How to deal with emotional abuse and neglect: further development of a conceptual framework (FRAMEA)

Objective

To develop further the understanding of emotional abuse and neglect.

Methods

Building on previous work, this paper describes the further development of a conceptual framework for the recognition and management of emotional abuse and neglect. Training in this framework is currently being evaluated. The paper also briefly reviews more recent work on aspects of the definition, harm caused by emotional abuse and neglect and threshold.

Results

The paper arrives at a working definition as ‘persistent, non-physical, harmful interactions with the child by the caregiver, which include both commission and omission.’ There are many forms of harmful caregiver-child interactions, which can be placed in five categories, each category reflecting the fulfillment of one of the child's basic psycho-social needs and requiring a different therapeutic approach for its alleviation. The caregiver-child relationship is embedded within a psycho-social context. It is suggested that greater clarity can be gained about the child and family when information is sorted into the appropriate tiers of concerns: Tier 0 – Social & environmental factors, Tier I – Caregiver risk factors, Tier II – Caregiver-child interactions and Tier III – Child's functioning. It is further suggested that while intervention is required, this is directed towards protection, rather than providing immediate protection of the child. The work takes the form of a time-limited trial of therapeutic work to gauge the capacity of the caregivers to change. This initial work focuses Tiers 0–II. Statutory steps might be required in order to encourage the caregivers to engage. If insufficient progress is achieved, active child protection may be required which might include placing the child in an alternative family. However, some, usually older, children will remain in the emotionally abusive environment and they will require ongoing help and support.

Conclusion

While a greater understanding of emotional abuse and neglect is now possible, further evaluation of the utility of this framework is suggested.     

Emotion dysregulation as a mediator between childhood emotional abuse and current depression in a low-income African-American sample

Abuse and neglect in childhood are well-established risk factors for later psychopathology. Past research has suggested that childhood emotional abuse may be particularly harmful to psychological development. The current cross-sectional study employed multiple regression techniques to assess the effects of childhood trauma on adulthood depression and emotion dysregulation in a large sample of mostly low-income African Americans recruited in an urban hospital. Bootstrap analyses were used to test emotion dysregulation as a potential mediator between emotional abuse in childhood and current depression. Childhood emotional abuse significantly predicted depressive symptoms even when accounting for all other childhood trauma types, and we found support for a complementary mediation of this relationship by emotion dysregulation. Our findings highlight the importance of emotion dysregulation and childhood emotional abuse in relation to adult depression. Moving forward, clinicians should consider the particular importance of emotional abuse in the development of depression, and future research should seek to identify mechanisms through which emotional abuse increases risk for depression and emotion dysregulation.     

Variations in emotional abuse experiences among multiply maltreated young adolescents and relations with developmental outcomes

Objective

Based on the data obtained through Child Protective Services (CPS) case records abstraction, this study aimed to explore patterns of overlapping types of child maltreatment in a sample of urban, ethnically diverse male and female youth (n= 303) identified as maltreated by a large public child welfare agency.

Methods

A cluster analysis was conducted on data for 303 maltreated youth. The overall categorization of four types of abuse (i.e., physical, sexual, emotional abuse and neglect) was used to provide a starting point for clustering of the 303 cases and then the subtypes of emotional abuse were broken down in the clusters. The different clusters of child maltreatment were compared on the multiple outcomes such as mental health, behavior problems, self-perception, and cognitive development.

Results

In this study, we identified four clusters of child maltreatment experiences. Three patterns involved emotional abuse. One cluster of children experienced all four types. Different clusters were differentially associated with multiple outcome measures. In general, multiply-maltreated youth fared worst, especially when the cluster involved sexual abuse. Also, sex differences were found in these associations. Boys who experienced multiple types of maltreatment showed more difficulties than girls.

Conclusion and practice implications

These results reiterate the importance of creating more complex models of child maltreatment. Children who have experienced various types of maltreatment are especially in need of more attention from professionals and resources should be allocated accordingly.     

