Physical and Sexual Abuse,Battering, and Substance Abuse

Abstract

Women born before 1945 are the older women of today. Many of these women were subjected to childhood physical and sexual abuse and spouse battering at a time where there were no laws to protect them and few people discussed such subjects. Some of these women became substance abusers or lived with substance abusers. While there are retrospective studies on the experiences of adult women who suffered abuse in the family, little is known about the experiences of women over the age of 60 years.

Similarly, there is information on substance abuse among young and middle-aged women, but very little information on or about older womens' experiences with substance abuse. In this study, we review the literature on abuse and substance abuse. We present three clinical cases of older women who have experienced various forms of abuse and who in turn abuse substances. The cases are analyzed. Assessment, treatment, and evaluation methods for social workers are discussed.     

Patterns and correlates of co‐occurrence among multiple types of child maltreatment

This study examined the patterns and correlates of the types of maltreatment experienced by adolescents aged 9–12, participating in an ongoing longitudinal study on the impact of neglect on children's development. Using case record abstraction, the study compared the child protection classification and findings from the case record abstraction with regard to the rates of four types of maltreatment (i.e. physical, sexual, emotional abuse and neglect) as well as co‐occurrence across multiple types of maltreatment. Next, the study examined the frequently observed patterns of child maltreatment. Finally, the study investigated whether aspects of caretaker functioning and the detailed incident characteristics in the cases of neglect differed by the number of different types of maltreatment the children experienced. Results showed significant discrepancies between the Child Protective Service classification and case record abstraction. Child Protective Service classification considerably underestimated the rate of co‐occurrence across multiple types of maltreatment. Neglect accompanied by physical and emotional abuse was the most common form. Some of the caretaker functioning variables distinguished the number of types of maltreatment. Based on the findings, future‐research directions and practice implication were discussed.     

Giving voice to experiences: parental maltreatment of black children in the context of societal racism

ABSTRACT This paper seeks to explore the ways in which black children who have been maltreated within their families come to voice to tell their stories. A discussion of black children's recovery from maltreatment necessitates understanding how they interpret and name their experiences as abusive. Research indicates that while many factors mediate the effects of abuse on children's development, telling your story about childhood trauma is critical in the healing process for promoting psychological well‐being. However, what does the naming and speaking of trauma entail for black children when the broader context of their lived realities is embedded in racism that confers on them a stigmatized status? Where black children's lived experiences encompass the complexity of societal racism as a mutually reinforcing and contradictory reality in their lives, their capacity to name the maltreatment they experience will be particularly problematic. Essentially, parents’ issues silence children and can encourage them to block out painful emotions, ultimately putting their emotional and psychological well‐being at risk. Taking race and gender as benchmarks for analysis, the complexities involved in giving voice to childhood maltreatment are discussed to consider how these dynamics contribute to black children's resilience and adaptive behaviours in the aftermath of abuse.     

Child maltreatment types and adolescent substance use: The role of deviant peer affiliation

This is the first study to examine the mediating effects of deviant peer affiliation on the association between different types of child maltreatment and adolescent substance use that includes alcohol, tobacco, and marijuana. Peer deviance is a well‐established correlate of adolescent substance use, but most studies exploring the relationship between child maltreatment and adolescent substance use have failed to include peer deviance. Structural equation modelling was conducted to examine the direct effects of each type of child maltreatment (i.e., physical, sexual, and emotional abuse, and neglect) on adolescent substance use, as well as indirect effects via deviant peer affiliation, using Longitudinal Studies of Child Abuse and Neglect. The results indicated that deviant peer affiliation fully mediated the individuals who had been emotionally abused showed increased deviant peer affiliation, which in turn was associated with higher levels of adolescent substance use. None of the four types of child maltreatment was directly associated with adolescent substance use. The study's findings underscore the importance of early assessment and intervention for the peer relationships of youth who have been emotionally abused.     

