Child abuse and neglect in infancy: sources of hostility within the parent-infant dyad and disorders of attachment in infancy

The human infant is prepared during fetal life and arrives on the scene ready to participate actively as a partner with the parent in structuring his own development. Parents are normally prepared for this participant activity by achieving a high degree of sensitivity to the signals of distress of and by the infant's affective engagement with them. The meaning of ordinary distress signals is in instances of child abuse and neglect determined by an unconscious mythology which the parent has about the infant, and also by what the parent finds unacceptable in oneself and projects onto the infant. The recent research on mother-infant attachment is reviewed. Landmarks for normal attachment behaviors from birth to age 3 are defined within seven different age groupings, and the psychiatric syndrome, "Reactive Attachment Disorder of Infancy," is described and is found almost universally in failure to thrive without organic cause babies. The diagnosis of Reactive Attachment Disorder is preferable because it leads to appropriate preventive and interventive action.     

Infant Care: Evaluation of Pre-Care Differences Hypotheses

189 infants/toddlers and their parents were visited in their homes 2 weeks before starting an out-of-home care arrangement and followed every two weeks until 6 months after care had begun (or its equivalent for parent care groups). At the beginning of the study infant/toddlers ranged in age from 2 to 30 months. In this report, hypotheses examining the role of pre-care family characteristics in determining child care use and later child adjustment were evaluated. Discriminant function analyses reliably separated care type and age of entry groups using pre-care family and infant characteristics as predictors. There were no significant differences in child behavior problems (externalizing and internalizing behavior) as a function of care arrangement type experienced. Mother's pre-care parent stress (PSI parent domain subscale: attachment to child) predicted anxious/withdrawn behavior 6 months later. Aggressive/destructive behavior was related independently to mother's health status and parent stress (PSI parent domain subscale: sense of competence) as measured before out-of- home care was begun. Difficult temperament infants had more behavior problems of all types.     

Predicting infant outcome in families of employed and nonemployed mothers

Differences in infant outcome, predictor variables, and their relationships were explored as a function of maternal employment. Thirty 18-month-olds and their mothers were studied. Child intelligence, attachment security, and dependency were measured, as well as frequency of stressful events in the mother's life, quality of the parents' marital relationship, frequency of the mother's social contacts, and extent of the mother's emotional and parenting supports. Also included were the mother's ability to cope; satisfaction with emotional, parenting, and child care supports; and role satisfaction. For children of employed mothers, attachment and dependency were negatively correlated; securely attached children showed less dependency behavior. For employed mothers, satisfaction with child care and frequent social contacts predicted secure child attachment. Satisfaction with child care, role satisfaction, and ability to cope were strongly interrelated. For nonemployed mothers, maternal coping predicted attachment security, while frequent social contacts predicted greater child dependency. Predictors of child outcome were highly interrelated for nonemployed mothers, with satisfaction with emotional supports playing a pivotal role. These differences suggest that different models to predict infant outcome in employed and nonemployed mother families may be appropriate.     

Risk of mother-reported child abuse in the first 3 years of life

OBJECTIVE: The purpose of this research was to investigate, within an at-risk population, parent and child characteristics associated with a mother's self-reports of severe physical assault and assault on the self-esteem of the child in the first 3 years of life. DESIGN: The study population consisted of a community-based sample of mothers of newborns identified as at-risk for child maltreatment (n=595). Families were assessed annually from the child's birth through age 3 using instruments with established psychometric properties. Independent variables investigated included: family socio-demographics, parity, mother's social support, maternal depression, maternal problem drug or alcohol use, partner violence, child's age, child's sex, low birth weight/small for gestational age (SGA), and mother's perception of child's demand level. Associations with maltreatment were examined using multivariable methods for longitudinal data. RESULTS: Child severe physical assault was significantly associated with parent characteristics (maternal depression and partner violence); and child characteristics (SGA). Assault to the child's self-esteem was significantly associated with maternal depression, maternal illicit drug use, partner violence and mother's perception of child's demand level. Controlling for family sociodemographic characteristics did not change the associations. Likewise, while mother's perception of child demand level had an independent association with self-esteem assault, the associations described above persisted while demand level was held constant. In this high-risk sample, abuse was not associated with mother's age, education, race, parity, or household income level. CONCLUSIONS: While characteristics such as SGA can serve as markers for increased abuse risk, they are not amenable to intervention after the child is born. However, certain other risk factors, such as maternal depression and domestic violence are malleable and should be targeted for intervention with the goal of preventing child maltreatment.     

