Linking childhood sexual abuse and abusive parenting: the mediating role of maternal anger

OBJECTIVE: This study had two primary objectives: First, to examine the association between childhood sexual abuse (CSA) and later parenting characteristics, particularly physical abuse potential, and second, to explore maternal anger as a mediator of the relationship between CSA and adult physical abuse potential. METHOD: Utilized a community sample of low SES participants that included 138 mothers classified as having experienced CSA, and a comparison group of 152 non-sexually abused mothers. Parenting variables examined included the mothers' physical abuse potential, nurturance toward their children, unrealistic developmental expectations of children, as well as frequencies of spanking and general punishment. Data was collected via interview and other self-report measures. RESULTS: Even after controlling for mothers' childhood experience of Physical abuse, CSA significantly predicted adult risk of physically abusing one's own children. Further, maternal anger was confirmed as a mediator of the relationship between having been sexually abused as a child and the potential for physically abusing one's own children. CONCLUSIONS: CSA may be a risk factor for subsequent physically abusive parenting, while anger appears to play a significant role in mediating this relationship. Findings are discussed in the context of current knowledge concerning the impact of child sexual abuse and the processes contributing to abusive parenting.     

Current understanding about intergenerational transmission of child sexual abuse

OBJECTIVE: The aim of this article is to review what is currently understood about intergenerational transmission of child sexual abuse (CSA). METHOD: CSA transmission is discussed first from the point of view of men CSA survivors who become sexually abusive, and then from the perspective of mothers who survived CSA whose children have been sexually abused. Mechanisms that may help us understand how CSA is transmitted from one generation to another are described. More specifically, focus is given to those mechanisms that might differentiate CSA survivors who break the cycle of abuse from those who perpetuate it. RESULTS: In light of the research reviewed, it seems that the transmission of CSA is far from inevitable, since one-third of sexually abusive men and half of sexually abused children's mothers mentioned having been sexually abused in their childhood. Because of the retrospective method used in many studies, causal links could not be established. However, some mechanisms have been proposed in order to better understand the phenomenon of CSA. Severity of abuse, attachment relationships with parental figures, as well as dissociative symptoms that follow the abuse were identified. Dissociative symptomatology appeared to be a determining factor in understanding the cycle of CSA. CONCLUSIONS: More studies on CSA transmission are needed to understand the mechanisms that are involved in that cycle, as well as to develop effective strategies to treat and prevent CSA.     

Mothers' protection of their children after discovering they have been sexually abused: an information-processing perspective

OBJECTIVE: The purpose of this study was to understand why some non-offending mothers did not protect their children consistently after they knew they were sexually abused. METHODS: The sample included 85 mothers who were involved with child protective services: 48 mothers who protected their children consistently were compared to 37 mothers who did not. RESULTS: Several variables explained 47% of the variance in the multivariate analysis. If the mother did not ask the abuser whether the abuse occurred, attributed responsibility to the abuser, believed consistently that the abuse occurred, and was not a victim of domestic violence, then she was more likely to protect her child consistently. CONCLUSIONS: Some maternal characteristics believed to affect protectiveness, such as mothers' mental health and substance abuse, were not related to whether they protected their children consistently, whereas other variables, such as domestic violence, were. Researchers need to continue to examine these and other variables simultaneously, so that practitioners can better understand which children are most likely to receive inadequate protection. PRACTICE IMPLICATIONS: Practitioners should ask mothers whether they believe the abusers' behavior was sexual and abusive. If mothers do not perceive sexual abuse, then they will not believe abuse occurred or attribute responsibility to the abusers. Helping mothers understand the nature of sexual abuse may change their beliefs and attributions. If the abuser is the mother's partner and he has physically assaulted her, practitioners need to assess her willingness and ability, with adequate services and support, to restrict his access to her child.     

