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.     

Less money,more problems: How changes in disposable income affect child maltreatment

A number of research studies have documented an association between child maltreatment and family income. Yet, little is known about the specific types of economic shocks that affect child maltreatment rates. The paucity of information is troubling given that more than six million children are reported for maltreatment annually in the U.S. alone. This study examines whether an exogenous shock to families’ disposable income, a change in the price of gasoline, predicts changes in child maltreatment. The findings of a fixed-effects regression show that increases in state-level gas prices are associated with increases in state-level child maltreatment referral rates, even after controlling for demographic and other economic variables. The results are robust to the manner of estimation; random-effects and mixed-effects regressions produce similar estimates. The findings suggest that fluctuations in the price of gas may have important consequences for children.     

Emotion dysregulation as a mechanism linking child maltreatment exposure and self-harm behaviors in adolescents

Although child maltreatment exposure is a recognized risk factor for self-harm, mechanisms underlying this relationship remain unclear. Self-harm may function as a compensatory strategy to regulate distressing emotions. This cross-sectional study examines if emotion dysregulation mediates between the severity of maltreatment exposure and self-harm, adjusting for demographic variables and depressive symptoms. Participants were 108 adolescent patients recruited from a psychiatric hospital in Singapore (mean age 17.0 years, SD = 1.65; 59.3% female). Study measures included the Childhood Trauma Questionnaire (CTQ-SF), Functional Assessment of Self-Mutilation (FASM), Difficulties in Emotion Regulation Scale (DERS), and the Patient Health Questionnaire (PHQ-8). Path analysis was conducted to examine the direct and indirect effects of maltreatment exposure on self-harm via emotion dysregulation, controlling for demographic variables and depressive symptoms. Indirect effects were tested using bootstrapped confidence intervals (CI). Results showed that self-harm was highly prevalent in our sample (75.9%). Emotion dysregulation and depressive symptoms were found to be associated with higher self-harm frequency. In addition, results from path analysis showed that the association between the severity of maltreatment exposure and self-harm frequency was significantly mediated by emotion dysregulation B = 0.07, p < 0.05, 95% CI [0.02, 0.16]. Thus, emotion dysregulation may be a proximal mechanism linking maltreatment exposure and adolescent self-harm. Notably, self-harm may represent maladaptive attempts to manage emotion dysregulation that may have resulted from maltreatment. Findings from the study have implications for the prevention and treatment of self-harm in maltreated youth.     

Using simulation to identify sources of medical diagnostic error in child physical abuse

Little is known regarding sources of diagnostic error at the provider level in cases of possible child physical abuse. This study examines medical diagnosis as part of medical management and not as part of legal investigation. Simulation offers the opportunity to evaluate diagnostic accuracy and identify error sources. We aimed to identify sources of medical diagnostic error in cases of possible abuse by assessing diagnostic accuracy, identifying gaps in evaluation, and characterizing information used by medical providers to reach their diagnoses. Eight femur fracture simulation cases, half of which were abuse and half accident, were created. Providers from a tertiary pediatric emergency department participated in a simulation exercise involving 1 of the 8 cases. Performance was evaluated using structured scoring tools and debriefing, and qualitative analysis characterized participants’ rationales for their diagnoses. Overall, 39% of the 43 participants made an incorrect diagnosis regarding abuse. An incorrect diagnosis was over 8 times more likely to occur in accident than in abuse cases (OR = 8.8; 95% CI 2 to 39). Only 58% of participants correctly identified the fracture morphology, 60% correctly identified the mechanics necessary to generate the morphology, and 30% of ordered all appropriate tests for occult injury. In misdiagnoses, participants frequently falsely believed the injury did not match the proposed mechanism and the history provided by the caregiver had changed. Education programs targeting the identified error sources may result in fewer diagnostic errors and improve outcomes. The findings also support the need for referral to child abuse experts in many cases.     

Child maltreatment in the “Children of the Nineties:” deprivation, class, and social networks in a UK sample

Aim: To determine risk factors for child maltreatment within the socio-economic environment of a contemporary UK child population.Methods: The research is based on a large cohort study, the Avon Longitudinal Study of Parents and Children. Out of 14,256 children participating in the study, 115 have been identified as having been placed on local child protection registers prior to their 6th birthday. Data on the socio-economic environment of the families have been obtained from a series of questionnaires administered during pregnancy and the first 3 years of life. Risk factors have been analyzed using logistic regression analysis.Results: Four indicators of deprivation all showed significant relationships with registration. Adjusted odds ratios were 2.33 for paternal unemployment; 7.65 for council housing; 2.16 for overcrowding; and 2.33 for car ownership. There was a strong relationship between the number of indicators of deprivation and the risk of maltreatment. In a second model, maternal unemployment, high mobility (> 3 house moves in the previous 5 years) and a poor social network were also significant with odds ratios of 2.82, 2.81, and 3.09, respectively.Conclusions: This study confirms the importance of social factors in the etiology of child maltreatment. Social deprivation is an important determinant of child maltreatment, and encompasses a number of different aspects, including financial security, housing situation and material benefits; in addition, the job situation of the parents and the stability and richness of their social networks all have a significant impact on risk of maltreatment. Interventions at both an individual and a community level are important to support families and reduce the risk of maltreatment.     

