Victims Of Child Abuse Research Articles

Trauma-Informed Care for Infant and Early Childhood Abuse

ABSTRACTTrauma-informed care for those who experienced early childhood maltreatment is being developed to meet the needs of infant, toddler, and preschool victims of child abuse and neglect. This age group experiences a disproportionate amount of abuse, and the resultant toxic stress during this rapid developmental stage is more damaging than it is in later years. The concept of trauma-informed care in general is presented, followed by a focus on trauma care for early childhood abuse. Trauma-informed care for younger children is united by common principles and is seen as developmental, relational, sensory oriented, and evidence based in nature. Dissemination of knowledge about this unique population to every system that encounters survivors of any age has begun, although it must be broadened and increased. Evidence-based treatment programs for young children are available and effective but limited, especially for age 0–2. Home visiting programs for mothers and babies are effective and cost efficient. Major funding by U.S. Department of Health and Human Services to each state has significant potential for success because it targets mother-child attachment and care, as well as the disproportionate amount of damage resulting from early childhood abuse. Infants and preschoolers are in some ways comparable to children with disabilities due to their developmental limitations. The nature of this population requires a more rigorous and proactive awareness and identification process because these children are physically dependent on surrounding adults. Addressing child abuse in the first years of life offers an excellent opportunity to assist the most vulnerable victims and effectively reduce the impact to families and communities in the ensuing years.

Is interviewer support associated with the reduced reluctance and enhanced informativeness of alleged child abuse victims?

Child maltreatment victims are often reluctant to report abuse when formally interviewed. Evidence-based guidelines like the National Institute of Child Health and Human Development Standard Investigative Interview Protocol do not adequately address such reluctance because they are focused on cognitive rather than socioemotional strategies. The present study was designed to determine whether the Revised National Institute of Child Health and Human Development Protocol, which emphasizes supportive interviewing more than the standard protocol does, might predict increases in the overall informativeness and reductions in the reluctance of alleged victims. A total of 254 interviews, 166 using the revised protocol and 88 using the standard protocol, were conducted with 4.06- to 13.98-year-old children (M = 9.20, SD = 2.49) who disclosed multiple incidents of physical abuse by their parents and were thus expected to be more reluctant than victims of extrafamilial abuse. We coded indices of interviewer support and question types, children's reluctance, and informativeness in each utterance during the substantive phases of the interviews. The Revised Protocol was associated with better interviewer support and questioning as well as reduced reluctance and increased informativeness on the part of the children. These findings document the value of training interviewers to attend to the socioemotional needs of suspected abuse victims during investigative interviews. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Care and rehabilitation services to child victims of abuse in the United Arab Emirates: Examples of innovation

This research investigated the innovative services provided to child victims of abuse by the Dubai Foundation for Women and Children (DFWAC) using a qualitative methodology: in-depth interviewing of 20 participants and analysis of DFWAC documents. A logic model is used as a framework for understanding the program and shows the relationships among resources used, the processes and activities implemented, outputs, and outcomes. The similarities to and differences from the Child Advocacy Center model are discussed. The findings suggest that DFWAC has appropriate policies and procedures for assisting child victims of abuse, and ecological theory is used to explain the results. Although more work is needed to accurately document DFWAC's effectiveness, the DFWAC is an innovative example of civil society's capacity to address child abuse.

Child Maltreatment Disclosure to a Text Messaging-Based Crisis Service: Content Analysis.