Child peer sexual abuse: preliminary data on outcomes and disclosure experiences

OBJECTIVE: This study compared experiences of children sexually abused by peers to those of children abused by adolescents/adults. Variables examined included perceived negativity of the abuse, self-reported outcomes, overall psychological functioning, and disclosure. METHOD: An archival data set containing retrospective reports of childhood sexual experiences was culled for instances of sexual abuse by child peers and adolescents/adults. An equivalent nonabused comparison group was identified. The Self-Report Outcome Checklist (SROC; Gilbert, 1994b), the MMPI-Hugo Short Form (Hugo, 1971) and a disclosure survey were also retrieved from these data. RESULTS: Compared to abuse by peers, abuse perpetrated by adolescents/adults was more intrusive and intrafamilial. Both groups rated their experiences as equally negative, and reported equally pervasive outcomes. Those abused by adolescents/adults reported significantly higher scores on the Psychopathic Deviate, Psychasthenia, and Schizophrenia scales compared to nonabused controls; similar findings did not emerge for those abused by child peers. Less than a fourth in either abuse group reported disclosing their experience to a parent. Among those who did not disclose, participants abused by child peers anticipated less support from both parents and more anger from their mothers. CONCLUSIONS: The findings suggest that child peer sexual abuse may be associated with adverse outcomes.     

Prior incest in mothers of abused children

Previous studies have shown that most abusing parents have a history of physical abuse or neglect in their own childhoods. There is little data on the frequency of prior sexual abuse among parents who physically or sexually abuse their children. Many case reports describe the uncovering of a prior incest experience in a parent during the investigation of the child's current incest accusation, but it is unclear how frequently this occurs. One hundred mothers of abused children were asked about sexual incidents that occurred before age 18; the control group consisted of 500 normal women from the same community who were surveyed during meetings of various voluntary organizations. Age and ethnicity did not differ in the two groups. Of the mothers of abused children, 24% reported a prior incest experience, whereas only 3% of the control women reported prior incest. This eightfold difference was highly significant. The 34 mothers from families where sexual abuse was occurring were no more likely to report prior incest than were the 66 mothers from families where physical abuse occurred. The one case of genital mutilation of a child occurred in a family where both parents had been incest victims. Case studies indicate that the parent who has been an incest victim has inhibitions and fears about tenderness, traceable to the childhood incest experience, which are important in the development of either physical abuse or sexual abuse in the family.     

Breaking the cycle of abuse

The aim of this study was to identify variables that distinguish mothers who broke the cycle of abuse from mothers who were abused as children and who also abused their own children. Based on maternal interviews and questionnaires completed over a 64-month period, measures of mothers' past and current relationship experiences, stressful life events, and personality characteristics were obtained. Abused mothers who were able to break the abusive cycle were significantly more likely to have received emotional support from a nonabusive adult during childhood, participated in therapy during any period of their lives, and to have had a nonabusive and more stable, emotionally supportive, and satisfying relationship with a mate. Abused mothers who reenacted their maltreatment with their own children experienced significantly more life stress and were more anxious, dependent, immature, and depressed.     

Predictors of treatment outcome in sexually abused children

PROBLEM: This study evaluated the impact of child and family characteristics on treatment outcome of sexually abused children. METHOD: Forty-nine recently sexually abused 7- to 14-year-old children were randomly assigned to either abuse-focused cognitive behavioral therapy or nondirective supportive therapy, and assessed pre- and post-treatment using several standardized instruments. These included five measures of psychological symptomatology and four measures of child and family characteristics hypothesized to mediate treatment response. Correlational and multiple regression analyses were utilized to evaluate the impact of the following mediating factors on treatment outcome: Children's abuse-related attributions and perceptions; family cohesion and adaptability; parental support of the child; and parental emotional reaction to the child's abuse. RESULTS: Children's abuse-related attributions and perceptions and parental support of the child were strong predictors of treatment outcome in this population. CONCLUSIONS: Therapeutic attention to children's sexual abuse-related attributions and to enhancing parental support may be important factors in optimizing treatment outcome in 8- to 14-year-old sexually abused children.     

Child sexual abuse: who goes home?