Childhood history of abuse and child abuse potential: The role of parent's gender and timing of childhood abuse

It has been suggested that being physically abused leads to someone becoming a perpetrator of abuse which could be associated to parents’ gender, timing of the physical abuse and specific socio-demographic variables. This study aims to investigate the role the parents’ gender, timing of childhood abuse and socio-demographic variables on the relationship between parents’ history of childhood physical abuse and current risk for children. The sample consisted of 920 parents (414 fathers, 506 mothers) from the Portuguese National Representative Study of Psychosocial Context of Child Abuse and Neglect who completed the Childhood History Questionnaire and the Child Abuse Potential Inventory. The results showed that fathers had lower current potential risk of becoming physical abuse perpetrators with their children than mothers although they did not differed in their physical victimization history. Moreover, the risk was higher in parents (both genders) with continuous history of victimization than in parents without victimization. Prediction models showed that for fathers and mothers separately similar socio-demographic variables (family income, number of children at home, employment status and marital status) predicted the potential risk of becoming physical abuses perpetrators. Nevertheless, the timing of victimization was different for fathers (before 13 years old) and mothers (after 13 years old). Then our study targets specific variables (timing of physical abuse, parents’ gender and specific socio-demographic variables), which may enable professionals to select groups of parents at greater need of participating in abuse prevention programs.     

The development and evaluation of a training program for school-based professionals dealing with child abuse: The University of Toronto interfaculty child abuse prevention project 1978–1979

This paper reports on a child protection training program for teachers, social workers, and nurses. The training format consisted of two 5-day workshops, one for preprofessional students and the other for practicing professionals, and two one-day workshops for students. The evaluation employed a pre-test/post-test design. Data were obtained from a total of 254 workshop participants who were randomly selected from a group of 400 volunteers. The training program was designed to provide information and experience in the areas of identification, family dynamics, legislation, intervention, and team responses. Curriculum effects were the dependent variables; group characteristics were the independent variables. The general finding was that the program was an effective means of accomplishing its objectives. Some of the specific findings were that professionals wanted more content in contrast to students who were satisfied with experiences which simulated practice. Both social work professionals and students were more confident in their ability to deal with the problem of child abuse before and after the program than teachers and nurses. In contrast, teachers began and ended the program with relatively low confidence and information levels. Overall, nurses had the highest level of entry and exit knowledge at the beginning and the end of the program. While the results indicate that the three groups profited from shared training experiences they also suggest that certain areas of training may best be realized by specialized workshops.     

Cultural factors in decision-making about child physical abuse: identifying reporter characteristics influencing reporting tendencies

OBJECTIVE: This study examined cultural factors that may influence child physical abuse reporting. Relevant cultural factors such as the respondents' ethnic identity and corporal punishment acceptability were investigated as proximal variables of ethnicity that affect child physical abuse reporting tendencies. METHOD: Participants consisted of 378 Caucasian, Hispanic, and African American college students. Participants read 12 vignettes that varied the ethnicity of the child and described a parent using physical punishment with the child. Participants' level of ethnic identity and their acceptance of different discipline practices were also assessed. Data were analyzed using multiple regression procedures. RESULTS: The ethnicity of the respondent was a significant predictor of reporting tendencies for African American respondents only. For African Americans, higher levels of ethnic identity and acceptance of corporal punishment were significant mediators of reporting tendencies, which influenced the relationship between ethnicity and likelihood to report a child of the same ethnicity. CONCLUSION: The results of this study indicate that ethnic minorities may not share similar cultural values and may differ in their degree of adherence to certain cultural variables. These results demonstrate how cultural variables that influence reporting tendencies may not apply across ethnic groups. Therefore, specifying relevant cultural variables is essential to understanding the relationship between ethnicity and reporting tendencies.     

Parents' self-reporting of child physical maltreatment in Yuncheng City, China

Objective

To investigate the prevalence of child physical maltreatment (CPM) by parents in a city locating in central-western region of China and identify associated risk factors.

