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.     

Child maltreatment severity and adult trauma symptoms: Does perceived social support play a buffering role?

Objectives

The current study investigates the moderating effect of perceived social support on associations between child maltreatment severity and adult trauma symptoms. We extend the existing literature by examining the roles of severity of multiple maltreatment types (i.e., sexual, physical, and emotional abuse; physical and emotional neglect) and gender in this process.

Methods

The sample included 372 newlywed individuals recruited from marriage license records. Participants completed a number of self-report questionnaires measuring the nature and severity of child maltreatment history, perceived social support from friends and family, and trauma-related symptoms. These questionnaires were part of a larger study, investigating marital and intrapersonal functioning. We conducted separate, two-step hierarchical multiple regression models for perceived social support from family and perceived social support from friends. In each of these models, total trauma symptomatology was predicted from each child maltreatment severity variable, perceived social support, and the product of the two variables. In order to examine the role of gender, we conducted separate analyses for women and men.

Results

As hypothesized, increased severity of several maltreatment types (sexual abuse, emotional abuse, emotional neglect, and physical neglect) predicted greater trauma symptoms for both women and men, and increased physical abuse severity predicted greater trauma symptoms for women. Perceived social support from both family and friends predicted lower trauma symptoms across all levels of maltreatment for men. For women, greater perceived social support from friends, but not from family, predicted decreased trauma symptoms. Finally, among women, perceived social support from family interacted with child maltreatment such that, as the severity of maltreatment (physical and emotional abuse, emotional neglect) increased, the buffering effect of perceived social support from family on trauma symptoms diminished.

Conclusions

The results of the current study shed new light on the potential for social support to shield individuals against long-term trauma symptoms, and suggest the importance of strengthening perceptions of available social support when working with adult survivors of child maltreatment.     

Childhood trauma,PTSD, and psychosis: Findings from a highly traumatized,minority sample

Trauma, especially early life trauma, is a risk factor for the development of both posttraumatic stress disorder and psychosis. The goal of the present study was to determine specific associations between exposure to childhood abuse, PTSD symptoms, and current psychotic disorder. Subjects were recruited from a public, urban hospital (N = 328, >90% African American). Psychotic disorders were measured using the MINI International Neuropsychiatric Interview, PTSD was measured using the Clinician Administered PTSD Scale, child abuse was measured with the Childhood Trauma Questionnaire, and lifetime trauma exposure was measured with the Traumatic Events Inventory. Logistic regression analyses showed that both child abuse and current PTSD were statistically significant predictors of psychotic disorder beyond the effects of lifetime trauma load. When PTSD symptom clusters were examined, avoidance and numbing symptoms showed unique association with psychotic disorder independent of demographic variables and trauma exposure. Using bootstrapping techniques, we found a full indirect effect of PTSD on the association between child abuse and, suggesting a particularly important role of PTSD symptoms in relation to psychotic disorder in the presence of early life trauma. Because this is a cross-sectional study, continued research is needed to determine causality of such models. Identifying co-occurring psychosis and PTSD, particularly in populations with high levels of trauma exposure, is critical and will likely aid in more successful treatment interventions.     

Social and legal ramifications of a child crisis line

The article suggests the importance of a crisis line for children as a way of making it easier for them to report when they are abused or neglected. The Childhelp Line set up in Christchurch, New Zealand, in 1982, has shown that such a service is effective in reaching critical child and family situations not previously known to helping professionals. The Line is manned by carefully selected and trained volunteers. This has proved to have significant advantages, particularly in the absence of mandatory reporting of child abuse. The article also looks at the ambivalence towards the Childhelp Line expressed by parents, children, counselors, and the community, and at the legal issues raised by the service.     

Child abuse potential inventory and parenting behavior: Relationships with high-risk correlates

The primary purpose of this research was to examine the construct validity of the Child Abuse Potential Inventory by comparing maltreating and high-risk parents' CAP Inventory abuse scores to their behavior during interactions with their children. A second purpose was to determine the degree to which CAP Inventory scores and parenting behavior were related to several known correlates of abuse, as measured by parent and teacher reports. Participants (n = 41) included abusive and high-risk parents and their children referred to a treatment group. Correlational analyses revealed that CAP Inventory scores and observed parenting style yielded highly related findings, supporting construct validity of the CAP Inventory. However, the CAP Inventory and observed behavior index showed a different pattern of relationships to the risk correlates. Implications for assessment of risk status are discussed and recommendations are provided for continued research.     

Reactions to children's transgressions in at-risk caregivers: Does mitigating information,type of transgression,or caregiver directive matter?

