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1.
BackgroundAlthough prior research has indicated that sexual behavior problems (SBPs) are present among maltreated and non-maltreated children, risk factors for SBPs remain understudied. Further, few studies have examined multiple forms of trauma such as exposure to community violence and several likely important familial and environmental factors have yet to be investigated in the context of SBPs. The use of a more comprehensive ecological model of child, trauma-related, family, and environmental risk factors may help to further delineate the factors that contribute to the development of SBPs.ObjectiveThe aim of the current study was to build upon previous research by utilizing an ecological model that includes child, trauma-related, caregiver and familial, and environmental factors as potential predictors of SBPs.Participants and SettingThe present study was conducted with 1,112 8-year-old children (51.6% female; 48.9% Black) and their primary caregivers from the Longitudinal Studies in Child Abuse and Neglect (LONGSCAN) study.ResultsSeveral child, caregiver, and familial factors, as well as sexual and physical abuse demonstrated bivariate associations with SBPs. A number of these factors remained significant in a regression model, such as child’s living arrangement, child’s aggressive behaviors and posttraumatic stress symptoms (PTSS), sexual and physical abuse, caregiver’s psychological difficulties, and children’s perceptions of family health.ConclusionsThe findings highlight the role of select child, trauma-related, caregiver and familial, and environmental factors in the context of SBPs and also demonstrate the need to examine multiple levels of children’s environments when investigating SBPs. 相似文献
2.
《Child abuse & neglect》2014,38(9):1533-1539
To assess the quality and diagnostic accuracy of pediatric sexual abuse forensic examinations conducted at rural hospitals with access to telemedicine compared with examinations conducted at similar hospitals without telemedicine support. Medical records of children less than 18 years of age referred for sexual abuse forensic examinations were reviewed at five rural hospitals with access to telemedicine consultations and three comparison hospitals with existing sexual abuse programs without telemedicine. Forensic examination quality and accuracy were independently evaluated by expert review of state mandated forensic reporting forms, photo/video documentation, and medical records using two structured implicit review instruments. Among the 183 patients included in the study, 101 (55.2%) children were evaluated at telemedicine hospitals and 82 (44.8%) were evaluated at comparison hospitals. Evaluation of state mandatory sexual abuse examination reporting forms demonstrated that hospitals with telemedicine had significantly higher quality scores in several domains including the general exam, the genital exam, documentation of examination findings, the overall assessment, and the summed total quality score (p < 0.05 for each). Evaluation of the photos/videos and medical records documenting the completeness and accuracy of the examinations demonstrated that hospitals with telemedicine also had significantly higher scores in several domains including photo/video quality, completeness of the examination, and the summed total completeness and accuracy score (p < 0.05 for each). Rural hospitals using telemedicine for pediatric sexual abuse forensic examination consultations provided significantly higher quality evaluations, more complete examinations, and more accurate diagnoses than similar hospitals conducting examinations without telemedicine support. 相似文献
3.
BackgroundAlthough research on the developmental antecedents of sexual offending has tended to focus on sexual abuse, recent research in juveniles and adults who have sexually offended suggests that psychological abuse perpetrated by a male caregiver may be a particularly important factor in the development of problematic sexual interests and behaviors.ObjectiveThis study aimed to extend previous findings by investigating the association between psychological abuse by a male caregiver and problematic sexual outcomes in a sample of adult males who had sexually offended.ParticipantsParticipants were 529 adult males incarcerated for sexual offenses, 21% of whom were civilly committed.MethodsChildhood maltreatment and problematic sexual outcomes were assessed using the Multidimensional Assessment of Sex and Aggression, a contingency-based inventory that assesses domains related to sexual aggression. Hierarchical regressions were calculated examining the association between childhood abuse types and sexual outcomes.ResultsChildhood sexual abuse was associated with child sexual (β = .247, p < .001) and other paraphilic interests (β = .189, p < .001). Male caregiver psychological abuse also emerged as marginally associated with child sexual interest (β = .100, p = .059), even after controlling for other abuse types.ConclusionsThese results partially replicate recent findings in a juvenile sample and challenge conventional developmental theories of sexual offending, by suggesting that male caregiver psychological abuse may play a role in the etiology of child sexual interest among males who have sexually offended. This study also suggests a possible gender symmetry effect moderating the developmental consequences of abuse. 相似文献
4.
