Cycle of violence among young Kenyan women: The link between childhood violence and adult physical intimate partner violence in a population-based survey

The aim of the current analysis is to elucidate the link between childhood experiences of violence and physical intimate partner violence in young adulthood in a national survey of young Kenyan women. In 2010, we conducted the Violence against Children Survey in Kenya, collecting retrospective reports from 13 to 24 year old males and females (N = 2928). The analysis presented here focused on females aged 18–24 who ever had an intimate partner (n = 566). Young Kenyan women had statistically higher odds of experiencing physical intimate partner violence (IPV) in young adulthood if they had experienced any childhood violence (including sexual, emotional, or physical) [adjusted odds ratio (AOR) = 3.1 CI: 1.2–7.9, p = 0.02)], any childhood sexual violence (AOR = 2.5, CI 1.3–4.9, p = 0.006), or unwanted completed sex (including pressured or forced sex prior to age 18) (AOR = 4.3, CI: 2.3–8.3, p < 0.0001). Exposure to two (AOR = 3.9, CI: 1.2–12.2, p = 0.02) or three (AOR = 5.0, CI: 1.4–18.1, p = 0.01) types of violence in childhood was also associated with a significantly higher odds of experiencing adult physical IPV. Childhood violence is associated with increased odds of adult physical IPV among young women; efforts to prevent violence against children and provide appropriate care and support to adult survivors are critical to interrupt this cycle of violence     

A sex-disaggregated analysis of how emotional violence relates to suicide ideation in low- and middle-income countries

BackgroundIn recent years, research has increasingly focused on examining the relationship between one type of child maltreatment -- emotional violence -- and suicidal behaviors. However, the growing body of empirical evidence supporting these associations has been mostly limited to high-income contexts.ObjectiveThis study examines how exposure to emotional violence is associated with suicide ideation in childhood and adolescence in low- and middle-income countries (LMICs), and whether this association differs by sex.Participants and settingWe employ nationally representative samples of 13–24 year-old males and females from the Violence Against Children Surveys in Tanzania (conducted in 2009), Kenya (2010), and Haiti (2012).MethodsWe use logistic regressions to estimate the odds of ever reporting suicide ideation, separately, for each country; models control for self-reported exposure to emotional violence, physical violence from a caregiver, physical violence by an adult in the community, sexual violence, intimate partner violence, and age. Formal moderation by sex for each form of child maltreatment is tested using interaction terms.ResultsWe find the odds of suicide ideation are consistently and significantly greater for adolescents who report ever exposure to emotional violence. This same consistency is not observed for any other form of maltreatment across countries. The size of the relationship between emotional violence and suicide ideation is statistically significantly larger for males in Kenya only.ConclusionResearch in LMICs should explore the mediating factors linking emotional abuse in childhood and adolescence to suicide ideation in adolescence, paying special attention to whether these pathways might operate differently by sex.     

Age-specific risk factors associated with placement instability among foster children

Placement instability places foster children at an increased risk of negative developmental outcomes. Previous research has yielded inconsistent results on risk factors for placement instability. Therefore, we investigated two research questions: (1) Which child attributes and case histories are associated with placement disruptions (moves indicative of child, agency or caregiver dissatisfaction with the existing placement)?; and (2) How do associations of child attributes and case histories with placement disruptions vary by developmental stage --early childhood (0–5 years), middle childhood (6–12 years), and adolescence (13 years or older)? Using a complete entry cohort of 23,765 foster children in Texas, our results demonstrated that the effects of different risk factors varied by placement end reason and across developmental stages. Of note, kinship placement, compared to non-relative foster care, and placement with all siblings were each associated with an increased risk of substandard care disruptions. Placements with females or Hispanic children were at an increased risk of child-initiated disruption, whereas placements with Black children were more likely to end due to placement mismatch or substandard care reasons. Finally, the adolescence age group was always associated with the greatest increase in risk regardless of disruption reason. These findings provide researchers, caseworkers, and policymakers important information on the risk factors for placement instability among children in foster care.     

