The influence of family environment on mental health need and service use among vulnerable children

Children in child welfare are especially likely to have unmet mental health needs. The role of family factors in children's use of mental health services was examined in a longitudinal sample of 1075 maltreated or at-risk children. Vulnerable family environment (poor family functioning, low social support, and caregiver psychological distress) is an important predictor of children's mental health needs. It also predicts them not having these needs met.     

Obstacles to victims' cooperation with the criminal prosecution of their abusers: the role of social support

Over the last 20 years, diminishing tolerance for domestic violence has triggered significant criminal justice reforms designed to facilitate the prosecution of abusers. Prosecutors, for example, have adopted policies requiring that cases go forward even if the victim later has second thoughts. Although increasingly common, these "no drop" policies reflect a profound irony about domestic cases that is well known but little understood: the most formidable problem in prosecuting such cases is often the victim's own unwillingness to bring the abuser to justice. This prospective study explored a range of factors potentially predictive of domestic violence victims' cooperation with the prosecution of their abusers. Although the study focused on interpersonal and institutional social support, it also investigated the influence of violence severity, victim demographic factors, and victim mental health characteristics, including the presence of depressive symptoms, emotional dependence on the abuser, and substance abuse. Findings showed that tangible support, severity of violence in the relationship, and the presence of children in common with the abuser all significantly predicted victims' cooperation with the prosecution of their abusers. Substance abuse significantly predicted victims' noncooperation with prosecution. The research and policy implications of these findings are discussed.     

The Effect of Severe Child Sexual Abuse and Disclosure on Mental Health during Adulthood

This study examined the relationship among severe child sexual abuse, disclosure, and mental health symptoms during adulthood. The sample consisted of 172 adults who were sexually abused in childhood. The multivariate model showed that respondents in their 30s and 40s who were abused by more than one abuser, who were injured by their abusers, who were abused by a biological relative, who told someone about the abuse when it occurred, and who did not discuss their abuse in depth within one year of the abuse had a greater number of mental health symptoms. Abuse severity and disclosure history should be assessed by professionals to identify clients who are at higher risk of mental health symptoms and to focus therapy.     

Resilience in Non-Offending Mothers of Children Who Have Reported Experiencing Sexual Abuse

Growing evidence shows that non-offending mothers experience significant loss and trauma following their child reporting experiencing sexual abuse. Maternal support offered to sexually abused children following disclosure can be a crucial factor in children’s recovery. Although mothers are often seen as playing a central role in facilitating the recovery of their sexually abused child, there has been little focus on their own needs and profiles. This present study aimed to increase our understanding of the diversity of profiles of non-offending mothers of sexually abused children by exploring the differences in psychosocial traits of non-offending mothers (N = 68; age range 28–67 years) reporting higher and lower resilience.

The mediating role of these psychosocial factors on the relationship between resilience and psychological distress will also be explored. Results found that non-offending mothers in the higher resilience group reported higher levels of positive reappraisal, self-compassion, social support, and significantly lower levels of psychological distress compared to non-offending mothers in the lower resilience group. Additionally, multiple mediation analysis indicated positive reappraisal, self-compassion, and social support to be significant mediators of the relationship between resilience and psychological distress. Increased levels of self-compassion and social support were found to be predictive of lowered psychological distress, while increased positive reappraisal predicted increased psychological distress. The findings of the present study provide support for the targeting of the psychosocial factors such as self-compassion, social support, and positive reappraisal in interventions for non-offending mothers in an effort to promote resilience.     

Do Children's Behavior Problems Limit Poor Women's Labor Market Success?

Economically disadvantaged mothers face numerous barriers to stable, quality employment opportunities. One barrier that has received limited attention in previous research is having a child with significant psychological or behavioral problems. Using a representative sample of low‐income mothers and early adolescent children from the Three‐City Study (N = 717), we assessed whether adolescents' behavior problems prospectively predicted mothers' employment status, consistency, and quality. Lagged random‐effects regression models suggested that adolescents' psychological distress and delinquency inhibited the labor market success of disadvantaged mothers, although school problems were related to greater work effort among mothers. Links between labor market success and both psychological distress and delinquency differed across mothers with male and female adolescents.     