Childhood emotional maltreatment and mental disorders: Results from a nationally representative adult sample from the United States

Child maltreatment is a public health concern with well-established sequelae. However, compared to research on physical and sexual abuse, far less is known about the long-term impact of emotional maltreatment on mental health. The overall purpose of this study was to examine the association of emotional abuse, emotional neglect, and both emotional abuse and neglect with other types of child maltreatment, a family history of dysfunction, and lifetime diagnoses of several Axis I and Axis II mental disorders. Data were from the National Epidemiological Survey on Alcohol and Related Conditions collected in 2004 and 2005 (n = 34,653). The most prevalent form of emotional maltreatment was emotional neglect only (6.2%), followed by emotional abuse only (4.8%), and then both emotional abuse and neglect (3.1%). All categories of emotional maltreatment were strongly related to other forms of child maltreatment (odds ratios [ORs] ranged from 2.1 to 68.0) and a history of family dysfunction (ORs ranged from 2.2 to 8.3). In models adjusting for sociodemographic characteristics, all categories of emotional maltreatment were associated with increased odds of almost every mental disorder assessed in this study (adjusted ORs ranged from 1.2 to 7.4). Many relationships remained significant independent of experiencing other forms of child maltreatment and a family history of dysfunction (adjusted ORs ranged from 1.2 to 3.0). The effects appeared to be greater for active (i.e., emotional abuse) relative to passive (i.e., emotional neglect) forms of emotional maltreatment. Childhood emotional maltreatment, particularly emotionally abusive acts, is associated with increased odds of lifetime diagnoses of several Axis I and Axis II mental disorders.     

A concurrent examination of protective factors associated with resilience and posttraumatic growth following childhood victimization

The present study concurrently examined protective factors associated with the adaptive outcomes of resilience and posttraumatic growth (PTG; defined as positive psychological change resulting from a life crisis or trauma), after accounting for relevant demographic factors and the impact of circumstances surrounding childhood victimization (i.e., age of first trauma, frequency of victimization, and perception of trauma severity). The protective factors examined in the present study included social support from friends and family, optimism, positive religious coping (i.e., looking to God for support and guidance; forgiveness), and negative religious coping (i.e., feeling abandoned by God; anger towards God). Participants included 161 college students from the US MidSouth, aged 18–24 (M_age = 19.97, SD = 1.86). All participants reported experiencing physical violence and/or sexual abuse during their childhood. Hierarchical multiple regression analyses indicated that after accounting for demographics and circumstances surrounding the childhood victimization, higher resilience was associated with greater family support, optimism, and positive religious coping, while higher posttraumatic growth was associated with greater optimism and positive religious coping. These findings underscore the protective role of optimism with respect to both resilience and posttraumatic growth. Additionally, results highlight the importance of examining cognitions related to religious coping rather than simply assessing broadband religiosity, as only positive religious coping was associated with adaptive outcomes. Findings suggest the importance of early intervention to bolster protective factors (i.e., family support, positive thinking, gratitude, and positive religious coping skills) among youth exposed to childhood physical and sexual victimization.     

Examining the link between emotional childhood abuse and social relationships in midlife: The moderating role of the oxytocin receptor gene

BackgroundA single nucleotide polymorphism (SNP), rs53576, of the oxytocin receptor gene (OXTR) has been associated with fundamental aspects of social processes and behaviors. Compared to A carriers, GG individuals have enhanced social competencies and tend to elicit more positive responses from social partners. However, the G allele of the OXTR rs53576 has also been associated with greater social sensitivity.ObjectiveThe current study examined the unique influence of emotional childhood abuse on positive and negative aspects of different types of social relationships (e.g., family, spouse/partner, and friends) in midlife and whether genetic variations of OXTR rs53576 moderated these associations.Participants and Setting: A total of 614 participants in midlife (aged 40–65), recruited for a large-scale study of Phoenix metropolitan residents (AS U Live Project), answered self-report questionnaires and provided blood samples for DNA genotyping.MethodsHierarchical multiple regression analyses tested whether emotional childhood abuse predicted social support and strain for each relationship type and whether these potential linkages differed by OXTR genotype (GG versus AA/AG).ResultsOverall, individuals with a history of emotional childhood abuse had less supportive and more strained relationships in midlife. For supportive family relationships, the effect of emotional childhood abuse was moderated by OXTR rs53576 (p < .001). Under conditions of experiencing more emotional abuse in childhood, GG individuals had more supportive family relationships in midlife compared to A carriers.ConclusionsOverall, genetic variations of OXTR rs53576 may be an important candidate in understanding the development of social functioning within the context of emotional childhood abuse.     