Epidemiologic variations in childhood sexual abuse

We retrospectively reviewed records of 566 children ranging from 6 months to 16 years of age who presented to a sexual assault crisis center. They represented 33.2% of all alleged sexual assault victims seen over a 36 month period. There were 103 males (18.2%) and 463 females (81.8%). Significant differences in presentation were demonstrated with respect to the victim's age, sex, and race, but the major factor influencing the variation is the victim/assailant relationship. Younger children were more likely than older children to present with histories of multiple assaults (p less than .0005), by known assailants (p less than .0005), occurring in the child's or assailant's home (p less than .001) and to report less violence (p less than .05). More risk of violence (p less than .0005) or evidence of trauma (p less than .0005) and less reporting of home assaults (p less than .0005) or multiple assault episodes (p less than .0005) were found in assaults by strangers when compared with non-stranger assaults. A lower frequency of reporting was found in females between 7 and 11 years of age. The dynamics of childhood sexual abuse are discussed in relationship to these findings. A number of victim and assailant related factors determine reporting patterns of childhood sexual abuse.     

Childhood sexual violence in Zimbabwe: Evidence for the epidemic against girls

Sexual abuse during childhood is a public health and human rights concern throughout the world, including Sub-Saharan Africa. In 2011, Zimbabwe initiated national prevalence data collection on violence against children to inform government policy and programs. We interviewed 567 females and 589 males, aged 18–24 years following standardized and previously tested survey methods from the region. Of females 32.5%, and of males 8.9%, reported experiencing sexual violence before age 18. Most female (62.7%) and male (47.9%) victims of sexual violence experienced more than one incident of sexual violence prior to age 18 years. Three in four females (77.7%) and one in four males (26.7%) of those who experienced sexual violence reported that the first incident was perpetrated by a boyfriend or girlfriend. Few victims received professional help (2.7% of females and 2.4% of males who had reported experiencing sexual violence). Violence against girls is at epidemic levels in Zimbabwe. Most sexual violence against girls occurs within the context of peer relationships. Child victims who seek potentially life-saving support tend not to receive it. This study is evidence of a national public health and child rights emergency in the country and a case for increased, longer-term investment by the government and its development partners in policy reform for enhancing adolescent girls’ empowerment and protection.     

Beyond residential mobility: A broader conceptualization of instability and its impact on victimization risk among children

Predictability in a child’s environment is a critical quality of safe, stable, nurturing relationships and environments, which promote wellbeing and protect against maltreatment. Research has focused on residential mobility's effect on this predictability. This study augments such research by analyzing the impact of an instability index—including the lifetime destabilization factors (LDFs) of natural disasters, homelessness, child home removal, multiple moves, parental incarceration, unemployment, deployment, and multiple marriages--on childhood victimizations. The cross-sectional, nationally representative sample of 12,935 cases (mean age = 8.6 years) was pooled from 2008, 2011, and 2014 National Surveys of Children’s Exposure to Violence (NatSCEV). Logistic regression models controlling for demographics, socio-economic status, and family structure tested the association between excessive residential mobility, alone, and with LDFs, and past year childhood victimizations (sexual victimization, witnessing community or family violence, maltreatment, physical assault, property crime, and polyvictimization). Nearly 40% of the sample reported at least one LDF. Excessive residential mobility was significantly predictive of increased odds of all but two victimizations; almost all associations were no longer significant after other destabilizing factors were included. The LDF index without residential mobility was significantly predictive of increased odds of all victimizations (AOR’s ranged from 1.36 to 1.69), and the adjusted odds ratio indicated a 69% increased odds of polyvictimization for each additional LDF a child experienced. The LDF index thus provides a useful alternative to using residential moves as the sole indicator of instability. These findings underscore the need for comprehensive supports and services to support stability for children and families.     

Sexual abuse of deaf children. A retrospective analysis of the prevalence and characteristics of childhood sexual abuse among deaf adults in Norway

OBJECTIVE: North American studies conclude that deaf children may have a 2-3 times greater risk of sexual abuse than hearing children. No comparative studies are available in the Nordic countries. The present study was initiated to estimate the prevalence of childhood sexual abuse among deaf children in Norway, describe the nature of the abuse, and to examine risk factors. METHOD: A self-administered questionnaire was sent in 1999 to all 1150 adult deaf members of the Norwegian Deaf Register. The Deaf Register includes all deaf Norwegians. The questionnaire, which was also available videotaped in sign language, was an adapted version of a questionnaire used in a Norwegian survey among the general adult population in 1993. The results from this earlier study were used as a comparison group. RESULTS: Deaf females aged 18-65 who lost their hearing before the age of 9 (N = 177) reported sexual abuse with contact before the age of 18 years more than twice as often as hearing females, and deaf males more than three times as often as hearing males. The abuse of the deaf children was also more serious. Very few cases were reported to parents, teachers, or authorities. CONCLUSIONS: Deaf children are at greater risk of sexual abuse than hearing children. The special schools for the deaf represent an extra risk of abuse, regardless of whether the deaf pupils live at home or in boarding schools.     

