Outcome of abuse during childhood among pregnant low income women

The outcome of experiencing abuse as a child was studied by comparing pregnant women who did recall versus those who did not recall this type of maltreatment. Fourteen hundred low income women were interviewed in prenatal clinic; those who said they were both punished by abuse and beaten by caretakers as children were considered abused. Abuse was recalled by more white than black women but families were followed after delivery and protective service reports of abuse for their offspring were equal. Because of low numbers, black subjects were dropped and the 95 white women who recalled abuse during childhood were compared to the remaining 832 white subjects. The groups did not differ in attitude about current pregnancy, age or marital status, and no differences were found for their children at birth. Abused mothers were more likely to have felt unwanted and unloved as children and to have lower self-images and more isolation than controls. Abused mothers had greater stress, and many of their stresses reflected disturbances in interpersonal relationships. Thus, women abused as children had some characteristics similar to those of known child abusers. Although abused women had more aggressive tendencies, their children were reported to protective services for abuse at the same frequency as control children. Intergenerational transmission of abuse was therefore not demonstrated prospectively. Classic theories of child abuse suggest a special child, special parent and stress act as independent agents to cause abuse. The above data suggest, alternatively, that abuse during childhood may lead to other risk characteristics and to greater stress. These may act together to increase risk for abuse. The special child may have an independent influence on abuse.     

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.     

Hospitalized cases of nonorganic failure to thrive: the scope of the problem and short-term lay health visitor intervention

This paper describes the characteristics of thriving and failure to thrive (FTT) children and their mothers and examines the effect of short-term lay health visitor intervention in cases of nonorganic failure to thrive (NO FTT). Twenty-five FTT children and mothers received lay health visitor (LHV) intervention in addition to other community and medical treatment; 25 other FTT children and mothers did not receive the LHV intervention but did receive all other medical and community treatment. Twenty-five thriving children and mothers were matched with the FTT children and mothers in the LHV group on the child's age at intake, sex, birth weight, and the mother's age, ethnicity, and number of living children. At initial assessment, the FTT and thriving groups were found to be comparable on demographic factors, infant birth weight percentiles, apgar scores, complications of pregnancy or delivery, and separations in the newborn period. There were more premature births in the LHV group although the proportion of premature births for the FTT and thriving groups overall were similar. A majority of mothers in the FTT groups had negative memories of childhood in contrast to more positive memories in the thriving group. At initial assessment, the majority of thriving children were developmentally normal and had increased from their birth weight percentiles whereas all of the FTT children had decreased from their birthweight percentiles and over half were developmentally delayed. There were clear differences in mother-child interaction patterns in the thriving and FTT groups. Three patterns of interaction were identified in the FTT group: benign neglect, incoordination, and overt hostility. Intervention had no measurable effect on the child's weight, development, or interaction patterns. Only 8 of 37 FTT children reevaluated 6 months later showed "catch up" growth and only 7 had improved in developmental score category. Patterns of interaction were found to persist over the 6 months in all cases. One to three year follow-up of 44 families emphasized the severity of the condition and the need for differentiation of the severity of the disturbance in the mother-child relationship and for more intensive intervention than was available in this study. Of these 44 cases, 2 children had died, 5 had been physically abused or further neglected, and 10 were in alternative care arrangements.     

Linking childhood sexual abuse and abusive parenting: the mediating role of maternal anger

OBJECTIVE: This study had two primary objectives: First, to examine the association between childhood sexual abuse (CSA) and later parenting characteristics, particularly physical abuse potential, and second, to explore maternal anger as a mediator of the relationship between CSA and adult physical abuse potential. METHOD: Utilized a community sample of low SES participants that included 138 mothers classified as having experienced CSA, and a comparison group of 152 non-sexually abused mothers. Parenting variables examined included the mothers' physical abuse potential, nurturance toward their children, unrealistic developmental expectations of children, as well as frequencies of spanking and general punishment. Data was collected via interview and other self-report measures. RESULTS: Even after controlling for mothers' childhood experience of Physical abuse, CSA significantly predicted adult risk of physically abusing one's own children. Further, maternal anger was confirmed as a mediator of the relationship between having been sexually abused as a child and the potential for physically abusing one's own children. CONCLUSIONS: CSA may be a risk factor for subsequent physically abusive parenting, while anger appears to play a significant role in mediating this relationship. Findings are discussed in the context of current knowledge concerning the impact of child sexual abuse and the processes contributing to abusive parenting.     

