Exploring the relationship between child physical abuse and adult dating violence using a causal inference approach in an emerging adult population in South Korea

Child maltreatment is one of the most commonly examined risk factors for violence in dating relationships. Often referred to as the intergenerational transmission of violence or cycle of violence, a fair amount of research suggests that experiencing abuse during childhood significantly increases the likelihood of involvement in violent relationships later, but these conclusions are primarily based on correlational research designs. Furthermore, the majority of research linking childhood maltreatment and dating violence has focused on samples of young people from the United States. Considering these limitations, the current study uses a rigorous, propensity score matching approach to estimate the causal effect of experiencing child physical abuse on adult dating violence among a large sample of South Korean emerging adults. Results indicate that the link between child physical abuse and adult dating violence is spurious rather than causal. Study limitations and implications are discussed.     

Intimate partner violence among female caregivers of children reported for child maltreatment

OBJECTIVE: The purpose of this study was to determine the prevalence and correlates of intimate partner violence among female caregivers of children reported to child protective services. METHOD: Data were derived from the National Survey of Child and Adolescent Well-Being, a national probability study of children investigated for child abuse and neglect in the United States. Caregivers were interviewed about demographic characteristics, mental health, substance use, and physical violence by a partner. RESULTS: The lifetime and past year prevalence of intimate partner violence was 44.8 and 29.0%, respectively. Caregiver major depression and history of prior reports of child maltreatment were strongly associated with violence against women. CONCLUSIONS: The findings highlight the need for effective screening and identification of intimate partner violence in families in which child maltreatment has occurred.     

A study of the relationship between child abuse and drug addiction in 178 patients: Preliminary results

Social histories and demographic data were collected on 178 patients—101 in the United States and 77 in Australia—in treatment for drug/alcohol addiction. The purpose of the study was to determine the degree to which a correlation exists between child abuse/neglect and the later onset of drug/alcohol addiction patterns in the abuse victims. The questionnaire explored such issues as family intactness. parental violence/abuse/neglect, parental drug abuse, sibling relationships and personal physical/ sexual abuse histories, including incest and rape. The study determined that 84% of the sample reported a history of child abuse/neglect.     

Violence towards children in the United States and Sweden

This paper reports the results of a cross-cultural comparison of violence towards children in the United States and Sweden. Data from the United States are based on interviews with a nationally representative sample of 1,146 households with at least one child between the ages of 3 and 17 years living at home. Data from Sweden are based on interviews with a nationally representative sample of 1,168 households with a child 3 to 17 years of age at home. Violence and abuse were measured using the Conflict Tactics Scales. In general, Swedish parents reported using less violence than did parents in the United States. There was no significant difference between the two countries in the rate of reported severe or abusive violence. The paper compares factors found associated with violence towards children in the two countries, including age, marital status, education, and parents' background. The results are analyzed by considering methodological and cultural factors that explain the similarities and differences in the use of violence towards children in the two countries.     

Victim, perpetrator, family, and incident characteristics of infant and child homicide in the United States Air Force

OBJECTIVE: The present study describes factors related to fatal abuse in three age groups in the United States Air Force (USAF). METHOD: Records from 32 substantiated cases of fatal child abuse in the USAF were independently reviewed for 60 predefined factors. RESULTS: Males were over-represented in young child victims (between 1 year and 4 years of age) and child victims (between 4 years and 15 years of age) but not in infant victims (between 24 hours and 1 year of age). African-American infant victims and perpetrators were over-represented. Younger victims were more likely to have been previously physically abused by the perpetrator. Perpetrators were predominantly male and the biological fathers of the victims. Infant and young child perpetrators reported childhood abuse histories, while child perpetrators reported the highest frequency of mental health contact. Victims' families reported significant life stressors. Families of young child victims were more likely divorced, separated, or single. Incidents with infants and young children tended to occur without witnesses; incidents with child victims tended to have the victim's sibling(s) and/or mother present. Fatal incidents were more frequent on the weekend, in the home, and initiated by some family disturbance. CONCLUSIONS: Differences among groups in factors related to infant and child homicide across age groups may assist in the development of more tailored abuse prevention efforts and may also guide future investigations.     