Violence against women with physical disabilities

This study explored risk factors for violence among a sample of adult women with physical disabilities. Fifty-six percent (100) of the 177 women participating in the study indicated a positive history of abuse. Of the women who reported abuse, most reported multiple abuse situations and abusers who were typically their male partners. In addition, only a small proportion of women sought and received adequate help. Women who indicated that they did not seek help were asked why this was the case. Their responses included: feeling that they could handle it themselves, having other sources of support available, being unaware of where to go, feeling embarrassed, feeling guilty about being a burden or that it was their fault, fear that abuser would come after them, fear of not being believed, and, to a lesser extent, concern that the shelter would lack appropriate accommodations. These findings highlight the importance of intervention strategies including advocacy activities for women with disabilities, activities with schools, activities to deter and prevent partner and caregiver violence, community awareness activities, and dissemination activities.     

Acculturation Gap,Intergenerational Conflict,Parenting Style,and Youth Distress in Immigrant Chinese American Families

This study examined mother–child acculturation gaps in relationship to youth distress and the possible mediating role of parent–child conflict and parenting style in a sample of 81 Chinese American families. Hierarchical multiple regression analyses provided partial support for a relationship between acculturation gaps and youth distress. No mediators of this relationship were found; however, post-hoc analyses indicated that intergenerational conflict and parenting style were associated with youth distress above and beyond acculturation gaps. These results suggest that interventions developed to reduce parent–child conflict and increase parental bonding (increase parental warmth and decrease parental overprotection) may be valuable for Chinese American adolescents, regardless of acculturation gap status.     

Early abuse experiences and subsequent gender differences in couple adjustment

The main purpose of the current study was to evaluate the relationship between early abusive experiences (sexual abuse, parental violence, and witnessing parental violence) and subsequent couple adjustment with a theoretical model that incorporates attachment and psychological distress as mediator variables. We specifically examined the variability in long-term psychosocial characteristics of child abuse survivors across women and men. A representative sample of French-Canadian couples composed of 632 men and women completed measures of child abuse, attachment, psychological distress, and dyadic adjustment. Structural equation analyses showed that, for both women and men, sexual abuse was related to dyadic adjustment through anxiety about abandonment and psychological distress. For men, experiencing physical or psychological violence was associated with dyadic adjustment through psychological distress. For women, there was an indirect relationship between witnessing physical violence and dyadic adjustment through abandonment anxiety. Differences between men and women in the long-term adjustment to childhood sexual abuse were small and not consistent with a gender-specific model of psychosocial repercussions.     

Mental health and criminal justice issues among perpetrators of elder abuse

ABSTRACT Recent studies on elder abuse suggest that the pathology or impairment of the abuser may be a stronger predictor of elder abuse than characteristics of the victim. To examine the relationship between elder abuse, abuser pathology, and the criminal justice system, the New York City Department for the Aging (DFTA) undertook a survey of older victims of reported domestic abuse seeking assistance from the DFTA Elderly Crime Victims Resource Center. Preliminary findings from the survey indicate that impaired abusers were significantly younger than unimpaired abusers and more likely to live with their elderly victims, to be unemployed, and to have a history of involvement with the criminal justice system.     

Chronic avoidance helps explain the relationship between severity of childhood sexual abuse and psychological distress in adulthood

Recent studies have found that chronic avoidance of unpleasant internal experiences (e.g., thoughts, emotions, memories) is a maladaptive means of affect regulation often adopted by women with a history of sexual victimization in childhood. The primary aim of this study was to replicate and extend previous findings suggesting that higher levels of experiential avoidance may account for the relationship between childhood sexual abuse (CSA) and psychological distress in adulthood. It was hypothesized that, in a sample of undergraduate females (n = 151), the relationship between severity of CSA (e.g., frequency, nature of victimization) and trauma-related psychological distress would be mediated by avoidance. Results supported this hypothesis. Findings are consistent with previous studies, and further suggest that the general tendency to avoid or escape from unpleasant internal experiences may be a specific factor that exacerbates psychological distress among women with a history of sexual victimization in childhood.     