Validating a Korean Version of the Drug Abuse Screening Test-10 (DAST-10)

ABSTRACT

There are no screening instruments for adults in the Korean language that are specific to drugs other than alcohol and tobacco. The purpose of this study is to validate the Korean version of the Drug Abuse Screening Test-10 (DAST-10). The Korean version of the DAST-10 was validated with 1,000 adults including general adults and at-risk adults. The results indicated that the Korean version of the DAST-10 was unidimensional similar to its English-language counterpart and showed satisfactory internal consistency reliability and convergent validity. The results also showed that the Korean version demonstrated optimal performance at a cutoff score of 2, which is the same as that of its English-language counterpart. It is expected that as the development of Korean-language instruments measuring alcohol problems contributes to the expansion of related research, the development of the Korean version of the DAST-10 will facilitate research on various topics related to substance abuse in Korea. Validation with Korean adults identified as substance abusers is needed to improve the ability of the Korean version to correctly identify substance-abusing adults.     

Criteria for Admission to Detoxification Treatment

This paper examines the formal triage process used by an alcohol/drug detoxification center to determine a client's need for treatment. The analysis tests various types of client characteristics for their influence on admission decisions. In accord with the policy of the agency and the medical model of addiction, symptoms of acute physiological withdrawal should determine whether a client is admitted for treatment during the triage period. Societal reaction theory presents an alternative perspective suggesting that a person's history of substance abuse and socio-demographic characteristics will influence the likelihood of admission into a treatment program. Results offer support for both a medical model and societal reaction approach in that physiological withdrawal symptoms, history of abuse characteristics, and socio-demographic makeup each independently influence staff's assessment of the need for treatment.     

Substance abuse

Alcohol abuse poses special risks for increased morbidity and mortality among older adults, contributing to the heightened use of medical resources and the related increase in medical costs. Although the prevalance of alcohol use disorders in the older adults is generally less than that found in younger groups, it is expected to increase with the aging of the "baby-boom" generation. In spite of this, little attention has focused on developing, and evaluating the efficacy of, treatment programs for older adults with alcohol related disorders. This article discusses the availability of effective treatment strategies for older alcohol abusers and reviews the epidemiological and outcomes research literatures related to alcohol abuse and older adults. The few empirical studies that examine outcomes associated with the treatment of older substance abusers reveal positive outcomes, especially when "age-specific," cognitive-behavioral, and less confrontational treatment approaches are employed.     

Psychological distress among women who were sexually abused as children

One of the aims of the study was to investigate how participants in self‐help groups (SHG) for women (n = 87) who had been sexually abused in childhood rated their mental health and to what extent they were at risk of developing posttraumatic stress disorder (PTSD). A further aim was to investigate the relationship between the ratings of mental health, occurrence of PTSD, women's interpersonal relationships, reasons for participating in an SHG and characteristics of the childhood sexual abuse (CSA). The participants completed questionnaires regarding their personal relationships, reasons for joining a group, abuse characteristics, mental health (Symptom Checklist‐90‐Revised) and PTSD (Impact of Event Scale‐Revised). The women showed poor mental health, and more than half of them were at risk of developing PTSD. Lack of social support and feelings of shame correlated with poor mental health, whereas guilt did not. Relationships with female friends had a positive association. Further research is needed to determine whether participating in an SHG could provide adequate social support and reduce feelings of shame, thereby contributing to the healing process in the aftermath of CSA. Key Practitioner Message: ? Child abuse is a significant component of the global burden of disease; ? Both social workers and public health care providers meet sexually abused girls and it is important that they have knowledge about the subject; ? An important clinical implication for adequate treatment would be to assess and recognise childhood sexual abuse and to link diagnosis to trauma.     

Addressing common forms of child maltreatment: evidence‐informed interventions and gaps in current knowledge

This paper reviews interventions for preventing the occurrence and recurrence of major types of child maltreatment. We begin with an overview of the challenges of establishing evidence‐based interventions to prevent child abuse and neglect in many countries, and underscore the importance of this need with child maltreatment incidence rates in the USA, and how much each type and subtype contribute to child out‐of‐home placement. Next, we identify the well‐supported, supported and promising interventions for each child maltreatment type and subtype, according to their level of research evidence using an evidence‐based clearing house. The paper closes with a discussion of the implications for practice, evaluation, policy and agency management, including intervention knowledge gaps that showcase areas that need additional practice research.     