Parsing dimensions of family violence exposure in early childhood: Shared and specific contributions to emergent psychopathology and impairment

Early childhood exposure to family violence predicts increased risk for psychopathology. However, violence between partners and towards children often co-occur. This complicates efforts to determine how experiences of family violence contribute to early mental health problems. Utilizing mother-report data on harsh parenting and intimate partner violence (IPV) from two large community-based, socioeconomically and ethnically diverse samples of 3–5-year-old children, we illustrate the value of a bifactor method for characterizing a family climate in which verbal and physical violence are more chronic and pervasive among family members. In our Calibration sample (N = 1,179), we demonstrate the fit of a bifactor model with a shared violence factor reflecting violence among partners and towards children and orthogonal factors for physically harsh parenting and IPV. Examination of item distributions along quartiles on the identified factors reveals that violent behaviors are most frequent/chronic in families with high scores on the shared violence factor. Next, we apply this model in Validation (N = 1,316) and lab-visit samples (N = 369). Children’s symptoms and impairment showed relatively strong and consistent associations with the shared factor. Some unique associations with IPV and harsh parenting were also observed. Overall, patterns suggest particularly negative impact when verbal and physical violence are more chronic and pervasive among family members. Finally, evidence supporting the bifactor model’s validity relative to multi-method data from coded interviews about child abuse and IPV and observed parenting is presented. Findings illustrate the value of a bifactor approach for the meaningful characterization of shared and specific features of family violence.     

The experience of violence against children in domestic servitude in Haiti: Results from the Violence Against Children Survey,Haiti 2012

BackgroundThere have been estimates that over 150,000 Haitian children are living in servitude. Child domestic servants who perform unpaid labor are referred to as “restavèks.” Restavèks are often stigmatized, prohibited from attending school, and isolated from family placing them at higher risk for experiencing violence. In the absence of national data on the experiences of restavèks in Haiti, the study objective was to describe the sociodemographic characteristics of restavèks in Haiti and to assess their experiences of violence in childhood.MethodsThe Violence Against Children Survey was a nationally representative, cross-sectional household survey of 13–24 year olds (n = 2916) conducted May–June 2012 in Haiti. A stratified three-stage cluster design was used to sample households and camps containing persons displaced by the 2010 earthquake. Respondents were interviewed to assess lifetime prevalence of physical, emotional, and sexual violence occurring before age 18. Chi-squared tests were used to assess the association between having been a restavèk and experiencing violence in childhood.FindingsIn this study 17.4% of females and 12.2% of males reported having been restavèks before age 18. Restavèks were more likely to have worked in childhood, have never attended school, and to have come from a household that did not have enough money for food in childhood. Females who had been restavèks in childhood had higher odds of reporting childhood physical (OR 2.04 [1.40–2.97]); emotional (OR 2.41 [1.80–3.23]); and sexual violence (OR 1.86 [95% CI 1.34–2.58]) compared to females who had never been restavèks. Similarly, males who had ever been restavèks in childhood had significantly increased odds of emotional violence (OR 3.06 [1.99–4.70]) and sexual violence (OR 1.85 [1.12–3.07]) compared to males who had never been restavèks, but there was no difference in childhood physical violence.InterpretationThis study demonstrates that child domestic servants in Haiti experience higher rates of childhood violence and have less access to education and financial resources than other Haitian children. These findings highlight the importance of addressing both the lack of human rights law enforcement and the poor economic circumstances that allow the practice of restavèk to continue in Haiti.     

