Variation in prevention of child maltreatment by Dutch child healthcare professionals

Child maltreatment (CM) is a common condition with a large impact on the victim and society. In the Netherlands, the preventive child healthcare (CHC) aims to protect children against such threats. However, several studies indicate that the efficacy in this area may be suboptimal for many CHC professionals. Therefore, this study aims to map the practice variation in the primary and secondary prevention of CM, by CHC physicians and nurses. This mixed-methods study used interviews to identify relevant topics and develop an online questionnaire. All CHC organizations in the Netherlands (n = 45) were asked to forward this questionnaire to their professionals. Practice variation was described with domain scores and item response distributions. Multi-level analysis was used to assess case mix-corrected variance between organizations. Interview participants (n = 11) expected suboptimal care in 35 topics which they considered important for prevention of CM, resulting in a 15 min questionnaire. Nearly two-thirds of the organizations (n = 29) agreed to forward the questionnaire to their employees. The response rate was 42% (n = 1104). Suboptimal care and practice variation was found in all domains (i.e. communication, medical expertise, collaboration, involvement in prevention of CM, and improvement opportunities), mostly caused by intra-organization variance. Significant inter-organization variance was found for collaboration (variance partition coefficient 6–7%) and involvement (2–3%). Furthermore, the majority of the respondents (96%) reported fear in acting upon suspicions of CM. Substantial suboptimal care and practice variation in prevention of CM warrant action from authorities, CHC training institutes, CHC organizations, and professionals.     

Child sexual abuse research knowledge among child abuse professionals and laypersons

The purposes of this study were to: (1) Assess child abuse professionals’ and nonprofessionals’ knowledge of scientific research findings that are relevant to forensic child sexual abuse (CSA) evaluations and (2) describe associations between child abuse professionals’ levels of research knowledge and their education and experience. An 18-item multiple-choice test was administered to 188 child abuse professionals and 457 nonprofessionals (undergraduate college students) in Brazil and the United States. The nonprofessionals’ average percent correct, M = 44%, was not significantly different than what would be expected for random guessing (45%). The professionals’ average percent correct, M = 55%, was higher than that of nonprofessionals and random guessing (both ps < .001). The average percent correct score for the US-sample psychologists, M = 76%, was higher than the average score of the other professionals, M = 51%, p < .001. Professionals’ educational level, as measured by the highest academic degree obtained, was positively associated with percent correct scores, Spearman's ρ = .46, p < .001. Controlling for educational attainment, professional experience, as measured by the total number of CSA evaluations performed, was weakly associated with percent correct scores, partial r = .15, p = .04. Percent correct scores were low for both nonprofessionals and professionals. Most of the participants in this study were uninformed or misinformed about scientific research findings that are important for conducting optimal forensic CSA evaluations and for making accurate judgments about the validity of sexual abuse allegations.     

Economic socialization,saving and assets in European young adults

We analyze the role economic socialization plays in the economic behavior and asset accumulation of young adults by parents using data from European young adults and teenagers. We study the role of four distinct strands of economic socialization (providing pocket money, jobs at home, work for others, and parental encouragement) using a Dutch sample of young adults (age 18–32, n = 392). Results show positive links between parental encouragement and ability to control spending, saving preferences, future orientation, conscientiousness, and saving. A sample of teenagers (age 14–15, n = 548) and their parents (256 mothers, 227 fathers) is drawn for a Norwegian study of economic socialization. Analyses reveal a small difference in the socialization of adolescents from poorer and less educated backgrounds: they are less likely to receive pocket money and to have part-time work but are more likely to have piggy banks and savings accounts at a younger age. Variations in the economic socialization by parents highlight the importance of financial education in schools.     

