Maltreatment and Trauma: Toward a Comprehensive Model of Abused Children from Developmental Psychology

Knowledge of how maltreatment and trauma aects personality functioning in abused children has been greatly enhanced by clinical theory and research in developmental psychology. Developmental research and theory has allowed the child abuse field to move beyond symptom-lists toward broader models of how trauma impacts major domains of personality functioning. However, these models continue to be based largely on discrete theories of development that parallel, if not confound, one another. This paper attempts to expand our understanding of the traumatized child by using the synthetic model of personality development expounded by Fred Pine that promotes a more holistic and comprehensive view of the abused child and, thus, enhances clinical theory and intervention.     

Holocaust Child Survivors and Child Sexual Abuse

ABSTRACT

This study utilized a qualitative analysis of child survivors of the Holocaust who were sexually abused during World War II. The research study aimed to give this specific group of survivors a voice and to explore the impact of multiple extreme traumas, the Holocaust and childhood sexual abuse, on the survivors. Twenty-two child survivors of the Holocaust who were sexually abused during the war completed open-ended interviews. The data was qualitatively analyzed according to Tutty, Rothery, and Grinnell's (1996) guidelines. Three major themes were found: issues relating to the sexual abuse trauma, survivors' perceptions of the abuse, and survivors' general perspectives towards life. The identity of the offenders, Jewish or non-Jewish, determined the survivors' feelings towards themselves, the perpetrators, and about the worth of life.     

Researching Sexual Revictimisation: Associated Ethical and Methodological Issues,and Possible Solutions

This paper has been inspired by the processes of preparing for ethical scrutiny and seeking ethical approval for a series of studies examining causal mechanisms that might facilitate sexual revictimisation. The focus here is on just four of the issues that arose in the context of the first study: a web‐based survey. One of the aims of the survey is to test whether victims of child sexual abuse who experienced a period of psychogenic or dissociative amnesia demonstrate an exaggerated risk for adolescent/adult sexual assault during this amnesic phase. That is, cases where survivors report ‘suddenly remembering’ in adulthood that they were abused as children, but state that prior to this ‘remembering’ they had no prior knowledge of their abuse. The study design is considered to be the first ethical issue. To enhance the methodological robustness a strategy has been employed to reduce the erroneous inclusion of currently amnesic participants in the non‐abused comparison group. Secondly, consideration is given to the likely harms and benefits that might be incurred or bestowed upon the participants. Thirdly, problems of both re‐traumatisation and vicarious traumatisation in relation to the researcher are contemplated and juxtaposed against the possibility of the facilitation of post‐traumatic growth and a personal shift towards wisdom and generativity. Finally, the survey title was originally criticised as negating ‘fully’ informed consent and a defence is therefore offered that ultimately gained ethical approval. It is hoped that these deliberations and insights may prove useful to others in planning their own research and ethics proposals.     

Cognitive behavioural psychotherapy intervention in childhood sexual abuse: identifying new directions from the literature

The short‐ and long‐term consequences of childhood sexual abuse have been extensively reported. However, for many years there has been an absence of psychological conceptual frameworks for understanding and treating abuse trauma symptoms. This paper reviews a number of outcome studies for the treatment of child sexual abuse where a post‐traumatic stress disorder (PTSD) conceptualization was used to plan treatment interventions. The paper concludes that, contrary to some concerns expressed by clinicians, sexually abused children and their non‐abusing carers can signi?cantly bene?t from cognitive behavioural interventions which use reliving and confrontation of the abusive experience. Notwithstanding this, there is a need for further controlled outcome research of cognitive behavioural interventions using reliving techniques to explore how and why these interventions help in reducing abuse‐related PTSD symptoms. Copyright © 2004 John Wiley & Sons, Ltd.     

