High Risk For Child Abuse Research Articles

A comparison of the psychological resources of adolescents at low and high risk of mistreating their children

<h2>Abstract</h2> <b>Objective:</b> Our objective was to compare the psychological resources of pregnant teenagers who are at low and high risk for mistreating their children. <b>Method:</b> We studied 71 participants in a comprehensive, adolescent-oriented maternity program. During the prenatal period, the Family Stress Checklist was used to quantify child abuse potential, with scores ≥25 defining high risk. Information about the social context of the pregnancy and maternal psychological resources was obtained with self-administered questionnaires. A composite psychological resource variable was computed by summing the <i>z</i> scores for intelligence, mental health, and mastery, with scores ≤0 defining the low-resource group. <b>Results:</b> Of the 71 teenagers, 26 (36.6%) were classified as high risk for child abuse and neglect. Compared with low-risk teens, high-risk teens had more behavioral problems, lower psychological resource scores (mean ± SD of <i>z</i> score: −0.98 ± 2.02 compared with 0.39 ± 1.79; <i>P</i> =.004), and were more likely to have low psychological resources (69.2% compared with 44.4%; <i>P</i> =.04). <b>Conclusions:</b> Pregnant teenagers who are at risk for child abuse and neglect exhibit fewer psychological resources than their low-risk peers do, and may therefore benefit preferentially from intensive, in-home intervention. J Pediatr Health Care. (2001). <i>15,</i> 299-303.

Poor adolescent expectant mothers: can we assess their potential for child abuse?

To explore the correlates of high scores on the Child Abuse Potential Inventory in adolescent expectant mothers. Child Abuse Potential scores and data on demographics, pregnancy desire, history of maltreatment, psychological functioning, and perceived social support were obtained by self-report and semi-structured interview. The sample consisted of 50 poor single adolescents recruited from prenatal clinics during the second half of the pregnancy. The relationships among the variables were assessed using Pearson product-moment correlation and multiple regression strategies. Higher Child Abuse Potential scores were associated with higher maternal psychological distress, maternal history of psychiatric diagnosis, and lack of perceived support by the father of the baby. Older pregnant teenagers were more likely to report childhood history of maltreatment, higher psychological distress, and perceived and expected less support by the maternal mother. Expectant mothers who were raised by a single parent were more likely to have a history of childhood maltreatment, less likely to live with the father of the baby during their pregnancy and to expect less support from him. Child Abuse Potential scores, obtained during pregnancy in a sample of poor single adolescents provide a marker of maternal prenatal functioning and perceived social support. Further studies are warranted to validate prenatal use of the Child Abuse Potential Inventory (CAPI), which may help identify populations at particularly high risk for child abuse during pregnancy and inform strategies for early preventive interventions. Adolescent education on family planning, child rearing, and social support programs should address the importance of the fathers' role.

Adolescents at risk for mistreating their children: Part II: a home- and clinic-based prevention program

Objective: To determine if adding an intensive home visitation component to a comprehensive adolescent-oriented maternity program prevents child abuse and neglect. Methods: We studied 171 participants in a comprehensive, adolescent-oriented maternity program who were deemed to be at high risk for child abuse and neglect. Half were randomly assigned to receive in-home parenting instruction. Major disruptions of primary care-giving by the adolescent mother were classified hierarchically as abuse, neglect, and abandonment. Results: Compliance with home visits varied in relation to the support the teenage mothers received from their families and the fathers of their babies ( p < .0001). There were no significant treatment group differences in the pattern of health care utilization, the rate of postpartum school return, repeat pregnancies, or child abuse and neglect. The incidence of maltreatment rose in tandem with the predicted risk status of the mother. Ultimately, 19% of the children were removed from their mother’s custody. Conclusions: Prediction efforts were effective in identifying at-risk infants, but this intensive home-and clinic-based intervention did not alter the incidence of child maltreatment or maternal life course development. A parenting program that was more inclusive of the support network might be more popular with teenagers and therefore more effective. Our findings also emphasize the importance of including counseling specifically designed to prevent teenagers from abandoning their children.

Psychometric Assessment of the Adult-Adolescent Parenting Inventory in a Sample of Low-Income Single Mothers

