Victims Of Child Abuse Research Articles

Mental Health and Substance Use Problems of Parents Involved With Child Welfare: Are Services Offered and Provided?

Mental Health and Substance Use Problems of Parents Involved With Child Welfare: Are Services Offered and Provided?

Young adult victims of sexual abuse in childhood or adolescence - cases study from the perspective of human development bioecology

Young adult victims of sexual abuse in childhood or adolescence - cases study from the perspective of human development bioecology

P02-256 Punitive parental discipline among adult victims of child abuse

Aims:It has been shown that abusive experiences in childhood may be related to specific behavior patterns manifested in adulthood, especially those that refer to negative parenting practices. The aim of this study was to assess the relationship between the use of punitive parental discipline and the childhood abuse trauma in parents.Method:Sixty six parents (30 males, 36 females, age 45.92±8.79 yrs, predominantly urban) completed the socio-demographic questionnaire, the Childhood Trauma Questionnaire (CTQ), and the punitive discipline self-report measure.Results:The frequency of use of punitive discipline between parents with and without the history of abuse was not significantly different (t=-1.298; p>0.05). The difference was not found neither among fathers (t=-0.047; p>0.05) nor among mothers (t=-1.951; p>0.05). Emotional abuse was the only type of childhood maltreatment related to the use of punitive discipline (r=0.393; p< 0.01). This relationship was found among both fathers (r=0.428; p< 0.05) and mothers (r=0.371; p< 0.05). In females, the use of punitive discipline was additionally related to the history of emotional neglect (r=0.379; p< 0.05).Conclusion:The findings may emphasize the need for identification and modification of the parental discipline strategies in adult victims of child emotional abuse and neglect.

Child Maltreatment in United States: An Examination of Child Reports and Substantiation Rates

AbstractChild maltreatment represents a serious threat to children's rights and is a grave problem in the US and around the world. It is the second leading cause of death for children in the US. Each year, hundreds of thousands of reports are made to child protective services across the US. A fraction of these reports are made by the alleged victims of child maltreatment. While research into maltreatment reporting has generally focused on adult reporters, research on reports made by children themselves has been largely ignored. Data from a national child maltreatment reporting system were analyzed to first describe and then compare reports of maltreatment made by the alleged child victim to other adult reporters. Results indicated that a minority of self-reports are substantiated by child protective services and that the type of maltreatment most often reported by the alleged child victim differed significantly from other adult reporters. Differences related to the gender, race and ethnicity of the child reporter were also found.

The present state of chid abuse in Korea and its system for child protection

An act of children's welfare was made in 1961 for the first time in Korea but it had been nothing but the name in view of practical impact to prevention of child abuse. Real undertakings of Child Abuse Prevention were commenced overtly since 2000 in Korea, when the law for children's welfare was revised to put protective settings for the victims and to establish criterion for children's safety. The history of Child Abuse Prevention is very short in Korea but the reporting cases increased very fast from 4,133 cases in 2001 up to 9,570 cases in 2008 with the enthusiastic activities from people of the associated organizations along with the national supports. But the portion reported by the mandated reporters such as teachers or doctors is still low compared to those of the developed countries. The National Child Protection Agency (NCPA) was founded in 2001 by the Ministry of Health and Welfare to prevent child abuse and to aid recovery of abused and neglected children including their families, through the cooperation of related organizations. NCPA refers reported cases of child abuse to appropriate local centers, operates a computer database system for case management, publicizes national reports of child abuse on a yearly basis and technically supports the Local Child Protection Agency (LCPA) by developing scales for assessment of child abuse and neglect and distributing programs for the education of mandatory reporters. LCPAs operate 24-hour telephone hotline, investigate and visit homes and provide in home services networking with local resources, and operate multidisciplinary teams for screening child abuse victims and supervising case management through multimodal systems. We summarized the present state of child abuse in Korea and reviewed the operating systems for child protection in this country. Through this article, we hope that medical peoples are to be informed on the seriousness of child abuse and to be able to devote themselves for the prevention of child abuse. (Korean J Pediatr 2009;52:1185-1193