The barriers to a national inquiry into child sexual abuse in the United States

There is an often-overlooked but critical factor at the center of institutional child sexual abuse that must be acknowledged and addressed: adults tend to place the interest of institutions and other adults above the protection of children. As the Australian Royal Commission into Institutional Responses to Child Sexual Abuse has shown, this phenomenon is evident across institutional settings and any institutional reform aimed at improving child safety must therefore guard against this tendency if it is to be effective in protecting children. In the United States there are also other barriers to dealing with child sexual abuse in institutional contexts. State government responses to the challenges of child sexual abuse have varied. However, the federal governmsent has been silent on the problem of religious institutional sexual abuse. This commentary considers how the politics of religious liberty in the United States inhibits action by protecting institutions that cover up child sexual abuse.     

Intra- and extrafamilial child homicide in Sweden 1971-1980

Over the 10-year period studied, a total of 96 children under 15 years of age were killed in Sweden. This number constituted an average annual rate of 0.6 per 100,000 children. The violence, most frequently involving strangulation, shooting, and stabbing, was largely directed at young children. The pattern of child homicide was mainly characterized by intrafamilial violence, especially in connection with the suicide of a parent-perpetrator. Extrafamilial homicides were rare and only committed by male perpetrators. Cases of child abuse by a parent and cases of sexual abuse were infrequent. By psychiatric examination after the crime, only 10 perpetrators out of 47 examined were found not mentally ill.     

American Indian law on child abuse and neglect

A wide variety of American Indian tribal codes on child abuse and neglect are currently in effect. They range from anachronistic codes that were promulgated about fifty years ago and have never been revised to recently enacted codes that are innovative and incorporate the best practices in the field of protective services. The efforts, now underway, to collect and analyze Indian tribal codes on child abuse and neglect is supportive of the national interest to improve Indian child welfare services. The knowledge gained will be helpful to Indian tribes as they assess their own codes and will provide a new body of information on the laws in the U.S. on child abuse and neglect. In the past few years, increased national support in the United States has been focused on the protection of the best interest of Indian children with specific resources provided for the support of local Indian children and family programs operated by Indian tribal governments. Many Indian tribes are using these resources to develop and revise their child welfare codes, including those elements pertaining to child abuse and neglect. The momentum under way in the United States to improve Indian child welfare services can be expected to continue to include developments in Indian tribal codes on child abuse and neglect.     

Incest: a laughing matter

Although incestuous rape is considered to be the most prevalent and most devastating form of child sexual abuse being reported in the United States, a review of the most popular child sexual abuse prevention programs currently being marketed, purportedly for use with very young children, reveals that none of them explicitly deals with the subject. This lacuna is routinely justified on the grounds that the transmission of detailed conceptual knowledge of sexual violence violates the "innocence" of children, either frightening them or provoking precocious, possibly pathological behavior. The following analysis of the context and content of the Chulupi Indian myth, "The Man You Could Say Nothing To," unmasks this attitude as a cultural bias which permeates child sexual abuse prevention programs. By maintaining the silence which surrounds incest, one potentially becomes part of the problem that one seeks to resolve.     

Protecting abused and neglected children: Can law help social work?

In the United States, about 25% of all child fatalities attributed to abuse or neglect occur after the child has been reported to a child protective agency. (Tens of thousands of other children receive serious injuries short of death while under child protective supervision.) Increasingly, individual workers are being blamed when the children in their care suffer further maltreatment. In all parts of the country, workers are being given administrative reprimands, are being fired, downgraded, or reassigned for mishandling their cases. Many are being sued for professional malpractice; some are being criminally prosecuted for official malfeasance and negligent homicide. Blaming workers is sometimes deeply unfair and fear of unfair criticism leads to defensive social work and, hence, to overintervention into private family matters. Existing laws encourage this unfair criticism by greatly overstating the ability of workers to predict future maltreatment. Laws can be reformulated to help workers better protect maltreated children. Laws should make clear that, subject to certain minor exceptions, protective action is warranted only when the parents' past behavior seriously injured the children or was capable of causing serious injury.     