OBJECTIVE: This study investigated age and gender differences in perceived emotional support in children and adolescents who experienced sexual abuse from the time of discovery to 1 year later. Also examined were the relations among sources of support and adjustment and whether support explained resilience, defined as better adjustment over a year's time. METHOD: One hundred and forty-seven sexually abused youth were interviewed at the time of discovery (T1) and 1 year later (T2). Information gathered included severity of the sexual abuse, satisfaction with support from caregivers, same-sex and other-sex friends, feelings of shame about the abuse, and attributional style. Youth adjustment was measured using reports from the youth themselves, caregivers, and teachers. RESULTS: Children reported the most satisfaction with support from caregivers followed by friends whereas adolescents reported similar levels of support from friends and caregivers. Satisfaction with support was differentially related to adjustment. Youth who reported more satisfaction with caregiver support at T1, reported less depression, better self-esteem but more sexual anxiety 1 year later. More satisfaction with support from friends predicted lower self-esteem but less sexual anxiety. More satisfaction with initial caregiver support at T1 predicted better parent- and teacher-rated adjustment 1 year later, after controlling for initial adjustment. CONCLUSIONS: In general, initial caregiver emotional support at the time of abuse discovery predicted resilience in child and adolescent victims of sexual abuse. Findings suggested that treatment should include a focus on helping caregivers provide appropriate emotional support. 相似文献
5.
The purpose of this analysis was to estimate the frequency and severity of child abuse committed by adolescents who were in nonparental caregiving roles. The sample was composed of cases in which either physical or sexual abuse was substantiated through child welfare investigation. The main comparisons were between adolescent and adult caregivers. While caregiver age did not appear to have a consistent effect on the occurrence of physical abuse, notable differences between adolescents and adults were found in the area of sexual abuse. Not only were adolescents observed to commit substantially more sexual abuse than older caregiver cohorts, but the sexual abuse they committed was more likely to involve intercourse and physical assault. These findings have implications for future research and practice. 相似文献
6.
Child abuse prevention research has been hampered by a lack of validated multi-dimensional non-proprietary instruments, sensitive enough to measure change in abuse victimization or behavior. This study aimed to adapt the ICAST child abuse self-report measure (parent and child) for use in intervention studies and to investigate the psychometric properties of this substantially modified tool in a South African sample. First, cross-cultural and sensitivity adaptation of the original ICAST tools resulted in two preliminary measures (ICAST-Trial adolescents: 27 items, ICAST-Trial caregivers: 19 items). Second, ICAST-Trial data from a cluster randomized trial of a parenting intervention for families with adolescents (N = 1104, 552 caregiver-adolescent dyads) was analyzed. Confirmatory factor analysis established the hypothesized 6-factor (adolescents) and 4-factor (caregivers) structure. Removal of two items for adolescents and five for caregivers resulted in adequate model fit. Concurrent criterion validity analysis confirmed hypothesized relationships between child abuse and adolescent and caregiver mental health, adolescent behavior, discipline techniques and caregiver childhood abuse history. The resulting ICAST-Trial measures have 25 (adolescent) and 14 (caregiver) items respectively and measure physical, emotional and contact sexual abuse, neglect (both versions), and witnessing intimate partner violence and sexual harassment (adolescent version). The study established that both tools are sensitive to measuring change over time in response to a parenting intervention. The ICAST-Trial should have utility for evaluating the effectiveness of child abuse prevention efforts in similar socioeconomic contexts. Further research is needed to replicate these findings and examine cultural appropriateness, barriers for disclosure, and willingness to engage in child abuse research. 相似文献
7.