Characteristics of Sexually Abused Children and Their Nonoffending Mothers Followed by Child Welfare Services: The Role of a Maternal History of Child Sexual Abuse

Considering the importance of mother’s support in the adaptation of a sexually abused child, it is relevant to determine if the mothers and children involved in an intergenerational cycle of child sexual victimization differ from dyads in which only the child has been abused. The purpose of this study was to compare mother–child dyads with sexually abused children according to whether the mother had herself been victim of child sexual abuse. The sample included 87 dyads with sexually abused children aged 3–18 years old and their mothers (44 reporting maternal and child abuse), followed by social welfare services of the province of Quebec (Canada). The two groups of mothers were compared on their past family abuse experiences and past family relations, their mental health history, their current psychological distress, their parenting behaviors, and their current levels of family functioning. Children were compared on their adaptation. Multivariate analyses indicated that mothers reporting child sexual abuse were more likely to report more other maltreatments in their childhood and greater prevalence of lifetime history of alcohol abuse disorders, dysthymia, and panic disorder compared with mothers who had not experienced CSA. Compared to children whose mothers had not experienced CSA, those whose mothers had experienced CSA showed higher rates of problems behaviors and were more likely to report having been sexually abused by a trusted person. These results highlight the specific clinical needs for the assessment and treatment for sexually abused children whose mothers experienced child sexual abuse.     

Race, socioeconomic status, and psychological distress: an examination of differential vulnerability

Using data from a 1985 epidemiological survey of 2,115 adults in Florida, this research has two goals: it tests the proposition that race and SES jointly influence mental health, and it examines the contribution of undesirable life events and economic problems to psychological distress across SES groups. Using multiple indicators of SES and mental health, we found that the evidence for a model of joint influence of race and SES on mental health varied with the measures being used. The most general conclusion is that SES interacts with race to increase psychological symptoms of distress. Partitioning the sample into three SES categories (low, middle, high), we examined the contribution of stressors to the greater distress among lower-SES blacks compared to other blacks and lower-SES whites. Lower-SES blacks are more vulnerable than lower-SES whites to the impact of undesirable events, but they are less vulnerable than lower-SES whites to the impact of economic problems. Lower-SES blacks are more vulnerable than middle-SES blacks to the impact of both discrete events and economic problems. Limitations of the study indicate a need for future longitudinal studies with measures of coping resources and support networks to further our understanding of the race, social class and psychological distress relationship.     

IS BOWEN THEORY VALID? A REVIEW OF BASIC RESEARCH

In the last 15 years, a substantial number of studies have tested the theoretical validity of Bowen family systems theory. A review of this basic research provided empirical support for the relationship between differentiation and chronic anxiety, marital satisfaction, and psychological distress. Bowen's assumption that couples with the same level of differentiation marry was not supported. His specific theories of sibling position and triangulation also received little empirical support. Research on multigenerational transmission has generally ignored Bowen's theoretical perspective, and more research needs to test Bowen's claim that his theory is universal. In addition, researchers still need to examine the effect of differentiation on child functioning, physical health problems, and adaptability.     

A typology of St. Louis arrestees surveyed through the arrestee drug abuse monitoring (ADAM) program

Past research has demonstrated that the characteristics of substance abusers vary considerably. Often, however, addicts are considered members of a single, homogeneous group. These erroneous designations may indeed prevent the successful rehabilitation of substance abusers. In the present study, hierarchical and K-means cluster analyses are used to identify a typology of substance users from a sample of 1,580 St. Louis arrestees surveyed through the Arrestee Drug Abuse Monitoring (ADAM) Program. Five clusters are yielded in the present analysis. The analyses illustrate not only that drug-using classifications differ between criminal and non-criminal populations, but that arrestee populations themselves vary interjurisdictionally. Given these findings, implications for local and regional drug treatment programs are assessed.     