Sexual abuse: A sociological perspective

How have contemporary social changes affected the problem of child sexual abuse? The rapid rise of this problem to public attention in the United States is in part due to the mobilization around the problem by the women's movement and the child welfare movement there. But factors shown by research to be associated with the problem—social isolation and patriarchal authority—are so widespread as to suggest that this is a problem of international proportions, as well. The rising divorce rate in the U.S. and worldwide, would appear to put more children at risk at the same time that it has also made it easier for children and their mothers to escape from the most oppressive and intolerable family situations. The sexual revolution and the erosion of external controls on sexual behavior have also in all likelihood aggravated the problem, too. Sexual abuse needs to be seen as a problem distinct from physical child abuse—characterized by the preponderance of offenders who are males. This suggests searching for the sources of the problem in male sexual socialization rather than in problems of inadequate and disaffected parenting.     

Can we measure success in preventing child abuse? Issues in policy, programming and research

Can we measure success in preventing child abuse? As the field of child abuse and neglect prevention matures intellectually and as more and more agencies require evaluative research to substantiate claims of programmatic success, this issue is emerging with ever growing vigor. This paper reviews efforts to set prevention goals in the United States, e.g., by the federal government's Surgeon General's Report on Health Promotion and Disease Prevention and by the National Committee for the Prevention of Child Abuse. For such goal setting to be defensible and socially productive, it must be linked to a research base. This research base is growing and maturing. The home health visitor concept, in particular, has received clear and powerful support as a preventive strategy. However, many issues remain concerning other strategies. Of equal or greater importance are the many difficulties we face in documenting base rates of maltreatment with which to assess the impact of preventive interventions. Questions remain about the adequacy of infant mortality data, child injury rates, and the validity of officially reported cases of child maltreatment. The paper reviews the data available to clarify and resolve these issues, and outlines a strategy for assessing success of efforts to reduce severity and incidence of child abuse in the United States. These efforts are presented in the context of a series of principles regarding child abuse prevention, e.g., the difference between prevention linked to broad social and economic reforms versus preventive programming targeted at ameliorating the lives of high-risk families in the absence of broad socioeconomic change.     

The predictive impact of domestic violence on three types of child maltreatment

OBJECTIVE: This exploratory study investigated the co-occurrence of domestic violence and three types of child maltreatment: physical child abuse, psychological child abuse, and child neglect. METHOD: A sample of 2544 at-risk mothers with first-born children participated in a home-visiting child abuse prevention program. A longitudinal design using multiple data collection methods investigated the effect of domestic violence during the first 6 months of child rearing on confirmed physical child abuse, psychological child abuse, and child neglect up to the child's first 5 years. RESULTS: Logistic regressions revealed significant relationships between domestic violence and physical child abuse, psychological child abuse, and child neglect. These effects were significant beyond the significant effects of known risks of maltreatment, as measured by the Kempe Family Stress Inventory (KFSI). Domestic violence occurred in 59 (38%) of the 155 cases of confirmed maltreatment. Domestic violence preceded child maltreatment in 46 (78%) of the 59 cases of co-occurrence, as indicated by independent home observations and child protective service records. CONCLUSIONS: The findings indicate that domestic violence during the first 6 months of child rearing is significantly related to all three types of child maltreatment up to the child's fifth year. Domestic violence and risks factors measured on the KFSI continue to contribute to all three types of maltreatment up to the child's fifth year. Prevention programs would be wise to provide services to at-risk families until the child is at least 5 years old. Addressing concurrent problems during treatment may enhance intervention.     

