Childhood history of abuse and child abuse screening.

Although a childhood history of abuse is related to parental child abuse, many parents with a history of abuse are not abusive. To determine the effects of a childhood history of abuse on adult child abuse potential, a modified Conflict Tactics Scale (CTS) and the Child Abuse Potential (CAP) Inventory were administered to matched groups of physically abusive mothers with a childhood history of abuse, nonabusive comparison mothers with a childhood history of abuse, and nonabusive comparison mothers without a childhood history of abuse. The modified CTS asked about childhood events and was used to confirm a childhood history of abuse. As expected, the CTS verbal and violence scales were higher for the abusive and nonabusive mothers with a childhood history of abuse. None of the CTS scores were different for the abusive and nonabusive mothers with a childhood history of abuse. In contrast, the CAP abuse scores distinguished between all three study groups. However, on the CAP factor scales, only the rigidity and unhappiness factors discriminated between abusive and nonabusive mothers with a childhood history of abuse. Nonabusive mothers with a childhood history of abuse were less rigid in their child expectations and were happier in their interpersonal relationships than abusive mothers with a childhood history of 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.     

Change trajectories for parent-child interaction sequences during parent-child interaction therapy for child physical abuse

ObjectiveParent-child interaction therapy (PCIT) has been found to reduce future child abuse reports among physically abusive parents. Reductions in observed negative parenting behaviors mediated this benefit. The current study examined session-by-session interaction sequences in order to identify when during treatment these changes occur and how much the trajectory varies from case-to-case.MethodSession-by-session parent-child interaction sequences, using the Dyadic Parent-Child Interaction Coding System-II (DPICS-II) categories, were coded for 22 child welfare involved parent-child dyads undergoing PCIT for child physical abuse. A total 5,436 interactions across PCIT were coded and analyzed using growth curve analysis.ResultsAt pre-treatment baseline, negative and positive parental responses were about equally likely to follow a child positive behavior. This pattern changed rapidly during PCIT, with rapid increases in positive parental responses and decreases in negative parental responses to appropriate child behavior. A quadratic growth pattern accounted for 70% of observed variance and virtually all change occurred during the first three sessions.ConclusionChanges in observed abusive parent-abused child interaction patterns can occur early in PCIT, a parenting intervention that involves direct coaching and practice of skills. These benefits sustained throughout treatment.Practice implicationPrior to receiving behavioral parent training (PCIT), parents who have physically abused their children failed to match their parental response to their children's behavior. This pattern of interaction improved rapidly and substantially during the first three sessions of PCIT. The changes in the patterns of interaction also remained relatively stable for the remainder of treatment while parents continued to practice positive parental responses as well as began practicing effective discipline techniques. This suggests that use of immediate parent feedback through coaching, explicit directions to parents in how to respond to child behavior, and customization of the application of skills to the problems that arise in session are important components to effective parenting programs with physically abusive parents. Targeting these behaviors with PCIT has been found to reduce rates of recidivism, further supporting clinical application of PCIT in these cases.     

Measuring the components of parents' potential for child abuse and neglect

The purpose of the study was to develop a battery of tests with which to identify parents who have potential for abuse and/or neglect of children. The samples were composed of abusive men and women parents or parent figures matched with controls.The variables, parents' background, personality, child rearing attitudes, social networks and parent-child interactions, were tested by interview questionnaire, videotaped behavioral observation, and physiologic response.Both bivariate and multivariate data analysis were utilized including zero order correlations, factor analysis, path analysis, and discriminant analysis.The tests sharpley differentiated between groups on background, empathy, antecedents to early attachment, ways of handling irritating child behaviors, child rearing attitudes, parent-child communication, reference persons, and physiologic response. Abusive parents maintained higher heart rates, had less heart rate variability, higher electrodermal magnitude response and lower recovery times.     