Factors influencing mothers' reactions to intrafamily sexual abuse

A mother's question of whether to believe her child's disclosure of intrafamily child sexual abuse is complex, with many factors influencing her conclusion. Variables related to the abuse and to the family's functioning are examined to determine if particular circumstances are too threatening to mothers, resulting in their disbelief. The findings indicate that the age of the victim, nature of the abuse, presence of the mother in the home during the abuse, relationship of the victim to the offender, prior physical abuse of the child, and alcohol abuse by the offender all contribute to mother's conclusion regarding the reported abuse. The majority of mothers do believe their child, with difficult situations and other family stressors occasionally detracting from a mother's willingness to accept the report.     

Developmental origins of moral masochism: a failure-to-thrive toddler's interactions with mother

The case of a toddler diagnosed as failure to thrive with an unusual history of "accidents" illustrates the circumstances which may account for the infant's intense attachment to a sadistic love object and lead to moral masochism in adulthood. The observed behaviors of the toddler in interaction with mother show the pathological consequences of the infant's openness to influences of the social environment. He becomes attuned to his mother's wishes and performs behaviors which successfully evoke her attention and reciprocity even if these behaviors are contradictory to his survival. The mother's own experiences with unempathic and hostile parents are reflected in her attitudes and behaviors to the child. Suffering and victimization evoke her interest although she lacks the capacity for an empathic response to pain. Berliner's work on the origin of moral masochism, as well as the work of Steele on generational repetition, suggest the processes through which the infant's attachment to a sadistic mother gives rise to masochistic tendencies which may be reenacted throughout life in an effort to reproduce the affective feelings associated with mother's love and affection.     

Analysis and treatment of child abuse: A set of behavioral propositions

Five propositions are presented to suggest the potential of a behavioral approach to the understanding and treatment of child abuse. Each proposition deals with an important source of child abuse: (a) ineffective child management techniques; (b) deliberately punitive child rearing practices; (c) impulsive acts by the parent triggered by the child; (d) high levels of stress; and (e) negative attitude toward the child. For each proposition we discuss supportive findings from both child abuse and general psychological research as well as the additional information that would be needed in order to obtain a better functional analysis of clinical cases. Based on this discussion, behavioral therapy strategies are proposed with special attention being given to the various measures needed to evaluate the effectiveness of treatment programs.     

Mother's age and risk for physical abuse.

It is widely believed that young mothers are at greater risk of engaging in physical abuse. However, this relationship is not clearly supported by previous empirical research. This study reexamines the issue using a nationally representative sample of 1,997 mothers. All analyses controlled for family income, race, number of minor children in the home, age of abused child, mother's education, and whether mother was a single parent. Physical abuse was measured with the Conflict Tactics Scales. Using mother's age at time of birth of the abused child, the younger the mother, the greater the rate of child abuse; however, there was not a significant relationship when mother's age was measured at age at time of abuse. Large families and minority group children were also found to be at greater risk of abuse. The paper discusses implications for further research and for prevention of child abuse.     

New Lunchbox, Old Feelings: What Kids Bring to School

Research on the transition to school has shown successful adjustment to be characterized by a high degree of effort, initiative, and positive interaction with peers and adults. These behaviors often have their root in the earliest transactions between infant and caregiver, particularly the infant's experience of having his/her cues and signals responded to in a consistent, sensitive way and the secure attachment which develops from such care. Through experiences with caregivers in the first year of life children begin to develop “working models” of others and self, models which influence how that child behaves at later ages, and which in turn influence how others respond to that child. Children who are deprived of the opportunity to develop a secure attachment often fail to develop the initiative and social skills which would facilitate their transition to school. Teachers' low expectations and negative responses to the child in the first years of school may perpetuate the child's negative working models and decrease the child's chances for subsequent school success. The challenge to us is to contradict the negative working models many children bring to school. This implies l) considering the meaning of the child's behavior within the context of his/her relationship history and current life experiences, 2) consistently and persistently caring for a child even in the face of apparent rejection of our efforts, 3) looking for opportunities to reframe how we and others perceive the child, and 4) being alert to subtle ways in which we and others may be perpetuating negative working models held by both the child and his/her parents.     

