Alleged sexual abuse at a day care center: impact on parents

OBJECTIVE: This report describes the cascade of stressful events and secondary life changes experienced by parents in a case of alleged sexual abuse at a day care program. The study evaluated parents' Posttraumatic Stress Disorder (PTSD) symptoms and general psychological responses to the stressful events 4 years after the alleged abuse, and explored predictive factors of parental distress. METHODS: A total of 39 parents were interviewed about stressful events, life changes, and social support. Current distress reactions, psychological wellbeing, and locus of control were assessed with a battery of standardized measures. RESULTS: Hearing about the sexual abuse, testifying in court, hearing the verdict, and being exposed in media reports were all rated by the parents as distressing events. The majority of the parents experienced secondary life changes after the alleged sexual abuse. Four years after the alleged sexual abuse, one-third of the parents reported a high level of PTSD Intrusive symptoms and one-fourth reported a high level of PTSD Avoidance symptoms. There was a significant positive correlation between a measure of psychological wellbeing and PTSD. Secondary life changes and locus of control significantly predicted PTSD. CONCLUSION: This study demonstrates that the alleged sexual abuse of children in day care and the resulting events in the legal system and the media constitute significant and chronic stressors in the lives of the children's parents. These findings underscore the need to expand the focus of trauma-related sequelae from the child victim to their parents and family.     

Dispositional empathy in high- and low-risk parents for child physical abuse

OBJECTIVE: The present study was designed to investigate dispositional empathy in high-risk parents for child physical abuse, using self-report instruments. More specifically, the objective was to know if high-risk parents for child physical abuse, in comparison with low-risk parents, show deficits on main dimensions of dispositional empathy: empathic concern, role-taking, and personal distress. METHOD: Based on their scores on the Abuse Scale of the CAP Inventory (Milner, 1986), 36 high-risk and 38 low-risk for child physical abuse participants were selected from a total sample of 440 Basque Country (Spain) general population parents. Both groups were statistically matched on sociodemographic variables. The Interpersonal Reactivity Index (IRI, Davis, 1980), the Hogan Empathy Scale (HES, Hogan, 1969) and the Questionnaire Measure of Emotional Empathy (QMEE, Mehrabian & Epstein, 1972) were used to assess dispositional empathy. RESULTS: As expected, high-risk, relative to low-risk, parents showed lower total scores on the HES and QMEE measures and lower scores on the IRI "Empathic concern" dimension. Moreover, high-risk, relative to low-risk, parents showed higher scores on the IRI "Personal distress" dimension. No differences between groups were observed for the IRI "Perspective-taking" dimension. CONCLUSIONS: Findings of the present study supported the hypothesis that high-risk parents for child physical abuse show a deficit in dispositional empathy. High-risk parents reported less feelings of warmth, compassion and concern for others and more feelings of anxiety and discomfort that result from observing another's negative experience.     

Gender differences in empathy in parents at high- and low-risk of child physical abuse

OBJECTIVES: The present research was designed to study empathy in high-risk parents for child physical abuse. The main objective was to study if high-risk mothers and fathers, compared to low-risk mothers and fathers, presented more Personal distress, less Perspective-taking, less Empathic concern and a deficit in dispositional empathy toward their partner and children. METHOD: Based on their scores on the Abuse Scale of the CAP Inventory [J.S. Milner, The Child Abuse Potential Inventory: Manual, 2nd ed., Psytec Corporation, Webster, NC], 19 (9 fathers and 10 mothers) high- and 26 (12 fathers and 14 mothers) low-risk parents for child physical abuse were selected from a total sample of 331 parents of the Spanish general population. Both groups were statistically matched on sociodemographic variables. The Interpersonal Reactivity Index (IRI) [Catalog of Selected Documents in Psychology 10 (1980) 85] and the Parent/Partner Empathy Scale (PPES) [N.D. Feshbach, N. Caskey, A new scale for measuring parent empathy and partner empathy: factorial structure, correlates and clinical discrimination, 1985] were used to assess dispositional empathy. RESULTS: An interaction between risk status and gender for Personal distress and Perspective-taking was found. High-risk mothers for child physical abuse showed more Personal distress than low-risk mothers and low-risk fathers. High-risk fathers for child physical abuse showed less Perspective-taking than low-risk mothers and low-risk fathers. No difference between both groups was found for the IRI Empathic concern dimension. Moreover, high-risk, compared to low-risk, parents showed lower scores both on the Empathy toward the partner and on the Empathy toward the child dimensions of the PPES. No interaction between risk status and gender was found for the PPES dimensions. CONCLUSIONS: Findings of the present study supported the hypothesis that high-risk parents for child physical abuse show a deficit both in general empathy and in empathy toward their family members. Moreover, findings suggested the existence of a different pattern of deficits in empathy for high-risk fathers and high-risk mothers.     