Trajectory subgroups of perceived emotional support from teachers: Associations with change in mastery climate and intentions to quit upper secondary school

The aims of this three-wave longitudinal study were to identify and describe trajectories of perceived emotional support from teachers and investigate whether these trajectories were related to the development of intentions to quit upper secondary school via change in perceived mastery climate. Among 1379 Norwegian upper secondary school students, three trajectory subgroups were identified: stable high (84.9%), decreasing (7.8%), and low increasing (7.3%). The subgroups differed in levels of achievement ambition and academic self-concept. Further, a parallel process latent growth curve model revealed essential associations with change in intentions to quit school. Specifically, students with high probabilities of membership in the decreasing emotional support subgroup appeared to be at particular risk, perceiving a decrease in mastery climate that was related to a worrying development of intentions to quit school. The results are discussed considering the importance of a sustained supportive learning environment for late adolescents.     

Lesson Study with preservice teachers: Lessons from lessons

This article examines a 2-year process of integrating Lesson Study—a form of teacher-led professional development—into an introductory course on the principles of teaching for students majoring in early childhood education. The course is taught in conjunction with beginning practicum work in area schools. We describe obstacles, modifications, and outcomes as we adapted the Lesson-Study process to help preservice teachers pay closer attention to instructional strategies (such as questioning techniques, anticipating student responses, and how lesson flow affects student understanding), and become more comfortable with constructive criticism by focusing on the lesson plan rather than the teacher.     

A virtual safe zone: Teachers supporting teenage student resilience through social media in times of war

We examine how teacher-student communication through social network technologies may support student resilience during an ongoing war (i.e., the 2014 Israel-Gaza war). Based on student responses from open-ended surveys (N = 68), five content categories of emotional support were identified: caring, reassuring, emotion sharing, belonging, and distracting. The mere existence of continuous online contact with teachers also contributed to resilience perceptions. Interviews with 11 secondary school teachers revealed three main purposes for this communication: (a) delivering emotional support to students, (b) monitoring their distress; and (c) maintaining civilized norms of discourse. Practical implications and theoretical contributions are discussed.     

The development of learning patterns of student teachers: a cross-sectional and longitudinal study

Research on learning pattern development during pre-service teacher education is scarce. In a cross-sectional (study 1) and longitudinal study (study 2) the development of learning patterns of student teachers is analysed. Participants in study 1 were 646 first-year and 350 third-year student teachers enrolled in an initial pre-service teacher education programme. 236 student teachers participated in study 2. Vermunt’s’ Inventory of Learning Styles was used to assess differences in learning patterns. By examining intra-individual changes in learning patterns we expected to find developmental trends within learning patterns. Results show that meaning oriented learning increases over time and undirected learning decreases. Some learning patterns are however more subject to change than others. The development of learning patterns was found to be relative and dependent on the learning pattern which students have already mastered in the first-year of a teacher education programme.     

Maternal support following childhood sexual abuse: Relationships to child-reported

Maternal support has been conceptualized as a key factor in predicting children’s functioning following sexual abuse; however, empirical evidence for this assumption is rather limited. Prior studies may have failed to find a relationship between maternal support and children’s outcomes due to the methodological weaknesses of the prior literature such as the use of maternal support measures without adequately reported psychometric properties. Moreover, relatively few studies have investigated whether maternal support corresponds with children’s own self-reported symptoms. The aim of the present study was to utilize the only published measure of maternal support with sufficient psychometrics, the Maternal Self-Report Support Questionnaire (MSSQ; Smith et al., 2010), to determine if levels of pre-treatment support are associated with children’s self-reported trauma-related symptoms among 165 treatment-seeking children (M = 10.85, SD = 3.09) and their non-offending mothers. Levels of maternal emotional support corresponded with few of children’s outcomes, and when relationships were observed, emotional support was related to higher levels of symptoms. Maternal levels of blame and doubt were only associated with dissociative symptoms. Maternal support therefore appears to be an ineffective predictor of children’s post-disclosure trajectories and raises the possibility that maternal support is linked with poorer functioning.     

