Altruism, aggression, and social interactions in young children with a manic-depressive parent

This is an exploratory study of the emotional and social functioning of young children with a manic-depressive parent. Seminaturalistic observations and experimental manipulations of the affective environment were used to assess 2-year-old children's regulation of emotion, as well as their aggression, altruism, and affiliative interactions. Children with a bipolar parent sometimes showed heightened distress and preoccupation with the conflicts and suffering of others, especially disturbances in adults. These children had difficulty in maintaining friendly social interactions, in sharing, and in helping their playmates. They also had difficulty modulating hostile impulses; they showed more maladaptive patterns of aggression toward peers and adults. These interpersonal and emotional problems of offspring of manic-depressives were often similar to those problems of manic-depressives that have been implicated in the clinical literature as possibly associated with the transmission of the disorder. This apparent congruence of findings obtained from different disciplines employing very different research strategies and studying people of different ages, attests to the utility of an explicit interdisciplinary approach in the area of developmental psychopathology.     

A group for sexually abused young children: unravelling the web

This paper describes clinical material from a group for young sexually abused children. The group work combines both an educational and dynamic approach drawn from previous models. The group was clearly structured and ran over nine weeks in conjunction with a parallel caregivers' group who were informed each week of the main themes. The caregivers were also involved in evaluating the effectiveness of the therapy by completing questionnaires which recorded symptomatology. A statistical analysis based on the questionnaires showed a significant reduction in problems reported by the caregivers before and after the group therapy. The authors recommend that such therapeutic work be combined with formal evaluation in the future to assess the effectiveness of different approaches with a view to clarifying which aspects are responsible for promoting positive change.     

Post-traumatic stress in sexually abused, physically abused, and nonabused children

This investigation compared the rates of post-traumatic stress disorder symptoms across sexually abused, physically abused, and nonabused psychiatrically hospitalized children matched for age, sex, and socioeconomic status. Among the sexually abused children, 20.7% met diagnostic criteria for post-traumatic stress disorder compared with 6.9% of the physically abused and 10.3% of the nonabused children. Although these overall rates were not significantly different across groups, they were significantly high to reinforce the need for further study of post-traumatic stress in childhood. Further, significant symptom rate differences across groups were found with respect to specific post-traumatic stress symptoms. Specifically, sexually abused children exhibited significantly higher rates of inappropriate sexual behaviors than either the physically abused or nonabused children. In addition, both the sexually abused and physically abused groups showed a tendency to exhibit more avoidant/dissociative symptoms as compared to the nonabused children. Results are discussed in terms of their clinical and research implications.     

Self-esteem of abused children

Thirty-seven children admitted to hospital with a diagnosis of abuse at an average of 5.5 years previously were compared with 37 non-abused children matched for age, sex, ethnic group, school and social class. The mean age of the children with 8.9 years (range 4.6-14.0 years). Self-esteem in the children was assessed by means of a structured interview with the child and the Piers-Harris Self-Concept Scale. The abused children saw themselves as having significantly fewer friends than the comparison children and they played with friends less often. They were less ambitious than the non-abused children with regard to the sort of occupation they would like as adults and were significantly lower in self-concept on the Piers-Harris Self-Concept Scale. These results show that, as well as providing treatment for abusive parents, a long-term program which aims at improving interpersonal relationship skills and self-esteem is required for abused children.     

The hospitalized abused child: An interdisciplinary approach

The interdisciplinary approach to family diagnosis and treatment of child abuse often begins in the hospital. The tone established at this time has crucial implications for the treatment program following discharge from the hospital. There is, however, a paucity of information in the literature regarding the best utilization of this critical phase of treatment. Often this period is viewed as a time for assessment, diagnosis and treatment of the physical injuries while neglecting to recognize and utilize the potential for planned therapeutic intervention during the hospital stay. This paper identifies methods and interventions in implementing a treatment plan particular to this phase of the over-all treatment of the child and family.     