The objective of this study was to describe caregiver perceptions about mental health services (MHS) after child sexual abuse (CSA) and to explore factors that affected whether their children linked to services. We conducted semi-structured, in-person interviews with 22 non-offending caregivers of suspected CSA victims < 13 years old seen at a child advocacy center in Philadelphia. Purposive sampling was used to recruit caregivers who had (n = 12) and had not (n = 10) linked their children to MHS. Guided by the Health Belief Model framework, interviews assessed perceptions about: CSA severity, the child's susceptibility for adverse outcomes, the benefits of MHS, and the facilitators and barriers to MHS. Interviews were audio-recorded, transcribed, coded, and analyzed using modified grounded theory. Recruitment ended when thematic saturation was reached. Caregivers expressed strong reactions to CSA and multiple concerns about adverse child outcomes. Most caregivers reported that MHS were generally necessary for children after CSA. Caregivers who had not linked to MHS, however, believed MHS were not necessary for their children, most commonly because they were not exhibiting behavioral symptoms. Caregivers described multiple access barriers to MHS, but caregivers who had not linked reported that they could have overcome these barriers if they believed MHS were necessary for their children. Caregivers who had not linked to services also expressed concerns about MHS being re-traumatizing and stigmatizing. Interventions to increase MHS linkage should focus on improving communication with caregivers about the specific benefits of MHS for their children and proactively addressing caregiver concerns about MHS. 相似文献
8.
9.
Research Findings: Forty-five child caregivers and 120 parents participated in this study to examine perceptions of childcare programs in Jordan. The researchers developed a questionnaire that consisted of 6 dimensions: health, education, parent–caregiver relationship, facilities, building/landscape, and playground. Moreover, interviews with 10 child caregivers and 20 parents were conducted. Results indicated that child caregivers expressed moderate satisfaction with the programs. In contrast, parents expressed lower satisfaction with the childcare programs. The results also revealed that caregivers and parents perceived the playground area as effective but found health and the parent–caregiver relationship ineffective. Practice or Policy: This study highlights the need to supervise childcare programs effectively and the importance of fostering a strong partnership between child caregivers and parents. 相似文献
10.
BackgroundChild maltreatment by caregivers seem to make a significant contribution to general maltreatment rates. Interestingly, research assessing prevalence rates of maltreatment mainly focuses on individual components either in relation to different types of maltreatment or in relation to different types of institutions.ObjectiveThe current study assesses prevalence rates for child maltreatment by caregivers in hospitals, rehabilitation centers, facilities for the disabled, schools, Kindergartens, and after-school care or residential care.Participants and setting: In a cross-sectional survey, a representative sample of the German population above the age of 14 (N = 2,516) was selected in a random route approach. Participants were questioned retrospectively for the experience of physical, emotional and sexual abuse and neglect by caregivers in institutions.ResultsThe results demonstrate a relatively high rate of child maltreatment in German institutions. In detail, during inpatient stays in medical institutions, 19.0% of the participants reported to have experienced at least one type of maltreatment by nursing staff. Furthermore, 30.3% reported to have experienced at least one type of maltreatment by teachers during school life and 11.6% reported maltreatment by caregivers in care facilities. A significant number of participants reported multiple forms of maltreatment in all assessed institutions. Younger age of the respondents was associated with lower prevalence rates, which could be attributed to higher awareness for maltreatment in institutions nowadays.ConclusionsOur results demonstrate that child maltreatment by caregivers in institutions is a prevalent problem. A higher awareness for caregivers as potential perpetrators of maltreatment in institutions, including schools, medical institutions and care facilities, is needed in order to improve this alarming situation. 相似文献
11.
L Margolin 《Child abuse & neglect》1991,15(3):213-221
This study examined the social contexts in which sexually abusive child care providers came into contact with children and parents. Content analysis of 325 case records resulted in the identification of seven main child care arrangements in which sexual abuse occurred. These arrangements varied by the routinization and formality of the caregiving relationship, as well as the methods of caregiver selection and reimbursement. The main finding was that the vast majority of female perpetrators were adolescents whose abusive behavior took place in the caregiving arrangement in which she is selected by parents, engaged on a routine basis, and paid a sum of money for her child care. In contrast, sexually abusive male caregivers represented a wide range of ages and committed sexual abuse over a significantly broader range of situations than female caregivers. 相似文献
12.
