Long-term physical and mental health consequences of childhood physical abuse: results from a large population-based sample of men and women

OBJECTIVE: Child maltreatment has been linked to negative adult health outcomes; however, much past research includes only clinical samples of women, focuses exclusively on sexual abuse and/or fails to control for family background and childhood characteristics, both potential confounders. Further research is needed to obtain accurate, generalizable estimates and to educate clinicians who are generally unaware of the link between childhood abuse and adult health. The purpose of this project is to examine how childhood physical abuse by parents impacts mid-life mental and physical health, and to explore the attenuating effect of family background and childhood adversities. METHODS: We analyzed population-based survey data from over 2,000 middle-aged men and women in the Wisconsin Longitudinal Study using self-reported measures of parental childhood physical abuse, mental health (depression, anxiety, anger), physical health (physical symptoms and medical diagnoses), family background, and childhood adversities. RESULTS: Parental physical abuse was reported by 11.4% of respondents (10.6% of males and 12.1% of females). In multivariate models controlling for age, sex, childhood adversities, and family background, we found that childhood physical abuse predicted a graded increase in depression, anxiety, anger, physical symptoms, and medical diagnoses. Childhood physical abuse also predicted severe ill health and an array of specific medical diagnoses and physical symptoms. Family background and childhood adversities attenuated but did not eliminate the childhood abuse/adult health relationship. CONCLUSIONS: In a population-based cohort of middle-aged men and women, childhood physical abuse predicted worse mental and physical health decades after the abuse. These effects were attenuated, but not eliminated, by age, sex, family background, and childhood adversities.     

Re-referral to child protective services: the influence of child, family, and case characteristics on risk status

INTRODUCTION: This study examines child, family, and case characteristics that impact rates of re-referral to Child Protective Services (CPS) using data on all closed CPS investigations for the state of Rhode Island between 2001 and 2004. METHOD: A longitudinal dataset of all referrals to CPS was created using state submissions to the National Child Abuse and Neglect Data System (NCANDS). After excluding children whose initial CPS investigation resulted in removal from the home, a Cox proportional hazards model was tested to examine factors impacting the likelihood of re-referral. RESULTS: Consistent with other research in this area, the initial 6-month period following case disposition is the period of greatest risk of re-referral. Approximately 13% of cases experienced a recurrent allegation during the first 6-month period; an additional 14% experienced a re-referral over the following 12-month period; 7% during the next 12-month period. Family poverty was the strongest predictor of re-referral, though a number of child and case characteristics were significantly related to recurrence. Cases that were substantiated at index were significantly less likely to result in a new allegation, though substantiated cases of physical abuse or those receiving post-investigation services were at higher risk. CONCLUSIONS: Children from families facing multiple stressors (e.g., low SES, parental substance abuse child disability) are at highest risk of re-referral to CPS and may benefit from the development of preventive services targeted immediately following case closings within CPS.     

A meta-analytic investigation of therapy modality outcomes for sexually abused children and adolescents: an exploratory study

OBJECTIVE: The purpose of the current study was to investigate the independent effects of different treatment elements on a number of secondary problems related to childhood and adolescent sexual abuse, as well as investigate a number of different moderators of treatment effectiveness. METHOD: Twenty-eight studies that provided treatment outcome results for children and adolescents who had been sexually abused were included in the meta-analysis. Different aspects of psychological treatment, such as specific treatment modalities (individual, cognitive-behavioral, etc.) or secondary problems (behavior problems, psychological distress, etc.) were investigated. RESULTS: The overall mean weighted effect size for the meta-analysis was d=.72 (SE=.02). The results indicate that psychological treatment after childhood or adolescent sexual abuse tended to result in better outcomes than no treatment. There was significant heterogeneity in the effectiveness of the various psychological treatment elements. Play therapy seemed to be the most effective treatment for social functioning, whereas cognitive-behavioral, abuse-specific, and supportive therapy in either group or individual formats was most effective for behavior problems. Cognitive-behavioral, family, and individual therapy seemed to be the most effective for psychological distress, and abuse-specific, cognitive-behavioral, and group therapy appeared to be the most effective for low self-concept. CONCLUSIONS: The choice of therapy modality should depend on the child's main presenting secondary problem. Further research should be conducted investigating other possible moderators and secondary problem outcomes.     

Prevalence of child sexual abuse reported by a cross-sectional sample of New Zealand women

OBJECTIVE: The objective is to describe the prevalence of child sexual abuse (CSA) among women in New Zealand, document ethnic specific rates, and outline the frequency of abuse experienced and the most commonly identified perpetrators. Associations between CSA and later adverse consequences were also explored. METHODS: Retrospective report from a random sample of 2,855 women aged 18-64 years old in two regions in New Zealand. Face-to-face interviews with one randomly selected woman from each household were conducted. RESULTS: The overall prevalence rates for CSA were 23.5% for women from the urban region and 28.2% from the rural region. In both urban and rural regions, Māori women more frequently reported experiences of CSA than women from European and other ethnic groups (urban: 30.5% vs. 17.0% and rural: 35.1% vs. 20.7%). The median age of onset of the abuse was 9 years, and the median estimated age of the abuser was 30 years. Half of those who experienced CSA reported that it occurred once or twice, 27% "a few times," and 23% "multiple times." Sole perpetrators were involved in 83% of cases. The majority of cases were perpetrated by a family member, most frequently male. Compared with non-victims, victims of CSA were twice as likely to experience later intimate partner violence and violence by others. CONCLUSIONS: This study reports on a large, population-based sample in an ethnically diverse population in New Zealand, providing the first ethnic-specific rates of CSA available. Findings suggest important priorities for prevention and intervention activities.     

