The relation of emotional maltreatment to early adolescent competence: developmental processes in a prospective study

Child maltreatment and adolescent mental health problems in a large birth cohort

OBJECTIVE

To examine whether notified child maltreatment is associated with adverse psychological outcomes in adolescence, and whether differing patterns of psychological outcome are seen depending on the type of maltreatment.

METHODS

The participants were 7,223 mother and child pairs enrolled in a population-based birth cohort study in Brisbane, Australia. Exposure to suspected child maltreatment was measured by linkage with state child protection agency data. The primary outcomes were the internalizing and externalizing scales of the Youth Self Report (YSR) at approximately 14 years of age.

RESULTS

The YSR was completed by 5,172 subjects (71.6%), with increased attrition of cases of notified maltreatment. After adjustment for potential confounders, notified maltreatment was significantly associated with both internalizing behavior and externalizing behavior at 14. When evaluated as non-exclusive categories of maltreatment, physical abuse, neglect, and emotional abuse were each significantly associated with both internalizing and externalizing behavior after adjustment. When evaluated using an expanded hierarchical scheme that included combinations of multi-type maltreatment, the following groups had significantly higher internalizing behavior after adjustment: emotional abuse (with or without neglect), and multi-type maltreatment including physical (but not sexual) abuse with neglect and/or emotional abuse. The following groups were associated with externalizing behavior after adjustment: emotional abuse (with or without neglect), and multi-type maltreatment including physical abuse (with neglect and/or emotional abuse), or sexual abuse (with neglect and/or emotional abuse, and/or physical abuse).

CONCLUSION

This study suggests that child neglect and emotional abuse have serious adverse effects on adolescent mental health and warrant the attention given to other forms of child maltreatment. Additionally, it confirms that young people who are notified for more than one type of maltreatment are at particular risk of adolescent mental health problems.

Effects of resocialization on post-weaning social isolation-induced abnormal aggression and social deficits in rats

As previously shown, rats isolated from weaning develop abnormal social and aggressive behavior characterized by biting attacks targeting vulnerable body parts of opponents, reduced attack signaling, and increased defensive behavior despite increased attack counts. Here we studied whether this form of violent aggression could be reversed by resocialization in adulthood. During the first weak of resocialization, isolation-reared rats showed multiple social deficits including increased defensiveness and decreased huddling during sleep. Deficits were markedly attenuated in the second and third weeks. Despite improved social functioning in groups, isolated rats readily showed abnormal features of aggression in a resident-intruder test performed after the 3-week-long resocialization. Thus, post-weaning social isolation-induced deficits in prosocial behavior were eliminated by resocialization during adulthood, but abnormal aggression was resilient to this treatment. Findings are compared to those obtained in humans who suffered early social maltreatment, and who also show social deficits and dysfunctional aggression in adulthood.

Emotional maltreatment

Child abuse is a problem that affects the lives of many American children. The public is often bombarded with information regarding horrific cases of physical and sexual abuse. Emotional maltreatment, however, has been slow to achieve recognition as a serious social problem for a variety of reasons. Compared with physical or sexual abuse, emotional maltreatment is more difficult to identify and define, and good epidemiological data are not available. An erroneous perception also exists that the sequelae of emotional maltreatment are less severe than that of physical and/or sexual abuse. Prompt identification of emotional maltreatment, appropriate intervention and referral, and reporting of concerns to child protective services are essential to the health and well-being of the child. This article will define emotional maltreatment, discuss consequences of emotional maltreatment, and provide implications for pediatric nurse practitioner practice.

Emotional abuse towards children by schoolteachers in Aden Governorate, Yemen: a cross-sectional study

Background

Emotional abuse is central to other forms of abuse. The primary objective of this paper was to estimate the prevalence of emotional abuse among pupils in basic education schools and the risk factors associated with it in Aden governorate, Yemen.

Methods

Four districts were randomly selected from across the governorate of Aden, 2 schools were selected at random in each district, and then 1066 pupils were randomly selected from the 8 schools. An anonymous self-administered questionnaire was used for data collection. Data were analyzed using Statistical Package for Social Sciences ver.15. Mean, standard deviation and chi square were used for descriptive statistics. Univariate and Multivariate logistic regression analysis was used to examine the associations between emotional abuse with pupils/parents characteristics.

Results

Pupils reported high rates of emotional abuse 55.2% at least once in their school lifetime. Male pupils had higher prevalence of emotional abuse 72.6% than females 26.1%. Teachers constituted the highest proportion of perpetrators 45.6%. Odds Ratio (95% confidence interval) showed statistically significant association between emotional abuse and pupils' gender, family type and father education: 9.94 (7.19-13.74), 1.40 (1.02-1.91), .58 (.39-.86) respectively.

Conclusion

Emotional child abuse was highly prevalent in pupils in basic school education. Pupils' gender, family type and father education were the main risk factors associated with emotional abuse.

