Modeling risk for child abuse and harsh parenting in families with depressed and substance-abusing parents

Children with substance abusing parents are at considerable risk for child maltreatment. The current study applied an actor–partner interdependence model to examine how father only (n = 52) and dual couple (n = 33) substance use disorder, as well as their depressive symptomology influenced parents’ own (actor effects) and the partner's (partner effects) overreactivity in disciplinary interactions with their children, as well as their risk for child maltreatment. Parents completed the Center for Epidemiologic Studies Depression Scale (CES-D; Radloff, 1977), the overreactivity subscale from the Parenting Scale (Arnold, O’Leary, Wolff, & Acker, 1993), and the Brief Child Abuse Potential Inventory (Ondersma, Chaffin, Mullins, & LeBreton, 2005). Results of multigroup structural equation models revealed that a parent's own report of depressive symptoms predicted their risk for child maltreatment in both father SUD and dual SUD couples. Similarly, a parent's report of their own depressive symptoms predicted their overreactivity in disciplinary encounters both in father SUD and dual SUD couples. In all models, partners’ depressive symptoms did not predict their partner's risk for child maltreatment or overreactivity. Findings underscore the importance of a parent's own level of depressive symptoms in their risk for child maltreatment and for engaging in overreactivity during disciplinary episodes.     

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.     

Physiological responses to non-child-related stressors in mothers at risk for child abuse.

Physical child abusers and adults at risk for child abuse, relative to comparison subjects, are reported to be more physiologically reactive to child-related stressors. It is not known if the reported physiological reactivity is child specific or if physical child abusers and at-risk parents are also more reactive to other types of stressful stimuli. The present study investigated changes in heart rate and skin conductance in response to four types of non-child-related stressors in at-risk and matched low-risk mothers. The four types of stressful stimuli were: a cold pressor; a stressful film depicting industrial accidents; unsolvable anagrams; and an aversive car horn. At-risk mothers, relative to low-risk mothers, had greater and more prolonged sympathetic activation during presentations of the cold pressor and the stressful film, the stimuli rated as the most stressful. The present data, combined with previous findings, support the view that generalized sympathetic activation to both child and non-child-related stressors may serve as a mediator of physical child abuse.     

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.     

Neuroticism as a risk factor for child abuse in victims of childhood sexual abuse

Findings on the relationship of experienced sexual abuse and abuse behavior in adulthood are ambiguous. However, associations between experienced abuse and neuroticism as well as between neuroticism and active child abuse have been reported repeatedly. In our study, we compared pedosexual child abusers with consumers of internet child pornography and control subjects with adult-sexual preference with regard to traumatic childhood experience (Childhood Trauma Questionnaire, CTQ), personality traits (NEO – Personality Inventory – Revised, NEO-PI-R), and sexual abnormalities (Multiphasic Sex Inventory, MSI). In an initial analysis, sexual abuse experienced in childhood was not directly linked to sexual abuse behavior in adulthood. However, this relationship was mediated by neuroticism. In a second step, the CTQ scales were conflated and, using a structural equation model, direct links between the overall level of abuse experienced in childhood (generally high CTQ levels) and sexual abuse behavior in adulthood revealed again the mediation by neurotic personality. We conclude that the overall level of abuse experienced in childhood in general, and less sexual abuse experience in particular, modulates the tendency for child sexual abuse behavior in adulthood. Data suggest that, depending on the resilience of an individual, abuse experience during childhood increases the likelihood of developing neurotic personality traits in later life, which are in turn considered to increase the risk of child sexual abuse in child sex offenders.     

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.     

Exploring the disclosure of child sexual abuse with alleged victims and their parents

OBJECTIVE: The goal of the present study was to examine how children disclosed sexual abuse by alleged perpetrators who were not family members. METHODOLOGY: Thirty alleged victims of sexual abuse and their parents were interviewed. The children were interviewed using the NICHD Investigative Interview Protocol by six experienced youth investigators. The same principles were followed when the parents were asked to describe in detail what had happened since the abusive incidents. The statements made by the children and parents were then content analyzed. Major characteristics of the children's and parents' reported behaviors were identified by two independent raters. FINDINGS: More than half (53%) of the children delayed disclosure for between 1 week and 2 years, fewer than half first disclosed to their parents, and over 40% did not disclose spontaneously but did so only after they were prompted; 50% of the children reported feeling afraid or ashamed of their parents' responses, and their parents indeed tended to blame the children or act angrily. The disclosure process varied depending on the children's ages, the severity and frequency of abuse, the parents' expected reactions, the suspects' identities, and the strategies they had used to foster secrecy. CONCLUSIONS: The children's willingness to disclose abuse to their parents promptly and spontaneously decreased when they expected negative reactions, especially when the abuse was more serious. A strong correlation between predicted and actual parental reactions suggested that the children anticipated their parents' likely reactions very well.     

County-level socioeconomic and crime risk factors for substantiated child abuse and neglect

Rates of substantiated child abuse and neglect vary significantly across counties. Despite strong cross-sectional support for links between social-contextual characteristics and abuse and neglect, few longitudinal studies have tested relations between these risk factors and substantiated rates of abuse/neglect. The goal of this study was to identify county-level socioeconomic and crime factors associated with substantiated abuse/neglect rates over 13 years (2004–2016). Annual county-level data for Tennessee, obtained from the KIDS COUNT Data Center, included rates of substantiated child abuse and neglect, children’s race and ethnicity, births to unmarried women, teen birth rate, children in families receiving Supplemental Nutrition Assistance Program (SNAP) benefits, and children in families receiving Temporary Assistance for Needy Families. Annual county-level crime report data, obtained from the Tennessee Incident Based Reporting System, included sexual offenses, non-sexual assaults, stalking incidents, thefts, property damage, and drug-related offenses. Bayesian spatio-temporal models indicated that substantiated child abuse and neglect rates were independently and positively associated with teen birth rates, percentages of births to unmarried mothers, drug-related offenses, and percentages of children receiving SNAP benefits. In contrast, substantiated child abuse and neglect rates were negatively associated with percentages of African-American youth. The findings highlighted distinct demographic, socioeconomic, and crime factors associated with substantiated child abuse and neglect rates and have the potential to enhance identification of high-risk counties that could benefit from targeted abuse and neglect prevention efforts.     

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.     

Measuring actual reduction of risk to child abuse: a new approach

Previous efforts to measure the effectiveness of child abuse prevention programs have relied on proximate measures presumed to be predictive of actual skills. This paper presents documentation that brings those assumptions into question, describes actual observation and measurement of behavioral change in children before and after prevention education, and correlates that behavioral response with more traditional measures of effectiveness. Unique to the evaluation was the staging of an actual situation in which each of the children had an opportunity to leave the school building with a stranger. Each simulation was videotaped and conducted in such a way that the children remained unaware of the fact that they had been tested. In addition, tests of language development, self-esteem and knowledge of prevention and safety concepts were administered before and after participating in the Children Need to Know Personal Safety Training Program [1]. Several findings have significant value for future examinations and programming. The effectiveness of a primary prevention program based on age-appropriate, experiential and interactive instruction was empirically documented. Traditional instrumentation which elicits written or verbal responses to cognitive questions about safety may be misleading in assessing children's vulnerability. Higher self-esteem before instruction and higher knowledge/attitude scores after instruction were found to be predictive of a reduction in vulnerability. While this is a significant series of findings, some children did not achieve the objectives of the prevention program. These results suggest further possibilities for evaluation and some direction for improving prevention education.     

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.