Physicians' recognition of and response to child abuse: Northern Ireland and the U.S.A

There is a long history of professional and public concern with the problems of recognizing and reporting child abuse. The research reported here compares recognition of and response to potential abuse by physicians in Northern Ireland and the United States. An experimental study using vignettes in the USA and hospital data, showed that physicians' judgments were moderately affected by ethnic status (black-white) and socioeconomic status of the family, in addition to level of injury to the child. We conducted a comparative study to test whether the social cleavage based on religion (Protestant-Catholic in North Ireland), would affect the recognition of and response to child abuse by medical practitioners in North Ireland. While there was a slight tendency for responses to be affected by socioeconomic status and religion, the results were not statistically significant, as was true for the level of injury to the child. We also compared "diagnostic behavior," signs used to diagnose abuse and causal notions concerning abuse. Medical practitioners in the two countries differ with respect to (1) the amount and type of information desired about a case, and (2) the factors believed to "cause" abuse, but are in general agreement about the "signs" of abuse.     

Neighborhood alcohol outlet density and rates of child abuse and neglect: Moderating effects of access to substance abuse services

This study investigates the relationship between concentrations of on- and off-premises alcohol outlets and rates of child abuse and neglect. Additionally, the study seeks to locate protective features of a neighborhood's built environment by investigating the potentially moderating role that access to substance abuse treatment and prevention services plays in the relationship between alcohol outlet density and child maltreatment. Using a cross-sectional design, this ecological study utilized data from 163 census tracts in Bergen County, New Jersey, on reports of child abuse and neglect, alcohol outlets, substance abuse treatment and prevention facilities, and the United States Census to investigate the linkages between socioeconomic structure, alcohol availability, and access to substance abuse service facilities on rates of child abuse and neglect. Findings indicate areas with a greater concentration of on-premises alcohol outlets (i.e., bars) had higher rates of child neglect, and those with easier access to substance abuse services had lower rates of neglect, controlling for neighborhood demographic and socioeconomic structure. Additionally, the relationship between on-premises alcohol outlet density and rates of child neglect was moderated by the presence of substance abuse service facilities. A greater concentration of off-premises outlets (i.e., liquor stores) was associated with lower rates of physical abuse. Findings suggest that the built environment and socioeconomic structure of neighborhoods have important consequences for child well-being. The implications for future research on the structural features of neighborhoods that are associated with child well-being are discussed.     

Adolescents at risk for violence

Interpersonal violence among youth is a growing problem in many communities and schools across the nation. The causes of violence are multiple and complex. This paper examines the extent and nature of interpersonal violence among youth as well as the individual and societal factors which contribute to youth violence. Adolescents are disproportionately represented as both victims and perpetrators of fatal and nonfatal assaultive violence. Homicide rates among young men in the United States are vastly greater than those of other Western industrialized nations. Persons age 12–24 years face the highest risk of nonfatal violent victimization of any segment of our society. Arrest rates for homicide, rape, robbery, and aggravated assault peak among adolescents and young adults. Further, arrest rates for murder and other violent crimes have increased substantially among this age group since the mid-1980s. Effective prevention programs will require combinations of interventions aimed at multiple factors and delivered through many channels.     

Educational and psychological problems of abused children

The findings of this study tend to confirm the hypothesis that abused children are found to be significantly different from nonabused children in academic achievement, placement in classes for the emotionally disturbed and for the educable mentally retarded. The data also confirm the hypothesis that abused and neglected children are placed in special facilities more frequently than children who have not been adjudged as abused. Further, abused and neglected children were reported to exhibit behaviors indicative of psychological problems. Within each of the dimensions investigated, abused and neglected children were found to have significant problems.In light of the significant differences found in this study, we find substantial support for the projects being supported by the National Center for Child Abuse and Neglect designed to involve the schools in the United States in the battle against children abuse and neglect. Especially important is the project of the Education Commission of the States designed to create an awareness among school systems, professional teacher organizations, and state and local legislative governing bodies of their potential in the battle against child abuse and neglect.In light of the loss of human potential as well as the increased costs involved in providing special classes for the abused and neglected child, allocation of resources to involve schools and school personnel as a part of the multidisciplinary team concerned with child abuse and neglect seems well justified. Additionally, the allocation of fiscal resources for research designed to secure data regarding the sequelae of child abuse is also amply justified.     

