Sexual, physical, verbal/emotional abuse and unexplained chest pain

Objectives

Approximately one third of patients with non cardiac chest pain (NCCP) report a history of abuse, however no data exists on the prevalence of abuse among people with unexplained chest pain in the general population. We aimed to determine if there is a relationship between childhood sexual, physical, emotional abuse and unexplained chest pain, and to identify whether any potential relationship is being driven by an association with psychological distress.

Methods

Subjects were identified from 2 previous random population surveys that included people with irritable bowel syndrome (IBS) and/or functional dyspepsia (FD) and healthy controls. People in the unexplained chest pain group (n = 27) had chest pain in the past 12 months that was not heartburn or heart disease. People in the comparison group (n = 60) did not have chest pain for more than 12 months. Self-reported abuse and psychological variables were assessed using validated measures.

Results

Emotional/verbal abuse (20.8% versus 4.4%, P = 0.032) and physical abuse (16.7% versus 2.2%, P = 0.028) were significantly more common in people with unexplained chest pain versus the comparison group. Only a history of emotional/verbal abuse was a significant independent predictor of meeting criteria for unexplained chest pain (OR = 5.66; 95%CI 1.01–31.80, P = 0.049) even after controlling for IBS and/or FD (OR = 5.45; 95%CI 0.96–30.83, P = .05), but not when depression was controlled for (OR = 4.70; 95%CI 0.90–27.61), P = 0.08.

Conclusions

A history of childhood emotional/verbal abuse is a risk factor for having unexplained chest pain but the association may be moderated by psychological distress, specifically depression.     

Sixth graders in Israel recount their experience of verbal abuse by teachers in the classroom

AimThis study adopts a children’s rights perspective stated in Articles 3, 12, 19, 28 of the Convention on the Rights of Children (1989) with the goal of listening to Israeli children articulate their experience of verbal abuse by teachers in 6th grade classroomsMethodsA purposeful sample of sixty students was individually interviewed and content analysis was performed following Strauss’ (1987) constant comparative method.ResultsStudents reported teachers’ yelling, name-calling and put-downs when failing to pay attention, complete their work, or obtain good grades. They condemned teachers as particularly hurtful and cruel for publically humiliating them in class. However, awareness of teachers’ authority and fear of reprisal led to students’ silence and reluctance to report the abuse to their parents or principal. Covert opposition was nevertheless exhibited as students engaged in a silent monologue telling teachers they had no right to mistreat them (females), silently cursing (males) and/or withdrawing participation (both genders). Repeated public humiliation and scapegoating resulted in the loss of interest in teacher’s opinion and school and on rare occasions to the direct verbal confrontation or acting-out behaviour of the abused student.ConclusionThis study stresses the importance of gaining insight into the world of children by having them articulate their experience and denounce any form of abuse by teachers in the classroom. A child-safe school culture that listen to children’s view and make them feel safe when reporting any form of abuse in the classroom are preconditions to serving children’s best interests and wellbeing in schools.     

Taking a different path: A mother's reflections on homeschooling

Research conducted on academically gifted children's problem‐solving abilities suggests that heightened cognitive flexibility is an important component of academic intelligence. For example, academically gifted children are better able to adapt prior knowledge to formulate solutions to novel problems than other people. To date, little research has focused on applying these findings to the social domain. We propose that social‐cognitive flexibility (i.e., the ability to adapt prior social knowledge to formulate solutions to new interpersonal situations) is an important component of social intelligence. This article draws a comparison between the structure of academic and social intelligence, and speculates an important relationship exists between flexible social problem‐solving and social gift‐edness.     

母亲的牵挂

下午,我正在办公室里坐着,来了电话。一看,是姐姐的电话。当时,心里就咯噔了一声。家里谁怎么啦?或者发生了什么事?我吓得顿时胡思乱想起来。因为平常都是我往家里打电话,他们很少主动给我打。"今天这是怎么啦?"我问。姐姐说:"哦,没什么事,妈妈要跟你说句话。"     

动词词组的连带范畴

在系统功能语法的范围内,从理论阐述和分类描写两个角度,对现代汉语中动词词组的连带范畴这个一向只被看作句子成分的概念做定性说明。动词词组的连带成分可大致分为两类:一类是典型的词组构成成分,称为辅佐范畴;另一类同时作句子成分,称为跨级范畴,正是这后一类连带成分将具有等级差别的动词词组与小句甚至复句连成一个连续体。     

