Parenting Attitudes,Family Environments,Depression, and Anxiety in Caregivers of Maltreated Children

This study evaluated parenting attitudes, family environments, depression, and anxiety in a sample of primarily minority urban mothers to better understand maltreating mothers (n = 83), who retain custody of their children and how they are similar to and different from foster mothers (n = 50), kin caregivers (n = 52) of maltreated children, and comparison mothers (n = 100) from the same communities. Maltreating mothers were distinguished by their much higher levels of depression and anxiety from other mothers. In addition, like foster mothers, maltreating mothers were less likely to approve of corporal punishment. Foster mothers were higher in organization and lower in empathy than other groups. There were no differences by race/ethnicity on study dimensions. Higher education, however, was related to more favorable parenting attitudes and family environments. Practice implications related to appropriate services are suggested.     

School Performance in a Longitudinal Cohort of Children at Risk of Maltreatment

Objective: Previous research has suggested that child maltreatment is associated with poor school performance. However, previous studies have largely been cross-sectional or, if longitudinal, have had small sample sizes, short follow-up periods, or have not adequately controlled for confounders. The objective of this study is to determine the relationship between child maltreatment and school performance in a cohort of children at risk of maltreatment and followed since birth. Method: This prospective study followed children born at risk for maltreatment with semi-annual reviews of the North Carolina Central Registry of Child Abuse and Neglect. At ages six and eight years, children's teachers were surveyed using the Achenbach Teacher Report Form and project-developed questions regarding peer status. This information, along with control variables from maternal interviews, was used in logistic regression models to determine the impact of maltreatment on academic performance, peer status, and adaptive functioning. The generalized estimating equations (GEE) method was applied to adjust variance estimates for within-person correlations of school performance measures at two points in time. Results: A substantiated maltreatment report is significantly associated with poorer academic performance (p < 0.01) and poorer adaptive functioning (p < 0.001) but not with peer status. Conclusions: Understanding the consequences of maltreatment, including poor academic performance and adaptive functioning, is important in planning educational, health, and social service interventions that may help abused or neglected children succeed in school and later in life. Longitudinal analysis is the best way to establish a causal relationship between maltreatment and subsequent school problems.     

Treatment of Sexually Abused Children Who Are Deaf

This article will address the vulnerability of children who are deaf to sexual abuse and treatment techniques specifically for this population. The experience of the author was at a large city outpatient program in a department of psychiatry. This clinic served families where someone in the family was deaf or hard of hearing. The pioneering efforts in the 1980s were some of the first treatment for this population and this is the basis for this article.     

In the Front Line: The Impact of Specialist Training for Hospital Physicians in Children at Risk on Their Collaboration With Social Workers

Until recently, dealing with children at risk in Israeli hospitals was almost exclusively the domain of medical social workers. Suspected cases of abuse or neglect must be identified in real-time, during the child’s short stay in the hospital, and the decision of whether or not to report the case, and to whom (law enforcement or welfare authorities), must be made. The recognition that effective treatment also demands the involvement of physicians led to the development of an intensive training program for hospital-pediatricians. The current study, based on in-depth interviews with the doctors who participated in the program and the social workers who work with them at 14 hospitals in Israel, examined the impact of the training on cooperation between the two groups, seeking to determine whether the doctors’ increased familiarity with the social work profession enhanced team-work.

Phenomenological analysis of the interviews revealed several themes, indicating greater collaboration between the doctors and social workers. However, the participants also noted increased friction between the two groups. Possible explanations and practical recommendations for enhancing the potential effectiveness of such collaborations are offered. The study has implications for designing similar training programs as well as for improving the dynamics between the two professions.     

Distinguishing neglect from abuse and accident: analysis of the case files of a hospital child protection team in Israel

The study compares the characteristics of children assessed as neglected, physically abused, or accident victims by a hospital child protection team (CPT) and identifies the information on which the CPT based its assessments. The comparison is based on content analysis of records of 414 children examined by the CPT in a major hospital in Israel between 1991 and 2006, of whom 130 (31.4%) were neglected, 54 (13.0%) were physically abused, and 230 (55.6%) were accident victims. Findings of three hierarchical logistic regressions show that the children classified as neglected had the most early development problems, but were the least likely to have received psychological treatment, and that that their families were the most likely to be receiving state financial support and to have had prior contact with the social services. They also show that the CPT had received the least information indicative of maltreatment about these children from the community and that their medical and physical examinations aroused the least suspicion. Finally, they show that the impressions the hospital staff and CPT had of the parents during the hospital visit had greater power to distinguish between the groups than the children’s characteristics or the parents’ socio‐demographic background. The findings attest to the ability of the CPT to differentiate between neglect victims and physical abuse or accident victims. With this, they also point to ambiguities in the classification process that should be addressed by further research and training and to the need for detailed and thorough documentation of the information and observations on which the CPT’s assessments are based.     