Looking after the teachers: exploring the emotional labour experienced by teachers of looked after children

Whilst outcomes for looked after children (LAC) have been extensively discussed, less attention has been paid to the experiences of teachers of this group of children. It is accepted that Emotional Labour (EL) is commonplace in the teaching profession but no research has investigated how, and to what extent, teachers experience emotional labour during interactions with LAC. Fourteen Key Stage Two teachers of LAC participated in the current study by completing semi-structured interviews. Results indicate that participants experience emotional labour during interactions with LAC and that this may be mediated, to a degree, by factors including role constructions, perceptions of support and self-perceived role facilitators such as perception of a professional duty. The potential benefit of educational psychologists understanding better, and supporting, the impact of emotional labour on teachers of LAC is subsequently discussed.     

Maternal support following childhood sexual abuse: Associations with children's adjustment post-disclosure and at 9-month follow-up

Maternal support has been widely cited as an important predictor of children's adjustment following disclosure of sexual abuse. However, few studies have examined these effects longitudinally. The current study examines the relationships between a multidimensional assessment of maternal support rated by both mothers and children and children's adjustment in various domains (internalizing, externalizing, anger, depression, and posttraumatic stress disorder symptoms) concurrently and longitudinally. Participants were 118 mother-child dyads recruited from a Child Advocacy Center where children were determined through a forensic evaluation to be victims of sexual abuse. Child and mother ratings of maternal support and child adjustment were collected shortly after the forensic evaluation and at 9-month follow-up. Results were consistent with findings from past studies that maternal support is significantly related to children's post-disclosure adjustment and extends these findings longitudinally. Additionally, the study sheds light on differential relations between dimensions of maternal support (Emotional Support, Blame/Doubt, Vengeful Arousal, and Skeptical Preoccupation) and child adjustment and suggests the importance of using both child and mother ratings of maternal support in future research.     

Special education teachers under stress: evidence from a Greek national study

The present study examines the sources of job stress in a national sample of 373 Greek special education teachers, using a self‐report questionnaire assessing job stress, its perceived sources, and its demographic and professional characteristics. Although the participants in general considered their job moderately stressful, they felt stressed by issues concerning the special needs child, such as the child's progress, safety, and social development. More than half of the teachers indicated that teaching children with autism poses major stress to them, followed by teaching students with behavioural and emotional difficulties. Regression analysis showed that the implementation of the special educational curriculum was the most important predictor of job stress, followed by the social and academic progress of children. The implications of these findings for in‐service and pre‐service teacher preparation, support, and awareness‐raising regarding job stress are discussed.     

History of abuse and neglect in patients with schizophrenia who have a history of violence

Objective

To determine the prevalence of five forms of abuse/neglect during childhood and adolescence in a group of schizophrenic patients with a history of violence.

Methods

Twenty-eight patients hospitalized in a highly secured psychiatric unit were included. Abuse and neglect during patients’ growth were evaluated with the childhood trauma questionnaire (CTQ). History of substance abuse (consumption of cannabis, and/or alcohol, and/or heroin, and/or cocaine during the year that preceded the hospitalization), incarceration, and death of a close parent were also collected.

Results

We found that 46.4% of patients experienced at least 1 form of abuse and/or neglect during childhood and 21.4% of them had experienced more than 2 forms of abuse and/or neglect. The 2 most frequent forms of neglect and abuse were physical abuse (39.3%) and emotional neglect (17.9%). History of substance abuse was found for cannabis (57.1%), alcohol (57.1%), and cocaine and/or heroin (35.7%). We found that 42.8% of patients had 1 close relative who had died during their growth and that 41.6% of these deaths were violent.

Conclusion

It appears important to systematically search for and assess a history of abuse and neglect during growth in schizophrenic patients with a history of violence, in order to offer specific treatments for this group of patients.     