Feelings of Adult Survivors of Child Abuse Toward Their Offender-Parents

This study investigated the relationships among explanations given by adult survivors of child abuse for their offender's abusive behavior, the survivor's personal coping resource (potency), and his/her feelings toward the offender in adulthood. A sample of 51 adult survivors of child abuse, former patients at the Matar and Human Family centers and the rehabilitation center for substance abusers in Israel, were administered questionnaires consisting of four parts: family-history questionnaire, explanation of abusive behavior scale, potency scale, and feelings toward offender-parent scale. Results indicated that potency contributed to lowering the degree of negative feelings toward the offender-parent, while attribution of the abusive behavior to the offender's personality and frequency of the abuse exacerbated the negative feelings.     

Getting reluctant substance abusers to engage in treatment/self-help: a review of outcomes and clinical options

This review examines the results from 19 outcome studies, involving 1,501 cases, within 10 different clinical approaches to getting alcohol or drug abusers to engage in treatment or self-help. Each approach is summarized and its "success rate(s)" presented. Comparisons are made across various subcategories, such as alcohol vs. drug abusers, adolescents vs. adults, and experimental conditions vs. controls. A distinction is drawn between "Dual-Purpose" approaches, which combine engagement with counseling of the concerned person who originally sought help for the substance abuser, and "Engagement-Primary" approaches, which generally confine their efforts (through working with family members and others) to getting the substance abuser into treatment/self-help. "Best bet" clinical options are presented in terms of which particular approach appears to have the edge with which kind of substance abuser.     

Psychological distress among black and white Americans: differential effects of social support, negative interaction and personal control

This study examines the relationships among social support, negative interaction, financial strain, traumatic events, personal control, personality, and psychological distress among African American and white adults. These analyses: (1) test the overall adequacy of various models (i.e., main, mediator, and artifactual effects) of these effects, (2) examine the role of social support and negative interaction within the context of financial strain and traumatic events, and (3) verify possible indirect effects of social interaction on distress by assessing their impact on personal control. Data from The National Comorbidity Survey were used to examine these relationships using structural equation modeling techniques. Findings indicated different models of these relationships for African Americans and whites. Overall, personal control mediated the relationship between negative interaction and psychological distress. For whites, negative interaction was an overall stronger predictor of distress and contributed to the impact of financial strain and traumatic events on psychological distress. Among African Americans, social support was a stronger predictor of distress. The findings suggest that the underlying models of these relationships are different for African Americans and whites.     

Emotionally focused interventions for couples with chronically ill children: a 2-year follow-up

Couples with chronically ill children are particularly at risk for experiencing marital distress. The study presented here is a 2-year follow-up of a randomized control trial that assessed the efficacy of Emotionally Focused Therapy (EFT) in decreasing marital distress in a sample of couples with a chronically ill child. Thirteen couples with chronically ill children who received treatment were assessed to determine if the significant improvement in relationship distress observed at posttreatment and 5-month follow-up would be maintained at 2-year follow-up. Results demonstrated that improvements in marital functioning were not only maintained but, in some cases, enhanced at the 2-year follow-up. This uncontrolled follow-up study provides initial evidence of the longer-term benefits of EFT.     

Personality, Negative Interactions, and Mental Health

Research suggests that an individual's personality traits may mediate the relationship between social support and mental health. This study uses two national data sets to test a conceptual model that integrates personality, social support, negative interactions, and psychological distress. Results suggest that, beyond the influence of personality, social support is negatively associated with psychological distress, and negative interactions are positively associated with such distress. The findings also suggest that personality has direct and indirect effects, through social support and negative interactions, on psychological distress. Findings specify how positive and negative facets of relationships and personality influence mental health outcomes.