Substance use disorders and referral to treatment in substantiated cases of child maltreatment

Parents with substance use disorders (SUD) require treatment and support in order to provide children with appropriate care and protection. Using the 2012 National Child Abuse and Neglect Data System (NCANDS), this paper analysed 464 313 substantiated child maltreatment reports to determine (i) the proportion and characteristics of reports involving substance abuse; and (ii) the child and caregiver/perpetrator (C/P) characteristics that predicted referral to treatment as recorded in service plans. Findings indicate that 12% (N = 53 234) of maltreatment reports involved C/P SUD. Yet, of those reports, only (19%) (N = 10 088) were referred to substance abuse treatment as part of their service plan, indicating a large gap between those who need treatment and those who receive it. This finding is important given that parental SUD is consistently linked to poorer child outcomes. Amongst other variables, reports indicate that C/P with co‐occurring emotional disturbance were three times more likely to be referred to treatment for SUD as part of service plans. Additional research is needed regarding the characteristics that distinguish C/P who receive referrals for SUD treatment in substantiated cases of child maltreatment.     

Defining the boundaries: social worker assessment of sexual abuse in a cultural context – multivariate analysis of personal and professional factors influencing social workers' labelling of intimacy behaviour

To explore personal and professional factors influencing social worker assessment of family intimacy behaviour in diverse cultural groups, a 27‐item questionnaire was mailed to a random, stratified sample of MSW‐level social workers. The instrument measured rank‐order responses to 10 questions about attitudes towards public exposure to sexual stimuli and rank‐order responses to questions about three vignettes depicting culturally informed family intimacy behaviour. The instrument also measured sample characteristics such as area of social work practice and per cent of caseload involving sexually abused as well as diverse clients. Completed questionnaires (n = 387) were analysed for association between respondents' definition of intimacy behaviour (dependent variable), attitude towards sexual stimuli, and intervening variables thought to explain variance in the dependent measure. Labelling theory provided a basis for hypotheses testing. When mean attitude scores were correlated with mean definition scores, Pearson's r returned a significant low, positive association between conservative attitudes towards exposure to sexual stimuli and definitions of cross‐cultural scenarios as sexual abuse. Holding attitude scores constant, regression modelling of the sample's definition of scenarios indicated that practice area, minority status, and per cent of caseload with sexual abuse clients were significant predictors of R² change in the dependent variable. Further analysis of data through regression tree modelling showed that a small group of conservative practitioners with ethnically diverse caseloads were more likely to label culturally influenced behaviours as deviant. Among conservative practitioners with less diverse caseloads, number of hours in sexuality training had a moderating influence on deviancy labelling. Tree modelling of the data also indicated that an ethnic minority subgroup within the sample accounted for the lowest ranking of scenarios as sexual abuse. Results support earlier work on social worker assessment of child maltreatment as a function of agency setting. Another implication for social work is the need for practitioners to understand their attitudes towards human sexuality in relation to assessment of diverse patterns of childhood sexual socialization.     

The prevalence of heavy narcotics abuse in Sweden in 1992

A case-finding study was carried out in 1992 to determine the prevalence of drug abuse in Sweden. Several authorities in 100 local communities and 59 police districts were selected to participate in the case-finding research. The number of heavy drug abusers was estimated to be 17,000. Heavy drug use is defined as "any intravenous use of drugs, regardless of substance, or any daily or near-daily use of drugs, regardless of the method of administration". The study was designed to make the results comparable to a similar study in 1979 in which the number found was 12,000. According to the studies, the number of heavy drug abusers increased by 5000 between 1979 and 1992. The age distribution shows that the recruitment of abusers has declined, especially among young people.     

The impact of child and parental age on protective factors against child maltreatment

Although young age for both the parent and child is implicated in incidences of maltreatment, little is known about the association between parent or child age and protective factors related to child maltreatment prevention. With a sample of parents receiving child maltreatment prevention services in Kansas ( N  = 1993), we used regression analyses to examine whether the interaction of child and parent age influences family‐level protective factors over time. We found mixed support for each hypothesis, indicating that the age of parents and children differentially impacts family‐level protective factors. Implications for the Strengthening Families approach and child maltreatment prevention are discussed.     

