Child abuse potential among mothers of substance-exposed and nonexposed infants and toddlers

OBJECTIVE: The purpose of this longitudinal study was to determine whether there were differences in child abuse potential among mothers who were nonusers, drug users who accepted treatment, and drug users who rejected offers of treatment, over the first 2 years of their children's lives. METHOD: Participants were mothers of 140 infants, classified into Nonuser (n = 48), Treatment (n = 72), or Refuser (n = 20) groups. The Child Abuse Potential (CAP) Inventory [Milner, J. S. 1980. The Child Abuse Potential Inventory: Manual. Webster, NC: Psytec Corporation] was administered when infants were 4, 9, 12, 18, and 24 months. RESULTS: Results of mixed-model analyses of variances showed no group differences on CAP Inventory abuse scale scores. There were significant group differences in lie scale scores on the CAP Inventory, such that lie scale scores for the Nonuser group were significantly higher than lie scale scores for the Treatment group. CONCLUSIONS: Overall, results support the position that low-income women with many risk factors in their lives are at high risk for potential child abuse, but that their drug use status and drug treatment status does not differentiate them from their nonuser peers from a similar social and demographic background.     

Effects of a prenatal care intervention for adolescent mothers on birth weight, repeat pregnancy, and educational outcomes at one year postpartum

About one-third of adolescent mothers receive inadequate prenatal care, and babies born to young mothers are more likely to be of low birth weight. The objective of this study is to evaluate a peer-centered prenatal care program for adolescent mothers. Pregnant adolescents were randomly assigned to an experimental or control group in a mastery modeling peer-support intervention designed to improve long- and short-term perinatal outcomes. A sample of 282 urban pregnant adolescents (94% African American, 4% Caucasian, 2% other) participated in the study. Participants were recruited from five clinics located mainly in Detroit, Michigan. Participants in the experimental group received care in a small group setting and learned to perform critical measurements with a peer partner during prenatal visits. Participants in the control group received individual prenatal care in the same clinics. Outcome measures included birth weight, years of schooling completed at one year postpartum, planned and unplanned pregnancy at one year postpartum, and employment and school attendance at one year postpartum. Mothers in the experimental group had a lower rate of low birth weight (6.6% vs. 12.5%, p=0.08). The rate of unplanned pregnancy was also lower for adolescents in the experimental group (13.4% vs. 15.9%), although this difference was not statistically significant. Adolescents who participated in the intervention were more likely to have continued their education during the pregnancy and the postpartum year. The mastery modeling, peer-centered, prenatal care program produced some positive pregnancy outcomes for adolescent mothers.     

Effects of a prenatal care intervention on the self-concept and self-efficacy of adolescent mothers

The objective of this study was to examine changes in self-concept and self-efficacy during the childbearing year among adolescent mothers (defined as young mothers up to age 20) who were involved in a behavioral intervention. Subjects included a sample of 282 urban, pregnant adolescents (94% African American, 4% white, 2% other). The Tennessee Self-Concept Scale (TSCS) was used to measure self-concept. A scale to measure the self-efficacy of the adolescent mother during the childbearing year was developed and evaluated. Questionnaires were administered during intake for prenatal care and in the postpartum period. In the larger study, the intervention was a peer-centered, mastery modeling intervention designed to increase self-efficacy, improve self-concept, and improve long- and short-term perinatal outcomes. The results in this portion of the data showed that self-concept increased significantly for young women in the experimental group but did not change significantly for young women in the control group. Changes were noted in the TSCS for overall self-concept as well as for several subscores, including identity, self-satisfaction, behavior, the personal self, the family self, and the social self. However, differences between groups did not reach significance once age, parity, site, and time were accounted for, except on TSCS subscales of identity and personal self. Between intake for prenatal care and postpartum, self-efficacy changed significantly for both the experimental and the control groups. Both groups increased in self-efficacy for labor and delivery and decreased in self-efficacy for infant care. In this group of mostly African American teens, peer support and small group care demonstrated positive effects on self-concept. Professional and peer interactions were equally associated in intervention and nonintervention groups with regard to self-efficacy.     