Emotion recognition ability in mothers at high and low risk for child physical abuse

OBJECTIVE: The study sought to determine if high-risk, compared to low-risk, mothers make more emotion recognition errors when they attempt to recognize emotions in children and adults. METHOD: Thirty-two demographically matched high-risk (n = 16) and low-risk (n = 16) mothers were asked to identify different emotions expressed by children and adults. Sets of high- and low-intensity, visual and auditory emotions were presented. Mothers also completed measures of stress, depression, and ego-strength. RESULTS: High-risk, compared to low-risk, mothers showed a tendency to make more errors on the visual and auditory emotion recognition tasks, with a trend toward more errors on the low-intensity, visual stimuli. However, the observed trends were not significant. Only a post-hoc test of error rates across all stimuli indicated that high-risk, compared to low-risk, mothers made significantly more emotion recognition errors. Although situational stress differences were not found, high-risk mothers reported significantly higher levels of general parenting stress and depression and lower levels of ego-strength. CONCLUSIONS: Since only trends and a significant post hoc finding of more overall emotion recognition errors in high-risk mothers were observed, additional research is needed to determine if high-risk mothers have emotion recognition deficits that may impact parent-child interactions. As in prior research, the study found that high-risk mothers reported more parenting stress and depression and less ego-strength.     

Effects of infant cries on alcohol consumption in college males at risk for child abuse

This analog study examines the effect of hearing a child's cries on alcohol consumption, comprising one link in a possible association between drinking and child abuse. Thirty-two male undergraduate volunteers were preselected by age, drinking practices, and abuse potential. Subjects were assigned to either a high or low abuse potential group and were then randomly assigned to hear either an infant cry or a smoke alarm. Blood pressure was measured during each of three stimulus presentations. Following each presentation, the subject was asked to rate the stimulus on a number of different dimensions (e.g., soothing-arousing). Additionally all subjects participated in a subsequent taste-rating task as an unobtrusive measure of alcohol consumption. The results indicate that, regardless of risk group, subjects who listened to the infant cry consumed significantly more alcohol (M = 206 ml, SD = 126.43) during the taste-rating task than did those who heard only the smoke alarm (Mr = 95.68 ml, SD = 62.94) which was also rated as aversive. There was no relationship between abuse potential and alcohol consumption. Although diastolic blood pressure did not differ between groups, analysis of the infant rating scales revealed that, regardless of risk group, subjects who heard the infant cry reported feeling more aversion, arousal, and distress, than did those who heard the smoke alarm. These results lend additional support to studies depicting the infant cry as a stressful and aversive event, capable of eliciting increased drinking. Implications for arousal reduction by alcohol and a model of alcohol-induced child abuse are discussed.     

Interpretations of child compliance in individuals at high- and low-risk for child physical abuse

OBJECTIVE: Our studies compared individuals at high- and low-risk for child physical abuse on measures of social information processing. METHOD: Two studies were conducted using similar methods. Twenty-eight childless women in Study 1 and 36 mothers in Study 2 read vignettes of parent-child interactions in which the child's level of compliance was difficult to interpret. Participants were asked a series of questions about the child's behavior and their own reactions. RESULTS: Accuracy and bias in identifying compliant behavior were assessed using a signal detection paradigm. In both samples, high- and low-risk participants did not differ in their overall accuracy in identifying children's behaviors. However, they used different evaluation standards such that high-risk participants were biased toward seeing more noncompliance and low-risk participants were biased toward seeing more compliance. High- and low-risk participants also made different types of errors in interpreting children's behavior. Low-risk participants were more likely to misinterpret noncompliant behavior as compliant, and there was a trend for high-risk participants to not perceive compliant behavior when it occurred. There were no differences in reported disciplinary responses in either study and the results for affective reactions were mixed. CONCLUSIONS: Specific differences in social information processing between high- and low-risk individuals replicated across samples, suggesting a reliable association between evaluation standards and risk of child physical abuse. However, the absence of differences in reported discipline and inconsistent findings on affective reactions indicate the need to identify the mechanism through which cognition influences parenting behavior.     