Predicting Retention in Three Substance Abuse Treatment Modalities Among Anglo,African American,and Mexican American Juvenile Offenders

Abstract

Many of the same factors that predict delinquent behavior also predict adolescent drug use. This study examined factors that predict, and interventions that maximize, substance abuse treatment retention in three modalities among high-risk Anglo, Mexican American, and African American juvenile offenders. The study sample includes youth (N = 211) who were discharged from probation supervision and who received substance abuse services through a CSAT-funded federal demonstration project. The key predictors examined included the stage-of-change (i.e., precontemplation, contemplation, preparation) in which a juvenile fell, various dimensions captured by the Comprehensive Addiction Severity Index for Adolescents, and other intervention status (probation, case management, and mental health treatment). The research questions were addressed using statistical models known as survival analysis that treated time from entry into substance abuse treatment to exit from substance abuse treatment as the outcomes. Among key findings were that females were 73% more likely to leave day treatment relative to males; for each additional family problem ever experienced, Mexican American adolescents were 15% more likely to leave residential treatment compared with African American adolescents; and African American and Mexican American adolescents in the contemplation stage-of-change were 50% less likely to leave day treatment compared with Anglo adolescents. Applications for practice and research with this population are discussed.     

The impact of childhood maltreatment on young adults’ mental health: Evidence from the Philippines

Using a new retrospective data set on young Filipino adults, this study aims to quantify the prevalence, risk factors, and mental health consequences in later life of childhood maltreatment in the Philippines. A survey was conducted with a sample of 155 adults (83 women, 72 men) aged 18–24 living in Quezon City, the largest metropolitan city in the Philippines. Findings show that four out of five young Filipino adults experience minor physical violence during childhood, while one out of four suffer severe physical violence. Boys from less educated families that grow up in urban environments face the highest risks. While we find a strong link between childhood physical abuse and young adults’ mental health, no such effect was found for experiences of psychological aggression. Childhood physical abuse was further found to have negative effects on young adults’ family relations, social relations, and overall satisfaction with life.     

Are dual and single exposures differently associated with clinical levels of trauma symptoms? Examining physical abuse and witnessing intimate partner violence among young children

A significant portion of children living in the United States have experienced trauma. Informed by the developmental traumatology model, we explored the effects of physical abuse and witnessing intimate partner violence (IPV) on childhood trauma symptoms. This study utilizes a convenience sample of 580 high‐risk children between 3 and 12 years who received services from one‐child advocacy centre during a 12‐month period. We performed a series of binary logistic regression analyses to examine if physical abuse, exposure to IPV, and dual exposure (i.e., both physical abuse and IPV) are distinctly associated with six trauma symptoms, including anxiety, depression, posttraumatic stress (PTS), dissociation, anger, and sexual concerns. The results indicated that dual exposure was predictive of all trauma symptoms, except for dissociation. Additionally, physical abuse was associated with PTS, anger, and sexual concerns, whereas exposure to IPV was associated with depression, PTS, and sexual concerns. Research and implications for practitioners working with young children are discussed.     

The only child 1 : A study of one hundred only children living at home with both parents,referred, to a child guidance clinic

This study examined differences in attachment typology, early histories of unresolved trauma and loss, and intergenerational patterns of substance abuse in a high-risk sample of African American, White, Mexican American, and Native American mothers involved with the child welfare system. The Adult Attachment Interview and Chemical Dependency Assessment Profile were used to collect data from 24 mothers who were in-patients at a substance abuse treatment center. Consistent with attachment theory mothers classified as secure/autonomous (46%) had positive early attachment relationships, although several mothers in this group had histories of unresolved trauma and loss. The insecure classification included 21% dismissing and 33% preoccupied. The unresolved classification included mothers from all racial/ethnic groups who had histories of trauma and loss. Results indicated prevalence of substance abuse in all racial/ethnic groups as well as patterns of intergenerational substance abuse in the aforementioned attachment classifications.