Assessing parental understanding of sexualized behavior in children and adolescents

The current study assessed parents’ ability to identify normal, concerning and harmful sexualized behaviors in children and adolescents, as well as the parents’ ability to identify and select an appropriate level of intervention. The influence of a parent’s relationship with the victim or the perpetrator on the level of action taken was also examined. A cross-sectional survey incorporating a randomized experimental vignette condition determined that parents (N = 244) were not able to consistently identify sexualized behaviors accurately, and they provided lower-than-recommended levels of intervention responses. Parents were best able to identify and respond to behaviors considered normal and age-appropriate, but had greater difficulty with behaviors considered concerning or harmful. Parents were significantly less able to accurately identify and respond to behaviors exhibited by very young children (in the 0–4 year-old age-bracket). In three vignette comparisons, no significant difference in the level of intervention responses was found between parents who viewed the victim as their own child and parents who viewed the perpetrator as their child; while parents who viewed both the victim and perpetrator as being their children (siblings) reported lower intervention response levels. Because a lack of accurate knowledge around risks and indicators of child sexual abuse negatively affects the ability to prevent and detect abuse, the results have implications for a shift from a forensic model of child protection towards a public health model, which emphasizes parent and community education.     

New Lunchbox,Old Feelings: What Kids Bring to School

Research on the transition to school has shown successful adjustment to be characterized by a high degree of effort, initiative, and positive interaction with peers and adults. These behaviors often have their root in the earliest transactions between infant and caregiver, particularly the infant's experience of having his/her cues and signals responded to in a consistent, sensitive way and the secure attachment which develops from such care. Through experiences with caregivers in the first year of life children begin to develop "working models" of others and self, models which influence how that child behaves at later ages, and which in turn influence how others respond to that child. Children who are deprived of the opportunity to develop a secure attachment often fail to develop the initiative and social skills which would facilitate their transition to school. Teachers' low expectations and negative responses to the child in the first years of school may perpetuate the child's negative working models and decrease the child's chances for subsequent school success. The challenge to us is to contradict the negative working models many children bring to school. This implies l) considering the meaning of the child's behavior within the context of his/her relationship history and current life experiences, 2) consistently and persistently caring for a child even in the face of apparent rejection of our efforts, 3) looking for opportunities to reframe how we and others perceive the child, and 4) being alert to subtle ways in which we and others may be perpetuating negative working models held by both the child and his/her parents.     

Child abuse history in teen mothers and parent–child risk processes for offspring externalizing problems

This study examined whether child abuse history in teen mothers impacts offspring externalizing problems indirectly, through its influence on attachment and maternal hostility. In a longitudinal sample of 112 teen mother–child dyads, mothers reported on their own abuse experiences, attachment and maternal hostility were assessed via direct observations, and externalizing problems were measured using maternal reports. Compared with mothers with no abuse history, mothers with a history of sexual and physical abuse were more likely to have an insecurely attached infant, which predicted higher externalizing problems in preschool, which in turn predicted subsequent increases in externalizing problems in Grade 3. Furthermore, relative to the no abuse history group, mothers with a history of sexual and physical abuse showed more hostility toward their child at preschool, which in turn predicted elevated externalizing problems in Grade 3. Mothers’ history of either sexual or physical abuse alone did not have significant indirect effects on externalizing problems. Fostering secure attachment and reducing risk for maternal hostility might be important intervention goals for prevention programs involving at-risk mothers with abuse histories.     

Maternal Separation Anxiety: Its Developmental Course and Relation to Maternal Mental Health

Maternal separation anxiety is a construct that describes a mother's experience of worry, sadness, or guilt during short-term separations from her child. This investigation examined potential differences in psychological correlates between mothers with high and low levels of anxiety when their children were 8 months, 3 1/2 years, and 6 years of age. High levels of maternal separation anxiety had different psychological correlates contingent upon the age of the child. Depressive symptomatology and separation anxiety were unrelated at times 1 and 2, but when the children were 6 years old, mothers who had the highest levels of anxiety tended to have more depressive symptomatology, fewer coping skills, a more negative representation of self, and embraced more traditional sex-role values. Study findings are discussed with respect to their relevance to the mother's role as developmental partner to the child and linked to major theoretical perspectives that address the mother-child relationship.     

Adolescent survivors of childhood sexual abuse: the mediating role of attachment style and coping in psychological and interpersonal functioning

OBJECTIVE: To examine attachment style and coping strategies as potential mediating variables between childhood sexual abuse (CSA) and psychological and interpersonal functioning in an attempt to explain variability in extent of disorder and level of functioning. METHOD: Eighty adolescent females, aged 14-16 years, answered questions regarding abuse history, attachment style, coping with an interpersonal stressor, depression and trauma symptomatology, and conflict with a best friend. RESULTS: Structural equation modeling analyses indicated that attachment style mediates the effects of CSA and child abuse and neglect on coping and psychological distress. The indirect effects of CSA and other abuse through attachment accounted for most of the effects on coping and psychological distress. Avoidant and cognitive coping strategies also served as mediators in the models, accounting for most of the effects of the other variables on interpersonal conflict. CONCLUSIONS: The findings indicate that attachment style and coping strategies influence psychological and interpersonal functioning, mediating the direct effects of CSA and other types of child abuse and neglect. These results have implications for therapeutic intervention with children and adolescents who have experienced child abuse.     