The association of childhood sexual abuse with depressive symptoms during pregnancy, and selected pregnancy outcomes.

OBJECTIVES: The objectives were: (1) to investigate the association during pregnancy of sexual abuse before the age of 18 on depressive symptomatology in pregnancy, controlling for the presence of negative life events and challenges; and (2) to investigate the association of selected pregnancy outcomes (maternal labor and delivery factors, infant birth weight and gestational age) with sexual abuse before age 18. METHODS: Three hundred fifty-seven primiparous women aged 18 years and older were interviewed between 28-32 weeks gestation with reference to current functioning and past history (Objective 1). Medical record information was abstracted after delivery for pregnancy, labor and delivery factors, and pregnancy outcomes (Objective 2). RESULTS: Thirty-seven percent of the women reported past sexual abuse. Prevalence was not associated with ethnic background, educational level, or hospital payment source. Previously sexually-abused pregnant women reported significantly higher levels of depressive symptomatology, negative life events, and physical and verbal abuse before and during pregnancy. There were no significant associations found between past sexual abuse and labor or delivery variables or newborn outcomes. CONCLUSIONS: Previously sexually-abused pregnant women reported a wider constellation of past and current functioning problems than nonabused women although past sexual abuse was not associated with pregnancy outcome. Prenatal care provides a unique opportunity to evaluate the impact of life history and current life events during pregnancy, and to develop a coordinated intervention plan.     

Mother's age and risk for physical abuse.

It is widely believed that young mothers are at greater risk of engaging in physical abuse. However, this relationship is not clearly supported by previous empirical research. This study reexamines the issue using a nationally representative sample of 1,997 mothers. All analyses controlled for family income, race, number of minor children in the home, age of abused child, mother's education, and whether mother was a single parent. Physical abuse was measured with the Conflict Tactics Scales. Using mother's age at time of birth of the abused child, the younger the mother, the greater the rate of child abuse; however, there was not a significant relationship when mother's age was measured at age at time of abuse. Large families and minority group children were also found to be at greater risk of abuse. The paper discusses implications for further research and for prevention of child abuse.     

The role of parental stress in physically abusive families

This study examines the role of several components of parental stress in physically abusive and nonabusive families with conduct-disordered children. The 123 families studied were seen in a parenting clinic aimed at improving parent-child interactions in families with a highly oppositional child. Data were collected over a several-week period and included both mother and father self-report measures and independent observations by trained researchers. Parental stress was found to play an important role in abusive families. Physically abusive families were significantly more often low income, had younger mothers with less education, more frequently reported a family history of child abuse, and were more likely to be abusing alcohol or drugs. Abusive mothers reported more stress due to frequent life events, and had a more negative perception of these events. Further, these mothers had higher rates of both depression and state anxiety. Abusive fathers spanked their children significantly more often than the nonabusive fathers, and abusive mothers had the highest frequency of critical statements directed at their children. Children from abusive households had significantly more behavior problems. Finally, abusive mothers reported more marital dissatisfaction and social isolation than their nonabusive counterparts.     

Health status of abused and neglected children and their siblings

Fifty Greek children who had been neglected or physically abused by one or both parents were studied, along with their families. Of these 18 were single-child families. The other 32 children in the study, including two sets of twins, had a total of 53 siblings. In comparison with their siblings, the abused children were more frequently the result of an unplanned and unwanted pregnancy. They had a higher incidence of perinatal problems and more illnesses in the first year of life. Almost half had feeding problems, their nutritional status was often poorer than that of their siblings, and they were characterized by their parents as being more difficult than the other children. In some cases there was evidence of a lesser degree of neglect or abuse in the siblings. More than twice as many boys as girls were abused, although there were more girls than boys amongst the siblings. This possibly reflects the higher value and as a result higher expectations that Greek culture places on male children.     