Holocaust child survivors and child sexual abuse

This study utilized a qualitative analysis of child survivors of the Holocaust who were sexually abused during World War II. The research study aimed to give this specific group of survivors a voice and to explore the impact of multiple extreme traumas, the Holocaust and childhood sexual abuse, on the survivors. Twenty-two child survivors of the Holocaust who were sexually abused during the war completed open-ended interviews. The data was qualitatively analyzed according to Tutty, Rothery, and Grinnell's (1996) guidelines. Three major themes were found: issues relating to the sexual abuse trauma, survivors' perceptions of the abuse, and survivors' general perspectives towards life. The identity of the offenders, Jewish or non-Jewish, determined the survivors' feelings towards themselves, the perpetrators, and about the worth of life.     

Against the odds: the impact of woman abuse on maternal response to disclosure of child sexual abuse

Although the co-occurrence of woman abuse and child sexual abuse is high little research exists exploring the impact of woman abuse on maternal response to child sexual abuse (CSA). Findings from two qualitative studies indicate the form of woman abuse to have differential impact on maternal response. Mothers who were abused in non-physical ways, psychological, or emotional, displayed more ambivalent, less supportive responses. Mothers who were physically abused by their partners more often acted supportively to their children and displayed less ambivalence about separating from the perpetrator. Some survivors reported non-disclosure as children because of their fear of the perpetrator due to the woman abuse they were exposed to while being sexually abused. Practice and research implications are discussed.     

The Use of Peer Support for Parents and Youth Living with the Trauma of Child Sexual Abuse: An Innovative Approach

ABSTRACT

This article describes and reports on an innovative intervention program for parents of sexually abused children and youth. Peer support provided by non-professional staff and volunteers, who have been personally affected by the trauma of child sexual abuse, is an approach with unique advantages. Many of these consumers have not been able to benefit from traditional service delivery approaches. Goals and objectives of the Peer Support Program (PSP) have been developed through inter-agency collaboration initiatives comprised of a coalition of existing social service agencies. This report examines characteristics of service delivery and level of consumer satisfaction of parents and youth who have participated in the peer support program. Implications for interventions with sexually abused youth and parents of sexually abused children are discussed.     

Child Sexual Abuse Workers’ Emotional Experiences of Working Therapeutically in the Western Cape, South Africa

South African child sexual abuse workers active in low-income communities bear witness to stories of sexual and physical abuse, neglect, pervasive deprivation, and violence. North American, British, and European workers’ emotional experiences have been captured in the literature, and a gap remains to be filled by those of their South African colleagues. This research aims to focus on the emotional experiences of social workers who engage therapeutically with sexually abused children in the Helderberg basin of the Western Cape, and resonate in some way with readers working in situations of poverty and trauma in other parts of the world. This study employed an explorative inductive research method, and followed a critical realist and contextual constructionist approach. Multiple-case study data collection took place by means of semi-structured interviews with social workers who engage therapeutically with sexually abused children. Data were examined by means of thematic analysis, and psychoanalytic theory was employed to analyse defences that surfaced during interviews. There were similarities in emotional experiences between South African participants and their abovementioned counterparts. The research also identified salient features of working with child sexual abuse in South Africa. The emotional experiences of doing such work, coupled with participants’ ways of managing sexually abused children’s material, gave rise to possible vicarious traumatisation symptoms and allowed for a psychoanalytic understanding to be put forward. The research also reports on useful measures that might enable individuals to continue interventions. To enable ongoing effective therapeutic engagement, social workers should have access to opportunities for acknowledging countertransferences and processing dynamic material defended against. The research contributes to knowledge of working in South Africa by exploring the emotional experiences of those who help sexually abused children daily, and by investigating the psychological impact prolonged therapeutic engagement has on workers active in Western Cape low-income communities.     

Re-traumatization among adult women sexually abused in childhood: exploratory analyses in a prospective study

The current exploratory study examined a variety of risk factors related to re-traumatization, defined broadly, in a prospective sample of women who were sexually abused in childhood. Eighty women, who were part of a larger longitudinal study of the effects of child sexual abuse, were interviewed at three points in time: in childhood and at two points in early adulthood. Risk factors were measured at the second interview and used to predict reported trauma exposure between interviews two and three. Given theoretical arguments for differences in risk factors based on ecological context, analyses were conducted separately for married and unmarried women. Situational and intrapersonal risk factors such as homelessness and depression were predictive of re-traumatization risk while reported social support satisfaction was a protective factor. Reports of trauma exposure between interviews two and three were related to mental health symptoms.     