The Adult-Adolescent Parenting Inventory (AAPI) is a 32-item inventory widely used to identify adolescents and adults at risk for inadequate parenting behaviors. It includes four subscales representing the most frequent patterns associated with abusive parenting: (a) Inappropriate Expectations; (b) Lack of Empathy; (c) Parental Value of Corporal Punishment; and (d) Parent-Child Role Reversal. Although it has been used in a variety of samples, the psychometric properties of the AAPI have not been examined in low-income single mothers. The purposes of this study were to: (a) examine the reliability and validity of the Adult-Adolescent Parenting Inventory (AAPI) in a sample of 206 low-income single mothers; (b) assess the mother's risk for inadequate parenting by comparing their AAPI subscale scores with normative subscale scores on the AAPI; (c) assess the construct validity of the AAPI by testing the hypothesis that mothers with lower AAPI scores have a higher level of depressive symptoms and lower self-esteem in comparison to mothers with higher AAPI scores; and (d) determine whether the 4-factor structure proposed by Bavolek (1984) could be replicated. AAPI scores indicated these mothers were at high risk for child abuse when compared with normative data for parents with no known history of abuse. Higher risk for abusive parenting was associated with a higher level of depressive symptoms, less education, and unemployment. The subscales, Inappropriate Expectations and Parental Value of Corporal Punishment demonstrated poor internal consistency with Cronbach's alphas of .40 and .54, respectively. Hypothesis testing supported the construct validity of the AAPI. Bavolek's 4-factor structure was not supported. A 19-item modified version of the AAPI with three dimensions was identified. This modified version of the AAPI may provide a more efficacious tool for use with low-income single mothers.

Childhood history of abuse and child abuse potential in adolescent mothers: a longitudinal study

Objectives: The purpose of this research was to determine whether adolescent mothers of newborns are at higher risk for child abuse than adult mothers of newborns and to examine whether adolescent mothers with memories of child maltreatment have a higher risk for child abuse. Method: Two groups (adolescents and adults) of pregnant mothers were followed for 20 months beginning between the 5th and the 7th month of pregnancy until the child was 18 months old. Adolescent ( N = 24) and adult ( N = 24) mothers were matched on sociodemographic variables. During pregnancy, memories of child maltreatment were evaluated. When child was 1, 6, 12, and 18 months old, risk for child abuse was evaluated. Results: Adolescent and adult mothers showed no differences in memories of childhood physical or emotional abuse. Nevertheless, adolescent mothers showed higher child abuse potential and depression scores than adult mothers. Mothers with memories of severe physical punishment showed higher child abuse potential scores and mothers with memories of physical punishment producing physical damage showed higher child abuse potential and depression scores. A statistically significant age of the mother by physical punishment producing physical damage interaction was found for depression. Conclusions: The results of this longitudinal study indicated that the potential for abuse was significantly greater in adolescent mothers than in adult mothers, and in mothers who had been victims of physical abuse than in those who had not. It also appeared that, among adolescent mothers, those who had been victims of childhood physical abuse constitute a higher risk group for child physical abuse.

The Relationship of Maternal Adult Attachment Style and Risk of Physical Child Abuse

The present study assessed maternal adult attachment style and the specific adult attachment attitudes and behaviors of mothers as factors in physical child abuse risk. Interviews were conducted with 48 single mothers who were receiving government assistance and had a child of preschool age. Participants' child abuse risk potential was determined by their responses or performance on several instruments previously found to discriminate between abusive and adequate mothers. Mothers with an insecure adult attachment style (ambivalent or avoidant) were at significantly higher risk for child abuse than mothers with a secure attachment style. The role of several attachment-related dynamics (i.e., trust difficulties, jealousy or clinging behaviors, ambivalence in relationships, frustration with partners, and fear of abandonment) in physical child maltreatment dynamics are discussed.

Risk assessment in child abuse prevention program

j Karen McCurdy ; MA, is principal analyst, National Committee to Prevent Child Abuse, 332 South Michigan Avenue, Suite 1600, Chicago, IL 60604. With tims child have States over of been protective in child 1 1992 overwhelmed million maltreatment (McCurdy services children by & (CPS) confirmed the in Daro, the number agencies United 1994), vicof tims of child maltreatment in the United States in 1992 (McCurdy & Daro, 1994), child protective services (CPS) agencies have b n v rwh lm d by he umb r o children in need of both protection and treatment services. Experts in the field have begun to acknowledge the need for prevention in addition to child protection and treatment services to stem the increasing incidence of maltreatment ( Ayoub, Willett, & Robinson, 1992; U.S. General Accounting Office, 1992). To address this problem, many agencies have begun to target prevention services to high-risk communities with elevated levels of child abuse and other negative health outcomes for children. This strategy attempts to efficiently use scarce resources by focusing on the areas thought to be in greatest need of prevention services. Determining which families in such communities are at high risk for child abuse has proved, however, to be a complex and challenging undertaking. Numerous theoretical models exist that suggest that certain personal, familial, and environmental factors contribute to an increased likelihood of maltreatment. For example, learning theories suggest that individuals who have been raised in abusive or neglectful environments or have had limited experiences with positive relationships are likely to replicate these parenting behaviors with their own children (Steele, 1987). Individuals under stress or lacking the emotional or financial capacity to deal with the demands of child rearing may lash out at their children (Straus & Kantor, 1987). Still others argue that social policies that fail to nurture positive human interactions and leave communities without adequate social, health, or educational infrastructures create an environment ripe for abusive and violent behaviors (Garbarino, 1988). These theories have led to the development of various risk assessment models, most of which have been directed toward predicting a parent's likelihood of reabusing his or her child (McDonald & Marks, 1991; Schene & Bond, 1989). CPS agencies in at least 42

