Child Abuse and Neglect Zeanah, Charles H; Humphreys, Kathryn L
Journal of the American Academy of Child and Adolescent Psychiatry,
09/2018, Letnik:
57, Številka:
9
Journal Article
Recenzirano
Odprti dostop
Physical, sexual, and emotional abuse and various forms of neglect of children are associated with substantially increased risk for concurrent and subsequent psychopathology and are among the common ...problems encountered by clinicians in many clinical settings. Such cases pose additional challenges for clinicians because of the many complex family and system forces that engulf these children and their families. Assessing maltreated children generally requires more time than evaluations of children who have not experienced maltreatment. Young children, who experience the highest rates of maltreatment, present especially complex assessments because they are so dependent upon their caregiving environments. Treatment of psychopathology associated with maltreatment, which is often multimodal, requires addressing a variety of external factors that may perpetuate or exacerbate symptoms and impaired functioning. We suggest that the more clinicians understand the different cultures of the legal and child protective services systems will help them advocate more effectively for maltreated children's bests interests so that the complexity of their problems is matched by the comprehensiveness of our efforts to minimize their suffering, enhance their development, and promote their competence.
Child maltreatment occurs in the Black community at higher rates than any other racial group. Given the prevalence of child maltreatment risk factors in the Black community, such as being in a ...low-income family, single parent family, greater exposure to physical discipline, and less access to services and resources, it is not surprising but nonetheless concerning that Black children are at greater risk for abuse and/or neglect. Unearthing the cause and effect between the challenges faced by the Black community and the life outcomes for Black children is key to making positive changes happen. Through a feminist and womanist lens, the authors unpack the range of factors that intersect and impact the Black community that are necessary to address to effectively protect Black children. Understanding how to prevent maltreatment and promote health and wellness are essential to adequately address maltreatment so as to protect and empower Black children.
Background: Inconsistencies regarding developmental effects of non‐maternal childcare may be caused by neglecting the possibility that children are differentially susceptible towards such ...experiences.
Method: Interactions between difficult/negative child temperament and childcare type, quantity, and quality on teacher‐rated behavior problems and social competence at 54 months and in kindergarten were investigated via multiple regression using data from the NICHD Study of Early Child Care.
Results: Childcare quality interacted with infant negativity in predicting behavior problems and social competence, whereas effects of quantity and type were independent of child temperament. Consistent with Belsky’s (1997) differential susceptibility hypothesis, children with difficult temperaments as infants exhibited both more behavior problems when faced with low quality care and fewer when experiencing high quality care than children with easy temperaments.
Conclusions: Negatively‐emotional infants appear to be more affected by the quality of care they experience – both negatively and positively – than other young children.
The developmental consequences of childhood trauma for young children are extensive and impact a diverse range of areas. Young children require treatments that consider their developmental stage and ...are inclusive of caregiver involvement. Parent-Child Interaction Therapy (PCIT), with its dyadic focus and developmental sensitivity, is uniquely positioned to offer therapeutic support to young children and their families.
The current study aimed to conduct a systematic review of the current literature on PCIT and trauma and determine treatment outcomes for children and caregivers.
A systematic review of five electronic databases was undertaken. Studies that utilized PCIT to treat a population who had experienced trauma were included in the review regardless of study design.
PCIT was used to treat a population who had experienced trauma in 40 studies. PCIT was an effective treatment in improving a variety of child and parent outcomes in this population including reduced parenting stress, child behavior problems, child trauma symptoms, parental mental health concerns, negative parenting strategies, and reducing potential risk of recidivism of abuse and neglect. These findings should be taken with caution given attrition rates and potential for bias in the study samples.
Clinicians should consider PCIT as a potential treatment for children who have experienced trauma and their families. Future research should incorporate corroborative sources of information, assessment of caregiver and child trauma symptoms, examination of permanency outcomes, and consider standardization of PCIT modifications for child trauma to determine treatment in this population of children.
Many children in the child welfare system (CWS) have histories of recurrent interpersonal trauma perpetrated by caregivers early in life often referred to as complex trauma. Children in the CWS also ...experience a diverse range of reactions across multiple areas of functioning that are associated with such exposure. Nevertheless, few CWSs routinely screen for trauma exposure and associated symptoms beyond an initial assessment of the precipitating event. This study examines trauma histories, including complex trauma exposure (physical abuse, sexual abuse, emotional abuse, neglect, domestic violence), posttraumatic stress, and behavioral and emotional problems of 2,251 youth (age 0 to 21; M = 9.5, SD = 4.3) in foster care who were referred to a National Child Traumatic Stress Network site for treatment. High prevalence rates of complex trauma exposure were observed: 70.4% of the sample reported at least two of the traumas that constitute complex trauma; 11.7% of the sample reported all 5 types. Compared to youth with other types of trauma, those with complex trauma histories had significantly higher rates of internalizing problems, posttraumatic stress, and clinical diagnoses, and differed on some demographic variables. Implications for child welfare practice and future research are discussed.