The purpose of this study was to ascertain the factors which influence custody change in cases of children who have been sexually abused. Of 180 children admitted to La Rabida Children's Hospital and Research center with a suspicion of having been sexually abused, 138 met the state's criteria for proven sexual abuse, and 30% of those children had a sexually transmitted disease. One-third of the children with proven abuse were under 4 years of age. Of the children with proven abuse, ultimately 40% had a custody change. Only an initial outcry of abuse was associated with an increased probability of a change in custody. A change in custody was not found to be related to the patient's age, sex, the perpetrator's relation to the child or access to the home, the presence of sexually transmitted disease, whether the child was also physically abused, or whether the child had had developmental delay. These data suggest an absence of any discernible guidelines in the juvenile court's decision concerning custody change of a sexually abused child.     

Depression and suicidal ideation in sexually abused children

Sixty-five sexually abused children were administered the Children's Depression Inventory (CDI) following investigation of their abuse to determine the relationship of victims' depression and suicidal ideation with victims' age, post-investigation residence, nature of the abuse, and mothers' belief of victim and compliance with treatment recommendations. Results indicated that older victims were more likely to describe themselves as being depressed. In addition, older victims and those whose mothers were less compliant were more likely to have CDI scores that were above the 90th percentile reported by Smucker, Craighead, Craighead, and Green (1986). Suicidal ideation was more likely in victims who were older, whose mothers were less compliant, who were not removed from their homes, and who had been molested by a family member.     

Maternal Autonomy Granting: Predictors of Normal and Depressed Mothers'' Compliance and Noncompliance with the Requests of Five-Year-Olds

Maternal compliance and noncompliance to child requests, thought to represent an autonomy-granting aspect of socialization, were studied in 24 well mothers and 26 mothers with a history of depression and their 5-year-old children. Mothers continued to retain substantially more power than children in the control process. There were no differences between normal and depressed mothers in the extent to which they granted or denied their children's requests, but the determinants of maternal autonomy granting differed in the 2 groups. Depressed, but not well, mothers' responses to child requests could be predicted from their self-reported mood prior to the interaction and from the concurrent child's behavior. Depressed mothers who reported negative mood and whose children were uncooperative most often denied their requests. Depressed mothers' noncompliance to their children's requests was determined by the quantity rather than quality of their children's behavior: they did not discriminate between skillful and unskillful forms of the children's autonomy expressions.     

Outcome of abuse during childhood among pregnant low income women

The outcome of experiencing abuse as a child was studied by comparing pregnant women who did recall versus those who did not recall this type of maltreatment. Fourteen hundred low income women were interviewed in prenatal clinic; those who said they were both punished by abuse and beaten by caretakers as children were considered abused. Abuse was recalled by more white than black women but families were followed after delivery and protective service reports of abuse for their offspring were equal. Because of low numbers, black subjects were dropped and the 95 white women who recalled abuse during childhood were compared to the remaining 832 white subjects. The groups did not differ in attitude about current pregnancy, age or marital status, and no differences were found for their children at birth. Abused mothers were more likely to have felt unwanted and unloved as children and to have lower self-images and more isolation than controls. Abused mothers had greater stress, and many of their stresses reflected disturbances in interpersonal relationships. Thus, women abused as children had some characteristics similar to those of known child abusers. Although abused women had more aggressive tendencies, their children were reported to protective services for abuse at the same frequency as control children. Intergenerational transmission of abuse was therefore not demonstrated prospectively. Classic theories of child abuse suggest a special child, special parent and stress act as independent agents to cause abuse. The above data suggest, alternatively, that abuse during childhood may lead to other risk characteristics and to greater stress. These may act together to increase risk for abuse. The special child may have an independent influence on abuse.     