Clinical judgment of abuse-proneness based on parent-child interactions

Professionals skilled in working with abusive families and a sample of university undergraduates viewed video tapes of abusive and matched control parent-child dyads interacting in a free play setting. Subjects were asked to indicate which of each pair of dyads was abusive and the reasons for their judgment. Performance of both groups was at chance levels. Implications of these results for the prediction and prevention of child abuse and the training of clinicians are discussed.     

Abusive parents' reports of child behavior problems: relationship to observed parent-child interactions

PURPOSE: We evaluated the hypothesis that abusive parents' reports may exaggerate rates of child behavior problems in a clinical sample. METHOD: The association between parental ratings of behavior problems and independent observations of child behaviors was examined in a sample of 205 clinic-referred families, 58 of which had a reported history of physical abuse. RESULTS: Relative to the comparison group, parents in the abuse group reported more externalizing problems in their children after controlling for parental psychopathology, and displayed more emotionally controlling and less supportive behavior during parent-child interactions. However, there was no association between abuse history and observed child behaviors during the interaction tasks. Abuse status significantly moderated the association between parent-reported externalizing behaviors and observed demanding behavior by the child; the association was significant among comparison families, but not in the abuse group families. CONCLUSIONS: Results indicate that abusive parents may over-report externalizing behavior problems in their children.     

A treatment and education program for parents and children who are at-risk of abuse and neglect

A treatment program for families at-risk of abusive or neglectful parenting was described and evaluated. The program combined intervention strategies and concepts based on research on abuse, early intervention, education and social service. Treatment and education for the parent and child were provided in the three services of the program: Home-Based, Family School, and Neighborhood Peer Support Groups. At-risk families were identified by a high-risk stress index. Program evaluation was based on 46 families and their 74 preschool-age children. Data collected were: incidence of child abuse or neglect, family stresses, observations of parent-child interactions, family goal measurement, and developmental testing of the children. A significant reduction occurred in the number of children abused or neglected as compared to a similar high-risk, nonintervention sample. The family stresses were reduced, parent-child interactions improved, and the intellectual decline of the children was prevented. Families who participated in all three services gained the most from the program.     

Mother-child interactional patterns in high-and low-risk mothers

Objective: The aim of the present study was to determine the extent to which mother-child interactional patterns in high-and low-risk (for child physical abuse) mothers were similar to patterns observed in physically abusive parents.Method: Ten high-risk and 10 demographically similar low-risk mother-child dyads were studied. Trained observers coded maternal-child interaction patterns in the home during five 1-hour periods using the Standardized Observation Codes system.Results: As expected, high-risk mothers made fewer neutral approaches to their children, displayed more negative behaviors toward their children, and made more indiscriminant responses to their children's prosocial behavior. Expected risk group differences were not found in the number of neutral instructions or positive responses, albeit the proportion of positive responses out of the total number of positive and negative responses was higher for low-risk mothers. After control for educational differences, risk group differences remained in the rates of neutral approaches and the number of indiscriminant behaviors made in response to children's prosocial behaviors.Conclusions: The observational data indicated that high-risk mothers display some behaviors similar to those observed in physically abusive mothers. The finding that high-risk mothers made more indiscriminate or noncontingent responses when reacting to their children's prosocial behavior is consistent with a coercive model of child physical abuse.     

Control strategies and noncompliance in abusive mother-child dyads: an observational study

The present observational study of child abuse has isolated parental control strategies and child response as a promising area of investigation. The social interaction of 10 abusive and 10 matched control mothers and their preschool children was videotaped in a simulated home environment involving both structured and unstructured activities. A coding scheme was developed to record interactional behavior in each dyad. Particular emphasis was placed on the analysis of mother command/child compliance sequences. Compared to controls, abusive mothers employed more commands, and more power-assertive and less positively oriented control strategies. They were also more intrusive, more inconsistent in their use of parenting techniques, displayed more flattened affect throughout their control interactions, and were less flexible in their attempts to gain compliance from the child. In turn, children of abusive mothers demonstrated far more noncompliant behavior than their control counterparts.     