Impaired Reproduction of Three-Dimensional Objects by Cocaine-Dependent Subjects

Impaired Reproduction of Three-Dimensional Objects by Cocaine-Dependent Subjects

An historical perspective on family violence and child abuse: Comment on Moloney et al, Allegations of Family Violence, 12 June 2007

This comment discusses the historical development of social attitudes, social science research, and approaches in the justice system towards allegations of spousal and child abuse. Until relatively recently, victims of child abuse and spousal violence were largely ignored by the justice system, mental health professionals and social science researchers, and these victims rarely disclosed. In the late twentieth century, heavily influenced by feminist advocates and researchers, spousal violence and child sexual abuse were ‘discovered’; there was growing understanding and support for victims, and a great increase in reporting of child and spousal violence. The increase in reporting by genuine victims was accompanied a less frequent but serious problem – cases of false and exaggerated allegations. While a gendered basis analysis of issues of spousal and child abuse remains valuable, there is a need for development of more sophisticated and differentiated understandings of intimate partner violence and child abuse.

Child Abuse and Neglect: A System That Still Needs Pediatric Leadership

Four decades ago, a group of pediatricians published landmark research that substantiated abuse and neglect as an issue worthy of society's attention, providing the catalyst for cultural change and milestone legislation.1 Although a generation of child advocates has made remarkable progress, children remain at risk, and pediatricians must remain leaders in protecting vulnerable children. Every year in the United States, an estimated 900000 children are determined to be victims of child maltreatment, and more than 1500 die secondary to abuse and neglect. To ensure their safety, every year 800000 American children spend time in foster care. In addition, although the $100 billion annual cost of child abuse and neglect to US society is insignificant when compared with the measure of human suffering, it is not a trivial sum. Included in the August and September issues of Pediatrics are 2 articles about the child abuse identification and reporting behaviors of pediatricians.2,3 The Child Abuse Reporting Experience Study (CARES), conducted by the American Academy of Pediatrics (AAP) Pediatric Research in Office Settings (PROS) Network, has provided evidence-based confirmation of the perceptions of professionals who have spent entire careers evaluating cases of suspected abuse and neglect. CARES investigators found that health care providers do not report all cases of suspected abuse, in large part because of concerns over best outcomes, given a system perceived as dysfunctional. Previous research has suggested that the results of the CARES, although certainly unsettling for pediatricians, seem to be part of a larger and consistent picture of child abuse reporting (or the lack thereof) by professionals who are mandated to report it. For example, in 1994, Tilden et al4 surveyed a wider variety of … Address correspondence to Edward Bailey, MD, NSMC/North Shore Children's, 57 Highland Ave, Salem, MA 01970. E-mail: enbailey{at}partners.org

The Presence of Bruising Associated With Fractures

To determine the occurrence of bruising near the site of fracture in a group of children with inflicted fractures. Case series. Two children's hospitals. Suspected child abuse victims with fractures. The presence of bruising and fracture in a single body region or appendage. The study included 192 children with inflicted fractures. No bruising was found in 111 (57.8%) of the study participants. Forty patients (20.8%) had bruising near the site of at least 1 fracture. Of these, bruising or subgaleal hematoma near the site of a skull fracture was seen most often, in 43.3% of patients. Bruising in association with extremity fractures was seen much less commonly, ranging from 3.8% (n = 2) of children with tibia fracture to 16.7% (n = 1) of children with fibula fracture. Rib fractures also were associated uncommonly with bruising. When skull fractures are excluded, 45 (8.1%) of 555 fractures had bruising near the fracture site, in 13 (6.8%) patients. In children with inflicted skeletal trauma, the fractured bones that most frequently have associated bruising are the skull bones. The presence of bruising near the fracture site is uncommon in extremity or rib fractures.