Childhood physical abuse, early social support, and risk for maltreatment: current social support as a mediator of risk for child physical abuse

OBJECTIVE: The study investigated whether perceptions of social support in adulthood partially mediated the associations between childhood experiences (i.e., receipt of physical abuse and levels of early social support) and adult risk for child physical abuse. METHOD: Participants included 598 general population adults who completed self-report measures designed to assess childhood physical abuse, perceptions of early and current social support, and risk factors for child physical abuse. Structural equation modeling was used to test and cross validate a model that included the direct effects of child physical abuse and early social support on child physical abuse risk, as well as mediated effects through an influence on adult perceptions of social support. RESULTS: Childhood physical abuse and early social support covaried, such that receipt of physical abuse was associated with lower levels of perceived early social support. Early support, but not child physical abuse, had an indirect effect (i.e., through current support) on child physical abuse risk. More specifically, levels of early support were directly related to adult perceptions of support, and adult perceptions of support were inversely associated with child physical abuse risk. Childhood physical abuse was directly related to child physical abuse risk. CONCLUSIONS: Low levels of early support may impact risk for child physical abuse by affecting perceptions of others as supportive in adulthood. The receipt of physical abuse in childhood, however, does not appear to impact perceptions of support in adulthood. Research is needed to identify additional factors that may explain the association between receipt of physical abuse in childhood and increased risk of child physical abuse in adulthood.     

Randomized trial of a statewide home visiting program to prevent child abuse: impact in reducing parental risk factors

OBJECTIVES: To assess the impact of a home visiting program in reducing malleable parental risk factors for child abuse in families of newborns identified, through population-based screening, as at-risk of child abuse. METHODS: This randomized trial focused on Healthy Start Program (HSP) sites operated by three community-based organizations on Oahu, HI, USA. From 11/94 to 12/95, 643 families were enrolled and randomly assigned to intervention and control groups. Mothers in both groups were interviewed annually for 3 years (88% follow-up each year) to measure mental health, substance use, and partner violence. HSP records were reviewed to measure home visiting services provided. Home visitors were surveyed annually to measure their perceived competence. RESULTS: Malleable parental risks for child abuse were common at baseline. There was no significant overall program effect on any risk or on at-risk mothers' desire for and use of community services to address risks. There was a significant reduction in one measure of poor mental health at one agency and a significant reduction in maternal problem alcohol use and repeated incidents of physical partner violence for families receiving > or =75% of visits called for in the model. Home visitors often failed to recognize parental risks and seldom linked families with community resources. HSP training programs were under-developed in preparing staff to address risks and to link families with community resources. CONCLUSIONS: Overall, the home visiting program did not reduce major risk factors for child abuse that made families eligible for service. Research is needed to develop and test strategies to improve home visiting effectiveness in reducing parental risks for child abuse.     

Follow-up of children “at risk” of child abuse: Effect of support on emotional and intellectual development

This study is a follow-up of 47 children previously reported, who were referred to one paediatric unit and found to be “at risk” of child abuse. They were classified as “Satisfactory” (12), “Unsatisfactory” (18), and “Uncertain” (17), on the basis of breakdown of natural parenting, growth failure, developmental delay, behaviour disturbance and nonaccidental injury. Three years later, of 6 “unsatisfactory” children still with natural parents, 3 were unchanged and 3 had deteriorated. Of 10 fostered children from this group, 4 were considered normal and 5 had improved. Of 17 children in the “Uncertain” group, 3 are reclassified as “Satisfactory,” 3 are now “Unsatisfactory” and in 3 significant organic disease makes attribution of disability difficult. Ten out of 12 children in the “Satisfactory” group have remained in this category. These findings point to the conclusion that in those families where child rearing practices are so poor as to produce emotional and developmental impairment, the usual social work support and other conventional methods are not able to reverse the harm and in some cases to prevent further deterioration.     

