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.     

Statistical methods for analysing discrete and categorical data recorded in performance analysis

In this paper, we identify appropriate statistical methods for analysing categorical differences in discrete variables or 'performance indicators' resulting from performance analysis. The random mechanisms associated with discrete events do not follow a normal distribution; that is, the normal distribution is a continuous not a discrete probability distribution. We propose appropriate statistical methods based on two key discrete probability distributions, the Poisson and binomial distributions. Two approaches are proposed and compared using examples from notational analysis. The first approach is based on the classic chi-square test of significance (both the goodness-of-fit test and the test of independence). The second approach adopts a more contemporary method based on log-linear and logit models fitted using the statistical software GLIM. Provided relatively simple one-way and two-way comparisons in categorical data are required, both of these approaches result in very similar conclusions. However, as soon as more complex models or higher-order comparisons are required, the approach based on log-linear and logit models is shown to be more effective. Indeed, when investigating those factors and categorical differences associated with binomial or binary response variables, such as the proportion of winners when attempting decisive shots in squash or the proportion of goals scored from all shots in association football, logit models become the only realistic method available. By applying log-linear and logit models to discrete events resulting from notational analysis, greater insight into the underlying mechanisms associated with sport performance can be achieved.     

Forensic child sexual abuse evaluations: assessing subjectivity and bias in professional judgements

Objectives

Evaluators examining the same evidence often arrive at substantially different conclusions in forensic assessments of child sexual abuse (CSA). This study attempts to identify and quantify subjective factors that contribute to such disagreements so that interventions can be devised to improve the reliability of case decisions.

Methods

Participants included 1106 professionals in the field of child maltreatment representing a range of professional positions or job titles and years of experience. Each completed the Child Forensic Attitude Scale (CFAS), a 28-item survey assessing 3 forensic attitudes believed to influence professional judgments about CSA allegations: emphasis-on-sensitivity (i.e., a focus on minimizing false negatives or errors of undercalling abuse); emphasis-on-specificity (i.e., a focus on minimizing false positives or errors of overcalling abuse); and skepticism toward child and adolescent reports of CSA. A subset of 605 professionals also participated in 1 of 3 diverse decision exercises to assess the influence of the 3 forensic attitudes on ratings of case credibility.

Results

Exploratory factor analysis identified 4 factors or attitude subscales that corresponded closely with the original CFAS scales: 2 subscales for emphasis-on-sensitivity and 1 each for emphasis-on-specificity and skepticism. Attitude subscale scores differed significantly by sample source (in-state trainings vs. national conferences), gender, years of experience, and professional position, with Child Protective Service workers unexpectedly more concerned about overcalling abuse and more skeptical of child disclosures than other professionals—a pattern of scores associated with an increased probability of disbelieving CSA allegations. The 3 decision exercises offered validation of the attitude subscales as predictors of professional ratings of case credibility, with adjusted R²s for the three exercises ranging from .06 to .24, suggesting highly variable effect sizes.

Conclusions

Evaluator disagreements about CSA allegations can be explained, in part, by individual differences in 3 attitudes related to forensic decision-making: emphasis-on-sensitivity, emphasis-on-specificity, and skepticism toward child reports of abuse. These attitudes operate as predispositions or biases toward viewing CSA allegations as likely true or likely false. Several strategies for curbing the influence of subjective factors are highlighted including self-awareness of personal biases and team approaches to assessment.     

Science Letters：IGFBP7 plays a potential tumor suppressor role against colorectal carcinogenesis with its expression associated with DNA hypomethylation of exon 1

Insulin-like growth factor binding-protein-7 （IGFBP7） was obtained from our previous colonic adenocarcinoma （CRC） and normal mucosa suppression subtraction hybridization （SSH） cDNA libraries. By RT-PCR and immunohistochemistry, we found that IGFBP7 was overexpressed in CRC tissue compared to normal tissue. However, our in vitro experiments performed in 10 CRC cell lines showed that IGFBP7 expressed only in SW480 and Caco2 cell lines, which implied an underlying reversible regulatory mechanism. Using methylation-specific PCR （MSP） and bisulfite sodium PCR （BSP）, we found that its expression was associated with DNA hypomethylation of exonl. This was further supported by the in vitro study which showed restored IGFBP7 expression after demethylation agent 5-aza-2＇-deoxycytidine treatment. Correlation analysis between IGFBP7 expression and prognosis indicated that overexpression of IGFBP7 in CRC tissue correlated with favourable survival. Investigation of the functional role of IGFBP7 through transfection studies showed that IGFBP7 protein could inhibit growth rate, decrease colony formation activity, and induce apoptosis in RKO and SW620 cells, suggesting it a potential tumor suppressor protein in colorectal carcinogenesis. In conclusion, our study clearly demonstrated that IGFBP7 plays a potential tumor suppressor role against colorectal carcinogenesis and its expression is associated with DNA hypomethylation of exon 1.     

The roles of peritraumatic dissociation, child physical abuse, and child sexual abuse in the development of posttraumatic stress disorder and adult victimization

OBJECTIVE: Previous research has indicated that women who experience childhood physical abuse or childhood sexual abuse are at increased risk for posttraumatic stress disorder (PTSD) and adult victimization. Recently, peritraumatic dissociation (PD) has been suggested as another possible risk factor for PTSD and adult victimization. The purpose of the present study was to investigate the effects of childhood physical and sexual abuse and PD on PTSD and adult victimization. METHOD: A sample of 467 female college students completed questionnaires about childhood and adult sexual and physical abuse experiences, PD, and PTSD symptoms. RESULTS: The combined sexual and physical abuse (CA) and sexual abuse only (SA) groups reported significantly higher numbers of PTSD symptoms than the physical abuse only (PA) and no abuse (NA) groups. The CA and PA groups reported significantly more adult sexual and physical victimization than the SA and NA groups. Across all four groups, higher levels of PD were associated with higher levels of PTSD and adult sexual and physical victimization. CONCLUSIONS: The results of the current study suggest that different types of childhood abuse may lead to different adult problems. The results also indicated that PD may have a broad effect on PTSD development and adult victimization.     

Same beginnings, different stories: a comparison of American and Chinese children's narratives

This study examined social, emotional, and cognitive characteristics of American and Chinese children's narratives. Twenty-four American and 26 Chinese 6-year-old children participated. Each child was interviewed individually twice with a 1-week delay interval. During the two interviews, children were asked to tell 11 stories prompted by pictures and standard verbal leads and to recount 7 emotional memories. Content analyses were performed on children's stories and memories. In line with predictions, findings indicated that compared with American children, Chinese children showed greater orientation toward social engagement, greater concern with moral correctness, greater concern with authority, a less autonomous orientation, more expressions of emotions, and more situational details in both their stories and memories. A few gender differences were found. Findings are discussed in terms of different value systems and early socialization practices in these two cultures.