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1.
Objective
To examine evidence available in large-scale North American datasets on child abuse and neglect that can assist in understanding the complexities of child protection case classifications.Methods
A review of child abuse and neglect data from large North American epidemiological studies including the Canadian Incidence Study of Reported Child Abuse and Neglect (CIS), the National Child Abuse and Neglect Data System (NCANDS), and the National Incidence Studies of Reported Child Abuse and Neglect (NIS).Results
The authors of this paper argue that recent evidence from large North American epidemiological studies examining the incidence of child abuse and neglect demonstrate that children and families identified as being at risk of maltreatment present with as many household and caregiver concerns as investigations that are substantiated.Conclusions
In order to continue to develop appropriate services and policies for vulnerable children the authors urge continue definitional clarity for research in child maltreatment that considers the exemplars or indicators of categories, in tandem with parental and child characteristics which can provide one source of evidence-basis to meaningful child protection case classifications. Continued monitoring, refined by the dilemmas faced in practice, are critical for a continued public health investment in children's well-being, predicated upon upholding children's rights. 相似文献2.
In the present study, we tested the mediating role of moral disengagement in the effect of childhood maltreatment on bullying and defending. We also examined whether the mediating effect of moral disengagement differed between girls and boys, early and middle adolescents, as well as only and non-only children. Five hundred and fifty-two Chinese adolescents participated in this study. The results indicated that the prevalence rates of physical abuse, physical neglect, emotional abuse, and emotional neglect were 4.0%, 40.0%, 10.5%, and 27.9%, respectively. Path analysis showed that moral disengagement partially mediated the relation between childhood maltreatment and bullying, but did not mediate the relation between childhood maltreatment and defending. Moreover, multi-group analyses indicated that no significant path in the final model differed by gender. However, early adolescents exposed to high levels of childhood maltreatment were more likely to engage in bullying and less likely to engage in defending than middle adolescents, and early adolescents with high levels of moral disengagement were more likely to engage in bullying than middle adolescents. Compared to non-only children, only children exposed to high levels of childhood maltreatment were more likely to score higher on moral disengagement and less likely to engage in defending. 相似文献
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BackgroundChildhood maltreatment (CM) has been associated with a range of adult health outcomes; however, extant research has focused more on exposure to a single form of abuse rather than multiple forms. Moreover, very few studies have specifically investigated the impact of CM on exclusive breastfeeding (EBF) outcomes.ObjectivesThis study aims to examine: (1) the individual and combined effects of multiple forms of CM on EBF outcomes; and (2) whether postpartum depression and maternal stress act to mediate or moderate the association between CM and EBF.MethodCross-sectional survey data were collected between October 2015 and January 2016 from 426 women of Bangladesh who were six months postpartum.ResultsBased on the adjusted multivariate logistic regression model, women who experienced childhood sexual abuse (CSA) were significantly less likely to exclusively breastfeed babies than their non-abused counterparts (AOR: 0.38, 95% CI [0.15, 0.92]). When a composite measure was created to examine the additive effects of adverse childhood experiences, a dose-response association was observed between the reported number of different types of CM and early termination of EBF. Though experiencing postpartum depression and maternal stress do not mediate the effect of CSA on EBF, they do moderate them such that the odds of early termination of EBF are notably higher among women who experienced CSA in combination with postpartum depression or high levels of stress.ConclusionsFindings from this study offer some insight into the intergenerational effects associated with CM experiences, and underpin the need for effective policies and programs to prevent or reduce its occurrence and improve the EBF outcomes. 相似文献
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Criminal thinking styles were examined as mediational links between different forms of child maltreatment (i.e., sexual abuse, physical abuse, and physical neglect) and adult criminal behaviors in 338 recently adjudicated men. Analyses revealed positive associations between child sexual abuse and sexual offenses as an adult, and between child physical abuse/neglect and endorsing proactive and reactive criminal thinking styles. Mediation analyses showed that associations between overall maltreatment history and adult criminal behaviors were accounted for by general criminal thinking styles and both proactive and reactive criminal thinking. These findings suggest a potential psychological pathway to criminal behavior associated with child maltreatment. Limitations of the study as well as research and clinical implications of the results are discussed. 相似文献