Cognitive brain potentials in kindergarten children with subtyped risks of reading retardation

Cognition-related brain responses to meaningful and meaningless figures were registered in 5-year-old kindergarten children who either had been subtyped as being at-risk of developing an L- or P-type dyslexia (LAL versus LAP) or who were not at-risk. While identifying, naming, or categorizing pictures, event-related potentials (ERP) were registered. Three cognition-related components were found: the N460, the P780, and the Slow Wave (SW). LAP-children produced weak N460 activity across tasks, whereas LAL children, and to a lesser degree, non-risk children produced robust task-dependent activity. This finding may indicate that LAP-children lack semantic input while processing the figures. P780 latencies to frequently occurring figures were found hemisphere-dependent: LAP-children showed longer latencies in the right than in the left hemisphere, whereas the distribution was reversed in the LAL and non-risk children. It was also found that the right hemisphere is generally responsible for a lion's share of the processing of figures and therefore it seems that the right hemisphere of LAP-children invests ample time in doing so. Whereas LAP-children showed largest SW amplitude differences between frequent and infrequent stimuli at posterior locations, LAL children did so at frontal locations. Assuming that the SW represents working-memory processes, it may be that working-memory in LAP-children deals with figure-relevant visual-spatial information and with figure-derived concepts in LAL children. Overall, the findings suggest that LAL and LAP represent two different groups of kindergartners at risk of dyslexia and that these differences, to some degree, fit with the presumed etiology of L- and P-type dyslexia.     

Component skills of text comprehension in less competent Chinese comprehenders

The present study examined the role of verbal working memory (memory span and tongue-twister), two-character Chinese pseudoword reading (two tasks), rapid automatized naming (RAN) (letters and numbers), and phonological segmentation (deletion of rimes and onsets) in inferential text comprehension in Chinese in 31 less competent comprehenders compared with 37 reading comprehension control students and 23 chronological age controls. It was hypothesized that the target students would perform poorly on these cognitive and linguistic tasks as compared with their controls. Furthermore, verbal working memory and pseudoword reading would explain a considerable amount of individual variation in Chinese text comprehension. RAN would have a nonsignificant role in text comprehension. Structural equation analyses and hierarchical multiple regression analyses generally upheld these hypotheses. Our findings support current literature of the role of verbal working memory in reading comprehension found in English. The results, however, suggest differential role of the constructs and the tasks in reading comprehension and provide some answers for comprehension impairment in Chinese students.     

Phonological processing and emergent literacy in younger and older preschool children

Phonological awareness, phonological memory, and phonological access to lexical storage play important roles in acquiring literacy. We examined the convergent, discriminant, and predictive validity of these phonological processing abilities (PPA) in 389 3-, 4-, and 5-year-old children. Confirmatory factor analysis supported the validity of each PPA as separate from general cognitive ability and separate from each other. Multigroup structural equation modeling (SEM) with mean structure demonstrated that older preschoolers have better developed latent PPA than younger preschoolers but that the structure of PPA is equivalent. RAN was found uniquely associated with letter knowledge and text discrimination in younger preschoolers, and PA was found uniquely associated with word reading skills in older preschoolers. Finally, general cognitive ability was only indirectly associated with emergent literacy via PPA. These results highlight the importance of PPA in the early literacy development of English-speaking preschool children.     

Screening of phonological awareness in the early elementary grades: an IRT approach

The purpose of the present study was to explore the possibilities for the assessment of growth in phonological awareness of children in kindergarten and first grade. Phonological awareness was measured using four sets of items involving rhyming, phoneme identification, phoneme blending, and phoneme segmentation. The results of an exploratory factor analysis and analyses conducted within the framework of item response theory showed one latent ability to underlie the different sets of items, which nevertheless differed in difficulty. Analyses in terms of the children’s ability further showed the phonological awareness measures to be sensitive to growth. The amount of information supplied by the different sets of items depended on the children’s level of ability. The conclusion that it is possible to accurately monitor the development of children’s phonological awareness in the early elementary grades appears to be justified, and this possibility opens up new perspectives for the early screening for reading problems and dyslexia.     

Gödel’s proof

In 1931, the great Austrian mathematician Kurt Gödel proved “all consistent axiomatic formulations of number theory include undecidable propositions”. This discovery of Gödel and its proof had enormous repercussions in mathematics and computer science. The proof hinged upon the writing of a self-referential mathematical statement, in the same way as the liar’s paradox — I am lying — is a self-referential statement. In this three-part article, we describe Gödel’s discovery and his famous proof.