Methods

Cross-sectional survey was carried out among a randomly sampled population of primary school students’ parents in Yuncheng City. Data on parental CPM during the past 3 months, definition of CPM, Parenting Scale, parent-child interaction attitudes, social support, socio-demographic background were collected by a self-report questionnaire. Logistic regression analyses were used to investigate the associations between CPM and related risk factors.

Results

Of parents from 1,394 primary school students, there were 595 (42.7%) and 301 (21.6%) of them reported that they had minor/severe CPM behaviors toward their children during the past 3 months, respectively. The risk factors that were significantly associated with both prevalence and frequencies of minor/severe CPM included child problem behaviors, overreactivity and hostility parenting.

Conclusion

CPM by parents is not uncommon in China. More attention should be paid to programs that help parents learn parenting skills and use nonviolent child discipline.     

The expert witness in child abuse and neglect: An interdisciplinary process

The legal system is an important part of a society's response to child abuse and child neglect. Courts need to be guided in their deliberations by experts from many different professions. Consultation and in-court expert testimony is necessary from medicine, psychology, psychiatry, social work and other professions both to prove child abuse and neglect and establish the power of the court to act on behalf of a child but also to guide the court in the intervention strategy most suited to the needs of the child and his family. Non-lawyers often feel uncomfortable in the legal setting. The adversary process is foreign to their training and professional experience. Collaboration with a lawyer greatly improves their effectiveness in court. Lawyers, on the other hand, need to make maximum use of medical and social-psychological experts in the court process in the interests of their clients; but to do so lawyers need a basic understanding of the other professions. With an emphasis on a process of mutual education, the paper presents a framework for collaboration between lawyers and expert witnesses in child abuse and neglect cases. “Expert witness” is defined; informal consultation is encouraged; suggestions for selecting a collaborator are made; initial contracts between lawyer and expert, case conferencing and preparation for trial are discussed; specific advice on direct and cross examination is provided.     

Mandatory notification training for suspected child abuse and neglect in South Australian schools

OBJECTIVE: The present study provides the first empirical investigation of the South Australian Education Department Mandated Notification Training program. This program, which has been available since 1989, was developed to prepare educators and other mandated reporters to fulfill their reporting obligations for suspected child abuse and neglect. The main objective of the present study was to investigate whether Mandated Notification Training achieved its stated aims. METHOD: A three-sample independent groups design was used. A survey was responded to by 41 teachers and school personnel who had recently completed training, 31 people who had not completed training, and 73 people who had completed training some years previously. RESULTS: The training program increased participants' confidence in their ability to recognize the indicators of abuse, their awareness of their reporting responsibilities, their knowledge of what constitutes reasonable grounds for reporting, and of how to respond appropriately to a child's disclosure of abuse. Training also increased participants' acceptance of the incidence and seriousness of child abuse. CONCLUSIONS: The South Australian Education Department Mandated Notification Training is successful in achieving its stated aims. For some teachers, there is clearly a mismatch between the level of evidence required by law for reporting to occur and the level teachers expect to satisfy their own personal need for confidence in initiating the serious step of a child abuse report. This mismatch remains after training and probably contributes to the significant occurrence of nonreporting or discretionary reporting reported in the literature.     

Incidence and impact of sexual abuse in a child outpatient sample: The role of direct inquiry

From the child psychiatry outpatient department of a university medical center, 64 charts were reviewed in two phases: 29 were randomly selected from outpatient files, and 35 were examined after clinicians were asked to directly query sexual abuse. Although the reported sexual abuse rate for randomly selected charts was quite low (6.9%), reference to sexual abuse history in charts of children who were asked about molestation was 4.5 times more frequent (31.4%; 11.5% of all boys, 50% of all girls). Children with an identified sexual abuse history reported more psychological symptoms, had made more suicide attempts in the past, and were more likely than nonabused children to receive a diagnosis of major depression.     

Case disposition recommendations of attorneys and social workers in child abuse investigations

This study is concerned with decision making in child abuse investigations. The study used an experimental design to investigate the effects of four case factors that influence child protective service workers' and attorneys' dispositions choices in alleged cases of physical child abuse. The factors were: the physical injury, mild or serious; previous report of child abuse, yes or no; parental reaction, positive or negative; and parental admission of involvement with injury, admit or deny. The main findings were: Attorneys had a tendency to recommend court intervention, while protective workers had a tendency not to recommend court action; and all four case factors had a significant effect on the disposition choices for both professional groups, although injury and previous report accounted for a larger proportion of the variance.     