ObjectivesIn the context of the shortage of studies on child maltreatment changes over time in limited resource settings, this paper explored the changes in the prevalence of multiple types of child maltreatment over a period of 10 years in Vietnam and tested the moderating role of some demographic characteristics in these changes.MethodsWe used data from two prevalence studies conducted in 2004 and in 2014 using similar methodologies. Both studies used self-report questionnaires which were completed by randomly selected students aged 12–17 years from different provinces in Vietnam. We also compared Hanoi subgroups to examine the trend using the most equivalent samples.ResultsWhile the prevalence estimates of sexual abuse and neglect were unchanged over 10 years, the prevalence of physical abuse and emotional abuse declined. The decrease in the prevalence of physical abuse was larger for younger adolescents and boys than for their counterparts. For sexual abuse, older adolescents reported an increase in the prevalence of sexual abuse. In the Hanoi sample comparison, only the prevalence of emotional abuse declined and this reduction was smaller for younger adolescents than for the older group.ConclusionDespite the reduction of emotional and physical abuse in the whole sample and emotional abuse in the Hanoi sample, all types of child maltreatment were still highly prevalent in Vietnam. We argue that interventions on all types of child maltreatment should be further implemented. Similar studies could be conducted to evaluate the effect of child protection policies on the prevalence of child maltreatment. 相似文献
13.
《Child abuse & neglect》2014,38(9):1421-1435
This paper reports on national estimates for past year child maltreatment from a national household survey conducted in 2011. It also discusses the validity of such estimates in light of other available epidemiology. The Second National Survey of Children Exposed to Violence obtained rates based on 4,503 children and youth from interviews with caregivers about the children ages 0–9 and with the youth themselves for ages 10–17. The past year rates for physical abuse by caregivers were 4.0% for all sample children, emotional abuse by caregivers 5.6%, sexual abuse by caregivers 0.1%, sexual abuse by caregivers and non-caregivers 2.2%, neglect 4.7% and custodial interference 1.2%. Overall, 12.1% of the sample experienced at least one of these forms of maltreatment. Twenty-three percent of the maltreated children or 2.8% of the full sample experienced 2 or more forms of maltreatment. Some authority (teacher, police, medical personnel or counselor) was aware of considerable portions of most maltreatment, which suggests the potential for intervention. Many of the study's estimates were reasonable in light of other child maltreatment epidemiological studies, but comparisons about emotional abuse and neglect were problematic because of ambiguity about definitions. 相似文献
14.
BackgroundSibling sexual abuse (SSA) is a continuum of childhood sexual behaviors that do not fit age-appropriate curiosity. SSA may be the most prevalent, longest lasting form of intrafamilial sexual abuse – and the least reported, studied and treated.ObjectiveThis exploratory qualitative study examined the experience of intervention with SSA survivors from the perspective of mental health professionals, and explored their major therapeutic challenges.Participants and settingThe sample consisted of 20 Jewish Israeli mental health professionals working in private clinics or public social welfare services who had experience with SSA.MethodsSemi-structured interviews focusing on the characteristics of SSA events, perceptions about the effects of abuse, intervention priorities and therapeutic challenges compared to other types of child abuse.ResultsProfessionals working with SSA survivors are preoccupied with the need to provide them with physical and emotional protection, as well as to help them process the abuse narrative. They also find themselves dealing with survivors who do not experience themselves as victims despite external evidence of abuse, or with the need to reconcile their perception of the sexual relationship as mutual, as opposed to the formal requirement to differentiate between “offender” and “victim”. In either case, the reality of these survivors can be just as painful as in other SSA cases.ConclusionsThe complexity of SSA calls for unique intervention skills, including working with survivor narratives that do not fit the victim/offender dichotomy on one hand and that do not minimize the potentially harsh consequences of SSA on the other. 相似文献
15.
BackgroundThe current state of knowledge regarding the role of non-offending fathers in supporting their sexually abused children is very scarce.ObjectiveThe objective of this study is to further our understanding of fathers’ roles following disclosure of their children’s sexual abuse (SA) by evaluating fathers’ perceptions of the impact of disclosure on their involvement and support of their children.Participants and methodThis qualitative study relies on individual semi-structured interviews conducted with 17 fathers of allegedly abused children.ResultsInductive thematic analysis first highlighted that some reported a period of disengagement from the child during which they put into question their role and attitudes, followed by a period of re-involvement. This period of difficulties experienced by some fathers in regard to their involvement towards their children was due to either their own important psychological distress, their ambivalence towards their child or even because of feelings of uneasiness experienced during physical contact with them. Despite this, findings indicate the presence of thoughts and attitudes that suggest children are a source of concern for fathers. The four forms of abuse-specific support previously observed among mothers (believing the child, seeking out professional services, protecting him/her from the offender, supporting him/her emotionally) were also observed among fathers. In accordance with the activation theory, a form of support specific to fathers, namely, encouraging the child to open up to and explore the world outside the family, thereby, fostering the child’s self-esteem development, was observed and constitutes a relevant finding.ConclusionClinical and empirical implications are discussed. 相似文献
16.
