The intergenerational impact of trauma and family violence on parents and their children

BackgroundChildren who experience Child Abuse and Neglect (CAN) are at an increased risk of becoming a victim of Intimate Partner Violence (IPV) or a perpetrator of IPV or CAN. Moreover, maltreated children are at risk for developing long-lasting trauma symptoms, which can subsequently affect their own children’s lives. Understanding the mechanisms of the intergenerational transmission of violence and trauma is a prerequisite for the development of interventions.ObjectiveWe examine whether the relation between historical CAN and current trauma symptoms of mothers is mediated by current IPV. Furthermore, we investigate whether current CAN mediates the relation between current maternal trauma symptoms and child Post-Traumatic Stress Disorder (PTSD) symptoms. These mechanisms are compared for mothers and fathers.ParticipantsWe have recruited 101 fathers and 360 mothers (426 children, 50% boys, mean age 7 years) through child protection services.MethodsRespondents completed questionnaires about IPV, (historical) CAN and trauma symptoms.ResultsStructural equation models revealed that historical CAN of father and mothers was related to trauma symptoms. Only for mothers, this association was mediated by IPV. Trauma symptoms of both fathers and mothers were related to child PTSD symptoms. This effect was not mediated by current CAN.ConclusionIn violent families, maternal and paternal trauma can be transmitted over generations. However, intergenerational transmission of violence is found for mothers only. When family violence is reported, professionals should take the violence into account, as well as the history of parents and trauma symptoms of all family members.     

African American perspectives on racial disparities in child removals

BackgroundAfrican American children are overrepresented in foster care at twice to three times the rate of white children. Scholars argue that racism and oppression underlie disproportionality (Križ & Skivenes, 2011).ObjectiveThis study explored disproportionality as seen through the eyes of African American parents in the child welfare system. The aim was to understand why African American families are over-represented in child custody statistics and to improve family and parenting support for African American communities.Participants & SettingParticipants included twenty-one African Americans--12 women and 9 men, two of whom were foster parents and 19 of whom were parents involved with child welfare services. All participants reside in two impoverished areas in southern United States. Focus groups were used to collect data and were conducted at a community center.MethodsThe method of analysis was constant comparison analysis (Strauss) and thematic analysis of the focus group discussions in the context of institutional policy.FindingsSix themes (profound lack of trust; overwhelming trauma; severe and persistent poverty; health and mental health; socio-economic conditions; and sense of social isolation were identified, along with three participant suggestions to improve child welfare services (family support services, economic revival, and better communication).ConclusionsIn the current study we note the strong link between poverty, child maltreatment, and child removal and conclude with an exploration of practice and policy implications with recommendations for a way forward. The need for culturally competent and trauma informed child welfare services is also discussed.     

Professionals’ preferences and experiences with inter-organizational consultation to assess suspicions of child abuse and neglect

This study addresses the following questions in cases of suspected child abuse and neglect (CAN) in children up to four years of age: 1) How many professionals intend to seek inter-organizational consultation? 2) What types of organizations do professionals prefer to consult? and 3) What factors can be identified as facilitator(s) or barrier(s) regarding inter-organizational consultation, based on professionals’ experiences? Professionals working with children in 101 organizations in a medium-sized Dutch city were invited to fill in an online questionnaire. The questionnaire included a vignette about a suspected case. Quantitative, qualitative, and social network analysis approaches were used to analyze the data. Seventy-eight questionnaires were available for analysis. Fifty-five respondents (71%) intended to seek inter-organizational consultation. Ten different organization types were mentioned. The most frequently mentioned organization was preventive child healthcare. In total, 82 text fragments from 39 participants were available to analyze barriers and facilitators to inter-organizational consultation, 60 fragments that entailed a facilitator and 22 fragments that entailed a barrier. The text fragments were subdivided into twelve factors. The three factors that were most often identified as a facilitator were ‘support’, ‘undertaking action’, and ‘regard’. Barriers were found in relation to all twelve factors. No specific barrier(s) stood out. This study demonstrated that most professionals are inclined to seek inter-organizational consultation when they suspect CAN. They are especially likely to seek consultation from preventive child health care organizations. Their experiences mainly revealed facilitators and few barriers. The implications for research and practice are also discussed.     