A scale for home visiting nurses to identify risks of physical abuse and neglect among mothers with newborn infants

OBJECTIVE: The aim was to construct and test the reliability (utility, internal consistency, interrater agreement) and the validity (internal validity, concurrent validity) of a scale for home visiting social nurses to identify risks of physical abuse and neglect in mothers with a newborn child. METHOD: A 71-item scale was constructed based on a literature review and focus group sessions with social nurses and paraprofessionals who had experience with underprivileged families. This scale was applied in a random sample of 40 home visiting social nurses, who collected data in a sample of 373 nonabusive and 18 abusive/neglectful mothers with a newborn child. RESULTS: Items with prevalence rates below 5% and items making no significant difference between maltreating and non-maltreating mothers were omitted. The final version contained 20 items. This scale showed high internal consistency (alpha = .92) and high interrater reliability (r = .97). Exploratory factor analysis yielded a three-factor solution: Isolation (8 items, explaining 62.17% of the common variance), Psychological complexity (6 items, 18.86%), and Communication problems (6 items, 8.41%). Scores on Communication problems and Isolation significantly predicted scores on a social deprivation scale, which significantly distinguished maltreating from non-maltreating mothers. Mothers scoring high on Communication problems or Isolation obtained higher scores for social deprivation than low-scoring mothers. CONCLUSIONS: Home visiting nurses can identify risks for physical abuse and neglect among mothers with a newborn infant by focusing on signs of social isolation, distorted communication and psychological problems.     

Pre-kindergarten child care and behavioral outcomes among children of immigrants

The school transition model suggests that children's transitions into formal schooling can have lasting and profound implications for their educational careers, though this model is rarely used to understand the outcomes of children of immigrants. Using data from the Early Childhood Longitudinal Study-Kindergarten Cohort (ECLS-K), a nationally representative sample of kindergarteners in 1998–1999, we examine the pre-kindergarten child care arrangements of children of immigrants and how these care arrangements are associated with children's behavior. We find that minority and immigrant children are less likely than their native-born white counterparts to be enrolled in center-based care and other care, compared to parental care, prior to kindergarten. We also find that ethnic origin is an important predictor of child care usage. Finally, though center-based care, on average, is not independently associated with children's behavior in kindergarten, the association between center-based care and behaviors varies by race and immigrant status. Broadly, these findings underscore the importance of understanding how native- and foreign-born children experience the transition to schooling, a critical period in the life course.     

无权处分的时间点分析

无权处分的时间点,就是对无权处分的后果进行法律评价的时间。该点的具体“位置”,我国现有民法理论鲜有论述。本文从四个方面分析,指出无权处分的时间点是在物权变动之时。     

Interactions of black inner-city mothers with their newborn infants.

Interactions of 45 black inner-city mothers with their healthy full-term newborn infants were observed during a bottle-feeding on the third day after birth. An exhaustive catalog of some 100 mother and infant behaviors was used to describe objectively the interactions of mothers and infants. In addition to being observed with their mothers, infants were examined with the Rosenblith scale. The infants' birth weights, birth order, and sex and maternal medication were found to affect the infants' behaviors and/or the patterns of mother-infant interactions.     

Psychosocial and behavioral factors related to the post-partum placements of infants born to cocaine-using women