Parent-child interaction therapy: application to maltreating parent-child dyads

OBJECTIVE: Parent-Child Interaction Training (PCIT), which uses a social learning framework, is a dyadic intervention that is designed to alter specific patterns of interaction found in parent-child relationships. Previous research suggests that maladaptive and high-risk characteristics found in maltreating parent-child dyads may be responsive to PCIT. The primary focus of this study is to examine the effectiveness of PCIT with maltreating parent-child dyads. METHODOLOGY: This study describes the effectiveness of PCIT with 136 biological parent-child dyads in which 66.9% (N=91) of the children had been maltreated. Of the 91 maltreated children, 64.8% (N=59) of the parents had maltreated their children, and were thus considered to be at high risk of repeating the abuse. RESULTS: Primary outcomes of this study show the following: (1) a decrease in child behavior problems, (2) a decrease in parental stress, and (3) a decrease in abuse risk from pre- to post-treatment for dyads with and without a history of maltreatment. CONCLUSIONS: Our results add to the body of research supporting PCIT as a promising intervention and as a means to aid both children and parents in high-risk families for maltreatment.     

Empathy and narcissism in a sample of child abuse perpetrators and a comparison sample of foster parents

OBJECTIVE: The purpose of this research was to study the personality variables of empathy and narcissism in a sample of child abuse perpetrators and a comparison sample of foster parents, conceptualized as nonabusive parents, in order to gain further understanding of perpetrators and to provide clues for intervention. METHOD: The sample consisted of two groups: physically and emotionally abusive parents (n=52) and foster parents (n=101). Participants responded to three instruments: the Interpersonal Reactivity Index (IRI), an instrument measuring individual differences in empathy, and two instruments measuring narcissism: the Narcissistic Personality Inventory (NPI) and the Hypersensitivity Narcissism Scale (HSNS). RESULTS: Statistically significant differences were found between the two groups on three of the four subscales of the IRI: perspective-taking, empathic concern, and personal distress. Based on the definition of these subscales, the abusive parents as compared to the foster parents were not able to take the perspective of another or see things from another's viewpoint, showed less warmth, compassion and concern for others, and experienced difficulty in tense interpersonal situations. Statistically significant differences were found for the two groups on three of the six subscales of the NPI: authority, exhibitionism, and superiority, and on the HSNS. The abusive parents demonstrated less self-confidence, a greater lack of impulse control and were more narcissistic than their foster parent counterparts. CONCLUSIONS: The results suggest that it is how the perpetrators experience aversive behavior in their children that may provoke them to physically and emotionally abuse their children. Their self-centeredness in addition to their deficiencies in empathy may cause them to experience their children's misbehavior as an affront to their authority. Implications for treatment are made from this conceptualization of parental abuse.     

Childhood sexual abuse, attachment, and trauma symptoms in college females: the moderating role of attachment

OBJECTIVE: The present study tests a model linking attachment, childhood sexual abuse (CSA), and adult psychological functioning. It expands on previous work by assessing the degree to which attachment security moderates the relationship between a history of child sexual abuse and trauma-related symptoms in college females. METHOD: Self-reports of attachment, childhood sexual abuse, and adult psychological functioning were obtained from 324 female undergraduate students attending a Southeastern U.S. university. Separate analyses were conducted examining the potential moderating role for close-adult, parent-child, and peer attachment styles. RESULTS: In this sample, 37.7% of participants reported sexually abusive experiences prior to age 16. History of child sexual abuse was consistently associated with higher levels of trauma-related symptoms and lower levels of attachment security in close-adult, parent-child, and peer relations. Additionally, attachment security was consistently associated with trauma-related symptoms. Close-adult, parent-child, and peer attachment differentially moderated trauma-related symptoms. Specifically, in peer relationships, the strength of the relationships between attachment measures and trauma symptoms were greater for CSA survivors than for non-abused participants. The opposite pattern of results was found for attachment in parental and close-adult relationships. CONCLUSION: Results suggest that attachment security in peer and parent relationships protects against the negative effects of CSA, while only weak, marginally significant protective effects were observed for close-adult relationships. Only modest support was found for the conceptualization of attachment as a moderator of the relationship between CSA and trauma-related symptoms. However, the results suggest that attachment security at least partially protects against negative CSA outcomes.     