This study examined whether caregivers who exhibit high risk for child physical abuse differ from low-risk caregivers in reactions to transgressing children. Caregivers read vignettes describing child transgressions. These vignettes varied in: (a) the type of transgression described (moral, conventional, personal), (b) presentation of transgression-mitigating information (present, absent), and (c) whether a directive to avoid the transgression was in the vignette (yes, no). After reading each vignette, caregivers provided ratings reflecting their: (a) perceptions of transgression wrongness, (b) internal attributions about the transgressing child, (c) perceptions of the transgressing child's hostile intent, (d) own expected negative post-transgression affect, and (e) perceived likelihood of responding to the transgression with discipline that displayed power assertion and/or induction. For moral transgressions (cruelty, dishonesty, hostility, or greed), mitigating information reduced caregiver expectations that they would feel negative affect and, subsequent to the transgression, use disciplinary strategies that display power assertion. These mitigating effects were smaller among at-risk caregivers than among low-risk caregivers. Moreover, when transgressions disobeyed a directive, among low-risk caregivers, mitigating information reduced the expectation that responses to transgressions would include inductive disciplinary strategies, but it did not do so among at-risk caregivers. In certain circumstances, compared to low-risk caregivers, at-risk caregivers expect to be relatively unaffected by transgression-mitigating information. These results suggest that interventions that increase an at-risk caregiver's ability to properly assess and integrate mitigating information may play a role in reducing the caregiver's risk of child physical abuse.     

Social workers’ views on pre-trial therapy in cases of child sexual abuse in South Africa

This study sought to explore anecdotal reports that social workers in South Africa are often advised to postpone therapy with child complainants of sexual abuse until after the child's testimony, based on concerns of legal professionals that therapeutic interventions could influence the child's testimony. Applying purposive sampling and a qualitative research study, individual and focus group interviews were conducted with 18 social workers and one psychologist that provide therapeutic services to child complainants of sexual abuse in the Gauteng province. Interviews were audio-recorded, transcribed and independently analyzed by both researchers, performing thematic analysis. Emerging themes include a lack of directives in terms of the provision of pre-trial therapy for child victims of sexual abuse, current practices and challenges in this regard. Recommendations for the way forward are presented. Limitations and future research will be discussed.     

Predictors of placement for children who initially remained in their homes after an investigation for abuse or neglect

Objective

To examine the frequency and predictors of out-of-home placement in a 30-month follow-up for a nationally representative sample of children investigated for a report of maltreatment who remained in their homes following the index child welfare report.

Methods

Data came from the National Survey of Child and Adolescent Well-being (NSCAW), a 3-year longitudinal study of 5,501 youth 0-14 years old referred to child welfare agencies for potential maltreatment between 10/1999 and 12/2000. These analyses focused on the children who had not been placed out-of-home at the baseline interview and examined child, family and case characteristics as predictors of subsequent out-of-home placement. Weighted logistic regression models were used to determine which baseline characteristics were related to out-of-home placement in the follow-up.

Results

For the total study sample, predictors of placement in the 30-month follow-up period included elevated Conflict Tactics Scale scores, prior history of child welfare involvement, high family risk scores and caseworkers’ assessment of likelihood of re-report without receipt of services. Higher family income was protective. For children without any prior child welfare history (incident cases), younger children, low family income and a high family risk score were strongly related to subsequent placement but receipt of services and case workers’ assessments were not.

Conclusions/practice implications

Family risk variables are strongly related to out-of-home placement in a 30-month follow-up, but receipt of child welfare services is not related to further placements. Considering family risk factors and income, 25% of the children who lived in poor families, with high family risk scores, were subsequently placed out-of-home, even among children in families who received child welfare services. Given that relevant evidence-based interventions are available for these families, more widespread tests of their use should be explored to understand whether their use could make a substantial difference in the lives of vulnerable children.     

Social history: A qualitative analysis of child abuse pediatricians’ consultation notes

BackgroundChild abuse pediatricians (CAPs) are often consulted for injuries when child physical abuse is suspected or when the etiology of a serious injury is unclear. CAPs carefully evaluate the reported mechanism of the child’s injury and the medical findings in the context of the child’s family and social setting to identify possible risk and protective factors for child abuse and the need for social services. It is unknown what population risk indicators along with other social cues CAPs record in the social history of the consultation notes when assessing families who are being evaluated for child physical abuse.Participants and settingThirty-two CAPs representing 28 US child abuse programs.MethodsParticipants submitted 730 completed cases of inpatient medical consultation notes for three injury types: traumatic brain injury, long bone fracture, and skull fracture in hospitalized children 4 years of age and younger. We defined a priori 12 social cues using known population risk indicators (e.g., single mother) and identified de novo 13 negative (e.g., legal engagement) and ten positive social cues (e.g., competent parenting). Using content analysis, we systematically coded the social history for the social cues.ResultsWe coded 3,543 cues resulting in a median of 7 coded cues per case. One quarter of the cues were population indicators while half of the cues were negative and one quarter positive.ConclusionsCAPs choose a wide variety of information, not always related to known population risk indicators, to include in their social histories.