This study was carried out to examine the efficacy of a 12-week, low-intensity (1-hour/wk of therapist contact), parent-delivered intervention for toddlers at risk for autism spectrum disorders (ASD) ...aged 14 to 24 months and their families.
A randomized controlled trial involving 98 children and families was carried out in three different sites investigating the efficacy of a parent delivery of the Early Start Denver model (P-ESDM), which fosters parental use of a child-centered responsive interaction style that embeds many teaching opportunities into play, compared to community treatment as usual. Assessments were completed at baseline and 12 weeks later, immediately after the end of parent coaching sessions.
There was no effect of group assignment on parent-child interaction characteristics or on any child outcomes. Both groups of parents improved interaction skills, and both groups of children demonstrated progress. Parents receiving P-ESDM demonstrated significantly stronger working alliances with their therapists than did the community group. Children in the community group received significantly more intervention hours than those in the P-ESDM group. For the group as a whole, both younger child age at the start of intervention and a greater number of intervention hours were positively related to the degree of improvement in children's behavior for most variables.
Parent-implemented intervention studies for early ASD thus far have not demonstrated the large effects seen in intensive-treatment studies. Evidence that both younger age and more intervention hours positively affect developmental rates has implications for clinical practice, service delivery, and public policy.
•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.
Abstract Objective This research examined linkages between exposure to childhood sexual abuse (CSA) and childhood physical punishment/abuse (CPA) and mental health issues in early adulthood. Method ...The investigation analyzed data from a birth cohort of over 1,000 New Zealand young adults studied to the age of 25. Results Exposure to CSA and CPA was associated with increased risks of later mental disorders including depression, anxiety disorder, conduct/anti-social personality disorder, substance dependence, suicidal ideation, and suicide attempts at ages 16–25. Control for social, family, and individual factors reduced the associations between CPA and mental health outcomes to the point of statistical non-significance. However, there was a consistent finding for CSA to remain associated with increased risks of later mental health problems. After adjustment, those exposed to CSA including attempted or completed sexual penetration had rates of disorder that were 2.4 times higher than those not exposed to CSA. Those exposed to harsh or abusive physical punishment had rates of disorder that were 1.5 times higher than those exposed to no or occasional physical punishment. It was estimated that exposure to CSA accounted for approximately 13% of the mental health problems experienced by the cohort. Findings showed that exposure to CPA had only weak effects on later mental health. It was estimated that exposure to CPA accounted for approximately 5% of the mental health problems experienced by the cohort. Conclusions Exposure to CSA was associated with consistent increases in risks of later mental health problems. Exposure to CPA had weaker and less consistent effects on later mental health. These findings suggest that much of the association between CPA and later mental health reflects the general family context in which CPA occurs, whereas this is less the case for CSA.
Little is known about the effects of placing children who are abused or neglected into foster care. This paper uses the placement tendency of child protection investigators as an instrumental ...variable to identify causal effects of foster care on long-term outcomes-including juvenile delinquency, teen motherhood, and employmentamong children in Illinois where a rotational assignment process effectively randomizes families to investigators. Large marginal treatment effect estimates suggest caution in the interpretation, but the results suggest that children on the margin of placement tend to have better outcomes when they remain at home, especially older children.
The impact of early physical and sexual abuse (EPA/SA) occurring in the first 5 years of life was investigated in relation to depressive and internalizing symptomatology and diurnal cortisol ...regulation. In a summer camp context, school-aged maltreated (n = 265) and nonmaltreated (n = 288) children provided morning and late afternoon saliva samples on 5 consecutive days. Child self-report and adult observer reports of child internalizing and depressive symptoms were obtained. Children experiencing EPA/SA and high depressive or internalizing symptoms uniquely exhibited an attenuated diurnal decrease in cortisol, indicative of neuroendocrine dysregulation. These results were specific to EPA/SA rather than later onset physical or sexual abuse or early occurring neglect or emotional maltreatment.
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