Culture and child maltreatment: cultural competence and beyond

OBJECTIVE: The objective of this article is to comment on current issues in the relationship between culture and child maltreatment. METHOD: A review of the literature on culture and child maltreatment is the basis of the article. RESULTS AND CONCLUSION: While attention has been directed to the relationship between culture and maltreatment for more than 20 years, there is a need for further development in this area. Efforts need to be made to "unpack" culture, to promote understanding culture in context, and to enhance research on child maltreatment and culture.     

How neighborhoods influence child maltreatment: a review of the literature and alternative pathways

OBJECTIVE: To review the literature on the relationships between neighborhoods and child maltreatment and identify future directions for research in this area. METHOD: A search of electronic databases and a survey of experts yielded a list of 25 studies on the influence of geographically defined neighborhoods on child maltreatment. These studies were then critically reviewed by an interdisciplinary research team. RESULTS: Numerous studies demonstrate that child maltreatment cases are concentrated in disadvantaged areas. A number of socio-economic characteristics of neighborhoods have been shown to correlate with child maltreatment rates as measured by official reports to child protective service agencies. Only a few studies examine direct measures of parenting behaviors associated with maltreatment, and these show a weaker relationship with neighborhood disadvantage. Moreover, the processes that link neighborhood conditions to either maltreatment reports or parenting behaviors are not yet confirmed by the research literature. Selection bias, neighborhood definitions and spatial influences are largely uncontrolled in the existing research. CONCLUSIONS: We propose a framework for pursuing further study of neighborhoods and child maltreatment that addresses the gaps in the current literature. Neighborhood-based strategies to prevent and reduce child maltreatment will be enhanced by research that provides a better understanding of how neighborhood conditions act as stressors or supports for families at risk of child maltreatment.     

The protective role of mentalizing: Reflective functioning as a mediator between child maltreatment,psychopathology and parental attitude in expecting parents

BackgroundChildhood maltreatment impacts parenting and has intergenerational consequences. It is therefore crucial to identify clinically responsive resilience-promoting factors in pregnant women and expecting men with history of childhood maltreatment. Mentalization, or reflective functioning, appears as a promising concept to understand risk and resilience in the face of childhood maltreatment.ObjectiveThis study evaluated the multivariate relationship between exposure to childhood maltreatment, reflective functioning, psychological symptoms and parental attitude in expecting parents.MethodsTwo hundred and thirty-five pregnant women and 66 expecting fathers completed self-report assessment measures of childhood trauma, reflective functioning, depression, post-traumatic stress disorder, parental sense of competence and antenatal attachment. Twenty-eight percent (n = 85) of the community sample reported personal histories of childhood maltreatment.ResultsStructural equation modeling indicated that reflective functioning (a) partially mediated the association between childhood maltreatment and psychological symptoms during pregnancy and (b) independently predicted participants’ perception of parental competence and psychological investment toward the unborn child.ConclusionOverall, this study provides empirical evidence of the protective role of reflective functioning during the prenatal period in parents with histories of childhood maltreatment.     

Identifying Potential Mediators and Moderators of the Association Between Child Maltreatment and Bullying Perpetration and Victimization in School

A growing body of literature is demonstrating associations between childhood maltreatment and bullying involvement at school. In this literature review, four potential mediators (explanatory) and three potential moderators (mitigates or exacerbates) of the association between childhood maltreatment and school bullying are proposed. Mediators include emotional dysregulation, depression, anger, and social skills deficits. Moderators reviewed include quality of parent–child relationships, peer relationships, and teacher relationships. Although there might be insurmountable challenges to addressing child maltreatment in primary or universal school-based prevention programs, it is possible to intervene to improve these potentially mediating and moderating factors.     

Resilience in young children involved with child protective services

Child maltreatment increases the risk of poor developmental outcomes. However, some children display resilience, meaning they are high-functioning despite their adverse experiences. To date, few research studies have examined protective factors among very young maltreated children. Yet, domains of resilience, and the protective factors that promote resilience among maltreated children, are likely to differ by developmental stage. Drawing on ecological systems theory and life course theory, we examined how protective factors at multiple ecological levels across early childhood were related to social and cognitive resilience among very young children involved with child protective services. The results demonstrated that the buffering effects of protective factors varied by social or cognitive resilience and the cumulative effects of protective factors were more consistently related to later resilience than protective factors at specific time points. In addition, the influence of specific protective factors on resilience slightly varied by initial in-home or out-of-home placement. These findings have important policy and research implications for promoting optimal development among children involved in child protective services.     