General population norms about child abuse and neglect and associations with childhood experiences

BACKGROUND: A variety of definitions of child abuse and neglect exist. However, little is known about norms in the general population as to what constitutes child abuse and neglect or how perceived norms may be related to personal experiences. METHODS: We conducted a random-digit-dialed telephone survey of 504 Washington State adults. Respondents were asked whether they believed each of 34 behaviors, identified in focus groups as possibly physically, sexually or emotionally abusive or neglectful, constituted abuse or neglect. Then, they were asked whether they had experienced 33 of the behaviors. RESULTS: Five of the six behaviors with the highest levels of consensus were for sexual abuse, whereas only one emotionally abusive behavior had a high level of consensus (95% agreement). Consensus that spanking constituted abuse increased with severity. Those respondents who reported experiencing a particular behavior were significantly less likely to believe the behavior abusive for 11 of the 33 behaviors and more likely to believe the behavior abusive for two of the behaviors. Where comparisons were possible, there was a high level of consensus that behaviors identified as abusive in Child Protective Service operational definitions constituted abuse. CONCLUSIONS: Self-reported childhood experiences were associated with perceived norms about child abuse. A better understanding of community norms about child abuse and neglect may be helpful in communicating with the public or allow for better targeting of educational messages through the media, parenting education classes, and so forth.     

Approaching child abuse treatment from the perspective of empathy

Research identifies empathy as a moderating variable in the display of aggression. Research further suggests that empathy is a significant variable in the effective parenting of children. Studies in child abuse show that abusive parents score significantly lower on empathy measures as compared to their nonabusive counterparts. The purpose of this theoretical article is (1) to suggest based on the literature that empathy training should be a core component in treatment strategies with abusive parents. A variety of approaches to empathy training will be suggested; (2) to encourage the implementation of empathy training in interventions with abusive parents and the measurement through research of the effectiveness of this approach to treatment on a short and long-term basis.     

The prevalence and correlates of abuse among children with autism served in comprehensive community-based mental health settings

OBJECTIVE: To determine the demographic and psychosocial correlates of physical and sexual abuse among children with autism. METHODS: Data collected from 1997 to 2000 through the national evaluation of the Comprehensive Community Mental Health Services for Children and their Families Program on 156 children with autism were used. Data included a baseline assessment of child and family psychosocial experiences and presenting problems associated with referral into system-of-care service, demographic information, and a clinical record review to obtain psychiatric diagnosis. Binary and multinomial logistic regression was used to determine the association of different characteristics of children who were abused compared with those who were not abused. RESULTS: Caregivers reported that 18.5% of children with autism had been physically abused and 16.6% had been sexually abused. Physically abused children more likely had engaged in sexual acting out or abusive behavior, had made a suicide attempt, or had conduct-related or academic problems. Sexually abused children more likely had engaged in sexual acting out or abusive behavior, suicidal or other self-injurious behavior, had run away from home, or had a psychiatric hospitalization. In adjusted multivariate models, the relationship between sexual abuse and sexual acting out, running away from home and suicidal attempts persisted. CONCLUSION: Based on the prevalence of abuse and its association with various behaviors, clinicians should be as attuned to the psychosocial histories of children with autism as they are for other children, and consider the potential of abuse when these behaviors are observed.     