OBJECTIVE: To describe the advantages, disadvantages and current status of child abuse consultations conducted through telemedicine networks. METHOD: The results of a telephone survey of seven statewide telemedicine networks are reported and discussed with respect to goals, funding, technical support and expertise, infrastructure, and extent of use. Quality assurance and liability issues concerning telemedicine child abuse consultations are also reviewed. RESULTS: The goals of telemedicine networks in child abuse are to provide (1) expertise to less experienced clinicians primarily in rural areas; (2) a method for peer review and quality assurance to build consensus of opinions particularly in sexual abuse cases; and (3) support for professionals involved in an emotionally burdensome area of pediatrics. Problems encountered by existing networks include: (1) funding for equipment and reimbursement for consultation; (2) consistent technical support: (3) clinician lack of technical expertise, knowledge, or motivation; and (4) lack of network infrastructure. Legal considerations include licensure exemptions for consulting across state lines, potential for malpractice, patient confidentiality and security of images forwarded over modem lines, and liability of the equipment, consulting site, and the consultant in criminal proceedings. CONCLUSIONS: Telemedicine consultations offer a unique opportunity to raise the standard of care in child abuse evaluations, but success depends on clinician motivation, appropriate infrastructure, and ongoing funding and technical support. 相似文献
17.
ObjectiveTo examine whether shame-proneness mediates the relationship between women's histories of childhood sexual abuse and their current partner and family conflict and child maltreatment. Previous research has found that women with childhood sexual abuse histories experience heightened shame and interpersonal conflict. However, research examining the relationship of shame to interpersonal conflict is lacking.MethodParticipants were 129 mothers of children enrolled in a summer camp program for at-risk children from financially disadvantaged families. Data were collected on women's childhood abuse histories, shame in daily life, and current interpersonal conflict involving family conflict, intimate partner conflict (verbal and physical aggression), and child maltreatment.ResultsConsistent with our hypothesis, the results of hierarchical regressions and logistic regression indicated that shame significantly mediated the association between childhood sexual abuse and interpersonal conflict. Women with sexual abuse histories reported more shame in their daily lives, which in turn was associated with higher levels of conflicts with intimate partners (self-verbal aggression and partner-physical aggression) and in the family. Shame did not mediate the relationship between mothers’ histories of sexual abuse and child maltreatment.ConclusionThe role of shame in the intimate partner and family conflicts of women with sexual abuse histories has not been examined. The current findings indicate that childhood sexual abuse was related to interpersonal conflicts indirectly through the emotion of shame.Practical ImplicationsThese findings highlight the importance of investigating the role of shame in the interpersonal conflicts of women with histories of childhood sexual abuse. Healthcare professionals in medical and mental health settings frequently treat women with abuse histories who are involved in family and partner conflicts. Assessing and addressing the links of abused women's shame to interpersonal conflicts could be important in clinical interventions. 相似文献
18.
BackgroundChild abuse is a major concern in India with frequent reports of extreme maltreatment and fatalities. A dearth of robust and methodologically sound studies has resulted in ambiguity regarding the extent of child abuse in the general population.ObjectivesTo estimate the one-year and lifelong prevalence of exposure to violence, physical abuse, emotional abuse, sexual abuse, and neglect using a validated instrument—the International Society for the Prevention of Child Abuse and Neglect (ISPCAN) Child Abuse Screening Tool – Child, Home Version (ICAST-CH).Participants and Setting: Adolescents (n = 6957) attending randomly selected schools in one city in Kerala, India.MethodsCross-sectional survey using self-report instrument.ResultsThe one-year prevalence of any abuse was 89.9% (95% CI: 89.1–90.7) suggesting that child maltreatment was widespread. Physical and emotional abuses were also very common. Although sexual abuse was least common, a considerable proportion of adolescents reported it; one-year prevalence of sexual abuse was 16.7% and lifetime prevalence was 19.9%. Boys reported more abuse than girls across all the categories of abuse (including sexual abuse). Abuse was more frequent in the higher age groups and classes at school. Abuse was also more frequent in nuclear families and families that reported alcohol use. Children who reported an abusive experience usually faced more than one category of abuse; abuse in one category was significantly associated with abuse in other categories.ConclusionsAbuse of children is alarmingly common. There is an urgent need for improving the awareness surrounding this issue as it is a major public health challenge faced by the country. The priority should be on setting up easily accessible support services for children. 相似文献
19.