BackgroundDisclosure is a difficult but important process for victims of child maltreatment. There is limited research on child maltreatment disclosure. Young people have been reluctant to disclose victimization to adults, but short message service (SMS) crisis services may represent one novel method of engaging young people around sensitive topics.ObjectiveThe purpose of this study was to determine characteristics of child maltreatment disclosure to an SMS-based crisis service.MethodsWe conducted a content analysis of all conversations (N=244) that resulted in a mandatory report by an SMS-based crisis service between October 2015 and July 2017. We coded characteristics of the disclosure process, including the reason for initial contact, phrase used to disclose abuse, perpetrator, type of abuse, and length of victimization. After identifying terms used by young people to disclose child abuse, we randomly selected and analyzed 50 conversations using those terms to determine if use of the terms differed between conversations that did and did not result in mandatory report.ResultsParents were the most common perpetrator. Physical abuse was the most common form of abuse discussed in the initial abuse disclosure (106/244, 43.4%), followed by psychological abuse (83/244, 34.0%), sexual abuse (38/244, 15.6%), and neglect (15/244, 6.1%). More than half of the texters discussed abuse or other significant family issues in the first message. An explicit description of the experience or definite language, such as abuse, rape, and molested, was common in disclosures.ConclusionsEarly disclosure, combined with explicit language, may suggest at least a portion of young victims are actively seeking safe ways to talk about their experiences with abuse, rather than incidentally sharing experiences while seeking support for other issues. SMS text messaging may be a valuable way to engage with young people around sensitive topics, but these approaches will require careful consideration in their development, implementation, and evaluation to ensure a positive experience for young people.

Awareness of Social Infrastructures for Victims of Child Abuse Among Primary Health Workers in Ogun State, Nigeria.

There is a significant dearth of information on available social infrastructures for helping victims of child abuse among all cadres of primary health-care workers. The aim of this study was to assess the level of awareness of social and legal structures among primary health-care workers, which can help in reducing incidences and taking action. The survey was a cross-sectional survey of 20 primary health-care centers and 86 health workers in Ogun State, Southwest Nigeria. The result showed a low level of awareness among health workers. A large percentage of health workers were unaware of any social infrastructure or hospital protocol for child abuse reporting: 68.4% of medical officers, 54.5% of nurses, and 66.7% of other health workers. There is a need for deliberate training among health workers on social infrastructure, which can help victims of child abuse.

Comparative Study of Dental Pain Between Children With and Without a History of Maltreatment.

To assess the presence of dental pain in child abuse victims and to compare the findings to children in the same age group with no history of abuse in a Southern Brazilian city. This cross-sectional comparative study was carried out in a convenience sample of 68 child abuse victims from a center for psychologic support and in a comparative group of 204 students from public and private schools, all aged between 8 and 12 years. Data for socioeconomic and demographic variables were collected, and information regarding dental pain in the last 6 months was obtained via interviews with the children. World Health Organization criteria were used to assess the presence of decayed, missing, or filled teeth in primary and permanent dentition. Dental trauma was measured using the O'Brien Index, and gingival bleeding was assessed. Crude and adjusted logistic regression analyses were performed to assess the association between dental pain and history of abuse. Reporting of dental pain was higher among child abuse victims (54.41%) than in the comparative group (36.14%) (P < .01). After adjustment for clinical variables in the logistic regression analyses, the child abuse victims group had an odds ratio of 2.03 (95% confidence interval 1.13 to 3.64) for dental pain (P = .01). Child abuse victims presented a higher prevalence of dental pain than children with no history of maltreatment, regardless of oral health status.

Facilitating the Expression of Emotions by Alleged Victims of Child Abuse During Investigative Interviews Using the Revised NICHD Protocol.

Children's testimony is often critical to the initiation of legal proceedings in abuse cases. In forensic interviews, the expression of emotions can powerfully enhance both the quality of children's statements and perceptions that their statements are coherent and credible. However, children rarely express their emotions when reporting abusive events. The Revised The National Institute of Child Health and Human Development (NICHD) Protocol (RP) was designed to emphasize socioemotional communication during forensic interviews and thus should be associated with more extensive and diverse expressions of emotions by alleged victims of abuse. The present study focused on forensic interviews (178 using the Revised and 100 using the Standard NICHD Protocol) with victims of physical child abuse whose allegations were corroborated using independent evidence. Detailed content coding showed that the RP was associated with the expression of more different emotions, more expression of abuse-related emotions, and more expression of emotions related to the interview context. Emotional expressiveness was associated with increased informativeness, and the association between the type of protocol and informativeness was fully mediated by emotional expressiveness. These results suggest that the Revised Protocol facilitates the expression of emotions by alleged victims of abuse in a way that enhances the value of children's testimony in multiple ways.

