A screening tool for detecting eating disorder risk and diagnostic symptoms among college-age women

Objective: As eating disorders (EDs) often emerge during college, managing EDs would ideally integrate prevention and treatment. To achieve this goal, an efficient tool is needed that detects clinical symptoms and level of risk. This study evaluated the performance of a screen designed to identify individuals at risk for or with an ED. Participants: Five hundred forty-nine college-age women. Methods: Participants completed a screen and diagnostic interview. Results: Using parsimonious thresholds for ED diagnoses, screen sensitivity ranged from 0.90 (anorexia nervosa) to 0.55 (purging disorder). Specificity ranged from 0.99 (anorexia nervosa) to 0.78 (subthreshold binge eating disorder) compared to diagnostic interview. Moderate to high area under the curve values were observed. The screen had high sensitivity for detecting high risk. Conclusions: The screen identifies students at risk and has acceptable sensitivity and specificity for identifying most ED diagnoses. This tool is critical for establishing stepped care models for ED intervention.     

Reaching children at risk: a model for training child welfare specialists

An innovative model for the training of social welfare students in the special skills essential in child welfare work is predicated upon a classification system of children at risk and a continuum of services.     

Co-production of ICT and children at risk: The introduction of the Child Index in Dutch child welfare

This article studies the construction of children at risk in the introduction process of a novel ICT system in Dutch child welfare, the Child Index. This early warning electronic information system enables early reporting of children at risk to stimulate multidisciplinary collaboration among the different professionals involved with a particular child. We followed the introduction of the Child Index in practice. Our empirical analysis provides insight into the co-production of this ICT system and risk in child welfare practices. The analysis shows that the interaction between local and national, and disciplinary and organisational differences induces various constructions of risk, making the decision to signal and the act of signalling risk complex and the status of a signalled risk vague. Moreover, the analysis illustrates that the Child Index's goal of early signals for all children at risk does not fit professionals' daily practices and highlights the need to discuss whether the risk signalling ambitions of the Child Index are not a larger risk to children than the risks that are being targeted.     

An intensive perinatal mentalisation-based intervention for women at risk of child removal and the role of restorative relationships

Pregnant women with a history of child removal are at greater risk of being found unsuitable to care for their new babies. Neglect, showing a lack of capacity to provide for the child's physical and/or emotional needs, is the most frequent reason why infants are removed from their parents' care. Parents with a history of child removal have often been themselves subject to maltreatment as children and suffer the sequelae of relational trauma which then becomes a barrier to establishing nurturing relationships with their own children. Attachment, and particularly mentalisation-based, parenting interventions focus on restoring relationships by developing parents' capacity to reflect upon their own internal mental experiences as well as those of the child, helping them to better understand themselves and their children. The DAISY programme is an intensive perinatal attachment and mentalisation-based intervention for pregnant women with a history of child removal, aiming to improve mothers' mentalising capacities and care proceeding outcomes. This article uses a case study to describe the programme's model and mechanisms of change. Additionally, we present preliminary observations about the programme's delivery and impact from the perspective of one of its practitioners.     

Social services and social support: blended programs for families at risk of child maltreatment

Social support, increasingly put forth as a fundamental in helping multiproblem families to avoid placement, is a complex construct not easy to define and far more difficult to carry out conceptually and practically. This article describes four family support programs that illustrate certain common denominators for implementation.     

Hope as a coping resource among parents at risk for child maltreatment

This study investigated hope as a protective factor buffering the relationships between parenting stress and well-being among a sample of parents identified at moderate to high risk for child maltreatment. Two hundred parents were recruited from a nonprofit organization providing secondary and tertiary child maltreatment prevention programs. Results of the analyses showed that parental stress was negatively associated with subjective and emotional well-being. Hope was positively correlated with well-being and negatively associated with parenting stress. Hierarchical regression analyses showed that hope had a significant incremental relationship to well-being and that the negative effects of parenting stress fell below statistical significance. These findings provide preliminary support for hope as a coping resource social workers can target when working with parents in the prevention of child maltreatment.     