Impact of child noncompliance on stress appraisals, attributions, and disciplinary choices in mothers at high and low risk for child physical abuse

OBJECTIVE: The study investigated the impact of repeated child noncompliance on stress appraisals, attributions, and disciplinary choices in high- and low-risk mothers. METHOD: Fifty (25 high-risk and 25 demographically, matched low-risk) mothers responded to questions related to stress appraisals, attributions, and disciplinary choices following presentations of a child engaging in repeated noncompliance. RESULTS: After repeated child noncompliance, high-risk, compared to low-risk, mothers perceived more threat and uncontrollability, rated child behaviors as more stressful, and reported higher levels of negative affect. High-risk mothers also reported more stable, global, and intentional attributions, with a trend toward more internal attributions, but did not differ in their evaluations of wrongness and seriousness of the child's behavior. After repeated noncompliance, a risk group difference was found in estimates of future child compliance but not in the use of power assertive discipline. CONCLUSIONS: Results support the view that high-risk, relative to low-risk, mothers are differentially responsive to stressful situations and differ in their attributions for negative child behaviors and in their expectations of future child compliance. However, since risk group differences in disciplinary choices were not also found, additional research is needed to demonstrate the process through which risk group cognitive and affective differences are related to differences in disciplinary behavior.     

Preschool child development: implications for investigation of child abuse allegations

Allegations of mistreatment by adults made by children of preschool age are often dismissed as fictitious with the suggestion that children of this age are prone to fantasy and unable to discriminate fact from fiction. This paper is intended to familiarize those with a general concern about child abuse with the research and theories in child development. Specifically, it reviews those aspects of normal child development which have direct relevance to the question of the veracity of reports made by children ages 2 to 5 years. Examination of the research on children's thought and language, memory and learning, fears, fantasy, and play, as well as the research on the influence of television on children of this age, led to the conclusion that preschoolers base their play on the reality of their experience.     

The assessment of risk in child abuse and neglect case investigations

Estimates vary, but statistics indicate that anywhere between one and six million children will be abused and/or neglected this year in the United States. In the process of investigating reports of abuse and neglect, child protective service workers are called upon to make numerous case decisions. Critical to much of this decision making is the assessment by the worker of the potential risk of harm that exists to the child regarding further abuse or neglect. This paper, based on two separate research studies, identifies the criteria child protective service workers use to assess this potential risk of harm to the child. The research also shows that the criteria are not used as individual factors that indicate the presence or absence of risk. Instead the criteria form a constellation of factors that function for the worker in assessing the degree of potential risk to the child. The article concludes with a discussion of the implications of research findings for child welfare practice.     

Analog of parental empathy: Association with physical child abuse risk and punishment intentions

Objectives

Current research has been inconsistent in corroborating that parents’ compromised empathy is associated with elevated physical child abuse risk, perhaps in part because of an emphasis on dispositional empathy rather than empathy directed at their own children. Research has also relied on self-reports of empathy that are susceptible to participant misrepresentation. The present study utilized an analog task of parental empathy to investigate the association of parental empathy toward one's own child with physical child abuse potential and with their tendency to punish perceived child misbehavior.

Methods

A sample of 135 mothers and their 4–9 year old children were recruited, with mothers estimating their children's emotional reactions using a behavioral simulation of parental empathy. Mothers also provided self-reports on two measures of child abuse potential, a measure of negative attributions and expected punishment of children using vignettes, as well as a traditional measure of dispositional empathic concern and perspective-taking.

Results

Findings suggest that parental demonstration of poorer empathic ability on the analog task was significantly related to increased physical abuse potential, likelihood to punish, and negative child attributions. However, self-reported dispositional empathy exhibited the pattern of inconsistent associations previously observed in the literature.

Conclusions

Parental empathy appears to be a relevant target for prevention and intervention programs. Future research should also consider similar analog approaches to investigate such constructs to better uncover the factors that elevate abuse risk.     