School Trouble: A mother's burden

ABSTRACT The desire for parent involvement in children's schooling is based on the assumption that parents play a significant role in children's educational achievements. As a policy goal, parent involvement includes the participation of both mothers and fathers. However, in practice, parent involvement refers more often to the work of women in support of children's schooling. The coordination and supervision of children's educational activities often demands a significant portion of mothers' waking hours, particularly in the case of mothers whose children are doing poorly in school. This article draws on interviews with parents of children who struggled academically in school to examine the effects of 'school troubles' on mothers who, among the parents interviewed for this study, were much more likely to assume the material and emotional burdens for school troubles.     

Identified spouse abuse as a risk factor for child abuse

CONTEXT: There are limited data on the extent to which spouse abuse in a family is a risk factor for child abuse. OBJECTIVE: To estimate the subsequent relative risk of child abuse in families with a report of spouse abuse compared with other families. DESIGN: Cohort study. SETTING: Analysis of a centralized US Army database PARTICIPANTS: Married couples with children with at least one spouse on active duty in the US Army during 1989-95. MAIN OUTCOME MEASURES: The US Army Family Advocacy Program's Central Database was used to identify child and spouse abuse. The exposure was an episode of identified spouse abuse and the main outcome was a substantiated episode of subsequent child abuse.RESULTS: During the study period of an estimated 2,019,949 person years, 14,270 incident child abuse cases were substantiated. Families with an incident case of spouse abuse identified during the study period were twice as likely to have a substantiated report of child abuse compaired with other military families, rate ratio, 2.0, (95% confidence interval [CI] 1.9-2.1). Young parental age had the highest rate ratio, 4.9 (95% CI 4.5-5.3) in the subgroup analysis controlling for rank. Identified spouse abuse was associated with physical abuse of a child, rate ratio 2.4 (95% CI 2.2-2.5), and with sexual abuse of a child, rate ratio 1.5 (95% CI 1.3-1.7). Identified spouse abuse was not associated with child neglect or maltreatment, rate ratio, 1.0 95% CI 0.9-1.1) CONCLUSION: An identified episode of spouse abuse in a family appears to be associated with an increased risk of subsequent child abuse and serves as an independent risk factor. Therefore. care providers should consider the potential risk to children when dealing with spouse abuse.     

Dissociation as a mediator between child abuse history and adult abuse potential

OBJECTIVE: It has commonly been found that abused children are at risk for later becoming abusive parents (Kaufman & Zigler. 1987; Oliver, 1993) and observational learning has been discussed as a mechanism that perpetuates this intergenerational cycle of abuse. However, two thirds of abused children do not become abusive (Kaufman & Zigler, 1987). Thus, the goal of the current study was to examine whether dissociation functions as an additional mechanism mediating the relation between a history of child abuse and abusiveness as an adult. METHOD: A cross-sectional design was used to examine physical abuse history, dissociation, and physical abuse potential in a sample of 190 college students. Questionnaires were utilized to assess the three constructs. RESULTS: Findings indicated that the three constructs were intercorrelated. In particular, a newly established association was found between dissociation and physical abuse potential (r = .54, p < .0001). The primary finding was that the relation between physical abuse history and physical abuse potential was significantly mediated (z = 2.19, p < .05) by level of dissociation, with dissociation accounting for approximately half of the observed relation between history of abuse and abuse potential. CONCLUSION: Results suggested that dissociation may be one mechanism that helps to perpetuate the intergenerational cycle of abuse. Although dissociation promotes psychological survival during children's abuse experiences, it may result in the development of abusive tendencies in later life. Reducing parental dissociation may assist clinicians in preventing or terminating physical child abuse.     

The family environment of sexual abuse: a comparison of natal and stepfather abuse

Data from 17 states, drawn from the 1983 National Study on Child Neglect and Reporting, were used to compare families in which a daughter had been sexually abused by a natal father or stepfather. While broad comparisons are made in terms of age and race of victims, as well as household composition, the primary focus is on familial stress factors. Given the lower incidence of natal father abuse and the assumption that natal fathers have stronger emotional links to their children and greater commitment to the father role, we predicted that when they did engage in sexual abuse, it would be in a family environment characterized by relatively high levels of personal, social, and economic stress. This was confirmed to the extent that natal father abuser families showed significantly higher levels of drug and/or alcohol abuse, marital problems, and insufficient income than did stepfather abuser families.     

