Survivors Of Child Maltreatment Research Articles

Survivors of Child Maltreatment and Postpartum Depression: An Integrative Review

An integrative review was performed to explore the relationship between a maternal history of child maltreatment and subsequent postpartum depression (PPD) symptoms. Six electronic databases were used to explore the literature, including PubMed, CINAHL, MEDLINE, PsycINFO, Embase, and Scopus. Studies were included that used victims of child maltreatment as one of the independent variables and PPD symptoms as one of the dependent variables. Studies were excluded if they focused only on women with adult intimate partner violence or women with PPD who were perpetrators of child abuse rather than survivors. The studies were required to be original research, and there was no limit to years or language. The search yielded 589 studies, 16 of which were included in the final sample. These studies were assessed for quality, and a data display matrix was developed to extract the sample, design, methods, operational definitions for independent and dependent variables of interest, major findings with effect sizes, and limitations. Using the data display matrix, the studies' methods and findings were synthesized for divergent and convergent patterns. Studies were varied in their designs, samples, and operational definitions of child maltreatment and PPD, and were low to moderate in quality. Results were inconsistent, but a majority suggest a positive association between a maternal history of child maltreatment and subsequent symptoms of PPD. Child maltreatment and PPD are complex issues that require careful screening by women's health care providers and clearly defined operational definitions in future research. Implications for clinical practice and research are discussed.

Quality of life in maltreated children and adult survivors of child maltreatment: a systematic review.

To review data on health-related quality of life (HRQoL) in individuals with childhood trauma, including psychological maltreatment, physical maltreatment, sexual abuse, and neglect. The literature search was conducted with pre-defined keywords using the following electronic bibliographic databases: EMBASE, PubMed, MEDLINE, CINAHL, PsyINFO, PSYNDEX, and Cochrane Database of Systematic Reviews. Further databases were searched for relevant dissertations. Study selection and data extraction were completed by two independent reviewers. The literature search yielded 1568 entries. Nineteen articles met all inclusion criteria and were retained for further analysis. Findings quite consistently showed significant negative associations between child maltreatment and both self- and proxy-rated HRQoL. Effect sizes range from small to large. Number of types of maltreatment and HRQoL were found to be negatively related. Data on HRQoL for maltreated children are still rare. Studies often investigate adult survivors of child maltreatment. Considering HRQoL in children and adolescents who suffered maltreatment would allow the planning of effective interventions and the evaluation of treatments to improve HRQoL of these children.

The Child Maltreatment Survivor's Description of the Process of Becoming a Parent: A Grounded Theory Study

This research study was conducted to investigate the processes experienced by survivors of child maltreatment as they became parents. The study utilized a grounded theory approach to answer the research question, “How do survivors of child maltreatment experience the process of becoming a parent?” The goal of the study was to generate a theory about the actions, interactions, and emotions experienced by survivors of child maltreatment as they became parents. It was the intention of this study to enhance the knowledge base of the psychological profession. The research problem, the methodology chosen to answer the research question, and the findings of the data analysis are discussed in detail, as well as how the results of the research study relate to past research findings on the topic and the field of psychology. The results of this research study indicate that child maltreatment survivors desire to achieve an evolved parental identity, more specifically a parental identity that was a more developed form of the parental identity that had been achieved by the abusive parent(s) that served as their role model in childhood. The context and processes, as well as the factors identified as influential during the transition to parenthood, that influenced child maltreatment survivor’s ability to meet their goal of acquiring an evolved parental identity are also discussed.

Adult Sexual Experiences as a Mediator Between Child Abuse and Current Secretory Immunoglobulin A Levels.

The current study investigated whether a history of child abuse is a predictor of adult immune status, with unwanted adult sexual experiences as a proximal mediator. Participants included 89 young adult women (M(age) = 19.24) who were classified as having experienced no child abuse, child physical abuse, or child sexual abuse, based upon self-reported victimization history before 14 years of age. Participants also reported on unwanted sexual experiences in young adulthood and provided four saliva samples, which were collected over two consecutive days to determine secretory immunoglobulin A (sIgA). Age and negative life events were considered as covariates. The results indicated that adult sexual victimization partially mediated the relationship between child abuse (physical and sexual) and sIgA. Specifically, child abuse experiences predicted more adult sexual victimization experiences, which in turn predicted lower sIgA levels. These findings support long-term health effects of victimization, and suggest that the influence of child abuse on sIgA may be perpetuated through adult victimization. Prevention efforts should aim to empower child maltreatment survivors with skills to prevent adult re-victimization. By thwarting future unwanted sexual experiences in adulthood, individuals will be better protected from the health impairments associated with early abuse experiences.