Educational and psychological problems of abused children

The findings of this study tend to confirm the hypothesis that abused children are found to be significantly different from nonabused children in academic achievement, placement in classes for the emotionally disturbed and for the educable mentally retarded. The data also confirm the hypothesis that abused and neglected children are placed in special facilities more frequently than children who have not been adjudged as abused. Further, abused and neglected children were reported to exhibit behaviors indicative of psychological problems. Within each of the dimensions investigated, abused and neglected children were found to have significant problems.In light of the significant differences found in this study, we find substantial support for the projects being supported by the National Center for Child Abuse and Neglect designed to involve the schools in the United States in the battle against children abuse and neglect. Especially important is the project of the Education Commission of the States designed to create an awareness among school systems, professional teacher organizations, and state and local legislative governing bodies of their potential in the battle against child abuse and neglect.In light of the loss of human potential as well as the increased costs involved in providing special classes for the abused and neglected child, allocation of resources to involve schools and school personnel as a part of the multidisciplinary team concerned with child abuse and neglect seems well justified. Additionally, the allocation of fiscal resources for research designed to secure data regarding the sequelae of child abuse is also amply justified.     

Louisiana's statewide interdisciplinary approach to diagnostic, protective and treatment services to abused and neglected children and their families

The provision of the most comprehensive funded statewide delivery of diagnostic, protective and treatment services to abused and neglected children and their families in the country has been made possible by the State of Louisiana and its concerned citizenry. The importance of obtaining a legislative mandate establishing and funding the statewide child protection concept by the Louisiana legislature was illustrated.We described how the medical and protective services components cooperate and coordinate at the state and local levels to provide the abused and neglected child and his family with the best possible services available. Throughout our presentation the use of the interdisciplinary team concept was emphasized as the best system known to enhance the reporting, investigation and diagnosis of child abuse and/or neglect cases as well as providing protective and treatment services to the child and his family.The Child Protection Center is the community agency serving as the “core” for the interdisciplinary approach to be successful. The role of each discipline employed by the center was reviewed and how interagency coordination is accomplished through their efforts.The interdisciplinary dispositional conference prior to a child's discharge from the hospital was considered as an excellent method to insure that several disciplines share in the definitive protective and treatment plans for the abused child.Several treatment modalities and their success rates for the child and his family were discussed. The accomplishments of the center were listed.Finally, a review of how the citizenry from the Baton Rouge Community responded overwhelmly by their involvement and commitments in an all out effort to combat a serious social symptom and disease — child abuse and neglect.     

Developmental milestones in abused children, and their improvement with a family-oriented approach to the treatment of child abuse

Few objective measures of the efficacy of intervention programs in the treatment of child abuse exist. One such measure may be improvement in the developmental delays often seen in abused children. Using the Learning Assessment Profile, we tested 53 abused children, ages 2.5-5 years, just before and after involvement in our Family Development Center Program (FDC). The FDC emphasizes therapy-group-interaction for parents, where alternative ways of expressing anger are explored. Children attend daily preschool classes, and take occasional outside field trips. Of the 53 children tested 42 (79%) showed greater than expected developmental skills gains. Six children demonstrated no improvement in developmental skills, four of whom had severe developmental delays in one or two areas. Fine motor and language skills were significantly delayed for the group as a whole; these areas showed the greatest improvement after FDC. There did not appear to be an overall association between increased improvement in developmental skills and length of time in the FDC program, although certain subgroups of children appeared to improve with time while others appeared to lose ground. A five-year follow-up study of these children is presently underway. We conclude that a program which involves both parent and child, and focuses on their interaction, appears to be effective in dealing with abusive families; monitoring developmental levels in the abused children is one means of assessing their progress in such a program. Further controlled prospective trials are needed in this area.     