Factors associated with divorce in intrafamily child sexual abuse cases

This study analyzes factors related to the decision to divorce in intrafamilial sexual abuse cases. Data was collected on 128 cases of incest in St. Louis, Missouri, through the Washington University Child Guidance Center. Examination of multiple variables revealed there are differences between child sexual abuse cases that elect to stay together vs. those that divorce subsequent to the discovery of abuse. Families that broke up were more likely to have young child victims and have additional problems with domestic violence. The child was more likely to have revealed the abuse to the mother and have been believed by her in divorcing cases.     

A new protocol for screening adults presenting with their own medical problems at the Emergency Department to identify children at high risk for maltreatment

Identifying child abuse and neglect solely on the grounds of child characteristics leaves many children undetected. We developed a new approach (Hague protocol) based on characteristics of parents who attend the Emergency Department (ED) because they have the following problems: (1) intimate partner violence, (2) substance abuse, or (3) suicide attempt or other serious psychiatric problems. The goal of this protocol is to enable the Reporting Center for Child Abuse and Neglect (RCCAN) to rapidly assess family problems and offer voluntary community based support to these parents. The aim of this study is to assess whether this protocol for screening adults presenting for care in the Emergency Department can identify children at high risk for maltreatment. A before and after study was conducted at 9 EDs in 3 regions in the Netherlands (one intervention region and 2 control regions). During the period January 2006 to November 2007, prior to the introduction of the Hague protocol, from a total of 385,626 patients attending the ED in the intervention region 4 parents (1 per 100,000) were referred to the RCCAN. In the period after introduction of the protocol (December 2007 to December 2011), the number rose to 565 parents from a total of 885,301 patients attending the ED (64 per 100,000). In the control region, where the protocol was not implemented, these figures were 2 per 163,628 (1 per 100,000) and 10 per 371,616 (3 per 100,000) respectively (OR = 28.0 (95 CI 4.6–170.7)). At assessment, child abuse was confirmed in 91% of referred cases. The protocol has a high positive predictive value of 91% and can substantially increase the detection rate of child abuse in an ED setting. Parental characteristics are strong predictors of child abuse. Implementing guidelines to detect child abuse based on parental characteristics of parents attending the adult section of the ED can increase the detection rate of child abuse and neglect allowing appropriate aid to be initiated for these families.     

Intergenerational transmission of child abuse: Predictors of child abuse potential among racially diverse women residing in domestic violence shelters

Parental risk for perpetrating child abuse is frequently associated with intergenerational patterns of abuse: being abused increases the risk for future abuse. Yet, the mechanisms of intergenerational abuse are unclear, and the risk factors for perpetrating child abuse are interrelated. Research suggests that history of childhood abuse, psychiatric distress, and exposure to intimate partner violence (IPV) are all related risk factors for perpetrating child abuse. We investigated these three risk factors using the developmental psychopathology framework in a racially diverse sample of high-risk women: women residing in domestic violence shelters. 211 mothers residing in domestic violence shelters completed measures of their own childhood abuse (defined narrowly in a 10-item self-report survey), exposure to and severity of IPV victimization, and structured interviews to diagnose psychiatric disorders. We utilized a hierarchical regression model to predict child abuse potential, accounting for risk factors in blocks roughly representing theorized temporal relationships: childhood abuse followed by psychiatric diagnoses, and then recency of exposure to IPV. Consistent with hypotheses, the strongest predictor of current child abuse potential was the psychiatric diagnosis of PTSD. Mediation tests further explicated that the relationship between maternal history of childhood sexual abuse and current potential for perpetrating child abuse is mediated by IPV-related PTSD symptoms. Results suggest that IPV-related PTSD symptoms, rather than exposure to abuse (i.e., childhood abuse or IPV), is most strongly associated with child abuse potential in recent IPV survivors. Interventions which can ameliorate maternal psychopathology and provide resources are recommended for these vulnerable families.