Educational and emotional health outcomes in adolescence following maltreatment in early childhood: A population-based study of protective factors

Although childhood maltreatment is associated with long-term impairment, some children function well despite this adversity. This study aimed to identify the key protective factors for good educational attainment and positive emotional health in adolescents who experienced maltreatment in early childhood. Data were analyzed from the Avon Longitudinal Study of Parents and Children, a large UK prospective cohort study. The sample was defined by maternally reported exposure to physical or emotional maltreatment by a parent prior to 5 years. 1118 (8.0%) children were emotionally maltreated and 375 (2.7%) were physically maltreated before the age of 5. There were too few cases of sexual abuse to be considered. Positive outcomes were operationalized as achieving 5 or more grade A*-C GCSE exam grades at 16 years and scores above the cohort median on the self-report Warwick-Edinburgh Mental Wellbeing Scale and Bachmann Self-Esteem Scale at 17.5 years. The associations of individual, family and community covariates with successful adaptation to the adversity of maltreatment were investigated using logistic regression.School related factors, including engagement in extracurricular activities, satisfaction with school and not being bullied were the most important in facilitating resilience in educational attainment, self-esteem and wellbeing. Good communication and social skills was the most protective individual trait. There was insufficient evidence to suggest that family factors were associated with resilience to maltreatment. School-based interventions are recommended to promote positive adaptation following parental maltreatment. Future research should evaluate outcomes across the life-course to understand whether the protective influences of school persist into adulthood.     

Prevalence and demographic correlates of childhood maltreatment in an adult community sample

PURPOSE: This study had two aims: (1) to determine the prevalence of five categories of retrospectively reported childhood maltreatment in an adult community sample and (2) to examine relationships between three theoretically and practically chosen demographic variables and childhood maltreatment. METHOD: Participants were a representative sample of 967 adult men and women in the metropolitan Memphis, Tennessee area. They completed a telephone survey that included a reliable, valid questionnaire assessing five types of childhood maltreatment (i.e., emotional abuse, emotional neglect, physical abuse, physical neglect, and sexual abuse) and demographic questions. Simultaneous logistic regression analyses were used to identify demographic correlates of specific trauma types. RESULTS: Prevalence of childhood maltreatment ranged from approximately 30% for women to over 40% for men. Approximately 13% of participants reported multiple forms of maltreatment. The most common forms of trauma for both men and women were physical abuse, physical neglect, and emotional abuse, all of which were highly likely to co-occur. Race, sex, and current educational level were each associated with an increased likelihood of childhood maltreatment; differential relationships with particular maltreatment types were also observed. IMPLICATIONS: These findings highlight the importance of research on the prevalence of and risks for multiple types of childhood maltreatment, particularly in the somewhat neglected area of emotional abuse and neglect. These findings can be used to highlight the need for preventive interventions aimed at the negative sequelae of childhood maltreatment and to tailor preventive interventions to the needs and expectations of those at high risk.     

Global Perspectives on Resilience in Children and Youth

Global concerns about the consequences of disasters, political violence, disease, malnutrition, maltreatment, and other threats to human development and well‐being have sparked a surge of international interest in resilience science. This article highlights progress and issues in research that aims to understand variations in human adaptation to adverse experiences. Two key questions are considered: Why is a new wave of global research on resilience important for developmental science? and Why is developmental science important for global resilience? The conclusion calls for developmental scientists to engage in international efforts to promote resilience.     

Trauma-informed sexuality education: recognising the rights and resilience of youth

Experiences of maltreatment during childhood and the emergence of sexuality during adolescence are both critical developmental issues that intersect in meaningful ways, yet the two are often isolated from each other in practice. Despite the prevalence of childhood maltreatment, sexuality education does not accommodate young people with trauma histories. This results in curricula and content that ignore the particular needs and experiences of a proportion of students in sexuality education classrooms. Trauma interventions commit a similar oversight by neglecting the prospects for positive, growth-promoting sexual experiences and relationships among young people who have been abused. The failure to account for young people's resilience in the sexual domain results in treatment approaches that emphasise sexual risks (e.g. revictimisation) and problem behaviours to the exclusion of guidance in cultivating positive sexualities. Consequently, many forms of sexuality education and maltreatment interventions may be of limited effectiveness and relevance in promoting the future sexual well-being of young people with histories of trauma. To redress this gap, we advocate for trauma-informed sexuality education, an approach that acknowledges past experiences of abuse, the promise of resilience, and young people's right to positive sexualities.     