Further abuse of sexually abused children

OBJECTIVE: To determine the incidence of re-abuse in children known to have been sexually abused and to find factors that increase the risk of re-abuse. METHOD: The study group consisted of 183 children with substantiated sexual abuse who presented to two children's hospitals' Child Protection Units in Sydney, Australia during 1988 through 1990. At intake, when the children were aged between 5 years and 15 years, data about the child, the family, and the nature of the index sexual abuse were collected. Six years after presentation for the abuse, records of the Department of Community Services were checked to see if any of the young people had been the subject of substantiated notifications for abuse/neglect before and after intake to the study. Predictors of notifications for abuse/neglect after presentation for the index sexual abuse were identified. RESULTS: Of the sexually abused young people, nearly one in three were the subject of subsequent substantiated notifications to the Department of Community Services for some form of child abuse and neglect or behavior which placed them at risk of harm. Later notifications for abuse/neglect were predicted by notifications for emotional abuse before the index sexual abuse (adjusted RR = 4.88, CI: 1.43 to 16.65), severity of the index sexual abuse (p = .03), and the number of changes in the child's primary caregivers before intake (p = .03). Approximately one in six of the sexually abused young people were notified for sexual abuse after intake to the study. One in 10 also had prior notifications for sexual abuse. Sexual abuse notifications after study intake were predicted by caregiver changes before intake (p = .01) and whether or not there were notifications for emotional abuse before the index sexual abuse (adjusted RR = 3.40, CI: 1.05 to 11.02). CONCLUSIONS: Revictimization of children appears to be a marker of ongoing family dysfunction. Intervention in child sexual abuse needs to consider a range of risk factors associated with re-abuse and, in particular, should focus on family functioning if further abuse is to be prevented.     

Early indicators of pathological dissociation in sexually abused children.

Although reported cases of adult multiple personality disorder (MPD) are increasing, confirmation of MPD and related dissociative disorders in children remains rare. Since MPD can cause severe impairment and psychological distress, and is thought to originate in childhood, early recognition of pathological dissociation and predictors of MPD is critical. Sexual abuse in childhood has similarly been under-reported until recently, and is highly associated with the development of dissociative disorders. This paper reviews factors in the professional neglect of these syndromes as well as recent diagnostic developments in childhood dissociative disorders. The identification of subtle dissociative symptomatology in children is illustrated and two case examples are presented.     

The social and educational adjustment of abused children

Thirteen 6-year-old children who had been physically abused by their parents were assessed in school for language development, educational attainments and social adjustment, and compared with children from some of the same school classes who served as a comparison group. All the abused children had attended the Family Centre of the National Society for the Prevention of Cruelty to Children (NSPCC) in Manchester before starting school, and they and their parents had received social work support and supervision from the special unit team. Ten of the 13 abused children had made measurable progress in reading. There were no significant differences between the groups in language development or number skills, but the abused group did contain more high (maladjusted) scores on the Bristol Social Adjustment Guide. Monitoring educational progress and social adjustment in school would seem to be a useful method of following the progress of such children. Most of the children in this group are so far making progress within the ordinary school system despite the disturbances which have affected their home life.     

Peer group interaction of physically abused children

The aim of this research study was to test the assumption that physically abused children differ significantly from their non-abused peers along dimensions which characterize abusing adults and other social deviants. Nineteen 5-10 year-old physically abused children and 38 non-abused peers were assessed by video-taped behavioral observations during free-flowing social interaction in a playroom. The dimensions tapped were: aggression, warmth, fear, pleasure, concentration, imagination and social participation. The dimension social participation was split into three variables: total social participation, negative participation and positive participation. The data from these nine dimensions was subject to a Pearson's correlation. Given the high correlation amongst these variables the data was subject to a principal components analysis with varimax rotation. From this analysis two components emerged which explained 76.9% of the total variance. These components were designated "social interaction" (component 1) and "hostility" (component 2) and were then subject to analyses of variance. A significant difference was found between the two groups on the "social interaction" component. The implications of these findings were explored and treatment possibilities examined.     

Prior incest in mothers of abused children

Previous studies have shown that most abusing parents have a history of physical abuse or neglect in their own childhoods. There is little data on the frequency of prior sexual abuse among parents who physically or sexually abuse their children. Many case reports describe the uncovering of a prior incest experience in a parent during the investigation of the child's current incest accusation, but it is unclear how frequently this occurs. One hundred mothers of abused children were asked about sexual incidents that occurred before age 18; the control group consisted of 500 normal women from the same community who were surveyed during meetings of various voluntary organizations. Age and ethnicity did not differ in the two groups. Of the mothers of abused children, 24% reported a prior incest experience, whereas only 3% of the control women reported prior incest. This eightfold difference was highly significant. The 34 mothers from families where sexual abuse was occurring were no more likely to report prior incest than were the 66 mothers from families where physical abuse occurred. The one case of genital mutilation of a child occurred in a family where both parents had been incest victims. Case studies indicate that the parent who has been an incest victim has inhibitions and fears about tenderness, traceable to the childhood incest experience, which are important in the development of either physical abuse or sexual abuse in the family.     