Evaluations, attributions, affect, and disciplinary choices in mothers at high and low risk for child physical abuse

OBJECTIVE: The present study investigated several components of a social information-processing model of child physical abuse. The main objective was to examine the extent to which high-risk, relative to low-risk, mothers differed in their evaluations, attributions, negative affect, and disciplinary choices for children's behavior, and to explore whether these differences may be expressed in interactions between risk status and mitigating information. METHOD: Nineteen high- and 19 matched low-risk mothers' evaluations of children transgressions, attributions, affect, and choices of disciplinary techniques were examined using six vignettes depicting a child engaging in moral, conventional, and personal transgressions. One-half of the vignettes contained mitigating information and one-half did not. High- and low-risk mothers were chosen based on their potential for physical child abuse. A three-factor (2 x 3 x 2) design was used to assess the dependent variables. RESULTS: As expected, high-risk, relative to low-risk, mothers reported more hostile intent, stable and global attributions, aversiveness, annoyance, and use of power-assertion discipline. A risk group by type of transgression interaction was found for evaluation and indifference and a risk group by mitigating information interaction was found for evaluation of wrongness, internal attributions, and aversiveness. A risk by type of transgression by mitigating information interaction was found for global/specific attributions, aversiveness, and indifference toward child transgressions. CONCLUSIONS: Results support a social information processing model of child physical abuse, which suggests that high-risk, compared to low-risk, mothers process child-related information differently and use more power-assertive disciplinary techniques.     

Stability of retrospective self-reports of child abuse and neglect before and after therapy for child abuse issues

OBJECTIVE: This study is a follow-up to a previously reported outcome study evaluating the efficacy of an emotionally focused therapy for adult survivors of childhood abuse. The present purpose was to evaluate the stability of self-reports of child maltreatment in the context of reduced psychopathology after therapy. The Childhood Trauma Questionnaire (CTQ; Bernstein et al., 1994) was used to measure the extent of child abuse and neglect. METHOD: The CTQ and measures of symptomatology, abuse resolution, and self-esteem were administered at pretreatment to 44 clients and after 6 months of therapy to 33 therapy completers. Post-treatment interviews also assessed changes in clients' perceptions of self and abusive and neglectful others. Analyses examined change on dependent measures, in interviews, and on the CTQ, as well as the test-retest and alpha reliabilities of CTQ factor scales, and the relationship of CTQ factor scales with pretreatment measures of distress. RESULTS: Analyses revealed significant reductions in psychopathology on all dependent measures and reduced self-blame, negatively biased memories, avoidance, and minimization of the abuse after therapy. Reports of abuse and physical neglect on the CTQ remained stable from pre- to post-therapy. All CTQ dimensions demonstrated good internal consistency and convergent validity with trauma-specific measures of distress. CONCLUSIONS: The stability of the CTQ in the context of significantly reduced psychopathology contributes to evidence supporting the accuracy of retrospective self-reports of childhood abuse.     

Empathy and narcissism in a sample of child abuse perpetrators and a comparison sample of foster parents

OBJECTIVE: The purpose of this research was to study the personality variables of empathy and narcissism in a sample of child abuse perpetrators and a comparison sample of foster parents, conceptualized as nonabusive parents, in order to gain further understanding of perpetrators and to provide clues for intervention. METHOD: The sample consisted of two groups: physically and emotionally abusive parents (n=52) and foster parents (n=101). Participants responded to three instruments: the Interpersonal Reactivity Index (IRI), an instrument measuring individual differences in empathy, and two instruments measuring narcissism: the Narcissistic Personality Inventory (NPI) and the Hypersensitivity Narcissism Scale (HSNS). RESULTS: Statistically significant differences were found between the two groups on three of the four subscales of the IRI: perspective-taking, empathic concern, and personal distress. Based on the definition of these subscales, the abusive parents as compared to the foster parents were not able to take the perspective of another or see things from another's viewpoint, showed less warmth, compassion and concern for others, and experienced difficulty in tense interpersonal situations. Statistically significant differences were found for the two groups on three of the six subscales of the NPI: authority, exhibitionism, and superiority, and on the HSNS. The abusive parents demonstrated less self-confidence, a greater lack of impulse control and were more narcissistic than their foster parent counterparts. CONCLUSIONS: The results suggest that it is how the perpetrators experience aversive behavior in their children that may provoke them to physically and emotionally abuse their children. Their self-centeredness in addition to their deficiencies in empathy may cause them to experience their children's misbehavior as an affront to their authority. Implications for treatment are made from this conceptualization of parental abuse.