Early ERP components to emotional facial expressions in young adult victims of childhood maltreatment

The ability to appropriately recognize the facial expression of emotions is essential for the development of adaptive functioning. Studies suggest that maltreated children are hypersensitive to expression of anger. However, the neural mechanism of emotional face processing in young adults with a history of childhood maltreatment has yet to be explored. To explore whether the history of childhood maltreatment has a potential relationship with processing of emotional facial expressions, the present study used event-related potentials in investigating the early ERP components (P100 and N170) to the processing of emotional (angry, fearful, disgusted, and happy) faces in young adult victims of childhood maltreatment. Seventeen young adults with a history of childhood maltreatment and seventeen age and gender-matched non-maltreated participants performed a modified dot-probe task, using emotional faces paired with neutral faces. Results revealed no significant differences between maltreated group and non-maltreated group in P100 amplitude, but the N170 amplitude in the maltreated group was larger than non-maltreated group when processing angry, fearful, and happy faces. As such, this study provides biological evidence of altered neural processing of emotional facial expressions in young adults with a history of childhood maltreatment.

Geocoding child sexual abuse: An explorative analysis on journey to crime and to victimization from French police data.

For several years, the link between mobility, human behavior and crime have highlighted by criminologists. Nevertheless, due to the difficulty of compiling sensitive geographical data, the spatial behavior of extrafamilial child abusers has received little empirical attention. The purpose of this study is to explore the spatial mobility of victims and offenders of extrafamilial child abuse under the lens of the crime mobility triangle methodology. The main objective is to analyze the distribution of the spatial mobility patterns and determine which factors are associated with these patterns. This study analyses the characteristics of 612 cases of extrafamilial child abuses recorded by the French police between 1979 and 2013. By using police data, this research analyses firstly the journey to crime and the victims of child abuse with descriptive analyses. Secondly, geographical data are merged to compute and classify the cases in the geometric and geographic mobility typologies. Thirdly, multivariate analyses are used to identify which factors are associated with each specific mobility pattern. Results suggest that the journeys to crime and victimization are shorter compared to cases of adult sexual abuse. Over 50% of aggression occurred within 2.5 km of offenders' houses and 0.5 km of victims' residences. Acquaintanceship is more important when the victims are younger while the expansion of routine activities associated with secondary socialization increases the risk of aggression in public spaces. Journeys to crime are affected by children routine activities and modus operandi parameters, whereas offenders' characteristics were found to have no impact on the spatial behavior.

The effect of physical exercise on anxiety among the victims of child abuse

The victims of child abuse show more maladaptive behaviors compared to the normal children due to the behavioral problems such as anxiety and isolation consistent with their conditions. The present study was conducted with the aim of investigating the effect of physical exercise on anxiety among the victims of child abuse. The research method was quasi-experimental of pretest–posttest type with a control group. The statistical population of this research included all the students who were the victims of child abuse in Tehran during 2017–2018. Among them, 22 individuals were selected through random cluster sampling method and were randomly assigned into test (experimental) and control group. A pre-test was performed for both groups and then the physical exercise was applied for 8 weeks on the test group; while the control group did not receive any intervention. In the end, a post-test was performed for both groups. Data collection was conducted using State-Trait Anxiety Inventory (STAI) and Childhood Trauma Questionnaire (CTQ). Analysis of covariance (ANCOVA) along with using SPSS software was used to analyze the data. The results indicated that physical exercise has reduced anxiety among the victims of child abuse (p < 0.01). Therefore, consistent with the findings that confirm the effect of physical exercise on anxiety reduction among children who were victims of child abuse, it is recommended to design and implement physical exercise and extracurricular sport activities in order to reduce anxiety of these people.