Making the most of information‐gathering interviews with children

AbstractBecause child abuse victims are often the only available sources of information about their experiences, extensive efforts have been made to understand how to maximize their informativeness. There is now broad international consensus regarding optimal interview practices, and broad awareness that children's informativeness increases when interviewers conduct developmentally appropriate interviews with children. In this paper, we (1) summarize current understanding of how children remember, retrieve, and communicate information and (2) discuss ways in which children's memory and reporting can be fostered using techniques designed to help children recount past experiences such as the Cognitive Interview, the Narrative Elaboration Technique, and the National Institute of Child Health and Human Development‐Protocol. Communicative success clearly depends on how well children understand their role and how effectively interviewers take advantage of children's competencies and abilities to help them maximize their informativeness. Unfortunately, agreement regarding ways in which interviews should be conducted has not been paralleled by changes in the way interviews are actually conducted in the field and more attention thus needs to be paid to training and implementation. Copyright © 2008 John Wiley & Sons, Ltd.

Do chronic conditions increase young children's risk of being maltreated?

Objective To examine whether and to what extent specific chronic health conditions place young children at risk of maltreatment. Methods The study used a sample of Illinois children (born between January 1990 and March 1996) who were through age 3 continuously enrolled in Medicaid, a public health insurance program for low-income families. The study used “paid claims” data and ICD-9-CM health codes to identify children with one or more of three chronic conditions: chronic physical illness, developmental delay/mental retardation (dd/mr), and behavior/mental health conditions (b/mh). The analysis used Cox proportional hazard models to estimate the risk of substantiated child maltreatment that each of these health conditions confer on children under age 6. Results Among children under age 6, 24.1% had chronic physical health conditions, 6.1% had b/mh conditions, and 4.2% had dd/mr. Among the children, 11.7% were maltreated (abused or neglected). Children with b/mh conditions were 1.95 times more likely than children without such conditions to be victims of child abuse or neglect. Children with chronic physical health conditions were 1.1 time more likely to be maltreated ( p ≤ .001). In contrast, children with dd/mr were not at an increased risk of maltreatment. Further, if the child had a prior history of abuse or neglect before age 3 and was also diagnosed with a behavioral health condition, that child was 10 times more likely to be maltreated again (relative risk of 9.2, p ≤ .0001). Conclusions Behavioral/mental health conditions placed low-income children under age 6 at the highest risk of abuse or neglect. Developmental delay/mental retardation, however, did not appear to increase the risk of maltreatment, while chronic physical health conditions increased the risk slightly among this group of children. Therefore, identified behavior/mental health in young, low-income children should be considered a risk factor for potential abuse to pediatricians and other health professionals. Child protection agencies should be trained to identify behavioral/mental health conditions of children. Practice implications Chronic behavioral/mental health conditions place young children at heightened risk of abuse or neglect. Early detection of mental or psychosocial health conditions is mandated by the Individuals with Disabilities Education Act (IDEA), a federal law that governs how state and public agencies provide services to children with disabilities. Given the higher risk of abuse and neglect among children with behavioral/mental health conditions, clinicians should give added scrutiny to these children. Child protection agencies should also be trained to identify behavioral/mental health conditions, and more states should record disability status in their abuse records.

Death, Child Abuse, and Adverse Neurological Outcome of Infants After an Apparent Life-Threatening Event

Apparent life-threatening events in infants constitute a significant challenge for health care providers. Apparent life-threatening event evaluation and management are poorly defined, and outcomes have not been clearly determined. Our objectives were to characterize short- and long-term risks for death, child abuse, and abnormal neurological outcomes of infants after an apparent life-threatening event and to identify clinical features that are predictive of these outcomes. We collected data from infants ages birth to 12 months of age who were hospitalized after an apparent life-threatening event during a 5-year time period. Patients were evaluated for subsequent death, child abuse, or adverse neurological outcome (chronic epilepsy or developmental delay). A total of 471 patients met inclusion criteria and were followed an average of 5.1 years. Two patients died after developing chronic epilepsy and severe developmental delay. Fifty-four (11%) patients were diagnosed as being a victim of child abuse, but only 2 were identified at initial presentation. There were 23 (4.9%) patients with adverse neurological outcomes, including 17 (3.6%) with chronic epilepsy and 14 (3.0%) with developmental delay. Of those who developed chronic epilepsy, 71% returned within 1 month of the initial apparent life-threatening event with a second event. Neurological evaluation at the time of the apparent life-threatening event had low yield for predicting those who would develop chronic epilepsy. Infants who suffer an apparent life-threatening event are at risk for subsequent child abuse and adverse neurological outcomes. Deaths were uncommon and only occurred in the setting of severe developmental delay and seizure disorders. Neurological evaluation during hospitalization for a first apparent life-threatening event is of low yield, but close follow-up is essential.