Nearly 4 years after an event: children's eyewitness memory and adults' perceptions of children's accuracy

OBJECTIVE: The current study examined children's eyewitness memory nearly 4 years after an event and the ability of adults to evaluate such memory. METHOD: In Phase 1, 7- and 10-year olds were interviewed about a past event after a nearly 4-year delay. The interview included leading questions relevant to child abuse as well as statements designed to implicate the original confederate. In Phase 2, laypersons and professionals watched a videotaped interview (from Phase 1) that they were misled to believe was from an ongoing abuse investigation. Respondents then rated the child's accuracy and credibility, and the probability that the child had been abused. RESULTS: In Phase 1, few significant age differences in memory accuracy were found, perhaps owing in part to small sample size. Although children made a variety of commission errors, none claimed outright to have been abused. Nevertheless, some of the children's answers (e.g., saying that their picture had been taken, or that they had been in a bathtub) might cause concern in a forensic setting. In Phase 2, professional and nonprofessional respondents were unable to reliably estimate the overall accuracy of children's statements. However, respondents were able to reasonably estimate the accuracy of children's answers to abuse questions. Respondents were also more likely to think that 7-year olds compared to 10-year olds had been abused. Professionals were significantly less likely than nonprofessionals to believe that credible evidence of abuse existed. Professionals who indicated personal experience with child abuse or a close relationship with an abuse victim were more likely to rate children as abused. A gender bias to rate boys as more accurate than girls was apparent among laypersons but not professionals. CONCLUSIONS: Children were generally resistant to suggestions that abuse occurred during a long-ago generally forgotten event, but some potentially concerning errors were made. Both professionals and non-professionals had difficulty estimating the accuracy of children's reports, but adults were more likely to rate children as accurate if the children answered abuse-related questions correctly. Training and personal experience were associated with adults' ratings of children's reports. Implications for evaluations of child abuse reports are discussed.     

The factors of child physical abuse in Korean immigrant families

OBJECTIVE: This study explores Korean immigrant mothers' attitudes toward child physical abuse based on an ecological perspective. METHOD: One hundred and forty-four Korean immigrant mothers who came to the US after age 16 and have at least one child under 18 years old participated in this study. Data were collected using instruments translated in Korean that measure mothers' attitudes toward child physical abuse in four areas: degree of agreement with physical abuse, conflict tactics, belief in the use of physical punishment, and perceptions regarding physical abuse. RESULTS: This study found that the following variables affect Korean immigrant mothers' attitudes toward child physical abuse at ecological levels of the environment: amount of time spent with children, experience of corporal punishment as a child, children's gender and age, family acculturation conflicts, mothers' age, and length of time in US at the micro level; involvement in their children's school and involvement in social organizations at the meso level; level of education and reported stress of immigrant life at the exo level; value of children in Korean culture, familiarity with Child Protective Services (CPS), perceived discrimination, and value of corporal punishment at the macro level. CONCLUSIONS: This study suggests the importance of cultural sensitivity in social work practice when working with Korean immigrants. It also implies that intervention and prevention efforts of child abuse should be targeted at more than one level of the environment.     

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.     

A longitudinal analysis of maternal abuse potential and developmental delays in children of adolescent mothers.

OBJECTIVE: This project was designed to examine the impact of adolescent mothers' abuse potential on the development of preschool children. The specific aims were to demonstrate relationships between maternal abuse potential and developmental problems in preschool children, to examine these relationships across time, and to determine whether maternal abuse potential predicted developmental delays after controlling for problematic parenting orientations. METHOD: Using a longitudinal design, we examined 146 first time mothers and their children. Maternal abuse potential was assessed when children were 1, 3, and 5 years old; problematic parenting orientation was assessed when the children were 6 months old; and child development (i.e., IQ, adaptive behavior, and behavior problems) was assessed at ages 3 and 5. RESULTS: Regression analyses revealed significant relationships between maternal abuse potential and a variety of developmental problems. Path analyses revealed unidirectional relationships between abuse potential predicting IQ and adaptive behaviors. Further analyses indicated that maternal abuse potential at 1 and 3 years predicted intelligence and adaptive behavior at ages 3 and 5, even when problematic parenting orientation was controlled. In contrast, children's behavioral problems at ages 3 and 5 was better accounted for by problematic parenting orientation than by abuse potential. CONCLUSIONS: The results of this study revealed that developmental delays in children of adolescent are related to abuse potential. Two pathways were found for predicting developmental delays: One pathway linked child abuse potential with IQ and adaptive functioning: the other pathway showed that problematic parenting orientation accounted for the development of emotional and behavioral problems.     