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.     

Childhood history of abuse and child abuse potential in adolescent mothers: a longitudinal study

OBJECTIVES: The purpose of this research was to determine whether adolescent mothers of newborns are at higher risk for child abuse than adult mothers of newborns and to examine whether adolescent mothers with memories of child maltreatment have a higher risk for child abuse. METHOD: Two groups (adolescents and adults) of pregnant mothers were followed for 20 months beginning between the 5th and the 7th month of pregnancy until the child was 18 months old. Adolescent (N = 24) and adult (N = 24) mothers were matched on sociodemographic variables. During pregnancy, memories of child maltreatment were evaluated. When child was 1, 6, 12, and 18 months old, risk for child abuse was evaluated. RESULTS: Adolescent and adult mothers showed no differences in memories of childhood physical or emotional abuse. Nevertheless, adolescent mothers showed higher child abuse potential and depression scores than adult mothers. Mothers with memories of severe physical punishment showed higher child abuse potential scores and mothers with memories of physical punishment producing physical damage showed higher child abuse potential and depression scores. A statistically significant age of the mother by physical punishment producing physical damage interaction was found for depression. CONCLUSIONS: The results of this longitudinal study indicated that the potential for abuse was significantly greater in adolescent mothers than in adult mothers, and in mothers who had been victims of physical abuse than in those who had not. It also appeared that, among adolescent mothers, those who had been victims of childhood physical abuse constitute a higher risk group for child physical abuse.     

Caregivers of quality: One mother's search for child care

Too often, guidelines for quality child care emphasize the physical site, the equipment, safety, and the staff-child ratio. However, to ensure high-quality child care for our children, the personal and professional attributes of quality caregivers must be considered. The most important caregiver attributes are discussed, as one mother describes her search for child care.     

An empirical test of a communibiological model of trait verbal aggressiveness

The purpose of this study was to test Beatty and McCroskey's communibiological model of trait verbal aggressiveness. In general, this model views trait verbal aggressiveness as an expression of temperament; specifically, that trait verbal aggressiveness represents low thresholds for the fight or flight (FFS) neurobiological system. This model further contends that behavioral inhibition circuitry (BIS) moderates FFS activation by tempering aggressive impulses, otherwise FFS activation would manifest itself in the form of physical rather than verbal attacks. Beatty and McCroskey (1997) propose that low thresholds for stimulating the behavioral activation system (BAS) should be related to trait verbal aggressiveness to the extent that the construct involves a proactive rather than a purely reactive interpersonal function. Because previous research indicated that psychoticism (P), neuroticism (N) and extroversion (E) represent psychological manifestations of the FFS, BIS, and BAS systems, respectively, hypotheses linking P, N, and E to trait verbal aggressiveness (VAS) were tested. A multiple regression equation based on disattenuated correlations explained approximately 46% of the variance in VAS scores. Specifically, (1) the results for P and N were consistent with predictions derived from Beatty and McCroskey's model, and (2) the results for E were indicative of a purely reactive function of trait verbal aggressiveness. Implications for theory and research are discussed.     

Triangles of abuse: a model of maltreatment

Research and clinical evidence support the view that the perpetrator (P), victim (V), and observer (O), all contribute to child abuse and neglect. This paper describes a model in which they have a necessary part in precipitating and sustaining the maltreatment. It appears they form a triangle or triquetra which rotates with time and circumstance. The perpetrator of sexual assault often becomes the victim when he is imprisoned. The victim of physical abuse may become the perpetrator of physical abuse in the next generation. Within each P, V, and O there is also a triquetra which rotates and which will determine how that individual behaves in the next instance. Knowing the relative preponderance of P, V, or O within each individual can help predict possible future abuse. Since therapists often determine their intervention by the view of the situation they adopt, it is important for them to understand their principal orientation towards either the perpetrator, victim, or observer. The legal model of abuse emphasizes individual accountability by viewing people as they are solely responsible for their behavior. This article rather than diminishing the responsibility of any individual, emphasizes the collective responsibility of all involved.