The gender neglect and textual abuse of children in the print media

In recent years the relationship between the media and child abuse has been subjected to closer scrutiny. Research at Monash University into the media portrayal of child abuse has led the researchers to examine the language used by the print media to represent both children who have been abused or neglected and the offences committed against them. This paper presents two findings from this research. The analysis firstly found that a child who has been abused or neglected may be objectified in print media language even when the child’s gender is previously identified. Secondly, the analysis found that the language used to describe the sexual abuse of children may serve to reduce the seriousness of offences. These phenomena, termed ‘gender neglect’ and ‘textual abuse’, are highlighted by examples from UK and Australian print media. The authors argue that ‘critical language awareness’ is important for children, just as it has been identified in research that examines the representation of women in print media. Copyright 2000 John Wiley & Sons, Ltd.     

Identifying abused children using assessments and observations in the classroom: a preliminary study

The paper presents two pilot studies that attempt to identify maltreated children in the classroom. The aim of pilot study 1 was to determine whether six British physically abused children performed signi?cantly worse than matched non‐abused children on a battery of tests and rating scales over an 18‐month period. The aim of pilot study 2 was to concurrently identify maltreated children from a classroom of children using standardized tests and observed negative behaviours. The method used in study 1 was a cross‐comparison design with six physically abused and 12 comparison children, all between 4 and 8 years old. They were assessed over 18 months at four time‐points on a battery of standardized tests and rating scales. Study 2 was based on a concurrent prediction of child abuse in a class of 30 children (18 male and 12 female) 10 years old. They were assessed on a battery of standardized assessments and by the direct observation of negative behaviour in order to predict those who were on the child protection register (CPR) for actual or suspected abuse and those who were not. The results of study 1 showed signi?cant differences on the teacher rating scales and on a measure of sibling dependency. Study 2 used standardized assessments and identi?ed three of ?ve abused children. Direct observations identi?ed one of ?ve abused children. These two preliminary studies suggest standardized assessments are more useful than behavioural observations in identifying abused children in the classroom setting. Further con?rmation is required using larger‐scale investigations. Copyright © 2003 John Wiley & Sons, Ltd.     

The child welfare response to serious nonaccidental head trauma

Serious nonaccidental head trauma (NHT) can leave permanent neurological damage in children who survive abuse. This study reports on child welfare's handling of NHT cases compared with cases of physical abuse and head trauma due to neglect with regard to placement in foster care, reunification with family, and safety issues. The results show that workers placed children with NHT in foster care immediately after the abuse but treated them no differently than other physically abused children regarding reunification.     

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.     

An analysis of children and young people's calls to ChildLine about abuse and neglect: a study for the Scottish Child Protection Review

In 2001 a young child, who was known to child protection agencies, was murdered by her stepfather. Following a recommendation of an inquiry into her death, a ministerial multidisciplinary review of child protection across Scotland was carried out. The review aimed to promote the reduction of abuse or neglect of children and to improve the services for children who experience abuse or neglect. It was carried out by a multidisciplinary team and the report made 16 recommendations. The review was informed by a series of sub‐projects. This paper describes one sub‐project that aimed to collect the views of children and young people who might have been abused but might not have had contact with child protection agencies. The study was carried out in conjunction with ChildLine Scotland. Call data for one year were made available for quantitative analysis. Qualitative analysis was carried out on the counsellors' notes on all calls relating to abuse and neglect taken during a 2‐week period. Children described signi?cant levels of abuse and neglect. Many had told no‐one of the abuse and in particular had not contacted child protection agencies. The paper considers the implications of the ?ndings for the child protection system. Copyright © 2004 John Wiley & Sons, Ltd.     