Physically Abused Pregnant Women's Perceptions About the Quality of Their Relationships with Their Male Partners

SUMMARY

Objectives. Most studies of pregnant victims of intimate partner violence have focused on the violent behaviors, without examining other potentially important dimensions of the relationships. This research studies pregnant abuse victims to examine the frequency of violent behaviors occurring during pregnancy, how women characterize the quality of their relationships, and the association between violence frequency and women's perceptions concerning the overall quality of their relationships.

Methods. Eighty-one women who were physically abused by intimate partners during pregnancy were interviewed. Information was collected concerning the women's: experiences of partner violence during pregnancy; perceptions of other aspects of the quality of their relationships; and sociodemographic characteristics.

Results. The most frequent type of violent behavior occurring during pregnancy was verbal aggression, followed by minor violence, and then severe violence. Men perpetrated each type of violent behavior at significantly higher rates than did their female partners. In general, the women were quite negative in their characterizations of many dimensions of their relationships, as well as in their perceptions concerning the overall quality of their relationships, with women who had been victims of more frequent violence being significantly more likely to characterize their relationships as being of lower overall quality (OR = 3.5, 95% CI = 1.4–8.7).

Conclusions. Prenatal care providers are encouraged to screen their patients for intimate partner violence, and to work with others in their community to assure that women in abusive situations are offered appropriate services/interventions including safe and feasible alternatives to staying in unsatisfactory relationships with abusive partners.     

Intimate Partner Sexual Violence: A Comparison of Foreign- Versus US-Born Physically Abused Latinas

Men’s violence against women—particularly intimate partner sexual violence (IPSV)—is associated with the transmission of HIV. Men who physically abuse their female intimate partners often also sexually abuse them. Latinas are one of the fastest growing populations in the USA and at high-risk for contracting HIV, though little is known about IPSV against physically abused Latinas, including whether there is an association between nativity of the victim and the likelihood of sexual violence by intimate partners. This study examined the (1) prevalence of recent (past 6 months) IPSV against 555 physically abused, help-seeking Latinas and (2) relationship of nativity to recent IPSV. This study used data collected in 2002–2003 from participants in one major city on the East Coast and one West Coast county, who were involved in the Risk Assessment Validation (RAVE) Study. The RAVE Study assessed the accuracy of four different methods for predicting risk of future intimate partner violence. IPSV was defined as an abusive male partner physically forcing sex (rape) or making the woman have sex without a condom. Recent IPSV was reported by 38 % of the sample. Among those reporting recent IPSV, multiple assaults were common: 30 % of women were raped and 51 % were made to have unprotected sex six or more times during the past 6 months. IPSV was significantly associated with nativity. Physically abused Latinas who were foreign born had two times greater odds of reporting recent IPSV than physically abused Latinas born in the USA, after controlling for other demographic covariates. Exploratory post hoc analyses examining all pairwise comparisons of IPSV against Latinas born in the USA, Mexico, Central America, South America, and the Caribbean also revealed some significant differences that warrant further study with larger samples. HIV prevention efforts aimed at reducing IPSV in this population are needed.     

Maltreatment and Behavioral Characteristics of Youth Who Are Deaf and Hard-of-Hearing

This paper summarizes the available literature on child abuse and neglect among children with disabilities in general and considers children who are deaf and hard-of-hearing within this larger rubric given the low prevalence rates of children who are deaf and hard-of-hearing among the disabled population. This procedure allows for comparisons between disabilities as well as abused and non-abused children who are deaf and hard-of-hearing. Maltreatment data on children who are deaf and hard-of-hearing in a large epidemiological study of the prevalence of child maltreatment among children with disabilities are summarized. Children who are deaf and hard-of-hearing comprised 6.1% of the disabled population who were identified as victims of maltreatment. Their most prevalent form of maltreatment was neglect, followed by physical abuse and sexual abuse. Although children who are deaf and hard-of-hearing are significantly more likely to be maltreated by immediate family members, placement in a residential school is a risk factor for sexual and physical abuse. Maltreated children who are deaf and hard-of-hearing exhibit significantly more behavior problems including Post Traumatic Stress Disorder related behaviors than nonmaltreated peers.     