The association between perceived injunctive norms toward corporal punishment,parenting support,and risk for child physical abuse

The use of corporal punishment (CP) is a strong risk factor for many poor outcomes for children including child maltreatment. The use of CP occurs within social contexts which are important to understand. Although it is known that perceived social norms regarding CP are related to its use, the specific role that a mother’s primary support person plays in influencing attitudes toward and use of CP remains unknown. The current study assessed linkages between maternal perceived social support in parenting and perceived injunctive norms of CP from her primary source of support, with maternal attitudes toward and use of CP. Survey data were collected from female primary caregivers (N = 436) of children age 2 to 7 years (mean age = 3.7) enrolled in Special Supplemental Nutrition Program for Women, Infants and Children (WIC) clinics in Southeastern Louisiana. Most frequently, the biological father of the child (37.9%) and the maternal grandmother of the child (24.2%) were identified as the participant’s primary source of social support in parenting. Perceived injunctive norms of this support person toward CP use were significantly and positively associated with attitudes toward, AOR = 5.97, 95% CI = [4.04, 8.82], and use of CP, AOR = 3.77, 95% CI = [2.55, 5.59]. However, perceived social support was not associated with these outcomes and also did not moderate these associations. Findings suggest that efforts to reduce maternal risk for child physical abuse and use of CP must include the mother’s primary source of social support if they are to be successful.     

Parents’ PTSD symptoms and child abuse potential during the perinatal period: Direct associations and mediation via relationship conflict

BackgroundPosttraumatic stress disorder (PTSD) symptoms are associated with parental aggression towards children, but little is known about the relation between parents’ PTSD symptoms and their risk for perpetrating child physical abuse during the early parenting years, when the potential for prevention of abuse may be highest.ObjectiveTo examine direct associations between mothers’ and fathers’ PTSD symptoms and child abuse potential, as well as indirect effects through couple relationship adjustment (i.e., conflict and love) in a high-risk sample of parents during the perinatal period, most of whom were first-time parents.Participants and settingFrom March 2013 to August 2016, data were collected from 150 expecting or new parental dyads in which the mother was participating in a home visiting program.MethodsData were analyzed using the Actor-Partner Interdependence Mediation Model.ResultsFor mothers and fathers, there were direct associations between PTSD symptom severity and child abuse potential (βs = .51, ps <.001), and this association for fathers was stronger at higher levels of mothers’ PTSD symptoms (β = .15, p = .03). In addition, parents’ own and their partners’ PTSD symptoms were each indirectly associated with parents’ own child abuse potential through parents’ report of interparental conflict (standardized indirect effects = .052–.069, ps = .004) but not love.ConclusionsAddressing parents’ PTSD symptoms and relationship conflict during the perinatal period using both systemic and developmental perspectives may uniquely serve to decrease the risk of child physical abuse and its myriad adverse consequences.     

A mediational model linking perceptions of security,alexithymia and behavior problems of sexually abused children

BackgroundPerceptions of security toward parents are related with internalized and externalized problems among victims of child sexual abuse (CSA). Alexithymia, which is difficulty in identifying and expressing feelings, is associated with the quality of parent-child relationships (Oskis et al., 2013) and behavior problems in children (Di Trani et al., 2013).ObjectiveThe current study tested the mediational role of alexithymia in the relationship between perceptions of security toward parents and behavior problems among CSA victims.Participants and methodUsing a short-term multi-informant prospective design, 263 victims of CSA aged 6–12 years completed the Kerns Security Scale (Kerns, Klepac, & Cole, 1996), which evaluates perceived attachment security to mothers and fathers. Parents completed the Child Behavior Checklist (Achenbach & Rescorla, 2001) at Time 1 to provide baseline scores of behavior problems and again four months later. At Time 2, parents also assessed the children’s alexithymia using the Children’s Alexithymia Measure (Way et al., 2010).ResultsPerceptions of security were both associated with alexithymia, as well as with internalizing and externalizing problems (p < .05). A mediational model showed that perception of security toward fathers outweighed the mother-child relationship in predicting children’s alexithymia. Path analysis revealed that the father-child relationship predicted decreased behavioral problems at Time 2 through a lower level of alexithymia. The model explained 46.9% of internalizing problems and 56.1% of externalizing problems (p < .05).ConclusionsThe findings support the relevance of alexithymia as an intervention target for CSA victims and underscore the importance of the father-child relationship.     