Objective
The aim of the study was to examine caregiver management strategies for child sexual abuse (CSA) when presented with hypothetical scenarios that vary in physical invasiveness.Methods
One hundred fifty three caregivers were given 3 scenarios of CSA with 7 management strategies presented in the 21-item Taking Action Strategies (TAS) scale. Caregivers were asked to rate strategies according to their willingness to carry out each action with rating of 5 = greater likelihood of carrying out the action specified while a rating of 1 = a lower likelihood of carrying out that action. CSA scenarios included exposure to pornography/masturbation, fondling, and penetration while management strategies including fighting the accused, blaming the child, and outreaching to the authorities. Repeated measures ANOVA was used to compare mean TAS scores for the management strategies across CSA scenarios.Results
The difference between TAS scores across the abuse scenarios was statistically significant (p < .001). Mean TAS scores reflected greater preference for taking action if the abusive act was perceived as more physically intrusive (exposure to pornography/masturbation-TAS 3.5, fondling-TAS 3.7, penetration-TAS 3.8). Caregivers reported being less willing to handle a disclosure of CSA without outreach (TAS 2.5 and 2.0 for fighting and blaming the child, respectively) and more willing to manage a disclosure with outreach to authorities (TAS 3.8, 4.5, and 4.7 for outreaching to Child Protective Services [CPS], to the child's healthcare provider and police, respectively). A predictor of caregiver outreach to authorities identified was the caregiver having past interactions with CPS.Conclusion
Perception of the physical invasiveness of CSA and demographic factors can impact caregiver management strategies after a disclosure.Practice implications
Results suggest that several factors influence caregiver management of sexual abuse. These factors warrant further study, as they are potential contributors to declining trends in CSA cases observed. Other implications include the need for educational efforts targeting caregivers. These interventions should focus on dispelling myths about the perceived physical invasiveness of CSA. These perceptions should not mitigate a caregiver's decision to involve the authorities in their management after a disclosure. Lastly, despite criticisms of the child protective systems, caregivers with past encounters with CPS view these related agencies as valuable resources. 相似文献20.
BackgroundAbusive head trauma (AHT) is a preventable form of child abuse.ObjectiveThis project used a mixed method design to assess the feasibility of the Calm Baby Gently educational baby book intervention for promoting safe practices related to infant crying in an effort to prevent AHT.Participants and settingThree pediatric practices participated between June 2016 and January 2018, including 1045 caregivers who attended their infant’s 2-month well-child visit.MethodsPediatric providers gave the educational baby book to caregivers at the 1-month well-child visit. Caregivers completed a survey at the 2-month well-child visit on their use and satisfaction with the book and responses to infant crying. Thematic analysis of qualitative feedback was performed. Responses to infant crying were compared quantitatively between caregivers who had and had not read the book.ResultsOf the 819 caregivers (78%) who received the book, 92% (754) read it, and 51% (421) had another caregiver read it. Caregivers considered the book approachable, understandable, validating, and helpful for improving knowledge and skills related to infant crying. The book was rated more helpful by caregivers of younger age, male gender, and non-white race. Controlling for age, gender, and race, caregivers who read the book were more confident (p = 0.033) and had more knowledge on how to respond appropriately to infant crying (p = 0.019) than caregivers who had not read it.ConclusionsCalm Baby Gently is a feasible and well-received AHT prevention program. Randomized controlled trials are needed to better understand its impact on knowledge, behavior, and AHT rates. 相似文献