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OBJECTIVES: To understand the features of child abuse/neglect (CA/N) allegations in cases with emotional maltreatment (EMT) allegations, as well as the features of the EMT allegations themselves, and to describe any associations of EMT with distinct impairments of children's behavior, emotion and functioning. METHOD: The sample consisted of 806 high-risk children, 545 with one or more maltreatment reports to CPS. The Maltreatment Classification System was used to record the number and severity levels of maltreatment allegations, which compared cases with and without EMT. Multiple regression analyses were conducted using 10 outcome scales from the Child Behavior Checklist, Vineland Screener, and Trauma Symptom Checklist. Successive blocks of predictor variables included demographics, maltreatment classification variables, maternal and family characteristics, and study site. RESULTS: When there were allegations of EMT as well as CA/N in a CPS case-record (by age 8), the CA/N allegations tended to be either more frequent or less severe than those kinds of allegations in cases without EMT. When neglect was alleged to occur with EMT, neglect allegations outnumbered allegations of EMT. However, when sexual abuse allegations were accompanied by EMT allegations, there were more EMT allegations than sexual abuse allegations in the cases. Higher severity ratings for EMT allegations than for physical abuse occurred when cases included any abuse. Distinctive effects of EMT subtypes were found between problems of safety/restriction and self-reported anger symptoms, and between problems of self-esteem/autonomy and posttraumatic stress. CONCLUSION: Differences exist between the CA/N allegations in cases with and without EMT. Having few cases containing only EMT allegations made it difficult to assess distinctive harm associated with EMT. Certain types of EMT allegations were associated with increases in children's anger and posttraumatic stress. 相似文献
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BackgroundAlcohol outlet density has been linked to rates of substantiated maltreatment both cross-sectionally and over time. Most of these studies have been conducted in Anglo-Saxon countries, especially in the U.S., but other countries, where alcohol outlets and alcohol consumption may have different social meanings, are clearly underrepresented in the literature.ObjectiveThe aim of this study was to analyze whether alcohol outlet density is associated with neighborhood-level child maltreatment risk in a South-European city.Participants and settingA longitudinal study was conducted in the city of Valencia (Spain). As spatial units, we used 552 census block groups. Family units with child maltreatment protection measures from 2004 to 2015 were geocoded (n = 1799).MethodsA Bayesian spatio-temporal autoregression model was conducted to model the outcome variable.ResultsResults indicated that, once controlled for other neighborhood-level characteristics, the influence of off-premise density and restaurant/cafe density were not relevant, while bar density showed a negative relationship with child maltreatment risk. Spatially lagged alcohol outlet variables were also not relevant in the model.ConclusionsOur results suggest the importance of taking into account the cultural influences on the relationship between alcohol outlets and child maltreatment risk. Future cross-cultural research is needed for better understanding this relationship. 相似文献
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OBJECTIVE: This study uses administrative data to track the first re-reports of maltreatment in a low-income, urban child welfare population (n=4957) while controlling for other public service involvement. Service system involvement is explored across the following sectors: Child Welfare, Income Maintenance, Special Education, Juvenile Court, and various forms of Medicaid-reimbursed medical or mental health care. This study builds knowledge by adding the services dimension to an ecological framework for analyses and by following recurrence for a longer period of time than prior investigations (7.5 years). METHOD: We model the re-reporting of a child for maltreatment as a function of child, caregiver, service, and neighborhood characteristics using data from birth records, child welfare, income maintenance, Medicaid, adult corrections, juvenile court, special education, law enforcement, and census sources. Bivariate and multivariate analyses are presented, the latter using Cox regression with a robust sandwich covariance matrix estimate to account for the intracluster dependence within tracts. RESULTS: Key results across bivariate and multivariate analyses included a lower rate of re-reporting among children with parents who were high school graduates and/or permanently exited from the first spell on AFDC (p<.0001); and for children in families that received less intensive in-home services compared to those not receiving services, receiving intensive in-home, or foster care services (p<.0001). Higher rates of re-reporting were found for children with Medicaid mental health/substance abuse treatment records (p<.0001) and special education eligibility for emotional disturbance (p<.005). CONCLUSIONS: Caretaker characteristics and non-child welfare service use patterns had a strong association with the likelihood of a child being re-reported to the child welfare agency and should be more heavily attended to by child welfare workers. High rates of service sector overlap suggest that interagency ties and cooperation should be strengthened. The lower risk associated with less intensive in-home services compared to un-served cases may indicate under-identification of in-home service eligibility following a first report of maltreatment. 相似文献