Treatment Beliefs and Techniques of Clinicians Serving Child Maltreatment Survivors

A significant focus in the child maltreatment field is greater dissemination and implementation of evidence-based treatments (EBTs). Research has attempted to identify attitudes toward EBTs and training experiences that predict clinicians' use of EBTs; however, these findings have yielded mixed results. This study reports on the results of a nationwide (United States) sample of 256 clinicians serving child maltreatment survivors, who completed questionnaires assessing beliefs about the clinical process, treatment technique selection, and attitudes toward EBTs. Psychometric data are presented on two new scales. The first scale examines clinicians' beliefs about two components of the clinical process: (1) the extent to which treatment should be structured/directed by the clinician and (2) children's verbal capacity to discuss traumatic events. The second scale assesses clinician-reported selection of various treatment techniques and contains four subscales: Cognitive-Behavioral, Play/Experiential, Psychodynamic, and Uncommon. Using these scales, a series of analyses were performed to determine which attitudes, beliefs, and training variables were associated with the selection of treatment techniques. After controlling for the impact of other variables, significant associations between the two clinical process beliefs and cognitive-behavioral and play/experiential techniques utilization were observed. Implications of these results for increasing implementation of EBTs with child maltreatment survivors are discussed.

Psychiatric Nursing Care for Adult Survivors of Child Maltreatment: A Systematic Review of the Literature

To determine what is known from the literature about nursing care of psychiatric patients with a history of child maltreatment. Psychiatric nurses underline the importance of a routine inquiry of child abuse on admission of patients to psychiatric care, but are reluctant to ask about child abuse. They often feel insufficiently competent to respond effectively to patients with a history of child maltreatment. Psychiatric nurses need training in how to assess a history of child abuse and the late-life consequences of abuse in adult psychiatric patients. They also need to be trained to respond effectively to these patients.

Intergenerational transmission of abuse: Implications for parenting interventions from a neuropsychological perspective.

Neuroimaging provides robust evidence to demonstrate the functional and structural deficits in childhood and adult survivors of child maltreatment. These deficits mirror the neurocircuitry involved in parenting. Despite this, research into the mechanisms behind the intergenerational transmission of abuse fails to acknowledge the contribution of brain development on future parenting ability. A discussion of the cognitive, social, and emotional deficits of child and adult survivors of childhood maltreatment is presented. This is followed by a critical overview of how current parenting interventions fail to take into account the neuropsychological mechanisms behind the intergenerational transmission of abuse. A conceptual model of the neuropsychological transmission of childhood maltreatment is presented. This model will allow child welfare practitioners to gain a greater understanding of the specific deficits of individuals who have experienced childhood maltreatment and how parenting interventions may be enhanced for this population. This represents one step forward in breaking the cycle of the intergenerational transmission of childhood maltreatment.

Child maltreatment severity and adult trauma symptoms: Does perceived social support play a buffering role?

ObjectivesThe current study investigates the moderating effect of perceived social support on associations between child maltreatment severity and adult trauma symptoms. We extend the existing literature by examining the roles of severity of multiple maltreatment types (i.e., sexual, physical, and emotional abuse; physical and emotional neglect) and gender in this process. MethodsThe sample included 372 newlywed individuals recruited from marriage license records. Participants completed a number of self-report questionnaires measuring the nature and severity of child maltreatment history, perceived social support from friends and family, and trauma-related symptoms. These questionnaires were part of a larger study, investigating marital and intrapersonal functioning. We conducted separate, two-step hierarchical multiple regression models for perceived social support from family and perceived social support from friends. In each of these models, total trauma symptomatology was predicted from each child maltreatment severity variable, perceived social support, and the product of the two variables. In order to examine the role of gender, we conducted separate analyses for women and men. ResultsAs hypothesized, increased severity of several maltreatment types (sexual abuse, emotional abuse, emotional neglect, and physical neglect) predicted greater trauma symptoms for both women and men, and increased physical abuse severity predicted greater trauma symptoms for women. Perceived social support from both family and friends predicted lower trauma symptoms across all levels of maltreatment for men. For women, greater perceived social support from friends, but not from family, predicted decreased trauma symptoms. Finally, among women, perceived social support from family interacted with child maltreatment such that, as the severity of maltreatment (physical and emotional abuse, emotional neglect) increased, the buffering effect of perceived social support from family on trauma symptoms diminished. ConclusionsThe results of the current study shed new light on the potential for social support to shield individuals against long-term trauma symptoms, and suggest the importance of strengthening perceptions of available social support when working with adult survivors of child maltreatment.