A Latent Class Analysis of Lifetime Victimization Among Homeless Youth.

Homeless youth experience high rates of child physical and sexual abuse, and many are revictimized on the streets. Despite their high rates of victimization, few studies have examined whether specific victimization types (e.g., sexual vs. physical) cluster together and for whom (e.g., sexual minority youth). As such, the purpose of this study was to identify clusters of homeless youth based on their exposure to different forms of child abuse and street victimization, to examine what factors distinguish each cluster, and how unique clusters are related to youths' mental health using data collected at two time points. The sample included 150 youth experiencing homelessness in the Midwest. Latent class analysis was used to identify clusters of youth. Three latent classes emerge: The low exposure class had significantly lower rates of child physical and emotional abuse and threats compared with the medium- and high-exposure groups. The high exposure group had significantly higher rates of child sexual abuse compared with the other groups. Females, sexual minority youth, and those who have lived in more foster care homes were more likely to be in the high exposure group compared with the low and/or medium exposure groups. Multivariate results revealed that those in the medium and high exposure cluster groups had higher rates of Wave 1 depressive symptoms and Wave 1 anxiety compared with youth in the low exposure cluster. Overall, although these young people experience high rates of abuse and victimization both at home and while on the street, there are gradations in these experiences such that certain victimization experiences subgroups are at heightened risk for poor mental health.

Assessing the Relational Nature of Child Physical Abuse and Neglect Among 12-Year-Old Girls

Child maltreatment is a historical and current problem in the United States. Children are exposed to physical abuse, neglect, and sexual abuse in alarming numbers. In 2014, state agencies found an estimated 702,000 victims of child maltreatment. With two thirds of this group representing child neglect victims, research studies and effective interventions are needed for this group in particular. This study examined the relational nature of child neglect versus child physical abuse. The sample population consisted of 68 girls aged 12 years old at the Midwest site of the Longitudinal Studies of Child Abuse and Neglect research project. The secondary analysis was completed with descriptive, correlational, and multiple regression analyses. The results of the analysis revealed the mother–child relationship was significantly related to the presence of neglect and was significantly related to the presence of physical abuse. Peer relationships were not found to be significantly related to the presence of neglect or physical abuse. In the multiple-regression analysis, child neglect versus child physical abuse was more predictive of a negative mother–child relationship. Of note, the outcomes of the study lead to a better understanding of the need for relational interventions in treating victims of child abuse and neglect, as well as the relational nature of abuse and neglect demand interventions that focus on the victim and the caregiver/perpetrator. Such interventions can only result in socially and emotionally connected individuals, improving the functioning of the adolescent and the future adult.

Characteristics of statements of children who do not tell secrets: Focusing on Criteria Based Contents Analysis(CBCA)

Reportedly, child victims of abuse often do not disclose some or any parts of the criminal behaviors they experience. The purpose of this study was to confirm the characteries of children’s statements when they attempt to keep secretes by re-analyzing data from an earlier experimental study(Yi, 2014). In that study, 71 children aged 3- to 6-year-olds were invited a photography event where a photographer took photos of the children while having a range of interactions with them, including putting on and removing costumes, asking them to assume certain poses, and forth. The photographer allowed each child to take a photo of the photographer, then asked the child to keep this a secret with promise of gifts if the child did not tell anyone. The results showed that, of 71 children, 35(49.3%) disclosed the secrets while 36(50.7%) keep the photographer’s confidence. Children who did not disclose the secrets provided significant smaller amounts of information about the incident. They were also more likely to give no response than children did disclose the secrets but the details provided by the secrets keepers were not necessarily inaccurate. CBCA was able to distinguish the statements of children who did disclose the secretes from those who did not. Children who disclosed the secretes had higher total mean CBCA scores. Moreover, the statements of disclosers more frequently included the features of criterion2, 3, 6 and 9. Finally, the implications of these finding for the investigative interviewing of children who did not disclose alleged incidents in forensic contexts are discussed.

HISTORICAL JUSTICE THROUGH REDRESS SCHEMES?