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Given that childhood maltreatment is a significant international public health problem contributing to all major morbidity and mortality determinants, there is need to explore current practices and readiness of health care professionals (HCPs) to assess maltreatment, identify maltreatment risk factors, and complete mandated reporting. HCPs (N = 114) completed a child maltreatment mandated reporting measure to assess level of comfort with mandated reporting, commitment to the reporting role, and confidence in the child protection system to take action as needed. Additional questions explored comfort discussing maltreatment and risk factors for maltreatment in a medical setting and knowledge of community resources. Results indicated that HCPs were committed to their mandated reporting role and did not perceive substantial potential negative consequences of reporting. However, there were concerns regarding lack of confidence in the system’s ability to respond sufficiently to reports. Despite commitment to the reporting role, results showed that large proportions of HCPs do not routinely screen for maltreatment, feel uncomfortable discussing maltreatment history, and lack knowledge about community resources. Additional training efforts must be prioritized in health care systems to improve short- and long-term health outcomes. 相似文献
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Objectives
The 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.Methods
The 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.Results
As 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.Conclusions
The 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. 相似文献11.
OBJECTIVE: This study examines how the availability of alcohol and illicit drugs (as measured by alcohol outlet density and police incidents of drug sales and possessions) is related to neighborhood rates of child abuse and neglect, controlling for other neighborhood demographic characteristics. METHOD: Data from substantiated reports of child abuse and neglect in 304 block groups in a northern California city were analyzed using spatial regression techniques. RESULTS: This study found that higher concentration of bars (B=6.66, p<.05) and higher numbers of incidents of drug possession (B=.53, p<.001) were positively related to rates of child maltreatment in neighborhoods when controlling for neighborhood demographic characteristics. Thus, areas with more bars and drug possession incidents per 1000 population have higher rates of child maltreatment. CONCLUSIONS: The presence of more bars per population may represent a lack of resources available to residents, may increase the stress on neighborhoods by "attracting" populations prone to participating in dangerous activities, or increase the frequency of alcohol use that then leads to maltreatment. Areas with more drug possession incidents may also contribute to the overall level of neighborhood stress and disorganization or act as a marker for drug use that leads to maltreatment. These results suggest that the neighborhood substance availability may deserve special attention when developing preventive interventions to reduce child abuse and neglect in neighborhood areas. 相似文献
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This paper explores the well-documented relationship between child maltreatment and aggressive and criminal behavior, specifically examining several dimensions of maltreatment and cumulative child and family risk. Using data from the provincially representative Ontario Incidence Study of Reported Child Abuse and Neglect (OIS-2013), this paper utilizes a developmental lens to examine whether maltreatment dimensions and cumulative risk can differentiate maltreated young people who exhibit aggressive and criminal behaviors and those who do not.A total unweighted sample of 1837 substantiated maltreatment investigations was examined in this analysis using chi-square, t-test, and logistic regression. The findings indicate that 13% of maltreated children and youth served by the Ontario child welfare system exhibited aggression and 6% of maltreated adolescents were involved in the youth justice system. Aggressive children and youth were more likely to experience severe and co-occurring forms of maltreatment and to experience higher levels of cumulative child risk. In adolescence, youth exhibiting aggressive and/or criminal behavior commonly were investigated because of neglect, specifically because their caregivers were no longer willing or able to remain in a caregiving role. Implications for child welfare policy and practice are discussed. 相似文献
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Objective
This study considers the long-term health consequences of child maltreatment. Distinct from previous research, we examine the effects of maltreatment in the context of more general parental evaluations.Method
Analyses used retrospective and current data from the Midlife Development in the United States (MIDUS) study.Results
A considerable proportion of middle- and older-age adults who experienced frequent maltreatment nevertheless evaluated the relationship with their offending parent as “excellent”, “very good”, or “good” (e.g., 47% for physical and emotional maltreatment by mothers). Maltreated respondents generally evaluated their maltreating parents less favorably than non-maltreating parents, but there was considerable variation in these recollected relationships. Adults who experienced child maltreatment reported a greater number of chronic medical conditions and physical symptoms and lower self-rated health, but effects were smaller when they had positive relationships with their parents than when one or more of the relationships was perceived as negative.Conclusions
These findings highlight a common and seemingly paradoxical pattern among MIDUS participants: the co-presence of harsh parental behavior and positive recollections of parental relationships during childhood. Moreover, these surprising patterns of retrospective interpretation predict very different experiences of adult health – health problems are most pronounced among maltreatment in cases where the respondent had a generally negative relationship with one or more of his or her parents. 相似文献14.