OBJECTIVE: One objective was to determine if cocaine-using women who did not maintain infant custody (NMC) would report more psychological distress, domestic violence, negative coping skills, lower social support and more childhood trauma than cocaine-using women who maintained custody (MC) of their infant. A second objective was to evaluate the relative contribution of psychosocial factors to infant placement. METHODS: Psychosocial profiles of MC women (n=144) were compared with NMC (n=66) cocaine-using women. Subjects were low income, urban, African-American women who delivered an infant at a county teaching hospital. The Brief Symptom Inventory (BSI), an assessment of coping strategies (COPE), Multidimensional Scale of Perceived Social Support (MSPSS), Conflict Tactics Scale (CTS) and Childhood Trauma Questionnaire (CTQ) were administered. The associations of infant placement status to demographic factors, drug use and psychosocial measures were evaluated. RESULTS: The NMC group reported greater overall psychological distress, psychoticism, somatization, anxiety and hostility than the MC group. The NMC group had more childhood neglect and physical abuse and used more negative coping strategies than the MC group. Lack of prenatal care [OR=.83, CI (.75-.91), p<.0001], heavier prenatal cocaine use [OR=2.55, CI (1.13-4.34), p<.007], greater psychological distress [OR=2.21, CI (1.13-4.34), p<.02] and a childhood history of emotional neglect [OR=1.10, CI (1.02-1.19), p<.02] were associated with increased likelihood of loss of infant custody after control for other substance use and demographic variables. CONCLUSIONS: NMC women have more negative psychological and behavioral functioning post-partum than MC women. Less prenatal care and greater cocaine use, psychological distress and maternal childhood emotional neglect are associated with the post-partum placement of infants born to cocaine-using women. PRACTICE IMPLICATIONS: Results of this study indicate that poor, urban women who use cocaine prenatally display several measurable differences on psychosocial and behavioral risk factors based on child placement status. Among these risk factors heavier cocaine use, lack of prenatal care, more severe psychological symptoms and early childhood experiences of emotional neglect increase the likelihood of loss of infant custody. Routine, objective assessments of psychosocial and behavioral characteristics of women who use cocaine during pregnancy can aid Child Protective Service workers and clinicians by providing baseline data from which to tailor interventions and set improvement criteria for mother-child reunification.     

Child maltreatment prevalence and mental disorders outcomes among American Indian women in primary care

OBJECTIVE: To examine (1) the prevalence, types, and severity of child abuse and neglect (CAN) and (2) the relationship between CAN and lifetime psychiatric disorders among American Indian women using primary care services. METHODS: A cross-sectional study was conducted among 234 American Indian women, age 18-45 who presented for outpatient ambulatory services at a community-based Indian Health Service Hospital in Albuquerque, New Mexico. Dependent measures included mood, substance abuse, and anxiety disorders as well as posttraumatic stress disorder (PTSD) as measured by the Composite International Diagnostic Interview. CAN was assessed using the Childhood Trauma Questionnaire. RESULTS: Approximately three-quarters of respondents (76.5%; 95% CI = 70.4, 81.7) reported some type of childhood abuse or neglect; over 40% reported exposure to severe maltreatment. Severity of child maltreatment was associated in a dose response manner with lifetime diagnosis of mental disorders. After adjusting for social and demographic correlates, severe child maltreatment was strongly associated with lifetime PTSD (prevalence ratio [PR] 3.9; 95% CI = 1.9, 8.0); and was moderately associated with lifetime substance use disorders (PR = 2.3; 95% CI = 1.6, 3.3); mood disorders (PR = 2.1; 95% CI 1.4, 3.2); and with two or more disorders (PR = 2.3; 95% CI = 1.6, 3.4). CONCLUSION: CAN was common in our sample of American Indian women in primary care and was positively associated with lifetime psychiatric disorders outcomes. Screening for CAN and psychiatric disorders would enhance the treatment of patients seeking primary care services. Primary prevention of child maltreatment might reduce the high prevalence of mental disorders among American Indian women.     

Factors associated with re-entry to out-of-home care among children in England

Exiting and re-entering out-of-home care (OHC) is considered a disruption to permanence which may have long-lasting, negative consequences for children due to a lack of stability and continuity. Each year approximately one-third of children in OHC in England exit, but information is lacking on rates of re-entries and associated factors. Using national administrative data, we calculated rates of re-entry among children exiting OHC from 2007 to 2012, identified key child and care factors associated with re-entry using Cox proportional hazards modelling, and developed a simple probability calculator to estimate which groups of children are most likely to re-enter OHC within three months. Between 2007 and 2012 re-entries to OHC in England decreased (from 23.3% to 14.4% within one year of exit, p < 0.001), possibly due to concurrent changes in the way children exited OHC. Overall, more than one-third of children exiting OHC in 2008 re-entered within five years (35.3%, N = 4076), but rates of re-entry varied by child and care characteristics including age, ethnicity, mode of exit, and placement stability. Based on these associated factors, we developed a calculator that can estimate the likelihood of rapid re-entry to OHC for a group of children and could be used by social care practitioners or service planners. Our findings provide insight into which groups of children are most likely to re-enter OHC, who may benefit from additional support or ongoing monitoring.     