Family Trauma and Dysfunction in Sexually Abused Female Adolescent Psychiatric and Control Groups

Differences in family trauma, stressors, and dysfunction among psychiatric inpatients grouped by sexual abuse self-reports were investigated. Group membership was determined by self-report of adolescents during a structured interview using a modification of the Traumatic Antecedents Scale (TAS). Family trauma/dysfunction was determined from a composite score derived from the TAS. The results indicated a significant difference for family trauma/dysfunction, with sexually abused adolescents reporting more family trauma/dysfunction than psychiatric controls. Also, those abused extrafamilally reported significantly more family trauma and dysfunction than psychiatric controls, while those abused intrafamilially did not report significant differences. Group differences in the endorsement of certain traumas stressors also were investigated. These findings indicated that among psychiatric inpatients, family dysfunction and trauma are present in those extrafamilially abused. Moreover, the extrafamilially abused were significantly different from controls, while incestuously abused were not significantly different. These results are discussed in the context of separation and abuse vulnerability.     

Partner abuse among women whose children have been sexually abused: an exploratory study

To explore partner abuse among women in families in which a child has disclosed child sexual abuse, 102 mothers completed a measure of partner abuse and the Coping Responses Inventory. Results suggest that, like women in the general population, mothers of children who have been sexually abused have often experienced partner abuse. As expected, physical abuse in a current relationship was found to be related to the use of avoidance strategies in dealing with the sexual abuse disclosure. The implications for practitioners and for future research are discussed.     

Partner Abuse Among Women Whose Children Have Been Sexually Abused: An Exploratory Study

ABSTRACT

To explore partner abuse among women in families in which a child has disclosed sexual abuse, 102 mothers completed a measure of partner abuse and the Coping Responses Inventory. Results suggest that, like women in the general population, mothers of children who have been sexually abused have often experienced partner abuse. As expected, physical abuse in a current relationship was found to be related to the use of avoidance strategies in dealing with the sexual abuse disclosure. The implications for practitioners and for future research are discussed.     

Domestic Violence and Intergenerational Rates of Child Sexual Abuse: A Case Record Analysis

Using case review at a shelter for battered women and their children, this exploratory study investigated the association between physical abuse, exposure to domestic violence and intergenerational occurrence of child sexual abuse. The charts of 570 children were reviewed in an attempt to explore the relationship between the children's experiences with sexual abuse and their nonoffending parent's own history of having been sexually abused. Results indicated that a significant percentage of nonoffending parents who reported a history of child sexual abuse also had children who were sexually abused. Additionally, we found that most (93%) of the children studied had been exposed to domestic violence, and while the base rate of sexual abuse was relatively low (11%), the rate of physical abuse of the children was substantial (41%). Logistic regression results indicated that children of sexually abused nonoffending parents may be at heightened risk for sexual abuse. Implications for treatment and intervention are discussed.     

Child abuse,child protection and disabled children: a review of recent research

This paper reports the results of a scoping study that reviewed research about child abuse, child protection and disabled children published in academic journals between 1996 and 2009. The review was conducted using a five stage method for scoping studies. Several studies have revealed a strong association between disability and child maltreatment, indicating that disabled children are significantly more likely to experience abuse than their non‐disabled peers. Those with particular impairments are at increased risk. There is evidence that the interaction of age, gender and/or socio‐cultural factors with impairment results in different patterns of abuse to those found among non‐disabled children although the reasons for this require further examination. It appears that therapeutic services and criminal justice systems often fail to take account of disabled children's needs and heightened vulnerability. In Britain, little is known about what happens to disabled children who have been abused and how well safeguarding services address their needs. Very few studies have sought disabled children's own accounts of abuse or safeguarding. Considerable development is required, at both policy and practice level, to ensure that disabled children's right to protection is upheld. The paper concludes by identifying a number of aspects of the topic requiring further investigation. Copyright © 2010 John Wiley & Sons, Ltd.