Hussey JM Marshall JM English DJ Knight ED Lau AS Dubowitz H Kotch JB 《Child abuse & neglect》2005,29(5):479-492
OBJECTIVE: To examine whether children with substantiated maltreatment reports between 4 and 8 years of age differ from children with unsubstantiated reports on any of 10 behavioral and developmental outcomes. METHOD: Longitudinal data from 806 children and their adult caregivers collected in four US study sites were pooled and analyzed using Analysis of Variance (ANOVA) and multivariate linear regression. RESULTS: There were no significant differences between the mean scores of children with unsubstantiated and substantiated maltreatment reports filed between 4 and 8 years of age for any of the 10 behavioral and developmental outcomes. In the multivariate analysis, substantiation status was not significantly associated with any of the 10 outcomes after adjusting for prior functioning, prior maltreatment status, and sociodemographic characteristics. Findings from within-site analyses were generally consistent with the pooled analyses in finding no association between substantiation status and the outcomes examined. CONCLUSIONS: In this high-risk sample, the behavioral and developmental outcomes of 8-year-old children with unsubstantiated and substantiated maltreatment reports filed between ages 4 and 8 were indistinguishable. Future research should attempt to replicate these findings on probability samples that represent the full range of childhood maltreatment risk and with models that control for the impact of social services. 相似文献
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BackgroundPublic health surveillance is essential to inform programs that aim to eradicate child maltreatment (CM) and to provide services to children and families. However, collection of CM data imposes a burden on child welfare workers (CWWs). This study assesses the feasibility of hiring coders to abstract the required information from administrative records and case narratives.MethodsBased on a convenience sample of child welfare data from Manitoba, Canada, two coders abstracted information on 181 alleged CM cases. The coders completed a short web-based questionnaire for each case to identify which of five types of CM had been investigated, level of substantiation for each type, and risk of future CM. The CWWs responsible for each case completed the same questionnaire. Percentages of the occurrence of CM by the three sources were compared. The validity of the coders’ classifications was assessed by calculating sensitivity, specificity, and positive and negative predictive values, against the CWWs’ classifications as the “gold standard.” Cohen’s kappa was also calculated.ResultsThe coders’ classifications of physical abuse, sexual abuse and neglect generally matched those of CWWs; for exposure to intimate partner violence, agreement was weak for one coder. Coding of emotional maltreatment and risk investigations could not be evaluated.ConclusionResults were promising. Abstraction was not time-consuming. Differences between coders and CWWs can be largely explained by the administrative data system, child welfare practice, and legislation. Further investigation is required to determine if additional training could improve coders’ classifications of CM. 相似文献
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ObjectiveWe assessed the self-reported experience, comfort and competence of primary care pediatricians in evaluating and managing child maltreatment (CM), in rendering opinions regarding the likelihood of CM, and in providing court testimony. We examined pediatricians’ need for expert consultation when evaluating possible maltreatment.MethodsA questionnaire was mailed to 520 randomly selected AAP members. Pediatricians were asked how frequently they evaluated and reported children for suspected maltreatment, and whether child abuse pediatricians were available to and used by them. Pediatricians were asked to rate their knowledge, comfort and competence in the management of CM. Demographic information was also gathered. Pediatricians’ experience with CM, their comfort, self-reported competence, and need for expert assistance is described. Logistic regression was used to assess factors that predicted pediatricians’ sense of competence while controlling for covariates found to be significant in bivariate analyses.ResultsOne