Using Colposcopy in the Rape Exam: Health Care, Forensic, and Criminal Justice Issues

In the setting of a forensic examination following rape, colposcopy allows practitioners to identify and photograph genital injury not readily visible to the unaided eye, thereby clarifying the location and extent of injury as well as providing evidence for court proceedings. Since the 1980s, the technique once reserved for victims of child abuse has been used across the lifespan and has been shown to identify genital injury in up to 87% of women who have been raped. The role of colposcopic findings as evidence in court testimony, however, remains controversial. This paper explores the history of colposcopy in the rape exam and describes the epidemiology of genital injury in consensual sex as well as rape.

Violence, Abuse, and Asthma in Puerto Rican Children

Puerto Ricans have the highest prevalence of and morbidity from asthma of all ethnic groups in the United States. One potential contributor to the high burden of asthma in Puerto Rican children is exposure to stress and violence. To examine whether exposure to stress and violence is associated with an increased risk of asthma among Puerto Rican children. This study was a population-based probability sample of children in the San Juan and Caguas metropolitan areas in Puerto Rico. Information was collected in a household survey of 1,213 children and their primary caretakers. The prevalence of lifetime physician-diagnosed asthma was 39.6%. In the year before the survey, 14% of children had witnessed an act of violence, 7% had been victims of violence, and 6% had been victims of physical or sexual abuse. Although stressful life events and exposure to neighborhood violence were not associated with asthma, a history of physical or sexual abuse was associated with approximately twice the odds of current asthma (odd ratio [OR], 2.52; 95% confidence interval [CI], 1.27-5.00), health care use for asthma (OR, 1.95; 95% CI, 0.96-3.96), and medication use for asthma (OR, 2.35; 95% CI, 1.05-5.26). Physical or sexual abuse is associated with high asthma morbidity among Puerto Rican children. To our knowledge, this is the first report of an association between childhood abuse and asthma. Our findings highlight the importance of screening for asthma among victims of childhood abuse, and to be aware of the possibility of physical or sexual abuse among children with asthma.

A Case of Traumatic Osteomyelitis in a Victim of Child Abuse

A premature black female infant born at 31 weeks gestation with history of 4 weeks in the newborn intensive care unit was discharged healthy to the care of her mother and was lost to follow-up. At age 4 months the infant was found dead in bed. There was no history of trauma and no external injuries were noted. There was no attempt at resuscitation. Coroner's autopsy showed acute bronchopneumonia, 3 partially healed skull fractures, a chronic subdural hematoma, chronic intracerebral hemorrhage, retinal hemorrhages, multiple healing rib fractures, a fractured fibula, and a partially healed fracture of the distal right radius. The fracture of the right radius showed a medullary abscess of the bone surrounded by scar tissue and containing pus and granulation tissue. We believe this inflicted fracture became secondarily infected by a hematogenous route. The final diagnosis of the cause of death was pneumonia secondary to multiple blunt force trauma, and the manner of death was diagnosed as homicidal. This is believed to be the first reported case of osteomyelitis in a context of child abuse.