Predictors of resilience in abused and neglected children grown-up: the role of individual and neighborhood characteristics

PURPOSE: This paper examines individual, family, and neighborhood level predictors of resilience in adolescence and young adulthood and describes changes in resilience over time from adolescence to young adulthood in abused and neglected children grown up. METHOD: We use documented cases of childhood physical and sexual abuse and neglect (n=676) from a Midwestern county area during the years 1967-1971 and information from official records, census data, psychiatric assessments, and self-reports obtained through 1995. Analyses involve logistic regressions, replicated with Mplus to test for possible contextual effects. RESULTS: Almost half (48%) of the abused and neglected children in adolescence and nearly one-third in young adulthood were resilient. Over half of those who were resilient in adolescence remained resilient in young adulthood, whereas 11% of the non-resilient adolescents were resilient in young adulthood. Females were more likely to be resilient during both time periods. Being white, non-Hispanic decreased and growing up in a stable living situation increased the likelihood of resilience in adolescence, but not in young adulthood. Stressful life events and a supportive partner promoted resilience in young adulthood. Neighborhood advantage did not exert a direct effect on resilience, but moderated the relationship between household stability and resilience in adolescence and between cognitive ability and resilience in young adulthood. CONCLUSIONS: Ecological factors appear to promote or interfere with the emergence and stability of resilience following childhood maltreatment.     

Reports of parental maltreatment during childhood in a United States population-based survey of homosexual,bisexual, and heterosexual adults

OBJECTIVE: The study objective was to determine the nature and prevalence of childhood maltreatment experiences among lesbian, gay, and bisexual adults and to compare findings to those obtained from similar heterosexual adults. METHOD: Data from the National Survey of Midlife Development in the United States (MIDUS), which measured both childhood experiences with parental emotional and physical maltreatment and adult sexual orientation, were used to compare childhood maltreatment experiences of 2,917 heterosexual, homosexual, and bisexual individuals, age 25-74 years, separately by gender. RESULTS: Homosexual/bisexual men reported higher rates than heterosexual men of childhood emotional and any physical maltreatment (including major physical maltreatment) by their mother/maternal guardian and major physical maltreatment by their father/paternal guardian. In contrast, homosexual/bisexual women, as compared to heterosexual women, reported higher rates of major physical maltreatment by both their mother/maternal guardian and their father/ paternal guardian. Differences among individuals with differing sexual orientations were most pronounced for the more extreme forms of physical maltreatment. CONCLUSIONS: Adult minority sexual orientation is a risk indicator for positive histories of experiencing parental maltreatment during childhood. While the reasons for this are beyond the scope of the current study, previous research suggests that childhood individual differences, including possibly gender atypicality, may be a causal factor.     

Protective factors associated with resilient functioning in young adulthood after childhood exposure to violence

Children may be subjected to many forms of violence and a significant number will experience multiple victimizations. These children are at high risk for developing psychological and emotional difficulties that may last into adulthood. Despite the increased risk for psychopathology, a substantial percentage of young adults exhibit resilient functioning following a history of childhood violence. This study examines the role of social support, spirituality, and emotional intelligence in promoting resilience during emerging adulthood. Participants included 321 young adult American college students, age 18–24, who experienced childhood violence, including community violence, interpersonal aggression, child maltreatment, peer/sibling victimization, and/or sexual assault. Findings revealed that this sample was highly victimized, with an average of 9 violent experiences reported during childhood. Hierarchical multiple regression analyses indicated that after controlling for exposure to childhood victimization, other potentially traumatic events, and current depression and anxiety symptoms, higher resilience during emerging adulthood was associated with greater spirituality, greater emotional intelligence, and support from friends (but not from family). Findings suggest that the potency of protective factors outweighs that of adversity and psychopathology when predicting resilient functioning. By identifying variables that can enhance resilience, this study offers unique insight into how functioning may be improved by both individual and environmental factors.     

