice implications of particular drug policies; and the international consequences of US drug policy.
Childhood maltreatment has been discussed as a risk factor for the development and maintenance of depression.
To examine the relationship between childhood maltreatment and adult depression with ...regard to depression incidence, severity, age at onset, course of illness and treatment response.
We conducted meta-analyses of original articles reporting an association between childhood maltreatment and depression outcomes in adult populations.
In total, 184 studies met inclusion criteria. Nearly half of patients with depression reported a history of childhood maltreatment. Maltreated individuals were 2.66 (95% CI 2.38-2.98) to 3.73 (95% CI 2.88-4.83) times more likely to develop depression in adulthood, had an earlier depression onset and were twice as likely to develop chronic or treatment-resistant depression. Depression severity was most prominently linked to childhood emotional maltreatment.
Childhood maltreatment, especially emotional abuse and neglect, represents a risk factor for severe, early-onset, treatment-resistant depression with a chronic course.
•Child abuse linked to drug problems in South African school attending adolescents.•Drug use coping motives mediated this relationship.•Prevention programs should target drug use coping motives.
In ...adults, it has been shown that the relationship between childhood abuse and substance misuse problems is mediated by the belief that substance use helps cope with negative affective states. By contrast, in adolescents, it is unknown whether drug use coping motives play this same mediating role.
Secondary analysis of 1149 school attending adolescents in Cape Town, South Africa (average age = 16.24 years, range = 13–23; 60% female). Questionnaire measures obtained during a single test session (among a larger battery) assessed childhood trauma (CTQ), alcohol (AUDIT) and drug problems (DUDIT), and coping orientation (A-COPE) which contained three items assessing drug use to cope with negative affect.
The three types of childhood abuse measured by the CTQ – emotional, physical and sexual – were positively associated with greater alcohol/drug problems, and drug use coping motives. Drug use coping motives mediated the relationships between childhood abuse types and alcohol/drug problems, and these mediational pathways remained significant when gender and other subscales of the A-COPE were included as covariates.
These data are preliminary insofar as drug use coping motives were assessed with a non-validated subscale of the A-COPE. Nevertheless, drug use to cope with negative affect mediated the relationship between all three types of childhood abuse (emotional, physical, sexual) and alcohol/drug problems in school attending adolescents. The implication is that drug prevention programs for this risk group should seek to mitigate drug use coping motives.
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