An examination of the types of leading questions used by investigative interviewers of children

PurposeThe purpose of this paper is to examine the nature of leading questions used by a representative sample of investigative interviewers of children. In particular, it examined whether these interviewers use the type of questions that are known to elicit reports of false activities or events among child samples.Design/methodology/approachA total of 82 police officers who were authorized to conduct interviews with alleged child abuse victims conducted individual mock interviews with children aged 5‐7 years. The focus of the interviews was an event that was staged in the children's school a week earlier. Prior to the interview, each officer was provided with accurate and inaccurate information about the event, including details about an activity that did not occur. The officers' task was to elicit as detailed and accurate account of the event as possible using the techniques they would “normally” use in the field.FindingsAlthough the officers refrained from using coercive interview techniques, two problematic types of questions were relatively common. These include: questions that presumed that an activity/detail occurred that had not been previously mentioned by the child; and questions that included highly specific details about an activity. Both of these techniques had featured in prior laboratory research on children's false event narratives.Research limitations/implicationsThese results support the need for better training techniques for assisting officers to avoid the use of leading questions.Originality/valueWhile it is well established that investigative interviewers do sometimes use leading questions when interviewing children, this is the first study to specify the incidence of various types of leading questions.

Substance Abuse, Chronic Sorrow, and Mothering Loss: Relapse Triggers Among Female Victims of Child Abuse

The purpose of this qualitative study was to explore chronic sorrow as a relapse trigger among female victims of child abuse seeking treatment for substance abuse relapse. A purposive convenience sample of 12 women was interviewed using qualitative description to provide insight into their perceptions of relapse triggers. In addition to chronic sorrow, three common themes were interwoven in the narrative stories of these women: mothering loss, blocking feelings, and relapse triggers. Feelings described as relapse triggers included loneliness, sadness, anger, and frustration. The information gleaned from these women can be incorporated into the treatment of women and children in an effort to better prepare them for these recurrent feelings and triggers that could result in substance abuse and relapse.

The Impact of Public Housing Policy on Family Social Work Theory and Practice

ABSTRACT Social workers are the professionals most engaged with families living in low-income and subsidized housing and most familiar with the problems associated with inadequate housing. Yet the discussion of public housing policy has been left largely to economists and housing activists and the clear implications for family social work practice have not been made clear. To connect these critical policy and practice issues, this article provides a theoretical foundation and a review of the research supporting the use of housing vouchers to combat race and class segregation, joblessness, family breakdown, inferior public services, child abuse, mental illness and crime victimization.

The Cumulative Burden Borne by Offspring Whose Mothers Were Sexually Abused as Children

This multigenerational study empirically demonstrates the extent to which offspring whose parents experienced childhood abuse are at increased risk of being abused or neglected. Females with substantiated childhood sexual abuse and non abused comparison females were assessed at six points spanning 18 years in a prospective, longitudinal study. Non abusing parents or caregivers and offspring were also assessed. Descriptive results indicate that offspring born to mothers with histories of sexual abuse were more likely to be born preterm, have a teenage mother, and be involved in protective services. Abused mothers were more likely to be high-school dropouts, be obese, and have experienced psychiatric problems, substance dependence, and domestic violence. Results provide evidence for the advantages of intervention and prevention programs for victims of childhood maltreatment and their families. Primary prevention/intervention efforts extending throughout development and focusing on the cumulative risk to offspring will likely improve victim outcomes and curtail intergenerational transmission of adversity.

The neuroendocrinological sequelae of stress during brain development: the impact of child abuse and neglect

Severe stress during the sensitive periods of neurodevelopment, (which include the prenatal period, infancy, childhood and adolescence), has a long-lasting organizing effect on the brain and stress axes. Child abuse and neglect thus exert a cumulative harmful effect on neuroendocrinological development, which persists into adulthood. It is not merely the memory of the trauma which leaves a mark, but rather the effect on neurodevelopment which negatively influences the ability of adult survivors of childhood maltreatment to cope with current stressors. The victims of child abuse and neglect are likely to maltreat their own children and so perpetuate the intergenerational transmission of child maltreatment. In this paper relevant normal brain development is first summarized. Child abuse/neglect is next discussed with detailed reference to the aberrant neuroendocrinological development that is known to occur. We specifically examine effects on the hypothalamo-pituitary-adrenal and central noradrenergic-sympathoadrenomedullary stress axes and other neurotransmitter systems before turning to changes described in the cerebral volumes, corpus callosum and cortical hemispheres, prefrontal cortex and amygdalae, superior temporal gyrus, hippocampus as well as the cerebellar vermis.