Health effects of adverse childhood events: Identifying promising protective factors at the intersection of mental and physical well-being

Research documents how exposure to adversity in childhood leads to negative health outcomes across the lifespan. Less is known about protective factors – aspects of the individual, family, and community that promote good health despite exposure to adversity. Guided by the Resilience Portfolio Model, this study examined protective factors associated with physical health in a sample of adolescents and adults exposed to high levels of adversity including child abuse. A rural community sample of 2565 individuals with average age of 30 participated in surveys via computer assisted software. Participants completed self-report measures of physical health, adversity, and a range of protective factors drawn from research on resilience. Participants reporting a greater burden of childhood victimization and current financial strain (but not other adverse life events) had poorer physical health, but those with strengths in emotion regulation, meaning making, community support, social support, and practicing forgiveness reported better health. As hypothesized, strengths across resilience portfolio domains (regulatory, meaning making, and interpersonal) had independent, positive associations with health related quality of life after accounting for participants’ exposure to adversity. Prevention and intervention efforts for child maltreatment should focus on bolstering a portfolio of strengths. The foundation of the work needs to begin with families early in the lifespan.     

Resilience in higher education students: a scoping review

ABSTRACT

The health, wellbeing and employability of university students are key considerations within higher education. In response, interest in student resilience is on the rise. Reviews of contemporary resilience literature highlight both conceptual and methodological weaknesses, issues which hamper attempts to design effective resilience interventions. To inform the design of a student resilience program, to be piloted at three Australian universities, a scoping review of resilience specific to the higher education context was undertaken. Searches of three electronic databases (PsychINFO, CINAHL and ProQuest) were conducted. Seventy-two peer-reviewed articles published between 2007 and 2017 were included in the review. While the review reaffirms the conceptual and methodological issues found in previous resilience research, it provides a useful critique of key issues in relation to university student resilience and interventions to enhance students’ resilience. Recommendations for educators and researchers are provided.     

Multivariate correlates of childhood psychological and physical maltreatment among university women

Little is known about the long-term effects of psychological or physical child abuse, despite recent advances in the related area of childhood sexual victimization. The present study used multivariate techniques to examine the relationship between four newly devised scales, measuring extent of psychological and physical maltreatment by mothers and fathers and a variety of current psychological symptoms in 251 university women. Results suggest two independent relationships: a global association between all four forms of maltreatment and almost all symptom variables and specific connections between paternal psychological and physical maltreatment, maternal physical maltreatment, and smaller subsets of symptoms. The data are interpreted as supporting an "ecological" perspective on abuse effects as well as demonstrating the value of multivariate methodologies in this area.     

Children’s resilience and trauma-specific cognitive behavioral therapy: Comparing resilience as an outcome,a trait,and a process

Resilience, which is associated with relatively positive outcomes following negative life experiences, is an important research target in the field of child maltreatment (Luthar et al., 2000). The extant literature contains multiple conceptualizations of resilience, which hinders development in research and clinical utility. Three models emerge from the literature: resilience as an immediate outcome (i.e., behavioral or symptom response), resilience as a trait, and resilience as a dynamic process. The current study compared these models in youth undergoing trauma-specific cognitive behavioral therapy. Results provide the most support for resilience as a process, in which increase in resilience preceded associated decrease in posttraumatic stress and depressive symptoms. There was partial support for resilience conceptualized as an outcome, and minimal support for resilience as a trait. Results of the models are compared and discussed in the context of existing literature and in light of potential clinical implications for maltreated youth seeking treatment.     