Further abuse of sexually abused children

OBJECTIVE: To determine the incidence of re-abuse in children known to have been sexually abused and to find factors that increase the risk of re-abuse. METHOD: The study group consisted of 183 children with substantiated sexual abuse who presented to two children's hospitals' Child Protection Units in Sydney, Australia during 1988 through 1990. At intake, when the children were aged between 5 years and 15 years, data about the child, the family, and the nature of the index sexual abuse were collected. Six years after presentation for the abuse, records of the Department of Community Services were checked to see if any of the young people had been the subject of substantiated notifications for abuse/neglect before and after intake to the study. Predictors of notifications for abuse/neglect after presentation for the index sexual abuse were identified. RESULTS: Of the sexually abused young people, nearly one in three were the subject of subsequent substantiated notifications to the Department of Community Services for some form of child abuse and neglect or behavior which placed them at risk of harm. Later notifications for abuse/neglect were predicted by notifications for emotional abuse before the index sexual abuse (adjusted RR = 4.88, CI: 1.43 to 16.65), severity of the index sexual abuse (p = .03), and the number of changes in the child's primary caregivers before intake (p = .03). Approximately one in six of the sexually abused young people were notified for sexual abuse after intake to the study. One in 10 also had prior notifications for sexual abuse. Sexual abuse notifications after study intake were predicted by caregiver changes before intake (p = .01) and whether or not there were notifications for emotional abuse before the index sexual abuse (adjusted RR = 3.40, CI: 1.05 to 11.02). CONCLUSIONS: Revictimization of children appears to be a marker of ongoing family dysfunction. Intervention in child sexual abuse needs to consider a range of risk factors associated with re-abuse and, in particular, should focus on family functioning if further abuse is to be prevented.     

Coping with sexual abuse: development and evaluation of a videotape intervention for nonoffending parents

OBJECTIVE: The aims of the study were: (1) to develop, apply, and evaluate a videotape intervention that targeted the development of supportive behaviors in mothers of children who were being examined because of suspected molestation; and (2) to examine the relationship between mothers' reported responses to and beliefs about the molestation and their children's perceptions of support. METHOD: Mothers (N = 87) who had children 4 to 12 years of age were recruited and randomly assigned to view either a treatment or control videotape during the time when their child was being examined. Observers who were blinded to this assignment observed and rated parent-child interactions in the waiting room prior to and again after the mothers viewed the videotape. One week after this brief intervention, 64 of the mothers and 30 of the children (8- to 12-years-old) were interviewed. RESULTS: Mothers who viewed the treatment tape were more likely to engage in supportive behaviors with their child immediately after viewing the tape, and were able to identify more supportive behaviors at the 1-week followup. In addition, mothers' reports of how they responded to the molestation (including perceived blame) was related to child perceptions of parental support. CONCLUSIONS: The findings indicate that children who have been sexually molested are sensitive to the initial reactions of their nonoffending parent to the disclosure. In addition, there is some evidence that we can design and deliver cost-effective interventions during the early disclosure period that promote more positive (or supportive) responses by the nonoffending parent.     

Child abuse: A study of the child''s perspective

This study ascertained the child's response to various types of abuse and neglect. With interviews and questionnaires for the staff of a child psychiatric unit, the mothers and the children involved, we assessed the severity, frequency and duration of physical abuse, verbal abuse, physical neglect, emotional neglect or sexual abuse of children. The physically abused children accepted blame for mild but not severe mistreatment. Verbally and sexually abused children did not believe it was their fault if the mistreatment was moderately extensive but did if it was mild or severe. The relationship between extent of abuse and blame was less clear for neglect, but children usually though it was their fault. Verbal and sexual abuse appeared to have a greater impact on the children's perception of themselves and the world. Verbally abused children were more angry and more pessimistic about their future. Although physical abuse appeared to make some children feel they were unwanted at birth, how much the mother wanted her children was not related to the extent of any type of abuse. Both the type and extent of mistreatment appear to have different effects on the child's subjective experience. The use of the visual analogue scale in this study made it possible to differentiate a continuum of severity and frequency of five types of mistreatment without the need for definition.