The Swedish redress scheme intended for victims of historical child abuse in out-of-home care compensated only 46% of claimants who sought economic compensation for past harms. This article explores the reasons behind this comparatively low validation rate by investigating a) how the eligibility criteria of the Redress Act were evaluated by the Redress Board; and b) the justifications and underlying values used when applications were rejected with reference to the fact that reported abuse was not deemed to be sufficiently severe according to past standards. Victim capital, which determines how vulnerable or credible a victim is perceived to be by others, as well as competence and narration, are essential aspects for this type of legal proceeding. The article demonstrates that the claimants had to traverse a complicated web of criteria to be awarded compensation. The outcomes for claimants were affected by how the past was conceptualized in this legal setting, what competences the victims themselves possessed, what competence and resources the administrative system offered, and the extent to which the decision-making process fragmented victims’ narratives.

Are parents at a higher risk for secondary traumatic stress?: How interviewing child victims impacts relationships with forensic interviewer's friends and family.

Forensic interviewers are at a heightened risk for secondary traumatic stress (STS) due to their frequent interactions with victims of child maltreatment (Bonach & Heckert, 2012). To date, however, few studies have examined the negative effects of this work on interviewers' social and emotional well-being. The present study seeks to explore the effect of STS on the relationships of forensic interviewers, including those with friends, family, and their respective children. Data are derived from a sample of 367 forensic interviewers (FIs) recruited from across the United States. The current study used a cross-sectional research design to obtain qualitative and quantitative data from an online survey of certified forensic interviewers. Personal-level predictors of STS included interviewers' sex (β = 0.11, p = 0.02), trauma history (β = 0.13, p = 0.004), and frequency of socializing with family members outside of work (β = -0.12, p = 0.01). Work-related predictors included the frequency of direct (β = 0.10, p = 0.04) and indirect exposures to graphic details of child maltreatment (β = 0.09, p = 0.05), burnout (β = 0.58, p = 0.000), and years of experience investigating crimes against children (β = 0.10, p = 0.03). Factors such as parental status and external social support were not significantly associated with STS in the qualitative analysis. Forensic interviewers experience both positive and negative effects of exposure to crimes against children, with work-related factors being particularly impactful on the potential for STS.

Association between emergency department utilization and the risk of child maltreatment in young children

BackgroundThis study aims to assess the association between emergency department (ED) utilization and the risk of child maltreatment.MethodsUsing ED discharge data from the California’s Office of Statewide Health Planning (OSHPD) and Development for 2008–2013, we performed a nested case-control study to examine the relationship between the frequency of ED visits and child maltreatment diagnosis under 4 years of age among children born in California between 2008 and 2009 who visited the ED.ResultsThe study sample consisted of 3772 children diagnosed with child maltreatment (cases) and 7544 children selected by incidence density sampling (controls). After adjustment for demographic characteristics, the estimated odds ratios of child maltreatment were 1.72 (95% CI:1.55–1.90) for those with two to three ED visits and 3.03 (95% CI: 2.69–3.41) for those with four or more ED visits, compared to children with one visit. Race/ethnicity, insurance status, and location of residence were also significantly associated with the risk of child maltreatment.ConclusionsYoung children with higher frequency of ED visits are at significantly increased risk of being victims of child maltreatment. ED utilization patterns and other established risk markers may assist healthcare professionals in identifying and treating victims of child maltreatment.

Beyond accessing information: Claiming to understand in child social welfare interviews.

The present article investigates how people manage understanding of personal experiences in an institutional setting in which shared understanding of one party's experience can become an issue at stake: social welfare interviews with child victims of abuse. New recommendations on how to respond to child interviewees limit interviewers' support to experiences of which they have direct access. Using conversation analysis and discursive psychology to examine cases in which interviewers respond to children's reports of experiences by claiming to understand, the current article shows that interviewers primarily use such claims after interviewees have indicated that the interviewer may not understand. By claiming to understand, interviewers orient to a difference between an interview requirement - not assuming they know the children's specific experiences - and their ability to interpret the children's situations. The study shows how interviewers use claims of understanding to distinguish themselves as understanding persons from their information-eliciting approach as social welfare investigators. Findings contribute to social psychological research on how people manage challenges related to eliciting and recognizing experience in interaction. In particular, the study offers research on interviews with child victims of abuse a new angle on the tension between information elicitation and support.