Victimization and polyvictimization of Spanish children and youth: Results from a community sample

Most research into adolescent victimization and polyvictimization has been carried out in the United States and in northern European countries. The present study aims to determine the prevalence of victimization and polyvictimization in a community sample of Spanish adolescents. The sample consisted of 1,107 youth (M = 14.52, SD = 1.76), 590 males and 517 females, randomly recruited from 7 secondary schools in a north-eastern region in Spain. The Spanish version of the Juvenile Victimization Questionnaire was applied, assessing 6 aggregate categories of childhood victimization (conventional crimes, caregiver, peer and sibling, witnessed and indirect, sexual, and electronic victimization). A total of 83% of adolescents reported at least 1 type of victimization during their lives, and 68.6% during the last year. Boys were generally more exposed to conventional crimes (68.0%), and girls to emotional abuse by caregivers (23.0%) and to sexual (13.9%) and electronic (17.6%) victimization during their lifetime. Age differences obtained in victimization rates for the past year confirmed that peer and sibling victimization peak in early adolescence (33.9%). Witnessing community violence was more frequent in older adolescents (34.7%). Almost 20% of the sample were considered as polyvictims (i.e., experienced victimization in 7 or more forms of victimization). Adolescent polyvictims experienced victimization in 4 or more domains during their lifetime. This study adds new information on the epidemiology of victimization in the international context and is the first to do so from the perspective of a country in south-western Europe. It illustrates that Spanish youth experience a higher level of victimization than official records suggest, and that gender and age should be taken into account when analyzing this complex area of study.     

Correlates of disclosure of sexual violence among Kenyan youth

IntroductionSexual violence (SV) against children is a global health and human rights issue that can have short and long-term consequences for health and wellbeing. Disclosing SV increases the likelihood that children can access health and protective services and receive psychosocial support. Research in high-income countries has found that child SV survivors are more likely to disclose when they are girls/women, experience fewer SV events, and experience SV perpetrated by a stranger. No studies have examined correlates of SV disclosure in Kenya.ObjectiveThe objective of this research was to assess the correlates of disclosing SV among Kenyan youth ages 13–24 who reported an SV experience before age 18.MethodsIn 2010, the Kenya Ministry of Gender, Children and Social Development, the U.S. Centers for Disease Control and Prevention’s (CDC) Division of Violence Prevention, the UNICEF Kenya Country Office, and the Kenya National Bureau of Statistics (KNBS) conducted a national survey of violence against children. These data were used to conduct weighted logistic regression analyses to determine which factors were correlated with reporting SV disclosure.ResultsAmong the 27.8% of girls/women and 14.5% of boys/men who reported SV before age 18, 44.6% of girls/women and 28.2% of boys/men reported to have disclosed the experience. In weighted logistic regression analysis, the odds of disclosure were lower among survivors who were boys/men and among survivors who reported more SV events, and higher when any perpetrator was a family member.ConclusionMore context-specific research on SV disclosure among young people is needed globally.     

The contribution of childhood emotional abuse to teen dating violence among child protective services-involved youth

ObjectiveFor child protective services (CPS) youth who may have experienced more than one form of maltreatment, the unique contribution of emotional abuse may be over-looked when other forms are more salient and more clearly outside of accepted social norms for parenting. This study considers the unique predictive value of childhood emotional abuse for understanding adolescent post-traumatic stress disorder (PTSD) symptomatology and dating violence. Further, PTSD symptomatology is assessed as an explanatory bridge in the emotional abuse—teen dating violence link.MethodsA random sample of 402 youth from the active caseload of a large urban CPS catchment area participated as part of a larger longitudinal study on adolescent health behaviors. Mid-adolescent youth across types of CPS status were targeted. CPS youth reported on lifetime maltreatment experiences, PTSD symptomatology, and past year dating experiences, using published scales.ResultsOver 85% of CPS youth had begun dating. For dating youth, some level of dating violence was common: over half of females (63–67%) and nearly half of males (44–49%). Taking into account other forms of maltreatment, emotional abuse emerged as a significant predictor of both PTSD symptomatology and dating violence among males and females. PTSD symptomatology was a significant mediator of the male emotional abuse-perpetration and the female emotional/physical abuse-victimization links, indicating a gendered patterning to findings.ConclusionsThese results indicate that: (1) CPS youth are a high priority group for dating violence and PTSD-linked intervention; and (2) CPS youth continue to experience the unique negative impact of childhood emotional abuse in their adolescent adjustment. All CPS children should be evaluated for emotional abuse incurred, and appropriate intervention attention be given as to how it specifically impacts on the child's approach to relating to themselves and to others.Practice implicationsThe present study directs practice implications in regards to: (1) the problem of teen dating violence, (2) the salience of childhood emotional abuse; and (3) the importance of targeting PTSD symptomatolgy among CPS youth. A substantial number of CPS youth report early engagement in violent romantic relationships and require support towards attaining the non-coercive relationship experiences of their non-CPS-involved age mates. The topic of dating, healthy dating relationships, and dating violence may need to be part of the regular casework, with a view towards supporting youths’ conceptualization of and skill set for healthy, close relationships. Further, this knowledge needs to be translated to foster parents and group home staff. With regard to the impact of childhood emotional abuse, CPS workers need to be sensitive to its potential for long-term, unique impact impairing relationship development. Emotional abuse is (a) unique among genders (i.e., for females, it clusters with physical abuse) and (b) uniquely predictive of PTSD symptoms and dating violence. Finally, as is consistent with theory and biopsychosocial evidence, PTSD symptomatology is a key causal candidate for understanding maltreatment-related impairment. Attention to targeting PTSD symptoms may be preventative for dating violence; attention to targeting emotional abuse experiences may be preventative for PTSD symptoms. CPS youth are an important population to involve in research, as their inclusion adds to the evidence-base to achieve evidence-informed practice and policy within child welfare.     