A study of Attachment Disorders in young offenders attending specialist services

Attachment disorders, specifically Reactive Attachment Disorder (RAD) and Disinhibited Social Engagement Disorder (DSED) are disorders associated with neglect and abuse in which people have significant difficulties relating to others. This study aims to explore Attachment Disorder symptoms and diagnoses in young offenders and factors that may be associated with them such as mental health problems. A cross-sectional design was used with 29 young people who were known to Intensive Services, aged 12–17 (M = 16.2, SD = 1.3), 29 carers and 20 teachers. They completed measures investigating symptoms of Attachment Disorders and psychopathology. Eighty-six percent of the young people had experienced some form of maltreatment and the rates of an actual or borderline Attachment Disorder was 52%. A positive correlation between Attachment Disorder symptoms and other mental health problems (as rated by carer-report Strengths and Difficulties Questionnaire Total Difficulties Score), accounting for 36% of the variance was found, with a large effect size (r_s = 0.60). Attachment Disorder symptoms were associated with hyperactivity and peer relationship problems.     

The distal consequences of physical and emotional neglect in emerging adults: A person-centered,multi-wave,longitudinal study

Despite being the most prevalent form of child maltreatment, the correlates and consequences of neglect are poorly understood, particularly during early adulthood. The present multi-wave, longitudinal study sought to address this gap in this literature by examining physical and emotional neglect in emerging adults in a diverse community sample. 580 adolescents (Age_Mean = 18.25; Age_SD = 0.59; 58.3% female; 31% Hispanic, 28.9% Caucasian; 26.2% African-American; 13.9% other) completed self-report measures for child maltreatment at baseline, and measures for depression, posttraumatic stress disorder, generalized anxiety disorder, and substance use every year for three years. For our analyses, we used both variable-centered (mixed-level modeling) and person-centered (latent profile analysis) analyses to best understand a) how physical and emotional neglect relate to other forms of maltreatment and b) to determine physical and emotional neglect’s unique impact on prospective mental health functioning. Our person-centered analyses revealed that a three-profile model provided the best solution for our data (“No Trauma,” “Abuse”, and “Neglect”). In longitudinal analyses, the “the neglect” group had significantly elevated scores compared to the “no trauma” group on all outcomes except alcohol use (p < 0.01). Results from our variable-centered analyses showed comparable findings between physical and emotional neglect, with higher scores corresponding to elevated symptoms of depression, PTSD, illicit substance use, and cigarette use over time (p < 0.01). In conclusion, our results suggest that early neglect-exposure poses a risk for the subsequent development of internalizing symptoms and substance use behaviors among emerging adults.     

Online sexual solicitation by adults and peers – Results from a population based German sample

Prevalence of Internet use among adolescents is high, but little is known about the online sexual activities of German adolescents. This study aimed to describe the 12-month prevalence of German adolescents’ online sexual experiences with a focus on Online Sexual Solicitation (OSS, subjectively negative online sexual experiences with a peer or any sexual online experience, positive or negative, with an adult). A sample of male and female adolescents aged 14–17 (N = 2238) was recruited using online survey panel. The sample was representative for gender and education. Subjects completed an online survey reporting their online sexual activities (i.e., sexual conversation, exchanging pictures, and cybersex) with peers (14–17 y.) and/or adults (≥18 y.). Findings illustrated that 51.3% (n = 1148) of adolescents had experienced online sexual activity, which mostly involved peers (n = 969; 84.4%). In contrast, 23.2% (n = 519) of the adolescents experienced OSS with 2.6% (n = 57) reporting subjectively negative online sexual interactions with peers and 22.2% (n = 490) reporting online sexual interactions with adults, of which 10.4% (n = 51) were perceived as negative. The findings suggest that adolescents frequently engage in sexual interactions on the Internet with only a relatively small number perceiving such contacts as exploitative. In addition, females and adolescents with incomplete family situation, foreign nationality, higher education, homo- or bisexual orientation, and those without perceived social support reported OSS significantly more often.     