An assessment of the behavior of sexually abused and nonsexually abused children with anatomically correct dolls

The behaviors of two groups of children were observed and recorded in their play with anatomically correct dolls. One group had been determined to have been sexually abused and the other group had not been determined to have been sexually abused. The findings show that significantly more children who had been sexually abused demonstrated sexual behavior(s) with the anatomically correct dolls than did the group of children who had not been sexually abused. These findings suggest that anatomically correct dolls are a useful instrument in sexual abuse investigations.     

A clinical-demographic study of sexually abused children

Forty-five children who had been sexually abused were psychologically evaluated. Parents or guardians of the children completed symptom checklists. Results indicated that the majority of children (71%) were abused 4 or fewer times. In addition, genital manipulation and/or fondling was the most common form of abuse. In 82% of the cases, there were no marital separations or family breakups of any kind within six months before or six months after the abuse. Many children (69%) displayed psychological symptoms. The most frequent were nightmares, bedwetting, clinging behavior, inappropriate sexual behavior, anxiety and sadness. Results of this study are largely inconsistent with popular notions about the nature of child sexual abuse. The major methodological shortcoming of the investigation was the lack of a systematic control group.     

Memory, maternal representations, and internalizing symptomatology among abused, neglected, and nonmaltreated children

A depth-of-processing incidental recall task for maternal-referent stimuli was utilized to assess basic memory processes and the affective valence of maternal representations among abused ( N  = 63), neglected ( N  = 33), and nonmaltreated ( N  = 128) school-aged children (ages 8–13.5 years old). Self-reported and observer-rated indices of internalizing symptoms were also assessed. Abused children demonstrated impairments in recall compared to neglected and nonmaltreated children. Although abused, neglected, and nonmaltreated children did not differ in valence of maternal representations, positive and negative maternal schemas related to internalizing symptoms differently among subgroups of maltreated children. Valence of maternal schema was critical in differentiating those with high and low internalizing symptomatology among the neglected children only. Implications for clinical intervention and prevention efforts are underscored.     

Parental physical and psychological aggression: Psychological symptoms in young adults

ObjectiveThe purpose of the present study was to evaluate the relationship between various levels of parent-child physical violence and psychological symptoms reported by college students, while controlling for demographic variables, severity and frequency of violence, and co-occurrence of parental psychological aggression.MethodParticipants included 298 college students ranging in age from 18 to 27 years. Participants completed a demographic information form, the Brief Symptom Inventory (BSI), and the Parent-Child Conflict Tactics Scale (CTSPC).ResultsResults of analysis of variance and multivariate analysis of variance indicated that individuals in the child physical abuse group obtained higher BSI scores compared to individuals in the corporal punishment and no violence groups. Few differences were observed between mild and severe corporal punishment groups. Multiple regression analyses indicated that when frequency of corporal punishment, child physical abuse, and psychological aggression, along with demographic variables, were considered simultaneously, psychological aggression was the most unique predictor of BSI scores.ConclusionsThe findings suggest that severe forms of physical violence were associated with long-term psychological symptoms. When demographic variables and the frequency of several parent aggression variables were considered simultaneously, however, psychological aggression was most predictive of psychological outcome. These findings suggest that messages communicated to a child via psychological aggression may be more important in contributing to psychological outcome than the actual occurrence of physical violence toward the child.Practice implicationsThe current study supports the premise that severe physical aggression experienced in childhood is associated with serious psychological consequences in adulthood. In contrast, individuals who experienced less severe forms of parent-child violence, such as corporal aggression, exhibited similar symptom levels to those reporting no parent-child violence. When severe physical aggression, corporal aggression, and psychological aggression were considered simultaneously, however, psychological aggression emerged as the most unique predictor of psychological outcome. Researchers and clinicians who work with adults reporting childhood histories of severe parent-child violence should be aware of the importance of parent-child psychological aggression in contributing to psychological outcome.