Developmental timing of polyvictimization: Continuity,change, and association with adverse outcomes in adolescence

Children who experience polyvictimization (i.e., exposure to multiple and varied traumatic stressors) are at heightened risk for psychopathology. While polyvictims generally have worse outcomes than those with fewer types of traumatic experiences, not all polyvictims experience significant, or similar, impairment suggesting that polyvictims are a heterogeneous group. This variation in outcomes among polyvictimized children, may be due to differences in how polyvictimization is operationalized and measured. The current study examines a clinically-referred sample of adolescents (N = 3754) aged 13–18 (M = 15.3, SD = 1.4) to examine whether polyvictimization in early developmental age periods predict polyvictimization in later periods and whether there are differences in severity of adolescent psychopathology based on variations in timing of polyvictimization in childhood and adolescence. Results from latent class analysis (LCA) reveal the greater the number of developmental periods in which adolescents were classified as polyvictims, the greater the severity of PTSD, externalizing problems, and internalizing problems. In addition, there was variation in the relation between developmental timing of polyvictimization and different types of adolescent psychopathology.     

Food for Education in Honduras: Psychosocial correlates of childhood literacy

School feeding programs in low- and middle-income countries tend to focus on school attendance and literacy. Some evidence suggests that bolstering schools as a nexus of community plays an important psychosocial function for children and families. This study examines the extent to which childhood literacy rates are associated with parents’ and teachers’ perceptions of community violence and cohesion, following participation in a large-scale school feeding program in the Department of Intibucá, Honduras. Primary school children (n = 3,147) from 176 schools completed standardized literacy tests. Scores were linked to parents’ (n = 328) and teachers’ (n = 537) responses about community cohesion and violence. Social bonding among parents was positively associated with children’s literacy. Community violence reported by teachers exerted a negative influence. The authors discuss these results in light of how vertically focused interventions such as school feeding can be integrated to account for the specific contextual factors that affect, and are affected by, the program itself.     

Conditional and indirect effects of age of first exposure on PTSD symptoms

Childhood violence exposure (CVE) in formative developmental years may have potent effects on severity and complexity of post-traumatic stress symptoms (PTSS) in adulthood, yet little research has examined the role of age of first exposure in the context of polyvictimization or gone beyond an examination of direct effects. The current study examines the specific associations between age of first exposure, total CVE, and posttraumatic stress symptoms in adulthood. Further, the conditional and indirect effects of age of first exposure on posttraumatic stress symptoms were examined. We hypothesized that age of first exposure to violence would be associated with higher total violence exposure across childhood, thereby predicting current posttraumatic stress symptom severity (i.e., indirect effect). We also postulated that age of first exposure would affect the relationship between total violence exposure and posttraumatic stress symptoms such that earlier exposure would exacerbate the effects of violence exposure (i.e., conditional effect). Participants included 269 violence-exposed adults recruited through MTurk; the mean age of first CVE was 6 years (SD = 3.29). Conditional process models indicated that age of first exposure was significantly associated with higher total childhood violence exposure, which in turn, was significantly associated with current posttraumatic stress symptoms in all domains. Further, a conditional effect of age of first exposure was present such that the relationship between total exposure to violence and symptoms of hyperarousal was stronger for those first exposed at earlier ages. Findings provide support suggesting the particular potency of early trauma on regulatory response systems.     