The effect of illustrations in arithmetic problem-solving: Effects of increased cognitive load

Arithmetic word problems are often presented accompanied by illustrations. The present study examined how different types of illustrations influence the speed and accuracy of performance of both good (n = 67) and poor arithmeticians (n = 63). Twenty-four arithmetic word problems were presented with four types of illustrations with increasing information value. The results show that illustrations can have a detrimental effect on performance on arithmetic word problems, produced by irrelevant, redundant or interacting sources of information. Principles from cognitive load theory are used to explain the results, in particular in relation to (poor) working memory ability.     

Sexual abuse history among adult sex offenders and non-sex offenders: A meta-analysis

ObjectiveThe sexually abused–sexual abuser hypothesis states there is a specific relationship between sexual abuse history and sexual offending, such that individuals who experience sexual abuse are significantly more likely to later engage in sexual offenses. Therefore, samples of adult sex offenders should contain a disproportionate number of individuals who have experienced sexual abuse, but not necessarily other types of abuse, compared with samples of other types of offenders.MethodsWe compared rates of sexual and other forms of abuse reported in 17 studies, involving 1,037 sex offenders and 1,762 non-sex offenders. We also examined the prevalence of different forms of abuse in 15 studies that compared adult sex offenders against adults (n = 962) and against children (n = 1,334), to determine if the sexually abused–sexual abuser association is even more specific to individuals who sexually offend against children.ResultsWe observed a higher prevalence of sexual abuse history among adult sex offenders than among non-sex offenders (Odds Ratio = 3.36, 95% confidence intervals of 2.23–4.82). The two groups did not significantly differ with regard to physical abuse history (OR = 1.50, 95% CI = 0.88–2.56). There was a significantly lower prevalence of sexual abuse history among sex offenders against adults compared to sex offenders against children (OR = 0.51, 95% CI = 0.35–0.74), whereas the opposite was found for physical abuse (OR = 1.43, 95% CI = 1.02–2.02).ConclusionThere is support for the sexually abused–sexual abuser hypothesis, in that sex offenders are more likely to have been sexually abused than non-sex offenders, but not more likely to have been physically abused. We discuss potential mechanisms for the relationship between sexual abuse history and sexual offending, including the possibility that a third factor might account for the relationship.Practice implicationsThe most obvious implications of these findings is that the prevention of sexual abuse of children, either through prevention programs directly targeting children or through treatment programs targeting individuals who are likely to sexually offend against children (e.g., known sex offenders against extra-familial boys), may eventually reduce the number of sex offenders. This implication is dependent, however, on a causal role of childhood sexual abuse, and on the effectiveness of prevention and treatment practices.     

Early-married and sexually abused girls differ in their psychiatric outcomes

Early marriage and sexual abuse are the two of the most frequent types of childhood abuse. Although early marriage is also a type of sexual abuse, it is associated with different physical, social, and mental outcomes than sexual abuse alone. The purpose of this study was to compare early-married girls and sexually abused girls who were referred for forensic evaluation in Turkey in terms of their sociodemographic characteristics, mental disorder rates, and mental symptom severity. We included 63 adolescent girls for whom a judicial report had been demanded and who were under 15 years old when they were married but were not yet 18 years old during the evaluation (15.51 ± 0.78) and 72 sexually abused adolescent girls between 14 and 18 years old (15.80 ± 1.10) in this study. Following a psychiatric evaluation, the study participants completed the Child Posttraumatic Stress Disorder Reaction Index (CPTS-RI) and the Brief Symptom Inventory (BSI). We used the Windows SPSS 16.0 software program to assess the results. At least one psychiatric disorder was determined in 44.4% of the early-married and 77.8% of the sexually abused cases (p < 0.001). A diagnosis of PTSD or ASD was observed in 11.1% of the early-married cases and in 54.2% of the sexually abused victims (p < 0.001). MDD was determined in 33.3% of the early-married cases and 56.9% of the sexually abused cases (p = 0.006). The CPTS-RI scores of the sexually abused victims were higher than those of the early-married cases (p < 0.001). All of the subscale scores of the BSI were higher in the sexually abused adolescents than in the early-married cases (p < 0.001). Although early marriage has severe physical, social and mental outcomes, it is not as severe as sexual abuse in terms of psychiatric disorder rates and the psychiatric symptom severity it causes.     