Child protection cases,one size fits all? Cluster analyses of risk and protective factors

BackgroundTo provide effective tailor made case management in Child Protection Services (CPS) a insight is needed into the specific characteristics of the target group. Using the ecological perspective of maltreatment, this study explored poorly known characteristics of the CPS population.ObjectiveTo distinguish CPS subgroups based on risk and protective factors enables tailor made case management that fits the specific needs of these subgroups.Participants and settingWe studied 250 Dutch CPS cases of family supervision by court order that had completed the LIRIK and Action Plan checklists in August 2014–March 2015.MethodsThis quantitative study analyzed risk and protective factors for children and parents reported in client files. Subgroups were identified by two-step cluster analyses. Chi-square analyses identified relations between parental risk subgroups and other groups.ResultsBuilding on the interplay between risk and protective factors on the levels of child, parent and environment, we found five distinct subgroups in the CPS population. The most vulnerable is parents with multiple problems (31%) or socio-economic problems (13%). Parts of both subgroup have limited protective factors. Parents with major life events (16%) or poor parenting (13%) are characterized by single-level problems. One subgroup (28%), the unaccepted, has no parental risk factors registered.ConclusionsStudying client files can lead to a better understanding of the healthcare needs of the CPS population. To develop and implement more effective case management requires constant dialogue between science, policy, and the experiences of both clients and professional.     

Child and family traumatic stress intervention (CFTSI) reduces parental posttraumatic stress symptoms: A multi-site meta-analysis (MSMA)

BackgroundFollowing traumatization, caregiver support is a crucial factor contributing to children's successful management of posttraumatic reactions and their recovery. Caregivers who have been traumatically impacted themselves, however, may be compromised in this posttraumatic caregiving role. Although there are a number of evidence-based child trauma treatments that are effective in reducing children's trauma symptoms, the impact of child treatment on participating caregiver's posttraumatic symptoms (PTS) has received less attention.ObjectiveExplore PTS reduction caregivers experience through participation in their child's evidence-based trauma-focused mental health treatment.Participants and setting640 Child-Caregiver dyads referred for the Child and Family Traumatic Stress Intervention (CFTSI) following formal disclosure of abuse in a Child Advocacy Center (CAC).MethodsData were collected from 10 community treatment sites trained in CFTSI. A multi-site meta-analytic approach was used to evaluate pooled and site-specific therapeutic effect sizes for caregivers and children.ResultsCFTSI was associated with significant changes (Hedge's g = 1.17, Child-rated; g = 0.66, caregiver-rated) in children's PTS and with clinically meaningful improvements in PTS for 62% of participating caregivers who had started CFTSI with clinical levels of PTS as measured by the Post Traumatic Checklist–Civilian Version (PCL-C). The overall mean PCL-C change (9.31, SD = 12.9) in paired, pre-post PCL-C scores is close to a clinically meaningful change of 10 or higher. There was a robust moderate pooled effect size (g = 0.70, N = 640, p < 0.0001).ConclusionThe value of a reduction in caregiver PTS as a secondary outcome of children's trauma-focused treatment is discussed.     

Ain’t nobody got time for dad? Racial-ethnic disproportionalities in child welfare casework practice with nonresident fathers

BackgroundGiven fathers’ potential role in bringing about desired child welfare case outcomes, researchers have begun to identify factors that impact agency efforts to identify and involve fathers. Racial-ethnic inequality and bias are not among factors studied, despite longstanding evidence that racial-ethnic minority children make up a disproportionate share of the child welfare population.ObjectiveWe set out to identify racial-ethnic patterns in initial casework activity with nonresident fathers and explore whether select factors explain racial-ethnic differentials.Participants and SettingCaseworkers of 1,754 children in foster care in four U.S. states were surveyed.MethodsBivariate and multivariate logistic regression models were used to identify factors associated with whether agencies identified, located, and contacted nonresident fathers.ResultsAgencies were less likely to identify nonresident fathers of Black, Latinx, and Multiracial children, relative to those of White children. Among fathers whom agencies identified, Black and Latinx fathers were less likely to be located. Among fathers whom agencies located, Black and Latinx fathers were less likely to be contacted. Whereas greater rates of international mobility among Latinx fathers explained agencies’ disproportionately low rates of contact, no other factor explained racial-ethnic differentials.ConclusionWe find evidence of historical racial-ethnic disproportionalities across the three initial stages of casework practice with nonresident fathers in U.S. child welfare systems. Though more recent data are needed, this research suggests that racial-ethnic minority foster children are more likely than White foster children to be denied the benefits of agency-father contact, whether due to societal or systemic racial inequalities.