Trauma symptoms among infants exposed to intimate partner violence

OBJECTIVE: To determine whether infants have a traumatic response to intimate partner violence (male violence toward their female partner; IPV) experienced by their mothers, two questions were explored: (1) Is the number of infant trauma symptoms related to the infant's temperament and the mother's mental health? (2) Does severity of violence moderate those relationships? METHODOLOGY: Forty-eight mothers reported whether their 1-year-old infants experienced trauma symptoms as a result of witnessing episodes of IPV during their first year of life. Mothers also reported on their own trauma symptoms that resulted from experiences of IPV. RESULTS: For those infants experiencing severe IPV and whose mothers exhibit trauma symptoms, we were able to predict whether infants exhibited trauma symptoms (b = .53, p < .01). This was not true for children who witnessed less severe IPV (b= -.14, ns). Maternal depressive symptoms and difficult infant temperament did not predict infant trauma symptoms for either group of infants. CONCLUSION: Mothers report that infants as young as 1-year-old can experience trauma symptoms as a result of hearing or witnessing IPV. The significant relationship between infant and maternal trauma symptoms, especially among those infants experiencing severe IPV, are consistent with the theory of relational PTSD. Findings suggest that interventions for mothers and families need to consider the influence of the severity of IPV on very young children.     

大学生拖延与时间管理倾向的关系

研究旨在探讨大学生拖延与时间管理倾向的关系.研究首先编制了大学生拖延行为量表,项目分析、探索性因素分析和验证性因素分析,均表明该量表具有较高的信效度,其中总体克朗巴哈系数为0.848,模型拟合指数χ2/df为1.624,CFI为0.897,IFI为0.900,RMSEA为0.047.研究表明大学生拖延行为和时间管理倾向均处于中上水平,拖延行为与时间管理倾向呈显著负相关,时间管理倾向中的时间效能感对大学生拖延行为预测力最佳,解释量达21.2%.     

海洛因依赖者时间管理倾向与自我价值感的相关研究

目的探讨海洛因依赖者的时间管理倾向与自我价值感的特点及二者的关系。方法运用时间管理倾向量表和自我价值感量表对150名海洛因依赖者进行问卷调查。运用均值差异性检验、方差差异分析、相关分析及多元逐步回归分析。结果 1.海洛因依赖者的时间管理倾向显著低于大学生;2.海洛因依赖者自我价值感高于常模群体;3.海洛因依赖者时间管理倾向和自我价值感有显著正相关;4.时间价值感和时间监控观对自我价值感有预测作用,但未发现时间效能感对自我价值感有预测作用,表现出特殊性。结论海洛因依赖者的时间管理倾向、自我价值感同常模有差异,海洛因依赖者的时间管理倾向与自我价值感呈显著正相关。     

Relationships among childhood maltreatment, PTSD, and health in female veterans in primary care

OBJECTIVE: Women with histories of childhood maltreatment (CM) have higher rates of physical health problems and greater medical utilization compared to women without abuse histories. This study examined whether current post-traumatic stress disorder (PTSD) symptoms mediate the relationship between CM and indicators of physical health and medical utilization in female veterans. METHOD: Respondents were 221 female veterans (56% of the potential sample), who received medical care from the San Diego VA Healthcare System during a 12-month period. Respondents provided self-report information about CM, PTSD symptoms, use of pain medication, and physical symptoms and functioning. Additional information about medical utilization was extracted from respondents' medical charts. Regression-based models were conducted to test whether PTSD symptoms mediate the relationships between CM and physical symptoms and between CM and medical utilization. RESULTS: Emotional abuse was associated with poorer role-physical functioning, increased bodily pain and greater odds of using pain medication in the past 6 months. Physical abuse was associated with poorer general health. Contrary to prediction, emotional neglect was associated with better role-physical functioning, and CM was not associated with increased healthcare utilization. PTSD was shown to mediate the relationship between emotional and physical abuse and health outcomes. CONCLUSIONS: PTSD, or psychopathology more generally, appears to be an important factor in the negative health impact of CM. Given that several empirically supported interventions are available for PTSD, there may be physical health benefits in early identification and treatment of psychopathology related to CM.     