Child maltreatment and risk behaviors: The roles of callous/unemotional traits and conscientiousness

Child maltreatment poses significant risk to the development of callous/unemotional traits as well as risk behaviors such as engaging in violence, having sex with strangers, and binge drinking. In the current study, the indirect pathway from child maltreatment to risk behaviors was examined via callous/unemotional traits; whereas the conscientious personality trait was tested as a moderator of this indirect pathway. Young adults and parents (N = 361; M_age = 19.14, SD = 1.44) completed questionnaires on child maltreatment histories, callousness/unemotional traits, personality characteristics, and risk behaviors. Structural equation modeling was used to examine the hypothesized direct, indirect and conditional indirect effects. Findings showed indirect links between the child maltreatment latent factor and physical fighting, having sex with strangers, and binge drinking via callous/unemotional traits. Furthermore, the conscientiousness personality type significantly buffered the connection between callous/unemotional traits and physical fighting, supporting a conditional indirect effects. Callous/unemotional traits are important factors in the underlying mechanism between child maltreatment and risk behaviors among young adults, and conscientiousness serves as a protective factor against violence. Preventive intervention programs and clinicians may benefit from focusing in addressing callous/unemotional traits among youth who report childhood maltreatment experiences as well as targeting conscientiousness as a protective factor.     

Testing an asset-building approach for young people: Early access to savings predicts later savings

A major hypothesis of asset-building is that early access to savings accounts leads to continued and improved educational and economic outcomes over time. This study asks whether or not young adults (ages 18–22) in 2007, particularly among lower income households, are significantly more likely to own savings accounts and to accumulate more savings when they have access to savings accounts at banking institutions as adolescents (ages 13–17) in 2002. We investigate this question using longitudinal data (low-to-moderate income sample [LMI; N = 530]; low-income sample [LI; N = 354]) from the Panel Study of Income Dynamics and its supplements. Results from propensity score weighting and bivariate probit estimates support this hypothesis. Asset-building policies that extend early access to savings accounts may improve savings outcomes for young people from lower income households, which hopefully affords them with the economic resources needed to lead productive and satisfying lives.     

Validating the English Language Learner Motivation Scale (ELLMS): Pre-college to measure language learning motivational orientations among young ELLs

This study modified and validated a measure of motivational orientations – grounded in self-determination theory and originally developed for postsecondary students – for use with younger (pre-college) English language learners (ELLs). Exploratory factor analysis results in Sample A (n = 528) indicated that the data were best explained by a three-factor solution (intrinsic motivation, introjected regulation, and external regulation) that explained 51.6% of the variance. These results were corroborated by a confirmatory factor analysis in an independent Sample B (n = 529; GFI = .97, CFI = .96, SRMR = .04, RMSEA = .05). The test for invariance across the two samples further supported the validity of the measure. The modified instrument, named English Language Learner Motivation Scale (ELLMS): Pre-College, showed strong psychometric characteristics for use with elementary (ages 9–11 years), middle (ages 12–14 years), and high school (ages 16–17) ELLs. Applications of the measure are discussed.     