Child-related cognitions and affective functioning of physically abusive and comparison parents

OBJECTIVE: The goal of this research was to utilize the cognitive behavioral model of abusive parenting to select and examine risk factors to illuminate the unique and combined influences of social cognitive and affective variables in predicting abuse group membership. METHODOLOGY: Participants included physically abusive parents (n=56) and a closely-matched group of comparison parents (n=62). Social cognitive risk variables measured were (a) parent's expectations for children's abilities and maturity, (b) parental attributions of intentionality of child misbehavior, and (c) parents' perceptions of their children's adjustment. Affective risk variables included (a) psychopathology and (b) parenting stress. A series of logistic regression models were constructed to test the individual, combined, and interactive effects of risk variables on abuse group membership. RESULTS: The full set of five risk variables was predictive of abuse status; however, not all variables were predictive when considered individually and interactions did not contribute significantly to prediction. A risk composite score computed for each parent based on the five risk variables significantly predicted abuse status. Wide individual differences in risk across the five variables were apparent within the sample of abusive parents. CONCLUSIONS: Findings were generally consistent with a cognitive behavioral model of abuse, with cognitive variables being more salient in predicting abuse status than affective factors. Results point to the importance of considering diversity in characteristics of abusive parents.     

The maltreated adolescent: patterns of physical abuse

Although adolescents are severely and chronically physically abused, relatively little attention has been directed towards understanding this phenomenon. This study explored the family characteristics and the behavioral-emotional reactions of 77 adolescents who were physically maltreated. The youths were selected at a number of sites including a runaway shelter, a hospital-based child abuse team, and a protective service unit. Six different patterns of adolescent reaction to abuse were identified: acting-out, depression, generalized anxiety, extreme adolescent adjustment, emotional-thought disturbance, and helplessness-dependency. Abuse toward these youth had been ongoing for an average of nearly five years. As there were no differences in family characteristics and emotional-behavioral reactions between subjects who were abused only during adolescence (including single-incident abuse) and subjects for whom family violence was evident from childhood on, the utility of a developmentally specific system of abuse categorization is questioned. It is suggested that it is the pattern of parent and child interaction rather than the course of the maltreatment that is related to the emotional and behavioral dysfunction of the adolescent victim.     

Child and partner abuse: self-reported prevalence and attitudes in the north of Portugal

OBJECTIVES: To determine the self-reported prevalence of child and partner physical and emotional abuse in the north of Portugal and to investigate attitudes about these forms of family violence. METHODS: Data were collected by questionnaire from a representative sample of parents in two-parent families with children under the age of 18 years. A total of 2,391 parents participated (1,057 males), aged 20-67 years. Four questionnaires were used, one behavioral and one attitudinal, for each of the forms of abuse: child and partner. RESULTS: At least one act of emotional or physical abuse towards a child during the previous year was reported by 25.9% of participants (12.3% reported physically abusive and 22.4% emotionally abusive acts). Abuse of a partner was reported by 26.2% of participants; at least one act of physical abuse during the previous year was reported by 12% and of emotional abuse by 23.7%. The attitudinal data, however, showed general disapproval of the use of violence, both for disciplining children and within marital relationships. The degree of self-reported support for physical punishment was higher in participants who reported using abusive behavior. Females more commonly reported acts of child abuse, and males reported acts of partner abuse. Both forms of self-reported abuse showed an association with low educational and socio-economic status. CONCLUSIONS: This is the first study in Portugal to analyze family violence through self-report using a representative sample. The findings indicate that child and partner abuse constitute a significant problem in the region of northern Portugal. The discrepancy between the self-reported behavioral and attitudinal data may reflect conflicts in Portuguese society, which is undergoing substantial cultural changes.     

Child physical and sexual abuse: the roles of sadism and sexuality

Based on the analytical concepts of narcissism and perversion and clinical material, an hypothesis is presented for the understanding of the mental functioning of the physically and sexually abusive parent. Relating the aggressive instinct to narcissism and the sexual instinct to perversion, two modes of functioning are presented which have some points in common and some diverging but which show the dynamics involved in physical and sexual abuse. Understanding the type of emotional relationship between the parents and the type of their emotional investment in their child allows us to see how the complicity of parents works against the child. This understanding implicitly gives insight into the structuring of the personality of the child-victim, who in turn undergoes the risk of himself becoming a physically and/or sexually abusive parent with his own children.     

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.