Teacher job satisfaction and motivation to leave the teaching profession: Relations with school context, feeling of belonging, and emotional exhaustion

This study examines the relations between school context variables and teachers’ feeling of belonging, emotional exhaustion, job satisfaction, and motivation to leave the teaching profession. Six aspects of the school context were measured: value consonance, supervisory support, relations with colleagues, relations with parents, time pressure, and discipline problems. The participants were 2569 Norwegian teachers in elementary school and middle school. The data were analyzed by means of SEM analyses. All six school context variables were related to job satisfaction and motivation to leave the teaching profession. These relations were primarily indirect, mediated through feelings of belonging and emotional exhaustion.     

Associations between childhood abuse and interpersonal aggression and suicide attempt among U.S. adults in a national study

The aim of this study is to examine associations among childhood physical, emotional, or sexual abuse and violence toward self (suicide attempts [SA]) and others (interpersonal aggression [IA]). Data were obtained from the National Epidemiologic Survey on Alcohol and Related Conditions Waves 1 and 2 (n = 34,653). Multinomial logistic regression examined associations between type of childhood abuse and violence categories, adjusting for demographic variables, other childhood adversity, and DSM-IV psychiatric disorders. The prevalence of reported childhood abuse was 4.60% for physical abuse, 7.83% for emotional abuse, and 10.20% for sexual abuse. Approximately 18% of adults reported some form of violent behavior, distributed as follows: IA, 13.37%; SA, 2.64%; and SA with IA, 1.85%. After adjusting for demographic variables, other childhood adversity, and psychiatric disorders, each type of childhood abuse was significantly related to increased risk for each violence category as compared with the no violence category. Furthermore, the odds ratio of childhood physical abuse was significantly higher for SA with IA when compared with IA, and the odds ratio of childhood sexual abuse was significantly higher for SA and SA with IA when compared with IA. Childhood physical, emotional, and sexual abuse is directly related to the risk for violent behaviors to self and others. Both internalizing and externalizing psychiatric disorders impact the association between childhood abuse and violence. The inclusion of suicidal behaviors and interpersonal aggression and internalizing/externalizing psychiatric disorders within an integrated conceptual framework will facilitate more effective interventions for long-lasting effects of child abuse.     

How teacher emotional support motivates students: The mediating roles of perceived peer relatedness,autonomy support,and competence

Multilevel mediation analyses test whether students' mid-year reports of classroom experiences of autonomy, relatedness with peers, and competence mediate associations between early in the school year emotionally-supportive teacher-student interactions (independently observed) and student-reported academic year changes in mastery motivation and behavioral engagement. When teachers were observed to be more emotionally-supportive in the beginning of the school year, adolescents reported academic year increases in their behavioral engagement and mastery motivation. Mid-year student reports indicated that in emotionally-supportive classrooms, adolescents experienced more developmentally-appropriate opportunities to exercise autonomy in their day-to-day activities and had more positive relationships with their peers. Analyses of the indirect effects of teacher emotional support on students' engagement and motivation indicated significant mediating effects of autonomy and peer relatedness experiences, but not competence beliefs, in this sample of 960 students (ages 11–17) in the classrooms of 68 middle and high school teachers in 12 U.S. schools.     

The role of teachers' instrumental and emotional support in students' academic buoyancy,engagement, and academic skills: A study of high school and elementary school students in different national contexts

In this investigation of high school students (N = 2510) in Singapore (Study 1) and elementary school students (N = 119) in Australia (Study 2), we examined the role of instrumental and emotional forms of teacher support in students' academic buoyancy and academic outcomes (engagement and academic skills). In both studies, perceived instrumental support (but not perceived emotional support) was positively associated with academic buoyancy (moderate effect size in Study 1, large effect in Study 2). In Study 1, academic buoyancy was positively associated with students' academic engagement (specifically, effort and persistence [large effect], perceived importance of school [moderate effect], and feelings of school belonging [moderate effect]). In Study 2 academic buoyancy was positively associated with gains in students' academic skills and engagement (specifically, class participation [large effect] and future aspirations [large effect]). In both studies, there was tentative support for a mediating role of academic buoyancy linking students' perceived teacher support to academic outcomes.