Multi‐type maltreatment and the long‐term adjustment of adults

Multi‐type maltreatment refers to the experience of more than one form of child maltreatment (sexual abuse, physical abuse, psychological maltreatment, neglect and witnessing family violence). Researchers have largely ignored the presence of other types of child abuse and neglect when examining the adjustment problems associated with a particular form of maltreatment. The association between ‘multi‐type maltreatment’ and adjustment was explored in the current study. Retrospective data were obtained on (a) the degree to which maltreatment types co‐occurred, (b) childhood family characteristics and (c) adjustment problems in adulthood in an Australian self‐selected community sample (N=175). As hypothesized, a large degree of overlap was reported in the experience of the five types of maltreatment. Family characteristics—particularly family cohesion and adaptability—discriminated between respondents reporting single‐type and multi‐type maltreatment. Greater adjustment problems were associated with reports of a larger number of different maltreatment types. Multi‐type maltreatment should be recognized as a crucial aspect of the nature and impact of child maltreatment and considered in the development of programmes for the prevention and treatment of child abuse and neglect. Copyright © 2000 John Wiley & Sons, Ltd.     

Economic predictors of child maltreatment in an Australian population-based birth cohort

A correlation between socioeconomic disadvantage and child maltreatment has long been observed, but the drivers of this association are poorly understood. We sought to estimate the effects of economic factors on risk of child maltreatment after adjusting for other known influences using the Australian Temperament Project, a population-based birth cohort of 2443 individuals and their parents. We used logistic regression to estimate associations of childhood economic factors (parental education, occupation, and unemployment; type of housing; and retrospective perception of poverty) with retrospective reports of perceived child maltreatment (physical abuse, sexual abuse, emotional abuse, neglect, and witnessing of domestic violence), controlling for demographic factors, parental mental health and substance use, and child health. We then used these estimates to approximate the proportions of child maltreatment—population attributable fractions—that are theoretically preventable by addressing childhood economic disadvantage. Economic factors were associated with all types of child maltreatment. For the most part, these associations diminished only partially when controlling for noneconomic confounders, supporting hypotheses of causal relationships. Jointly, economic factors were significant predictors of physical abuse, sexual abuse, and witnessing of domestic violence but not of emotional abuse or neglect. Retrospective perceptions of childhood poverty were, in particular, strongly associated with most forms of child maltreatment but not with sexual abuse after accounting for other economic factors. We estimated that 27% of all child maltreatment was jointly attributable to economic factors. These findings suggest that strategies that reduce economic disadvantage are likely to hold significant potential to reduce the prevalence of child maltreatment.     

Child Maltreatment, Abortion Availability, and Economic Conditions

Child maltreatment is a substantial problem in the U.S. yet has received relatively little attention from economists. This article examines the relationship between abortion availability and economic factors at the time children were conceived and subsequent measures of child maltreatment in the U.S. as well as the influence of contemporaneous economic conditions. Our measures of child maltreatment are state-level rates of child abuse and neglect reports, the fraction of children receiving social services, and child deaths and murders. The results indicate that legalized abortion for each successive cohort led to a decline in total reported incidents of child abuse and neglect of about 10 percent and a negative effect on the fraction of children receiving social services. Child deaths and murders are not related to abortion legalization. Medicaid funding restrictions are associated with an increase in substantiated reports of abuse and an increase in murders by relatives or parents; other post-legalization restrictions are not consistently associated with the various measures of child maltreatment. The effects of welfare benefits, average income, and unemployment rates are mixed.     

A Short Psychosocial History of British Child Abuse and Protection: Case Studies in Problems of Mourning in the Public Sphere

This paper offers a historical and psychosocial account of ‘moral panics’ about child maltreatment in England over the last four decades, and proposes this perspective as additional to Munro's more systemic account of the same history. The formal child protection system is theorised in terms of an explicit and a covert dual primary task. The overt task is to actually protect vulnerable children and prevent abuse; the covert task is to protect the remainder of society from exposure to anxiety provoking ‘dangerous knowledge’ about the prevalence of child maltreatment. Episodes of public and political moral panic occur when the boundaries of containment provided by the official system and its processes are breached, propelling debate and contestation about child maltreatment into the public sphere, where public enquiries and other social mechanisms are called upon to ‘settle’ the contested issues. Sometimes these social settlements appear to be successful in resolving conflicts about the reality or otherwise of specific forms of abuse; in other cases, especially child deaths, the controversial and anxiety-laden nature of the problem is recurrently projected back into the public domain. The paper suggests that this may be associated with a difficulty about establishing a secure symbolic framework or discourse in society for the emotionally indigestible facts of child torture and murder. In turn, this may be associated with problems about the decline of public mourning rituals and the failure of the public enquiry format to facilitate this. In line with Munro, the paper argues for the importance of a tragic perspective on child maltreatment, to counter idealisations of the capacity of the formal system to protect children.     