Spanking and adult mental health impairment: The case for the designation of spanking as an adverse childhood experience

Adverse Childhood Experiences (ACEs) such as child abuse are related to poor health outcomes. Spanking has indicated a similar association with health outcomes, but to date has not been considered an ACE. Physical and emotional abuse have been shown in previous research to correlate highly and may be similar in nature to spanking. To determine if spanking should be considered an ACE, this study aimed to examine 1): the grouping of spanking with physical and emotional abuse; and 2) if spanking has similar associations with poor adult health problems and accounts for additional model variance. Adult mental health problems included depressive affect, suicide attempts, moderate to heavy drinking, and street drug use. Data were from the CDC-Kaiser ACE study (N = 8316, response rate = 65%). Spanking loaded on the same factor as the physical and emotional abuse items. Additionally, spanking was associated with increased odds of suicide attempts (Adjusted Odds Ratios (AOR) = 1.37; 95% CI = 1.02 to1.86), moderate to heavy drinking (AOR) = 1.23; 95% CI = 1.07 to 1.41), and the use of street drugs (AOR) = 1.32; 95% CI = 1.4 to 1.52) in adulthood over and above experiencing physical and emotional abuse. This indicates spanking accounts for additional model variance and improves our understanding of these outcomes. Thus, spanking is empirically similar to physical and emotional abuse and including spanking with abuse adds to our understanding of these mental health problems. Spanking should also be considered an ACE and addressed in efforts to prevent violence.     

Child maltreatment and risk patterns among participants in a child abuse prevention program

The relationship between risk factors and Child Protective Services (CPS) outcomes in families who participate in home visiting programs to prevent abuse and neglect and who are reported to CPS is largely unknown. We examined the relationship between parental risk factors and the substantiation status and number of CPS reports in families in a statewide prevention program. We reviewed CPS reports from 2006 to 2008 for families in Connecticut's child abuse prevention program. Six risk factors (histories of CPS, domestic violence [DV], mental health, sexual abuse, substance abuse, and criminal involvement) and the number of caregivers were abstracted to create risk scores for each family member. Maltreatment type, substantiation, and number of reports were recorded. Odds ratios were calculated. Of 1,125 families, 171 (15.6%) had at least one CPS report, and reports of 131 families were available for review. Families with a substantiated (25.2%) versus unsubstantiated (74.8%) first report had a high number of paternal risk factors (OR = 6.13, 95% CI [1.89, 20.00]) and were more likely to have a history of maternal DV (OR = 8.47, 95% CI [2.96, 24.39]), paternal DV (OR = 11.23, 95% CI [3.33, 38.46]), and maternal criminal history (OR = 4.55; 95% CI [1.32, 15.60]). Families with >1 report (34.4%) versus 1 report (65.6%) were more likely to have >3 caregivers, but this was not statistically significant (OR = 2.53, 95% CI [0.98, 6.54]). In a prevention program for first-time families, DV, paternal risk, maternal criminal history, and an increased number of caregivers were associated with maltreatment outcomes. Targeting parental violence may impact child abuse prevention.     

History of sexual abuse and suicide attempts in alcohol-dependent patients

History of child abuse is considered one of the important risk factors of suicide attempt in general population. At the same time it has been shown that suicide attempts appear significantly more frequently in alcoholics than in healthy individuals. The objective of this study was to investigate associations between history of childhood sexual abuse and suicide attempts in a sample of Polish alcohol dependent patients. A sample of 364 alcohol-dependent subjects was recruited in alcohol treatment centers in Warsaw, Poland. Information was obtained about demographics, family history of psychiatric problems, history of suicide attempts, sexual and physical abuse during childhood and adulthood and severity of alcohol problems. When analyzed by gender, 7.4% of male and 39.2% of female patients had a lifetime history of sexual abuse; 31.9% of the study group reported at least one suicide attempt during their lifetime. Patients who reported suicide attempts were significantly younger (p = 0.0008), had greater severity of alcohol dependence (p = 0.0002), lower social support (p = 0.003), and worse economic status (p = 0.002). Moreover, there was a significant association between history of suicide attempts and family history of psychiatric problems (p = 0.00025), suicide attempts in the family (p = 0.0073), childhood history of sexual abuse (p = 0.009) as well as childhood history of physical abuse (p = 0.002). When entered into linear regression analysis with other dependent variables history of childhood sexual abuse remained a significant predictor of suicide attempt (OR = 2.52; p = 0.035). Lifetime experience of sexual abuse is a significant and independent risk factor of suicide attempts in alcohol-dependent individuals.     