Perceptions of parental substance use disorders in cross-system collaboration among child welfare,alcohol and other drugs,and dependency court organizations

Cross-system collaboration among child welfare (CW), alcohol and other drugs (AOD), and court organizations shows promise in addressing the many needs of CW-involved families experiencing parental substance use disorders (SUDs). Research has suggested that differing perceptions of parents with SUDs among staff in these organizations may hinder the collaborative process. Using a sequential explanatory mixed-method approach, this study explored staff perceptions of parental SUDs among CW, AOD, and court organizations. Logistic regression analyses indicated that, compared to CW respondents, AOD respondents were: (a) less likely to believe that parents could provide effective parenting; (b) more likely to believe that abstinence should be a criterion for reunification; (c) more likely to agree that parents should receive jail time as a consequence for noncompliance with court orders; and (d) more likely to believe that parents could succeed in treatment. Thematic analyses of these focal areas identified two core themes (focus on the primary client and mandated time frames for permanency), as well as multiple subthemes, that provided a nuanced understanding of differing perceptions on these matters. Suggestions for the development of anticipatory cross-system training and practices and implications for policy evaluation are discussed.     

Removing the child--prosecuting the offender in cases of sexual abuse: evidence from the national reporting system for child abuse and neglect

Sexual abuse has come to public attention so rapidly and is such a difficult problem to deal with that many observers are concerned that the quality of child protective intervention in these cases has been haphazard and indiscriminate. This article analyzes data on all 6,096 cases of child sexual abuse which were "officially reported" in 1978 to see what kinds of intervention were made. The data show that foster placement occurred in more cases of sexual abuse than physical abuse, and was concentrated among cases of older children who reported their own victimization. Criminal action was taken almost five times more often in cases of sexual abuse than in cases of physical abuse, and occurred more often among cases which were directly reported to police and involved offenders with prior criminal records. Black families and poorer families did not seem to be the objects of obvious discrimination in the disposition of these cases.     

A survey of state efforts in gathering information on child abuse and neglect in handicapped populations

This paper reports the extent to which states assemble information on the incidence of abuse and neglect among handicapped populations. Data were collected from all states on the types of pre-existing disabilities cited on child abuse reporting forms and the perceived accuracy of this information. The study also sought to identify specific methods used to provide assistance to local agencies regarding the problems associated with abuse of the handicapped. Surveys were distributed to and completed by representatives of the designated child protection agencies within each state and the District of Columbia (n = 51). General findings were that although it is generally acknowledged in research that handicapped children represent a disproportionate number of abuse and neglect victims, nearly half of the states do not collect any information on “special characteristics.” Forms from the remaining states exhibited much variation in style and in the competency of collection techniques. These results suggest a significant lack of services specifically designed to improve the awareness of field representatives on the influence of exceptionalities in abusive cases. This information indicates that training and prevention programs will remain basically inadequate until the relationship between handicapped conditions and abuse/neglect is more clearly defined.     

The escalation and maintenance of child abuse: A cybernetic model

A cybernetic model of child abuse is presented as a contribution to the theoretical literature on child abuse. The child's role in his or her own abuse is stressed; interaction between caretaker and child is emphasized. While the origins of abuse are discussed, the focus of the paper is on the maintenance and escalation of the pattern of abusive interaction. The author proposes to explain this pattern-maintenance through the application of Gregory Bateson's concept of schismogenesis, or regenerative feedback, a concept derived from cybernetics and family systems theory. Suggestions for intervention in this process are discussed in the conclusion.     

Influence of the referral process by a child protective agency on the outcome of psychiatric-psychological assessments of child abuse/neglect cases

Many Child Protective agencies in the United States have guidelines for referring certain kinds of abuse/neglect cases for psychiatric-psychological assessments which leave up to the referring agent such decisions as: choice of assessor (psychiatrist, psychologist, other), purpose of evaluation, and part of the family system to be evaluated. In order to develop a more systematic approach to comprehensive evaluations of abusive families, the referral process from the Hawaii Child Protective Services Agency to a child guidance center was analyzed through chart review, and its influence on the outcome of psychiatric-psychological assessments was examined. Evaluations by psychiatrists were also compared with those of psychologists. The results showed that the great majority of the cases referred for assessment were victim-children and that recommendations paralleled this trend by being child rather than adult or family oriented. In addition, referral questions and resulting recommendations centered more on diagnosis than on issues of intervention (treatment, placement, legal needs), suggesting an underutilization of the assessors' clinical skills. Differences between psychiatrists and psychologists are also reported. These findings point to a need for greater commitment to family pathology. Implications for developing more effective referral guidelines and for training are discussed.