The relationship of social support to physically abused children's adjustment

OBJECTIVE: This study had three main objectives: First, to assess physically abused children's perceptions of teacher, peer, and family support; second, to determine whether the levels of perceived support differ according to the person's social role; and third to assess which sources of social support show stronger associations with adjustment in a physically abused sample. METHOD: Perceived social support from teachers, families and peers was assessed in a sample of 37 physically abused children using a shortened version of the Survey of Children's Social Support (Dubow & Ullman, 1989). Child adjustment was indexed by child and parent reports of child depression, anxiety, and anger. RESULTS: Analyses indicated that the children rated their families, peers, and teachers highly as sources of social support, with families being rated as the most important source. Hierarchical multiple regression analyses indicated that perceived peer support was significantly negatively related to children's and parent's reports of children's depression and anxiety. Furthermore, perceived family support was significantly negatively associated with child reported depression. No significant relationships were found between perceived teacher support and symptomatology. CONCLUSIONS: Overall, the results suggest that peer and family support are particularly important for physically abused children's psychological functioning, particularly for internalizing problems.     

Prediction and prevention of child abuse and neglect

Utilizing an interview, a questionnaire, and observations during labor, delivery, and the postpartum period, a sample of one hundred mothers was identified as at high risk for abnormal parenting practices. These mothers were randomly divided into a “High-Risk Intervene” group (N=50) and a “High-Risk Nonintervene” group (N=50). The “Intervene” group received comprehensive pediatric follow-up by a single physician, a lay health visitor, and/or a public health nurse in the home. The “Non-intervene” group received routine care, although the results of these screening procedures were shared with the physicians and nurses responsible for their ongoing care. Another group of 50 mothers, who delivered during the same time period and who were assessed as low risk in terms of abnormal parenting practices, served as controls. When the children were approximately two years old (mean age 26.8 months), 25 families in each of the three groups were chosen at random for detailed evaluation.     

Maternal variables related to sexually abused children's functioning.

OBJECTIVE: The purpose of this study was to explore how mothers' developmental history and current functioning affects their sexually abused children's functioning and recovery. METHOD: A sample of 67 African-American mothers and their sexually abused children participated in this study. Interviews and a range of adult and child measures were administered in order to assess maternal developmental history and current functioning, and child functioning. RESULTS: Mothers' past experiences as children were associated with their children's behavior and general functioning following the sexual abuse. Mothers who experienced more discontinuity of childhood care, who were sexually abused as children, and/or had more problems in their family of origin had children who showed poorer functioning and more behavioral symptomatology. In addition, mothers who currently were experiencing more trauma symptomatology, reported substance abuse, and/or were less able to provide support to their children, had children with more behavior problems and poorer functioning. CONCLUSIONS: The findings from this study point to the impact of mothers' developmental history and current functioning upon the symptomatology of their sexually abused children.     

Childbirth education for multiple pregnancy: part 2: intrapartum and postpartum considerations

Women with a multiple pregnancy can expect a different labor and birth course than those with a singleton pregnancy. While the postpartum period is similar to that of families with a singleton, it is likely to be more hectic in families with multiple infants. In addition, a multiple pregnancy increases both maternal and neonatal risks; therefore, women with a multiple pregnancy may experience slight differences in care due to these potential risks, including additional monitoring and treatment. This article discusses the intrapartum and postpartum considerations families with a multiple pregnancy/birth may experience. This information is provided so that the childbirth educator can incorporate this content into courses, as appropriate, and assist families with a multiple pregnancy to anticipate a realistic birth and postpartum experience.     