Predicting the use of single versus multiple types of violence towards children in a representative sample of Quebec families

OBJECTIVE: The purpose of this study is to determine which factors best predict parental use of single versus multiple types of violence. METHODOLOGY: The study uses data from a Quebec telephone survey conducted with a representative sample of 2,469 mothers of children aged 0-17 years. The interview covered topics such as mother's attitudes and reports of violence towards children, mother's experiences of childhood violence, level of marital discord, and socioeconomic factors. A discriminant function analysis was performed using individual and family factors to predict membership in five distinct groups: (a) no violence reported; (b) reports of psychological aggression only; (c) reports of minor physical violence only; (d) reports of psychological aggression and minor physical violence; and (e) reports of psychological aggression, minor and severe physical violence. RESULTS: One-way ANOVAs revealed that the groups differed significantly on factors such as child's age and gender, mother's attitudes, mother's experiences of childhood violence, level of marital discord, and number of children in the household. Discriminant function analysis revealed that the groups differed in two ways. The first function maximally separated the report of psychological aggression from minor physical violence only. The second function discriminated between the combined reports of all three types of violence versus the reports of minor physical violence only. Mother's attitudes and experiences of childhood violence were the two factors that best distinguished among groups and best predicted group membership. CONCLUSION: These results offer new insights for the prediction of mother's reports of one type versus multiple types of violence and highlight the importance of distinguishing between types and combinations of family violence in future research.     

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.     

Examining the intergenerational transmission of violence in a New Zealand birth cohort

OBJECTIVE: This paper examines whether exposure to interparental violence in childhood predicts subsequent involvement in interpartner violence and violent crime after controlling for potentially confounding factors. METHOD: The investigation analyses data from the Christchurch Health and Development Study, a prospective, longitudinal study of a birth cohort of over 1000 New Zealand young adults studied at multiple assessment points from birth to the age of 25. RESULTS: After controlling for potentially confounding risk factors, observed associations between exposure to interparental violence in childhood and increased risks of both (a) psychological interpartner violence perpetration and victimization and (b) violent crime, were reduced to statistical non-significance. No statistically significant associations were observed between exposure to interparental violence in childhood and increased risk of physical interpartner violence perpetration or victimization. CONCLUSIONS: It is concluded that the effects of childhood exposure to interparental violence on subsequent interpartner violence are weak and largely explained by the psychosocial context within which childhood exposure to interparental violence occurs.     

Violence among family members of children and adolescents evaluated for sexual abuse

OBJECTIVES: The two aims of this study were to: (1). describe the prevalence and characteristics of domestic adult and child physical violence in the homes of children and adolescents evaluated in a specialized sexual abuse clinic and (2). describe parent or caretaker responses to domestic adult and child violence and child sexual abuse, including tendencies to report or seek medical care. METHOD: A consecutive sample of 164 subjects (ages 7-19) were interviewed in a sexual abuse clinic regarding in-home violent or abusive experiences among family members that had occurred at any time during their childhood. RESULTS: Fifty-two percent of these children and teenagers reported spousal violence in their home. Fifty-eight percent of child sexual offenders who were in-home males also physically abused their adult female partner. Half of in-home males who were physically violent to children also sexually abused them. In 86% of homes with partner violence, the children were also physically assaulted. There was no difference in sexual abuse disclosure rates or patterns for children living with or without adult violence. CONCLUSIONS: Sexually abused children should be questioned about physical abuse and the presence of violence among adults in their home. Safety plans for sexually abused children should incorporate screening for family violence and safety plans for parents and siblings of child victims, when appropriate.     

The environment of poverty: multiple stressor exposure,psychophysiological stress,and socioemotional adjustment

The one in five children growing up in poverty in America have elevated risk for socioemotional difficulties. One contributing factor to their elevated risk may be exposure to multiple physical and psychosocial stressors. This study demonstrated that 8- to 10-year-old, low-income, rural children (N = 287) confront a wider array of multiple physical (substandard housing, noise, crowding) and psychosocial (family turmoil, early childhood separation, community violence) stressors than do their middle-income counterparts. Prior research on self-reported distress among inner-city minority children is replicated and extended among low-income, rural White children with evidence of higher levels of self- and parent-reported psychological distress, greater difficulties in self-regulatory behavior (delayed gratification), and elevated psychophysiological stress (resting blood pressure, overnight neuroendocrine hormones). Preliminary mediational analyses with cross-sectional data suggest that cumulative stressor exposure may partially account for the well-documented, elevated risk of socioemotional difficulties accompanying poverty.