Preventing Physical and Emotional Abuse of Children

Since the early 1960s, views on the primary causes of child abuse and neglect have changed considerably. The traditional assumption was that anyone who abused or neglected a child had to be abnormal or disturbed. Now, it is widely recognized that normal people under the pervasive influences of socio-economic disadvantage, cultural sanctioning of violence, and the break up of the nuclear family can be at high risk for child abuse or neglect. As these societal problems are not likely to abate in the near future, this book proposes that mental health professionals must play a larger role in helping parents and children establish healthier, violence-free relationships. Written to assist practitioners and students who regularly deal with at-risk families, it offers practical techniques and programmatic strategies for early intervention and treatment. The premise of this volume is that child abuse prevention is best achieved by maximizing the child's developmental abilities and strengthening the parent-child relationship. Laying the groundwork for this early intervention approach, the book opens with a definition of physical and emotional abuse in both legal and clinical terms, a discussion on the goals and boundaries of parental discipline, and a demographic profile of abusive families. Following an examination of why abusive behavior occurs, the impact of physical and emotional abuse on children's development, and what that implies for primary and secondary prevention, the author presents an intervention model linked to critical transition periods for family members. The program's practical requirements are enumerated and chapters describe how to: introduce families to the clinic, communicate concerns, delineate parental responsibilities, and establish peer group support and social services. Assessment procedures are detailed with an emphasis on the importance of identifying parental expectations so that treatment can be tailored to fit the needs of the family. Chapters on intervention describe methods for promoting parental sensitivity and responsiveness to child behavior and improving parental teaching, discipline, and anger management skills. Throughout, case examples and excerpts of therapist-client discussion illuminate both issues and technique. Presenting effective ways to help potentially abusive families change, this book is indispensable for a wide array of social service and mental health professionals. It complements today's reemphasis on maintaining integrity of the family, as opposed to out-of-home placements, and provides professionals with potent strategies for preventing child abuse and neglect.

Heightened Child Physical Abuse Potential

This study evaluates child, parent, and family factors related to parents' heightened potential for child physical abuse. Mothers ( n = 113) of child psychiatric patients and nonpatients (ages 6-13) were classified as being at low, moderate, or high risk for child abuse. Group comparisons revealed that high-abuse-potential mothers reported greater child externalizing and depressive symptoms, child rejection, personal psychological dysfunction, stressful life events, and family problems, but there were few differences in reports of parent management practices or family violence. Child reports indicated a few group differences in child dysfunction and violence. The results are in accord with interactional models and extend prior research by elaborating possible correlates of physical abuse.

MMPI-2 Profiles of Women at Risk for Child Abuse

This study addresses the utility of the MMPI-2 in assessing personality characteristics of women who have a high potential for abusing their children. A sample of 154 women was identified on the basis of demographic characteristics as high risk for child abuse and other care-taking problems. They were evaluated (with the MMPI-2-AX form) during their pregnancy and are being followed up as part of the evaluation of a prevention/intervention program. This preliminary study compares the MMPI-2 personality characteristics of 146 of these women with several control samples: 1,462 women from the MMPI restandardization sample, 466 low education women from the restandardization sample, 84 pregnant women from the restandardization sample, and 167 women military recruits who are about the same age as the experimental group. The results show that, on the MMPI-2 clinical scales, women from the high-risk sample closely resemble child-abusing parents described in the previous MMPI literature. Moreover, these women differed significantly from all of the comparison groups on a number of MMPI-2 clinical and content scales. The clinical implications of these differences are discussed.

A Family Focus approach to child abuse prevention

Family Focus is a child abuse prevention program established to assist families in the task of raising their children from birth through 3 years. Its goal is to prevent child abuse by reducing isolation, improving emotional support systems and increasing parental knowledge of child behavior and effective child management skills. It strives to be viewed by the community as a positive family resource center with its services available to any interested parent, not just those identified as being at high risk for child abuse. Family Focus provides playgroups, parent education classes and other resources. The "Infant Program" was added to the program to provide outreach and follow-up services to parents and their high risk infants birth to 2 years.

Primary prevention of child abuse: focus on the special child.

The authors review the literature on child abuse and present evidence demonstrating that children who are born prematurely or who are sickly or handicapped are at high risk for child abuse. The authors describe ways to identify such children and suggest a number of primary prevention techniques that can reduce parental stress and help prevent child abuse. The techniques include day-care programs for handicapped children, mothers' social clubs, and lay health visitors to give support and impart proper maternal attitudes.