African-American women who use crack cocaine: a comparison of mothers who live with and have been separated from their children

OBJECTIVE: This study examined factors that influenced caregiver status for African-American mothers who use crack cocaine but are not receiving drug treatment and participated in an HIV prevention study in North Carolina. METHOD: Caregiver mothers who were living with at least one of their children at intake (n = 257) were compared with non-Caregivers who were separated from all of their children (n = 378). Bivariate analyses and logistic regression were used to compare these mothers at intake on current drug use, risky sex practices, psychological symptoms, victimization, and aggression. RESULTS: Compared with Caregiver mothers, non-Caregivers reported higher frequencies of drug use, risky sex practices, psychological distress, and victimization experiences. Caregiver mothers were more likely than non-Caregiver mothers to have health insurance, but were less likely to have received drug treatment. Logistic regression found that non-Caregiver mothers were significantly more likely than Caregiver mothers to be older, to have been physically abused as children, to trade sex more frequently, to be homeless, and to have no health insurance. Recent crack use, psychological symptoms, and victimization were not significantly related to caregiver status. CONCLUSIONS: Findings that socio-environmental factors were more strongly associated with caregiver status than crack use underscore the importance of contextual issues such as housing, victimization history, and resources in serving maternal crack users. Community outreach and interventions that engage mothers who use drugs and live with their children may be more effective strategies than formal office-based services to link mothers who use crack and their children to needed drug treatment and family and child services.     

Maternal Education Preferences Moderate the Effects of Mandatory Employment and Education Programs on Child Positive and Problem Behaviors

Grounded in person–environment fit theory, this study examined whether low‐income mothers’ preferences for education moderated the effects of employment‐ and education‐focused welfare programs on children’s positive and problem behaviors. The sample included 1,365 families with children between ages 3 and 5 years at study entry. Results 5 years after random assignment, when children were ages 8–10 years, indicated that mothers’ education preferences did moderate program impacts on teacher‐reported child behavior problems and positive behavior. Children whose mothers were assigned to the education program were rated by teachers to have less externalizing behavior and more positive behavior than children whose mothers were assigned to the employment program but only when mothers had strong preferences for education.     

Child health and maltreatment

Children who are abused have been said to have more illnesses than children who are not maltreated. The relationship between abuse and illness has been hypothesized to function in 2 ways: (1) that abuse precedes the illnesses and children from abusive homes become ill because of the damaging environment they endure, or, conversely, (2) that the illnesses precede the abuse, with the fussy behavior of ill children eliciting abuse. This study was intended to clarify the temporal relationship between illnesses and maltreatment. Health data were collected on a sample of 80 children: 11 from abusive families, 31 with nonorganic failure to thrive (NOFT), 14 from neglectful families, and 24 from control families. Hospital records (both inpatient and outpatient) for these children from the time of birth until they were 3 years old were searched by data collectors unaware of the child's classification. Children from abusive families or with NOFT appeared to be ill more often than control children, particularly during the first few months after birth, before abuse had been reported, but not necessarily before NOFT had been discovered. Health records of neglected children were not significantly different from those of controls. In addition to the abused. These 6 children also had more illnesses than control children, again particularly during the first few months after birth. Having ill children is described as a source of stress that may trigger abuse in an already stressed family.     

Unique Contributions of Maternal Reading Proficiency to Predicting Children’s Preschool Receptive Vocabulary and Reading Proficiency

This study investigated whether mothers’ measured reading proficiency and their educational level predict, over and above each other, their children’s receptive vocabulary and reading proficiency when confounding factors of speaking a minority language, ethnicity, number of children in the family, and marital and employment status are controlled. The sample included 155 children (aged 3–5 years) and their mothers (aged 20–44 years) of low income and low educational background from Western Canada. Findings support the conclusion that maternal reading level predicts both their children’s receptive vocabulary and reading proficiency prior to schooling after maternal education is taken into account. The findings also show, after the effects of maternal reading ability are removed, maternal education predicts their children’s reading ability prior to school but not their receptive vocabulary proficiency. Thus, maternal reading proficiency and maternal education appear not to serve as proxies for each other, and the use of both variables should be used in studies where children’s reading and receptive vocabulary proficiency are dependent measures. Early childhood educators dedicated to the improvement of the language and literacy levels of children in their care may consider the implementation of programs that focus on improving mothers’ reading proficiency whereby their children’s levels also improve. Early childhood education is the prime time to provide a richer and more fruitful approach to reduce the persistent knowledge gap of children from low-income and low-educational background families.     