Parenting a child with Autism Spectrum disorder: parental work context

This research contributes to the literature on work-related factors for parents raising a child with a disability. Specifically, we used questionnaire methodology to compare two parent families raising a child with Autism Spectrum (AS) with similar families raising ‘typical’ children. Our findings suggested that parents raising a child with AS self-report higher parenting stress and more mental health symptomatology, as well as lower overall job satisfaction, less satisfaction with supervisors and less workplace contentment. In addition, our findings suggested that parents raising a child with a disability self-report similarly to parents raising ‘typical’ children with respect to work interest, commitment and quality, as well as time missed. In conclusion, our results appear to suggested that despite increased parental stress related to parenting a child with AS, with respect to several work-related factors, there are more similarities than differences among these parenting groups.     

Two generations at risk: child welfare, institutional boundaries, and family violence in grandparent homes

Participation of extended family members, particularly custodial grandparents, has generally resulted in better outcomes for abused children and relief for an overburdened child welfare system. This research explores the risk of adolescent perpetrated violence in custodial grandparent households with data from the Florida Department of Juvenile Justice. Findings suggest that living arrangements with custodial grandparents have a significant and differential impact on rates of violent offending for chronic and serious offenders by race and gender.     

The empirical basis of risk assessment in child welfare: the accuracy of risk assessment and clinical judgment

The importance of risk assessment is juxtaposed with the lack of empirical support regarding the validity of risk inventories. This study compared risk ratings of one risk assessment tool to decisions made by case managers. The researchers sampled 450 children and compared predictive utility of risk assessment to child protection decisions. Risk assessment was consistent with clinical judgment in 74% to 81% of cases, more than previously reported in studies of risk assessment validity. Further analyses identified discriminate functions at the instrument's category and individual-item levels. The results have implications for the validity of the instrument and its utility in child welfare.     

Polynesian child rearing: An alternative model

Literature on child-rearing practices and family style in Polynesia is reviewed. The five following themes common to Polynesian cultures are identified: community responsibility for the care of children, multiple parenting, early indulgence, early independence, and caretaking by siblings and peers. The persistence of, and changes in, the behavior patterns which flow from these themes are then described. Finally, the implications for Western child-rearing practices of Polynesian child-rearing patterns are discussed.     

The nature and effectiveness of program models for adolescents at risk of entering the formal child protection system

This article compares rationales and outcome research for five areas of programming for adolescents: adolescent competence and skill development programs, family- and parent-focused programs, social integration programs, multiple component programs, and neighborhood transformation programs. The article examines program evidence for maltreated teens as well as teens coping with a variety of other challenges. The study uses a framework based on common developmental challenges and risk factors for adolescents to select and review programs.     

The Great Recession and risk for child abuse and neglect

This paper examines the association between the Great Recession and four measures of the risk for maternal child abuse and neglect: (1) maternal physical aggression; (2) maternal psychological aggression; (3) physical neglect by mothers; and (4) supervisory/exposure neglect by mothers. It draws on rich longitudinal data from the Fragile Families and Child Wellbeing Study, a longitudinal birth cohort study of families in 20 U.S. cities (N = 3177; 50% African American, 25% Hispanic; 22% non-Hispanic white; 3% other). The study collected information for the 9-year follow-up survey before, during, and after the Great Recession (2007–2010). Interview dates were linked to two macroeconomic measures of the Great Recession: the national Consumer Sentiment Index and the local unemployment rate. Also included are a wide range of socio-demographic controls, as well as city fixed effects and controls for prior parenting. Results indicate that the Great Recession was associated with increased risk of child abuse but decreased risk of child neglect. Households with social fathers present may have been particularly adversely affected. Results also indicate that economic uncertainty during the Great Recession, as measured by the Consumer Sentiment Index and the unemployment rate, had direct effects on the risk of abuse or neglect, which were not mediated by individual-level measures of economic hardship or poor mental health.     