PedHITSS: A Screening Tool to Detect Childhood Abuse in Clinical Settings

Though child abuse is prevalent and detrimental, health care providers fail to screen for abuse at sufficient rates to detect or preempt events. Current child abuse screening tools lack brevity and usefulness in clinical settings. To validate the Pediatric Hurt-Insult-Threaten-Scream-Sex (PedHITSS) screening tool, a 5-item questionnaire designed to detect and prompt provider investigation into child abuse in clinical settings, the PedHITSS was compared to the Conflict Tactics Scale: Parent-Child Version (CTSPC) screening measure. Participants included 422 pediatric patients (n=242 nonabused; n=180 abused subsample) recruited from an ambulatory care setting, a medical center at-risk referral clinic, or homeless shelter clinic. Parents were asked to complete a cross-sectional survey, including PedHITSS and CTSPC questionnaires. Concurrent validity of PedHITSS was tested with 242 participants identified as nonabused. Construct validity was assessed with 180 participants previously identified as victims of child abuse. Concurrent validity between the CTSPC and PedHITSS was strong, rs=.70 (P&lt;.01). Sensitivity and specificity for correctly identifying abuse victims (≤12 years) was optimal at a cutpoint of one or greater. There was no significant difference in sensitivity and specificity of HITSS and CTSPC in correctly identifying victims of child abuse. This study indicates that PedHITSS performs as well as CTSPC in identifying and differentiating victims and nonvictims of child abuse. PedHITSS allows health care providers to confidently screen and report suspected cases of child abuse and serves as a mechanism to confirm abuse status through validated means.

Self-Representation: Pro se Cross-Examination and Revisiting Trauma upon Child Witnesses

In the United States, the right to confront one’s accusers at trial is one of the key components of the adversarial legal process. As a part of this process, defendants are permitted to represent themselves if they decide to do so voluntarily (Faretta v. California 1975). As cross-examination of witnesses is considered essential to the adversarial legal system, child victims can be faced with being personally cross-examined by defendants. In cases involving vulnerable witnesses, such as child abuse victims, there is concern that being cross-examined by the defendant can be highly problematic and create more trauma over and above being cross-examined by a defense attorney. In the United States, there are no laws that explicitly forbid defendants from cross-examining their own victims, and decisions are made on a case-by-case basis. We discuss relevant legal traditions in the United States, laws and procedures followed by other countries that use the adversarial system, current psychological research on cross-examination of child witnesses, the need for further research, and recommendations for ways the United States can protect the rights, well-being, and personal security of vulnerable children.

“My Reality is Just Different From Yours, That Doesn’t Mean I’m Crazy.” Exploring the Impact of Childhood Emotional Abuse on Adult Emotional Adjustment

ABSTRACTChildhood emotional abuse (CEA) is a pervasive set of destructive behaviors that has negative effects lasting into adulthood. In order to examine these negative effects, it is important to determine the links between CEA and adult adjustment, i.e., how various forms of abuse are dealt with by the recipients, and how effective different coping strategies are. A small-scale online survey was developed that included questions designed to elicit both qualitative and quantitative data, to facilitate the collection of rich and useful data, while maintaining participant anonymity. The survey was disseminated via social media and a number of charitable organizations working with adult victims of child abuse. Using qualitative and quantitative analytical procedures, research findings suggested how childhood experiences of emotional abuse impact on adulthood. The findings also exposed a potentially effective coping strategy that could be incorporated into practice settings. The identified coping strategy, reading was reported as effective when employed in both childhood and adulthood and may help clients cope with abusive experiences.