Determinants of maltreatment substantiation in a sample of infants involved with the child welfare system

Children under one year of age are highly vulnerable to child maltreatment, which can lead to serious immediate and long-term physical and mental health consequences. Child welfare workers encounter unique challenges when assessing allegations of maltreatment involving infants. This study identifies correlates of maltreatment substantiation in a sample of 793 infants less than one year of age investigated by child welfare. It is based on data from the 2003 Canadian Incidence Study of Reported Child Abuse and Neglect (CIS-2003), a national study of reports of child maltreatment. The analysis consisted of two stages. First, bivariate analyses were conducted using unadjusted odds ratios and chi-square tests on variables known to be associated with substantiation. In the second stage, a logistic regression was performed to examine these associations in a multivariate model.Multivariate findings suggest that certain vulnerabilities present in the primary caregiver, such as substance abuse and few social supports, as well as the child's positive toxicology at birth are associated with substantiated infant maltreatment. Exposure to domestic violence, which is reported mostly by the police, and physical harm stemming from maltreatment are strongly associated with substantiation, whereas reports of physical abuse and neglect have an inverse relationship. The authors discuss these results and implications for policy and programs.     

Effect of child protective services system factors on child maltreatment rereporting

This study examined how child protective services (CPS) systems respond to initial and subsequent reports in the context of child maltreatment rereporting and to what extent CPS system factors are associated with the risk of rereporting after controlling for abuse type and child and family factors. This study followed 67,243 families who were reported to the CPS agencies in seven counties in Florida for child abuse and neglect over a period of 5.4 years and found that 14,218 families had one or more child maltreatment rereports. Key findings include that CPS system factors were significantly different from initial report to subsequent reports. Five CPS system factors, reporting source, contact by CPS workers, investigative level at intake, postinvestigation services, and duration ofCPS involvement were significantly associated with the risk of child maltreatment rereporting. Multivariate analyses found that CPS system factors were substantially different for three categories ofrereporting, unsubstantiated rereports, substantiated rereports, and recurrence reports. Interpretations and implications for practice are discussed.     

A Critical Review of the Empirical Literature: Identifying Correlates of Child Neglect

More than half the children in the United States who were victims of maltreatment in 2000 were victims of neglect (USDHHS, 2002). The majority of all child maltreatment related fatalities in 2000 were the result of neglect (USDHHS, 2002), and 27.8% of these fatalities were associated with both physical abuse and neglect (USDHH, 2002). Neglected children are more likely to be younger children (USDHHS, 2000), and the highest rate of child fatality due to maltreatment is between the ages of zero and five (Petit & Curtis, 1997; Gustavsson & Segal, 1994; USDHHS, 1999). The purpose of this article is to present the findings of a systematic review of the research on child neglect from 1990 to 2002. The review critiques method and synthesizes of the current body of knowledge on child neglect.     

Parenting stress and child maltreatment: The buffering effect of neighborhood social service availability and accessibility

The current study examines the relationship between aspects of social service availability and child maltreatment. Specifically, the study uses negative binomial regression to estimate whether service availability, accessibility, and receipt are associated with physical child abuse and neglect. Relying on Social Cognitive Theory and Stress and Coping Theory, the moderating effect of the service variables was tested on the relationship between parenting stress and maltreatment. The sample is comprised of 1053 parents who completed a survey in July of 2014. The findings suggest that service availability has a potential protective effect against physical abuse and neglect, and that service accessibility has an additional protective effect above and beyond sheer availability of services for child neglect. Further, the availability of services has a significant moderating effect – it decreased the relationship between parent stress and abuse and neglect. Service receipt had a paradoxical effect — although one might expect receiving social services to reduce maltreatment, there was a positive correlation between the two such that parents reporting receipt of a greater number of services tended to have higher levels of abuse and neglect. Further, service receipt moderated the relationship between parenting stress and neglect, such that the relationship was stronger. The study suggests that efforts to increase service availability and accessibility may prevent child maltreatment.     