An epidemiological study of abused children and their families in the united kingdom between 1977 and 1982

Between 1977 and 1982 there were 6,532 children placed on the child abuse registers maintained by the National Society for the Prevention of Cruelty to Children (NSPCC) in England. This paper examines the data on these children. The rate of physical injury increased over the last four years of the study from .43 to .63 per thousand children under 15 in the NSPCC register areas, but the percentage of fatal and serious injuries decreased over the entire period. There was also a decline in the rate of re-injury. Infants, boys and low birthweights were overrepresented among the physically abused, neglected and nonorganic failure to thrive cases. Girls and 10-14 year olds were overrepresented among the sexually abused children. The parents or caretakers of the abused children were characterized by their early parenthood, marital instability, large families, criminality and mobility. An initial unemployment rate of 35% among the male caretakers increased to 58% over the last three years of the study.     

The developmental consequence of different patterns of maltreatment

From a longitudinal study of 267 high risk families, four different patterns of maltreatment were identified. The mothers have been tested, interviewed and observed in a number of situations starting during the last trimester of pregnancy and continuing at regularly scheduled intervals through the preschool period. The four maltreatment groups were: physical abuse; hostile/verbally abusive; psychologically unavailable; and neglecting. A control group of mothers who provided adequate care was selected from the remaining high risk sample. In an earlier follow-up, among the maltreated children a disproportionately large number of infants were found to be anxiously attached to their mothers at 12 and 18 months, and their performance in a problem-solving situation at age two was poor. In the current follow-up, the children were videotaped at 42 months in a "barrier box" and teaching situation, and at 56 months they were observed in a preschool situation. The physically abused children were distractible, lacked persistence, ego control and enthusiasm, and experienced considerable negative emotion. The children whose mothers were psychologically unavailable showed marked increases in maladaptive patterns of functioning from infancy through preschool. As expected, they were avoidant of their mother, angry, noncompliant, and they were highly dependent. The neglected children had the most difficulty pulling themselves together to deal with various tasks. They lacked self-esteem and agency necessary to cope with their environment.     

Maternal and paternal physical abuse: Unique and joint associations with child behavioral problems

Although there is a substantial amount of literature documenting the relationship between child abuse and behavioral problems in China, there is, on the other hand, a limited number of studies on the joint and unique associations of maternal and paternal physical abuse with child behaviors within the Chinese context. The present study, using the family systems theory as the theoretical framework, aims to examine these joint and the unique associations of maternal and paternal physical abuse with externalizing and internalizing behaviors among a community sample of Chinese children. A total of 296 children (54.7% boys, mean age 12.31 ± 0.56 years) from two-parent families participated in the study, and they reported their physical abuse experience by their mother and father in the previous year using the Chinese version of the Parent-Child Conflict Tactics Scale. Participants, using the Youth Self Report, reported personal externalizing and internalizing behaviors, and, similarly, their mothers, using the Child Behavior Checklist, assessed children’s externalizing and internalizing behaviors. Linear mixed effect models with random intercept and slope were used to examine the joint and unique associations of maternal and paternal physical abuse with child externalizing and internalizing behaviors. Results revealed that physically abused children were more likely to be simultaneously abused by both mothers and fathers. Furthermore, when compared with their non-abused counterparts, children with physical abuse that was carried out solely by mothers (externalizing behaviors: β = 6.71, 95% CI = 2.45–10.98, p < 0.01; internalizing behaviors: β = 4.52, 95% CI = 0.37–8.66, p < 0.05) or by both mothers and fathers (externalizing behaviors: β = 4.52, 95% CI = 1.80–7.24, p < 0.001; internalizing behaviors: β = 2.98, 95% CI = 0.34–5.61, p < 0.05) reported more externalizing and internalizing behaviors. Externalizing and internalizing behaviors of children who were physically abused solely by fathers did not significantly differ from those of their non-abused counterparts, which may result from the small sample size. The present findings suggest that maternal physical abuse may have a dominant and unique association with child behaviors, regardless of whether paternal physical abuse occurs within the family. Implications for future research and practice within the Chinese context regarding the subject of child behaviors and parental abuse are discussed.