Childhood sexual abuse, attachment, and trauma symptoms in college females: the moderating role of attachment

OBJECTIVE: The present study tests a model linking attachment, childhood sexual abuse (CSA), and adult psychological functioning. It expands on previous work by assessing the degree to which attachment security moderates the relationship between a history of child sexual abuse and trauma-related symptoms in college females. METHOD: Self-reports of attachment, childhood sexual abuse, and adult psychological functioning were obtained from 324 female undergraduate students attending a Southeastern U.S. university. Separate analyses were conducted examining the potential moderating role for close-adult, parent-child, and peer attachment styles. RESULTS: In this sample, 37.7% of participants reported sexually abusive experiences prior to age 16. History of child sexual abuse was consistently associated with higher levels of trauma-related symptoms and lower levels of attachment security in close-adult, parent-child, and peer relations. Additionally, attachment security was consistently associated with trauma-related symptoms. Close-adult, parent-child, and peer attachment differentially moderated trauma-related symptoms. Specifically, in peer relationships, the strength of the relationships between attachment measures and trauma symptoms were greater for CSA survivors than for non-abused participants. The opposite pattern of results was found for attachment in parental and close-adult relationships. CONCLUSION: Results suggest that attachment security in peer and parent relationships protects against the negative effects of CSA, while only weak, marginally significant protective effects were observed for close-adult relationships. Only modest support was found for the conceptualization of attachment as a moderator of the relationship between CSA and trauma-related symptoms. However, the results suggest that attachment security at least partially protects against negative CSA outcomes.     

Childhood sexual abuse precipitating maternal hospitalization

CHILD ABUSE often occurs in families with multiple and frequent stresses [1]. Disclosure of the abuse and the resulting therapeutic interventions may increase the stresses on family members and the family structure [2, 3], Some parents express greater concern about the disruption of their own lives caused by sexual abuse than they express for the victimized child [4, 5,]. Under such circumstances, the child may be deprived of the support needed to cope with the traumatic experience.This paper provides three case reports of unusual examples of family disruption following childhood sexual abuse. In each case the mother's hospitalization was precipitated by the disclosure and investigation of the child's sexual assault complaint.     

Reported anxieties concerning intimate parenting in women sexually abused as children

OBJECTIVE: The study had two aims: (1) To investigate whether mothers with a history of contact child sexual abuse were anxious about the intimate aspects of parenting compared with a clinical comparison group. (2) To determine if there was any relationship between the mother's anxieties and the kind of parenting they recalled receiving themselves. METHOD: Two groups of mothers in mental health out-patient care were interviewed; 34 women with a history of contact child sexual abuse and 29 women with no history of sexual abuse. They completed the Intimate Aspects of Parenting Questionnaire, The Parenting Stress Index (Short form) The Parental Bonding Instrument and The General Health Questionnaire-28. The index group also completed a sexual abuse history questionnaire. RESULTS: Mothers with a history of child sexual abuse were significantly more anxious about intimate aspects of parenting than the comparison group. They also reported significantly more overall stress as parents. The index group recalled that their own parents were significantly less caring and that their fathers more controlling than the comparison group. A low score on Father Care was significantly associated with concerns about intimate parenting, but not with total parenting stress. By contrast, a low score on Mother Care was significantly associated with higher stress experienced as a parent, but not as strongly with anxieties about intimate parenting. CONCLUSIONS: Mothers with a history of contact child sexual abuse who attend mental health services are often worried that their normal parenting behaviors may be inappropriate or seen as such by other people. These anxieties seem associated with their history of childhood sexual abuse.     

Early child care experiences and their association with family and child characteristics during middle childhood

Long-term correlates of early child care and maternal employment were examined in a representative sample of 333 6- to 12-year-old middle-class children. Intellectual, social, and behavioral development and parent-child relationships were related to nonparental infant care, center or preschool experiences, and maternal employment. Contextual analyses included child, parent, and family covariates related to choice of child care and children's development. Preschool and center day care was associated with slightly higher Wechsler Intelligence Scale for Children-Revised (WISC-R) Vocabulary scores and externalizing t scores on the Child Behavior Checklist. In addition, for African American children, center preschool experience was associated with 10-point-higher verbal intelligence scores and better ratings of positive behavioral attributes by parent and observers. Nonparental care during infancy and maternal employment patterns during the preschool years were not consistently related to the outcomes. The results of this study further support the growing consensus that the effects of early child care experiences must be considered in the context of parent, family, and child characteristics.