两种医疗操作过程中飞沫的产生

对2种会产生飞沫的医疗操作过程进行飞沫特性的初步实验研究：鼻咽分泌物（NPA）的抽吸和雾化治疗.抽吸鼻咽分泌物（NPA）时用玻片和水敏感试纸来收集产生的大飞沫,对玻片上飞沫留下的痕迹在显微镜下进行计数,然后进行粒径大小分析.雾化治疗时用粉尘监测仪来检测雾化器周围以及房间中不同位置的小飞沫和飞沫核.研究结果表明,鼻咽分泌物（NPA）的抽吸过程会引发咳嗽,产生大飞沫.雾化器每分钟可产生数千万0.3～20μm的细小飞沫,其中大部分飞沫会从雾化器面罩上的2个小孔中逸出,扩散到空气中.飞沫在面罩内壁以及志愿者脸上聚集凝结说明雾化治疗过程中药液极有可能被病人的分泌物污染.     

Placement disruption and negative placement outcomes among adolescents in long-term foster care: the role of behavior problems

OBJECTIVE: This study examined risk of placement disruption and negative placement outcomes (e.g., residential treatment and incarceration) among adolescents placed in traditional family foster care for a year or longer. A foster parent's report of externalizing behavior problems was expected to be a stronger predictor of disruption and negative outcomes than a caseworker's report. Additionally, the association between behavior problems and placement disruption was expected to be mediated by the youth's degree of belonging and integration in the foster home. METHOD: The caseworkers and foster parents of 179 randomly selected 12-13-year-old adolescents placed in traditional foster care were interviewed by telephone. Interviews included standardized measures of externalizing behavioral problems and several other variables that have been previously associated with placement movement. Disruption from the youth's foster home at the time of the interview was prospectively tracked for 5 years. RESULTS: Over half of the youth experienced a disruption of their placement. Contrary to expectations, behavior problems as reported by caseworkers, but not foster parents, were predictive of placement disruption. However, the foster parent's report of behavior problems predicted risk of negative outcome after a period of 5 years. As hypothesized, integration in the foster home was highly predictive of placement stability and mediated the association between behavior problems and risk of disruption. CONCLUSIONS: Results suggest that integration in the foster home might be an important dimension of placement adaptation that should be considered during service planning for foster youth in long-term foster care. In addition, using standardized measures of behavior with both foster parents and caseworkers might be necessary to assess both long-term risk of negative outcomes and more immediate risk of placement disruption.     

Antecedents and concomitants of parenting stress in adolescent mothers in foster care

OBJECTIVE: This study's aim was to examine variables associated with different short-term trajectories in multiply disadvantaged adolescent mothers by investigating antecedents and concomitants of parenting stress. METHOD: We followed 49 adolescent mothers (ages 14-18 at study outset) who were wards in Illinois foster care using a longitudinal correlational design. We examined whether parenting variables (childrearing beliefs, quality of parent-child interactions, and child abuse risk) and personal adjustment variables (emotional distress and social support) at initial assessment predicted parenting stress measured at follow-up (a mean of 22.5 months later). We also examined concurrent relationships between parenting stress and mothers' adaptive functioning in educational, social support, and childbirth areas at follow-up. RESULTS: We found that parenting variables, but not personal adjustment variables, predicted later parenting stress. Results also showed that current adaptive functioning was significantly related to parenting stress. Specifically, educational status and social support predicted concurrent parenting stress, whereas number of childbirths did not. CONCLUSIONS: These findings extend the small literature on the link between parenting difficulties and parenting stress to adolescent mothers in foster care. Parenting challenges, particularly as reflected in unrealistic childrearing expectations, appear to be markers for later parenting stress. Considering the longitudinal relationships observed, early and periodic assessment of adolescent mothers' parenting knowledge, skills, and interactions is recommended. Also, given that this study found concurrent social support and educational status to covary with current parental stress, these variables, and others for which they may serve as proxy, are implicated for careful monitoring.