Does changing mandated reporting laws improve child maltreatment reporting in large U.S. counties?

The effects of changes in mandated child maltreatment reporting laws have not been systematically evaluated. To better understand the effects of these changes, the objectives of the present study are: (1) to assess the relationships between report rates and state universal and clergy reporting laws in 2010; (2) to compare the changes in total, confirmed, and maltreatment type report rates and with changes in reporting laws from 2000 to 2010, and (3) to examine whether there is any relationship with report rates and the nature of the mandated reporting law change. We used county-level data from the U.S. National Child Abuse and Neglect Data System for the years 2000 and 2010 to evaluate changes in reporting rates for total reports, confirmed reports, and confirmed maltreatment types while controlling for concurrent changes in child and community variables. We found that trends in 2010 for increased total and confirmed reports were similar to 2000 for counties with universal and/or clergy reporting requirements, which significantly contributed to report rates even after controlling for child and community factors. Universal reporting was associated with higher report rates for physical and sexual abuse, and clergy reporting requirements were associated with more sexual abuse, medical neglect and psychological maltreatment confirmed reports. However, while counties in states that changed their clergy reporting laws had higher increases in total reports, they had fewer confirmed physical and sexual abuse, neglect, and psychological maltreatment reports. More pronounced changes were noted in a state that made more pronounced changes in its clergy reporting laws. Policymakers should consider whether changing requirements for mandated reporting meaningfully improves child maltreatment identification.     

Single mothers,the role of fathers,and the risk for child maltreatment

Single motherhood has long been linked to the risk for child maltreatment. However, little is known about the role of fathers in buffering mothers' risk for child maltreatment. Using data from the Fragile Families and Child Wellbeing Study, this paper investigates (1) the ways in which non-resident fathers' economic contributions and involvement in parenting may moderate associations between mothers' transitions to being single and the risk for child maltreatment, and (2) whether these processes vary by race/ethnicity. Results indicate that mothers' transitions to being single are not strongly associated with the risk for child abuse. However, mothers' transitions to being single are associated with an increase in the risk for child neglect, and this is moderated by non-resident father involvement. Last, Black but not other mothers' transitions to being single are associated with the risk for child abuse, and are largely not moderated by non-resident father involvement.     

Pathways Linking Childhood Maltreatment and Adolescent Sexual Risk Behaviors: The Role of Attachment Security

Previous research has shown an association between child maltreatment (sexual abuse, physical abuse, neglect, or witnessing interparental violence) and adolescent sexual risk behaviors (SRBs). The mechanisms explaining this association are not well understood, but attachment theory could provide further insight into them. This study examined the relationships between child maltreatment and SRBs and investigated anxious and avoidant attachment as mediators. The sample comprised 1,900 sexually active adolescents (13 to 17 years old; 60.8% girls) attending Quebec high schools. The results of path analyses indicated that neglect was associated with a higher number of sexual partners, casual sexual behavior, and being younger at first intercourse. Anxious attachment mediated the relation between neglect and number of sexual partners, whereas avoidant attachment explained the relation between neglect and number of sexual partners, casual sexual behavior, and age at first intercourse (for boys only). Sexual abuse was directly associated with all three SRBs. Neither anxious attachment nor avoidant attachment mediated these associations. Youth with a history of neglect and sexual abuse represent a vulnerable population that is likely to engage in SRBs. Interventions designed to induce a positive change in attachment security may reduce SRBs among victims of neglect.     

Substantiating neglect of first nations and non-aboriginal children

First Nations (Native American) children are greatly overrepresented in the Canadian child welfare system, and disproportionality in the substantiation of maltreatment contributes to this overrepresentation. This study explores the factors driving disproportionality in the substantiation of maltreatment and, more specifically, neglect. Data from the Canadian Incidence Study of Reported Child Abuse and Neglect (2008) are used in multivariate analyses which examine the relationship between the substantiation of maltreatment/neglect and worker assessments of case, child, household, and caregiver characteristics. These case factors fully explain disproportionality in maltreatment substantiation for First Nations and non-Aboriginal children; the disproportionality reflects underlying differences in the case, child, household and caregiver characteristics identified in First Nations and non-Aboriginal investigations. However, case factors do not fully explain disproportionality in substantiation of neglect-only investigations. Further analysis indicates that the weight that workers assigned to caregiver substance abuse, housing problems, and presence of a lone caregiver when substantiating neglect also differed for First Nations and non-Aboriginal children. Discussion of these findings explores possible explanations for these differences, and links to broader discussions around definitions of neglect and the role of substantiation in child welfare decision making processes.     