hundred forty-seven questionnaires were eligible for analysis. The majority of respondents had little experience evaluating and reporting suspected CM, and was interested in having expert consultation. While pediatricians often felt competent in conducting medical exams for suspected maltreatment, they felt less competent in rendering a definitive opinion, and did not generally feel competent to testify in court. Sense of competence was particularly low for sexual abuse. Increased practice experience and more courses in CM led to increased sense of competence in some areas.ConclusionsPediatricians acknowledged many limitations to providing care to maltreated children, and expressed interest in subspecialist input.Practice implicationsThese findings add additional support to the American Board of Pediatrics’ decision to create a Child Abuse Pediatrics subspecialty. The findings also indicate a need to ensure funding for fellowship training programs in this field. 相似文献
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OBJECTIVE: For nearly 25 years researchers have suggested that better taxonomic systems conceptualizing and reliably differentiating among different dimensions of maltreatment are required. This study examines the utility of three different characterizations of one dimension of maltreatment, chronicity, to predict child behavioral and emotional functioning in a sample of maltreated children. A secondary objective of the study is to examine additional parameters of maltreatment inherent in our definitions of chronicity: age at first report to CPS, extent and continuity of maltreatment. METHOD: The study consists of children reported for maltreatment (N=519) from the larger LONGSCAN study cohort. Lifetime maltreatment data were collected from CPS records and coded into two chronicity constructs: "developmental" and "calendar" definitions. Variables for age at first report, frequency, extent and continuity of maltreatment reports also were constructed. Hierarchical regression analyses were utilized to determine the extent to which the various chronicity constructs contributed to the prediction of child outcomes. RESULTS: The most salient definition of chronicity, in terms of its effects on child behavioral and emotional functioning, varied by outcome. The developmental definition was found to have the most balanced sensitivity across outcomes. Among other significant findings, extent and continuity of maltreatment contributed respectively to the prediction of behavior and emotional trauma symptoms. Early age at first report was a predictor of poor daily living skills. CONCLUSION: Chronicity is a complex construct. Findings indicate there are multiple parameters that make up the chronicity construct itself that may be important for understanding child outcomes. 相似文献
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OBJECTIVE: Child maltreatment and family functioning were examined as predictors of adult rape in a sample of 925 college women. METHOD: Information was obtained from retrospective self-report questionnaires. Child sexual abuse (CSA) was assessed with the Life Experiences Questionnaire, child emotional abuse (CEA) and physical abuse (CPA) were assessed with the Childhood Trauma Questionnaire, family functioning was assessed with the Family Environment Scale, and adult rape was assessed with the Sexual Experiences Survey. RESULTS: Approximately 17% of women reported a history of any form of child abuse: 8.9% reported CSA, 4.2% reported CPA, and 8.6% reported CEA. Fifteen percent of participants reported a history of rape since age 17. CSA and CEA, but not CPA, were related to adult rape. Experiencing multiple forms of child abuse increased the risk of adult rape. Logistic regression analyses indicated that CSA predicted adult rape (OR=1.9). Further, low levels of family cohesion predicted adult rape only in the absence of CEA (OR=1.2), and low levels of emotional expressiveness in the family predicted adult rape only in the presence of CEA (OR=1.4). CONCLUSIONS: Findings highlight the need to consider multiple forms of child abuse as well as family functioning in relation to the risk of adult sexual victimization. Findings suggest CSA is a risk factor for adult victimization independent of family functioning, and family dysfunction exerts an impact on rape only in relation to CEA. 相似文献