The risk climate and the delivery of child welfare services

The community is conceptualized as a “risk climate” in which the traditional child welfare services such as own-home services, foster placement, adoption and institutionalization are delivered. The community generates incidence of child welfare cases through the pressure of conditions, and affects prevalence by the extent of its response. Any method of allocating scarce resources should take variations in the risk climate into account in order to put resources where the problem is. This report presents an effort to achieve such a procedure through (1) a literature review to isolate variables related to child welfare service delivery; (2) a report of zero order relationships between these variables and outcome measures; and (3) the use of a multiple regression analysis to develop predictive procedures. The process developed is put forward as an equitable way of distributing scarce resources.     

Pilot study of a personality-based approach to assessing eating disorder and Obsessive Compulsive Disorder symptom risk in college men and women

Abstract

Objective: To conduct a pilot test of the validity of using empirically derived personality types to characterize eating disorder (ED) risk in college students and resolve discrepancies regarding the role of perfectionism and obsessive-compulsive disorder (OCD) symptoms.

Participants: Man and woman undergraduate students (N?=?169) at a small, private university. Data were collected from February to May 2016 and 2018. Methods: Participants completed self-report measures of personality (perfectionism, impulsivity, and effortful control) and psychopathology (EDs, OCD). Results: Our analyses replicated three validated personality types: overcontrolled, undercontrolled, and resilient. Analysis of variances demonstrated perfectionism, ED, and OCD symptoms were significantly elevated in the overcontrolled subtype. There was no interaction by sex. Conclusions: These findings suggest that personality types may be useful for classifying ED risk and OCD symptoms in college students across sexes. Further study and relevance to prevention and intervention efforts to reduce the burden of EDs on college campuses will be discussed.     

Impact of a multidimensional intervention programme applied to families at risk for child neglect

The purpose of this study is to evaluate the effects of an intervention programme applied to families at risk for child neglect. Twenty‐nine families were recruited through a Local Community Services Centre (LCSC) and were assigned to two groups: (1) the first group participated in a multidimensional eco‐systemic intervention programme called the Personal, Family and Community Help Program (PFCHP); and (2) the second group underwent psychosocial intervention that was provided as part of regular LCSC services and focused mainly on the social worker–family relationship. Pre‐test measures were obtained at the beginning of intervention for both groups and a follow‐up was held 24 months later. Quantitative and qualitative analyses indicated that both forms of intervention were associated with improved parent–child relationship and the reduction of parental stress, depression and the potential for child abuse and neglect. However, PFCHP participants showed multiple indications of improvement in their social and marital relationships, which was not the case for LCSC participants. The conclusion outlines the need for a long‐term intervention process for families at high risk for child neglect and the necessity of addressing multiple dimensions of family life if lasting changes are to be expected. Copyright 2000 John Wiley & Sons, Ltd.     

What every nurse needs to know about nocturnal sleep-related eating disorder

This article provides information about a bizarre pattern of eating while asleep called nocturnal sleep-related eating disorder. People with this disorder, which has begun to be studied only recently, demonstrate features of both a sleep disorder and an eating disorder. Many clients are reluctant to initiate discussions regarding this condition because of feelings of powerlessness and shame. Other clients do not discuss their symptoms because nurses and other clinicians fail to gather accurate assessment data due to lack of knowledge within the professional community regarding the disorder. This review includes the historical background, definition of terms, and clinical manifestations of nocturnal sleep-related eating. In addition, emphasis on assessment and clinical management are included. Safety issues, the need to educate health care providers, and the role of the nurse in advocating for appropriate diagnosis, treatment, and referral are addressed.     

Prenatal child abuse risk assessment: a preliminary validation study

Workers need an efficient prenatal screener that can identify mothers at greatest risk of child abuse. Existing risk assessment methods are often invasive and difficult to administer. This study assessed child abuse risk in a sample of 49 expectant mothers using the Brigid Collins Risk Screener (BCRS). At three months postpartum, high-risk mothers scored significantly lower on the quality of infants' physical, social, and emotional environments than moderate or low-risk mothers. BCRS appears to offer a noninvasive, efficient approach to assessing risk of child abuse.