Sudden death in infancy

SUMMARY. Sudden death in infancy is now one of the commonest cause of death in young children in the United Kingdom affecting two to three per 1,000 livebirths. A number of background factors are associated with an increased risk of sudden death and the aetiology is likely to be multifactional. Some of these background factors are reviewed together with possible causes. The relationship with child abuse is discussed. While the aetiology and therefore methods of prevention remain uncertain, it is clear that families who suffer this form of bereavemem need support and counselling. The response of one health authority to the challenge of cot death is described.     

Risk assessment in child sexual abuse cases

Despite continuing improvements in risk assessment for child protective services (CPS) and movement toward actuarial prediction of child maltreatment, current models have not adequately addressed child sexual abuse. Sexual abuse cases present unique and ambiguous indicators to the investigating professional, and risk factors differ from those related to physical abuse and neglect. Incorporation of research on risk factors specifically related to sexual offender recidivism into existing CPS risk assessment models may improve the ability to assess the risk of future sexual maltreatment to children. This article reviews the literature on risk factors for sexual offense recidivism and discusses their relevance and application to CPS assessment models. An evidence-based model for assessing risk in child sexual abuse cases is proposed.     

Dosage matters: The relationship between participation in the Nurturing Parenting Program for infants, toddlers, and preschoolers and subsequent child maltreatment

This article uses statewide data on caregivers of young children referred to the Nurturing Parenting Program (NPP) for allegations of abuse and neglect to examine the relationship between program dosage and subsequent maltreatment. At six months after participating in the program, caregivers who attended more sessions were significantly less likely to be reported for child maltreatment, holding other factors constant. At two years after participating, caregivers attending more sessions were significantly less likely to have a substantiated maltreatment incidence, controlling for other characteristics of families associated with maltreatment. These findings demonstrate the program is associated with preventing short-term allegations and longer-term substantiated incidences of maltreatment for a child welfare population. By demonstrating the importance of participation in the NPP, we increase the evidence about effective parent education programs for this population.     

The Role of Early Maladaptive Schemas in the Appearance of Psychological Symptomatology in Adult Women Victims of Child Abuse

ABSTRACT

Child abuse affects people’s ways of thinking, feeling, and observing the world, resulting in dysfunctional beliefs and maladaptive schemas. Thus, consequences of child abuse may persist during adulthood. Therefore, the aim of this study was to analyze the psychological consequences (anxiety, phobic anxiety, depression, and hopelessness) of different types of maltreatment (physical, sexual, and emotional abuse and physical and emotional neglect) and to study the role of early maladaptive schemas in the onset of symptomatology in adult female victims of child abuse. The sample consisted of 75 women referred by associations for treatment of abuse and maltreatment in childhood. Sexual abuse was the type of maltreatment that was most strongly related to most dysfunctional symptomatology, followed by emotional abuse and physical abuse, whereas physical neglect was the least related. Also, early maladaptive schemas were found to correlate with child abuse and dysfunctional symptomatology. Finally, early maladaptive schemas mediated the relationship between sexual abuse and dysfunctional symptomatology when the effect of other types of abuse was controlled. These results may provide important guidance for clinical intervention.     

Multisystemic Therapy for Child Abuse and Neglect: Do Parents Show Improvement in Parental Mental Health Problems and Parental Stress?

Multisystemic Therapy for Child Abuse and Neglect (MST-CAN) is an evidence-based program for families with children who experience maltreatment. This clinical trial is the first evaluation of MST-CAN in a German-speaking area. Parental psychological problems and parental stress have been shown to be risk factors for child abuse and neglect. By the end of treatment, parents reported significantly less psychological distress than before the start of MST-CAN. Six months after treatment, this reduction was still evident. However, parents did not report any significant reduction of parental stress at any of the three time points. MST-CAN is an effective intervention for child maltreatment that not only combats child abuse and neglect but also has the potential to alleviate parental psychological distress.