Services and recurrence after psychological maltreatment confirmed by child protective services

Recurrence rates of psychological maltreatment (PM) and the services that may reduce those rates have not been systematically evaluated. The National Child Abuse and Neglect Data System was used for 2003-2007 to study a cohort of children in 18 states with PM reports first confirmed by child protective services (CPS) during 2003. PM recurrence rates after counseling and other referrals were assessed while controlling for factors associated with service referral and other maltreatment. A total of 11,646 children had a first CPS-confirmed report with PM, and 9.2% of them had a second-confirmed PM report within 5 years. Fewer than one fourth of families were referred for services after PM, with service referrals being more likely for families with poverty, drug or alcohol problems, or other violence. Controlling for these factors, counseling referral was associated with a 54% reduction in PM recurrence, but other services were not associated with statistically significant reductions. Few families in which PM was confirmed receive any services, and most services provided were not associated with reductions in PM recurrence. Clarification of key services associated with efficacious prevention of PM is needed.

Psychological maltreatment in relation to substance use problem severity among youth

OBJECTIVES

Research has demonstrated that experiences of childhood maltreatment are prevalent in the life histories of youth with substance use problems; however, most of this research has focused on sexual or physical abuse. The purpose of the current study was to extend the scope of previous investigations to include psychological maltreatment experiences, examining the extent to which emotional abuse and emotional neglect predict substance use problem severity among youth. The current study also sought to examine whether a cumulative model fit the data, in which the experience of multiple forms of maltreatment would be related most strongly to severity of substance use problems, or whether there was a distinct effect of psychological maltreatment.

METHODS

Data were collected through self-report questionnaires from 216 youth (144 males, 72 females) entering an outpatient treatment program for youth with substance use concerns.

RESULTS

Results indicated that, when considering all forms of abuse together, only emotional abuse and emotional neglect emerged as significant predictors of substance use problem severity. Furthermore, the association between psychological maltreatment and substance use problem severity was unaltered by the consideration of concurrent experiences of interpersonal violence.

CONCLUSIONS

The results of the current study are consistent with those of a body of research describing the detrimental effects of psychological maltreatment. The findings have potential implications for the development and provision of trauma-informed youth substance use treatment services. The findings suggest that attending to the sequelae of psychological maltreatment may be important in assisting these youth in achieving successful treatment outcomes.

Impact of physical, psychological, and sexual violence on social adjustment of school children in India

This study sought to understand the pervasiveness and impact of physical, psychological, and sexual violence on the social adjustment of Grade 8 and 9 school children in the state of Tripura, India. The study participants, 160 boys and 160 girls, were randomly selected from classes in eight English and Bengali medium schools in Agartala city, Tripura. Data were collected using a self-administered Semi-structured Questionnaire for Children/Students and a Social Adjustment Inventory which were custom-made for the study based on measures in the extant research adapted for the Indian context. Findings revealed that students experienced physical (21.9%), psychological (20.9%), and sexual (18.1%) violence at home, and 29.7% of the children had witnessed family violence. Boys were more often victims of physical and psychological violence while girls were more often victims of sexual violence. The social adjustment scores of school children who experienced violence, regardless of the nature of the violence, was significantly lower when compared with scores of those who had not experienced violence ( p < 0.001). Social adjustment was poorer for girls than boys ( p < 0.001). The study speaks in favour of early detection and intervention for all child maltreatment subtypes and for children exposed to interparental violence, and highlights the crucial role of schools and school psychology in addressing the problem.

Deficits in emotion regulation mediate the relationship between childhood abuse and later eating disorder symptoms

The present study examined the relationship of child maltreatment to both emotion dysregulation and subsequent eating pathology. In an effort to extend previous research, the authors examined the unique impact of childhood emotional abuse (CEA) on emotion dysregulation and eating disorder (ED) symptoms while controlling for the effects of sexual and physical abuse. Structural equation modeling was utilized to simultaneously examine the effects of all three abuse types on multiple dependent variables as well as examine whether deficits in emotion regulation mediated the relationship between abuse and eating pathology. Results from a survey of 1,254 female college students revealed significant paths from abuse subtypes to specific eating disorder symptoms, with CEA evidencing the strongest association with ED symptoms. Additionally, emotion dysregulation was positively associated with ED symptoms, and mediated the effects of emotional abuse on symptoms. Findings support previous research on the enduring effects of emotional abuse as well as highlight the importance of the assessment of CEA in the treatment of ED symptoms.