Attachment in institutionalized children: A review and meta-analysis

In this article we review the literature on attachment patterns in institutionalized children and then perform a meta-analysis on data from 10 attachment studies involving 399 children in institutional settings. We computed the overall attachment distribution of secure, insecure, and disorganized rates and explored the effect of a set of moderating variables (i.e., country of institutionalization, attachment assessment procedure, age at entry, and age at assessment). To overcome bias related to the small number of studies, we conducted both classical and Bayesian meta-analysis and obtained comparable results. Distribution of children's attachment patterns was: 18% secure, 28% insecure, and 54% disorganized/cannot classify. Compared to their family-reared peers, children living in an institution were found to be at greater risk for insecure and disorganized attachment, with a similar medium effect size for both distributions (d = 0.77 and d = 0.76, respectively). The following moderating variables were associated with insecure attachment: representational assessment procedures (d = 0.63) and Eastern European countries of origin (d = 1.13). Moderators for disorganized attachment were: Eastern European countries of origin (d = 1.12), age at institution entry before the first birthday (d = 0.93), and age at assessment under three years of age (d = 0.91). Implications for child development and policies are discussed.     

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.     

Empowering and protecting children by enhancing knowledge,skills and well-being: A randomized trial of Learn to BE SAFE with Emmy™

Australia needs effective programs to protect children and prevent abuse, but there is little information available for policymakers or families. Using a randomized controlled trial, Learn to BE SAFE with Emmy™, a school-based protection program for young children designed by Act for Kids, was evaluated to determine its effectiveness for promoting young children's knowledge and skills. Grade one children (n = 245) from 15 classrooms across 5 primary schools completed assessment measures. A subset of these children received the program (n = 131) or acted as a comparison group (n = 114). Parents (n = 72) completed questionnaires about their child's participation in the program. When compared with children who had not received the program, children who completed Learn to BE SAFE with Emmy™ demonstrated increased knowledge of interpersonal safety and were more likely to choose a safe response option to hypothetical unsafe scenarios 6 months after participation than at both pre- and post-intervention. Parents reported their children who participated used more safety strategies immediately and 6 months after participation compared to pre-intervention. Outcomes can assist in guiding future policies around the prevention of child abuse and protect the well-being of Australian children.     

Measuring teacher regulating activities concerning student learning in secondary education classrooms: Reliability and validity of student perceptions

.This article describes the use and validation of the Pedagogical Practices Inventory, which uses student perceptions arranged into five subscales to measure teacher activities concerning the regulation of student learning in secondary education. To determine the reliability and validity of the instrument, an inventory study (N = 2128) and a study in which observational data (N = 11) and inventory data (N = 201) were combined, were carried out. Analysis of the inventory data showed internal subscale reliabilities between .83 and .90, indicating consistency of the PPI subscale scores. Correlations between inventory and observational data showed significant relations for three of the five subscales, indicating that the PPI is suitable to tap teacher regulating activities in classroom contexts.     

Academic goals,goal process cognition,and exam performance among college students

We investigated the nature of and linkages between student-generated academic goals, individual differences in self-regulatory thinking (goal process cognition), and exam performance among college students. In Study 1 (N = 365) and in Study 2 (N = 325), we elicited students' self-ascribed most important academic goals for introductory psychology and their goal process cognition toward their most important goal. In addition, in Study 2, we collected data on students' exam scores in introductory psychology and their most important academic goal and goal process cognition for another course. Three types of academic goals were identified: performance (39–55%), mastery (22–39%), and study strategies (20–23%). Students with mastery academic goals had the highest positive arousal whereas students with performance academic goals had the highest negative arousal. Compared to students with performance academic goals, students with mastery academic goals had lower exam scores in introductory psychology and this difference was mediated, in part, by goal process cognition.