Repeat reports among cases reported for child neglect: A scoping review

BackgroundIn the United States (US), child welfare policy prioritizes prevention of future harm (e.g., repeat reports) after a report of maltreatment. The majority of reports include some form of child neglect, but no prior review of the recurrence literature has focused on neglect.ObjectiveThis review sought to help guide future research, policy and practice by summarizing recurrence findings related to child neglect with attention to the broader ecological context in which maltreatment occurs.ParticipantsThe final review included 34 US studies of maltreatment recurrence. Twenty-eight studies compared child neglect with at least one other form of maltreatment and six studies examined recurrence among neglect cases.MethodsEleven online databases were searched to locate relevant empirical studies. This review attended specifically to contextualizing findings according to other modifiable factors as well as methodological variation. A scoping review approach was used to summarize findings.ResultsOf the 28 studies comparing neglect to other types of maltreatment, 14 found increased risk for neglect, 12 found no association, and two reported a lower risk. When significant, the effect size ranged from 10% to over three times higher risk for neglect. Poverty or material need was the most commonly included control (15 studies), with two thirds finding that lower resource families had higher risk.ConclusionMethodological variability across studies confounds current ability to guide practice or policy. More research is needed that can replicate and extend findings with comparable samples and model specifications that take into account the regional and policy context.     

国外儿童虐待的心理学研究述评

本文回顾了国外当前在儿童虐待问题上的心理学研究进展。儿童虐待的发生及其后果被理解为个人、家庭和社会环境因素的联合作用;另外,本文还介绍了虐待对儿童认知、社会性情绪、同伴关系和社会行为、神经生理的影响的研究状况,并认为强调对受虐儿童恢复力研究的重视以及对预防性干预成为国外该领域应用研究的趋势。     

The potential use of social media and other internet-related data and communications for child maltreatment surveillance and epidemiological research: Scoping review and recommendations

Collecting child maltreatment data is a complicated undertaking for many reasons. As a result, there is an interest by child maltreatment researchers to develop methodologies that allow for the triangulation of data sources. To better understand how social media and internet-based technologies could contribute to these approaches, we conducted a scoping review to provide an overview of social media and internet-based methodologies for health research, to report results of evaluation and validation research on these methods, and to highlight studies with potential relevance to child maltreatment research and surveillance. Many approaches were identified in the broad health literature; however, there has been limited application of these approaches to child maltreatment. The most common use was recruiting participants or engaging existing participants using online methods. From the broad health literature, social media and internet-based approaches to surveillance and epidemiologic research appear promising. Many of the approaches are relatively low cost and easy to implement without extensive infrastructure, but there are also a range of limitations for each method. Several methods have a mixed record of validation and sources of error in estimation are not yet understood or predictable. In addition to the problems relevant to other health outcomes, child maltreatment researchers face additional challenges, including the complex ethical issues associated with both internet-based and child maltreatment research. If these issues are adequately addressed, social media and internet-based technologies may be a promising approach to reducing some of the limitations in existing child maltreatment data.     

Child maltreatment and adult socioeconomic well-being

ObjectiveLittle empirical research has examined the impact that child maltreatment may have on victims’ long-term socioeconomic well-being. The current study sought to address this gap by exploring the relationship between childhood experiences of abuse and neglect and several indicators of socioeconomic well-being in adulthood.MethodData from the nationally representative National Comorbidity Survey (NCS) (n = 5004) were analyzed using logistic regression models to examine whether maltreatment in childhood (any maltreatment, physical abuse, sexual abuse, severe neglect, and multiple types of maltreatment) affected employment status, income, and health care coverage in adulthood. Several potential confounds of this relationship were included as covariates in the models, including race, sex, age, and several indicators of childhood socioeconomic status (SES).ResultsThe results show that adults who had experienced maltreatment differed significantly from non-maltreated adults across each of the socioeconomic domains examined. Effects were additionally found to differ depending on the number of types of maltreatment experienced.ConclusionsIncreased rates of unemployment, poverty, and Medicaid usage indicate the significant long-term personal impact of early victimization. They also suggest a substantial societal cost from this problem through lost economic productivity and tax revenue, and increased social spending. Low socioeconomic status among parents has also been identified as a salient risk factor for the perpetration of maltreatment, and, as such, these results indicate a potential mechanism in the intergenerational transmission of violence.Practice implicationsThe findings from this study suggest that victims of child maltreatment are at increased risk for financial and employment-related difficulties in adulthood. Approximately one million children are identified each year by state agencies as victims of maltreatment in the United States. Many maltreated children, furthermore, go undetected by protective service agencies, indicating the high prevalence of this problem, and underscoring its large economic costs to society. By highlighting the long-term socioeconomic costs of maltreatment, this research should encourage policy makers to focus on improving prevention, intervention, and treatment efforts for victims of abuse and neglect.