Abuse of the disabled child: a systematic review of population-based studies

OBJECTIVE: To ascertain the strength of the association between childhood disability and abuse and neglect. METHODS: Systematic review of population-based studies published between 1966 and January 2006. Medline, Embase, Cinahl, Cochrane library, National Research Register, Social Sciences database and PsychInfo databases were searched for potentially relevant studies. Inclusion criteria: population-based cohort, case-control or cross-sectional studies of children <18 years of age that reported empirical data on the association of abuse with disability. Risk estimates were expressed as odds ratios with 95% confidence intervals (CI) where possible. Meta-analysis was not undertaken because of heterogeneity of studies. RESULTS: Four studies met the inclusion criteria. Two were longitudinal studies, one was a retrospective birth cohort and the remaining study was a cross-sectional survey. Types of disability studied varied widely as did methods used to ascertain abuse and neglect. Two studies accounted for potential confounding. Three studies reported an association between psychological and emotional disabilities and abuse. Two studies reported an association of learning disability with abuse. Only one study examined the association of physical disability (cerebral palsy) with abuse reporting an adjusted odds ratio for all forms of abuse of 1.79 (95% CI 0.96, 3.36) and for physical abuse of 3.00 (95% CI 1.29, 6.78). CONCLUSIONS: The evidence base for an association of disability with abuse and neglect is weak. Psychological and emotional problems, and learning difficulties appear to be associated with abuse but this association might arise because these conditions share a common aetiological pathway with abuse. There is limited evidence that physical disability predisposes to abuse.     

The social ecology of girls' bullying practices: exploratory research in two London schools

This exploratory study adopts a socio‐ecological approach to examine the context of school bullying. It asks: (1) what are students' accounts of bullying practices?; (2) how are these enabled and constrained by the school‐environment?; (3) how is gender implicated? Qualitative data were collected from girls in two schools in London via focus groups (one in each school; students aged 12‐15) and seven semi‐structured interviews (in one school; students aged 16‐18); and from school policy documents. Our interpretation of girls' accounts, informed by Giddens' structuration theory, suggests that bullying practices were spatially patterned in the schools and often characterised by the regulation of girls' sexuality and sexual‐harassment. Repeated acts of aggression were fluid with regard to the bully and victim role, challenging the dominant view of bullying as characterised by consistent disparities in power between individuals. Schools structured bullying behaviour via policies and practices that ignored these forms of abuse and which focused on and may have been complicit in the making of stable ‘bully’ and ‘victim’ roles, thus indirectly contributing to the reproduction of unhealthy relationships between students. In terms of gender, traditional gendered and sexual discourses appear to structure the identities of the schools and girls in our study.     

Risk factors for multiple forms of violent experiences: Analyses of the 2009 Youth Risk Behavior Survey

There is a growing body of empirical research indicating a significant co-occurrence of multiple forms of experiences with violence among US youth. However, very little information is available about shared risk factors across forms of violence. Current analyses were based on cross-sectional data from the 2009 Youth Risk Behavior Survey (YRBS). The YRBS includes a nationally representative sample (n = 16,410) of high-school students in 9–12th grades in the US. Multinomial regression analyses were conducted to test the associations between risk factors and reports of multiple violence exposures (i.e. physical fights, dating violence, forced sex, and being bullied at school). Among high-school students, 33.0% reported one experience, 11.4% reported two experiences, and 4.0% reported 3–4 experiences with violence. Multinomial regression analyses indicate that experience with 3–4 forms of violence were highly associated with sadness, feeling too unsafe to go to school, early alcohol use, binge drinking, drug use, weapon carrying, asthma, low academic grades, and suicide attempts relative to those who did not report any experience with violence. These findings underscore that multiple experiences with violence are relatively common among US high-school students. Moreover, multiple experiences with violence are associated with a relatively broad range of risk factors. Youth who report multiple experiences with violence seem to be particularly vulnerable and in need of assistance, in particular because of the strong association between multiple violent experiences and suicidal behaviors.