Resilience in Elderly Survivors of Child Maltreatment

Resilience is a multifaceted construct that refers to the positive adaptation of individuals, despite exposure to adversity. This study of resilience in older individuals who have experienced adversity was conducted to deepen the understanding of the factors that contribute to resilience in this population. This qualitative study used purposive and homogeneous sampling criteria to recruit nine participants above the age of 65 with a past history of childhood maltreatment who were judged by their health care professionals to be unusually resilient. Resilience was found to be highly evident in this sample, despite earlier trauma and the subsequent challenges of old age. The authors found active engagement in relationships and in valued activities to be the most often mentioned contributors to resilience in these older survivors of childhood maltreatment. These findings have important implications for public policy and social interventions to preserve the well-being of older individuals who have experienced adversity.

Child Maltreatment and the Transition to Adult-Based Medical and Mental Health Care

Child maltreatment is a public health problem with lifelong health consequences for survivors. Each year, >29 000 adolescents leave foster care via emancipation without achieving family permanency. The previous 30 years of research has revealed the significant physical and mental health consequences of child maltreatment, yet health and well-being have not been a priority for the child welfare system. To describe the health outcomes of maltreated children and those in foster care and barriers to transitioning these adolescents to adult systems of care. We reviewed the literature about pediatric and adult health outcomes for maltreated children, barriers to transition, and recent efforts to improve health and well-being for this population. The health of child and adult survivors of child maltreatment is poor. Both physical and mental health problems are significant, and many maltreated children have special health care needs. Barriers to care include medical, child welfare, and social issues. Although children often have complex medical problems, they infrequently have a medical home, their complex health care needs are poorly understood by the child welfare system that is responsible for them, and they lack the family supports that most young adults require for success. Recent federal legislation requires states and local child welfare agencies to assess and improve health and well-being for foster children. Few successful transition data are available for maltreated children and those in foster care, but opportunities for improvement have been highlighted by recent federal legislation.

Daughters’ Obligation to Care in the Context of Past Abuse

Using theoretical sampling, we extended a previous grounded theory study of women's caring through interviews with 16 women currently giving care to parents who had abused them as children to more fully understand daughters’ obligation to care in the context of past abuse. Past relationship was characterized by emotional distance, “never being good enough,” degradation, control, and unpredictability. Obligation to care was grounded not only in duty to others but also in duty to self. Caregiving was seen as an opportunity for validation and reconciliation. These findings advance knowledge by illuminating how survivors of child maltreatment become caregivers for their abusers.

Measuring health-related quality of life for child maltreatment: a systematic literature review

BackgroundChild maltreatment causes substantial morbidity and mortality in the U.S. Morbidity associated with child maltreatment can reduce health-related quality of life. Accurately measuring the reduction in quality of life associated with child maltreatment is essential to the economic evaluation of educational programs and interventions to reduce the incidence of child maltreatment. The objective of this study was to review the literature for existing approaches and instruments for measuring quality-of-life for child maltreatment outcomes.MethodsWe reviewed the current literature to identify current approaches to valuing child maltreatment outcomes for economic evaluations. We also reviewed available preference-based generic QOL instruments (EQ-5D, HUI, QWB, SF-6D) for appropriateness in measuring change in quality of life due to child maltreatment.ResultsWe did not identify any studies that directly evaluated quality-of-life in maltreated children. We identified 4 studies that evaluated quality of life for adult survivors of child maltreatment and 8 studies that measured quality-of-life for pediatric injury not related to child maltreatment. No study reported quality-of-life values for children younger than age 3.Currently available preference-based QOL instruments (EQ-5D, HUI, QWB, SF-6D) have been developed primarily for adults with the exception of the Health Utilities Index. These instruments do not include many of the domains identified as being important in capturing changes in quality of life for child maltreatment, such as potential for growth and development or psychological sequelae specific to maltreatment.ConclusionRecommendations for valuing preference-based quality-of-life for child maltreatment will vary by developmental level and type of maltreatment. In the short-term, available multi-attribute utility instruments should be considered in the context of the type of child maltreatment being measured. However, if relevant domains are not included in existing instruments or if valuing health for children less than 6 years of age, direct valuation with a proxy respondent is recommended. The choice of a proxy respondent is not clear in the case of child maltreatment since the parent may not be a suitable proxy. Adult survivors should be considered as appropriate proxies. Longer-term research should focus on identifying the key domains for measuring child health and the development of preference-based quality-of-life instruments that are appropriate for valuing child maltreatment outcomes.

Clinical Assessment of Child Victims and Adult Survivors of Child Maltreatment

In the last 2 decades, various forms of child maltreatment, including physical abuse, sexual abuse, psychological abuse, and neglect, have gained the increased attention of the general public and mental health professionals. In this article, the authors review relevant literature to assist counselors in conducting quality clinical assessments of child victims and adult survivors of child maltreatment. Guidelines are discussed, and specific measures and procedures are recommended.

Survivors of child maltreatment: Diagnostic formulation and therapeutic process.

Survivors of child maltreatment: Diagnostic formulation and therapeutic process.