Childhood maltreatment, emotional distress, and early adolescent sexual intercourse: multi-informant perspectives on parental monitoring

This prospective investigation used multi-informant models to examine whether parental monitoring moderated associations between child maltreatment and either emotional distress or sexual intercourse. Data included 637 youth in the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). Child maltreatment was determined by lifetime Child Protective Service records and youth self-report and included sexual, physical, psychological abuse, and neglect (age 12). The moderating variable was youth- and caregiver-reported parental monitoring (age 12). Outcome variables were emotional distress (age 12) and sexual intercourse (age 14). Analyses included multi- and individual-informant models, adjusting for age, ethnicity/race, family income, and study site. Rates of parental monitoring did not differ by gender, but gender-specific analyses found that among girls, but not boys, youth-reported parental monitoring buffered the effect of maltreatment on emotional distress. Subtype analyses found that the buffering effects of monitoring on emotional distress were strongest for sexual and physical abuse and when youth experienced multiple subtypes of maltreatment. Caregiver-reported monitoring was not associated with reduced emotional distress. Youth and caregiver reports of parental monitoring were inversely associated with sexual intercourse, regardless of maltreatment history. Findings suggest that promoting parental monitoring among caregivers, and perceptions of monitoring among youth, may prevent early sexual intercourse regardless of maltreatment history. Promoting parental monitoring among youth with a history of maltreatment, especially girls or those who have experienced sexual or physical abuse or multiple subtypes of abuse, may reduce the likelihood of emotional distress.

[The (in)visibility of psychological family violence in childhood and adolescence]

Psychological family violence in childhood and adolescence is still poorly studied, due to difficulties in its definition and detection. This article aims to examine how psychological family violence reported by children and adolescents has been addressed in academic studies, using a literature review (LILACS, MEDLINE, SciELO, PubMed, CAPES Portal, PsycINFO, and SCOPUS databases). Among 51 epidemiological studies, 16 articles met the review's objectives; some of the articles reported a high prevalence of such violence. The study showed that the issue has been studied more in the international literature than in Brazil, which has significantly increased its visibility in the last decade but still faces difficulties involving definition, conceptualization, and operationalization. Eliminating the invisibility of psychological violence in the family could help promote prevention of such violence and protection of children and adolescents.

Trajectories of maternal verbal aggression across the middle school years: associations with negative view of self and social problems

OBJECTIVE

The primary research objective was to explore the relationship between trajectories of maternal verbal aggression (VA) experienced by low-income, community middle school students across a three-year period and outcomes that have been found to be related to VA in previous work, including a negative view of self and social problems.

METHOD

Longitudinal data were collected from 421 youth (51.8% male) attending two middle schools over 3 years using a multiple-informant survey design. K-means cluster analysis was used to identify trajectories of VA using youth ratings of the Conflict Tactics Scale: Parent-Child (Straus, Hamby, Finkelhor, Moore, & Runyan, 1998). Dependent variables were self-reported depression, self-esteem, delinquency, and peer victimization as well as peer-rated aggression and sensitive-isolated reputation.

RESULTS

Four trajectory groups of VA were identified: Low Stable, Increasing, Decreasing, and High Stable. The 3-year average occurrence of VA was: 1.31, 9.18, 10.24, and 31.14 instances, respectively. Gender-specific MANOVAs revealed dramatic differences between the High Stable and Low Stable groups. High Stable boys reported significantly more depressive symptoms, delinquency, peer overt and relational victimization, and were less likely to have a sensitive/isolated reputation than Low Stable boys. High Stable girls reported significantly more depressive symptoms, low self-esteem, delinquency, peer overt and relational victimization and were rated by peers as having more aggressive/disruptive and relationally aggressive reputations than Low Stable girls. Girls in the High Stable group were more likely than other youth to report levels of depressive symptoms and delinquency >1 SD above the mean, while boys in the High Stable group were more likely to report levels of delinquency >1 SD above the mean. The Increasing and Decreasing groups also demonstrated significantly poorer functioning than the Low Stable group on most outcomes. Growth curve analysis revealed that VA showed a contemporaneous association with self-reported delinquency suggesting these factors are closely related.

CONCLUSIONS

Any level of VA greater than the 1-2 instances per year reported by youth in the Low Stable group was associated with less favorable outcomes.

Emotional maltreatment in Canada: prevalence, reporting and child welfare responses (CIS2)

OBJECTIVES

To determine the prevalence and characteristics of reports of emotional maltreatment (EMT) in Canada, as well as changes in these reports between 1998 and 2003.

METHODS

This study is based on a secondary analysis of data collected in the first and second Canadian Incidence Study. Emotional maltreatment (excluding exposure to intimate partner violence) investigations were categorized into six groups: emotional abuse, emotional neglect, and other maltreatment as the only investigated form of maltreatment, and these same three groups were examined when they co-occurred with another form of maltreatment.

RESULTS

Both the rate of emotional-abuse-only investigations and emotional-neglect-only investigations increased almost threefold from 1998 to 2003. Substantiated emotional neglect investigations had the highest rate of transfer to ongoing services. Half of the investigations involving single forms of emotional maltreatment occurred for six months or more. Finally, emotional neglect cases (in single form and when it co-occurs with another form of maltreatment) were more likely to be associated with emotional harm and longer duration of maltreatment.

CONCLUSIONS

In 2003, EMT represented a significant increasing form of maltreatment and is detected nearly twice as often in situations in which abuse or neglect are also reported. Reports of emotional abuse are two and a half times more frequent than reports of emotional neglect. Nevertheless, lack of emotional engagement may also be difficult to identify, since an omission is more difficult to detect. Reports of EMT often reveal situations of chronic victimization that have been the subject of previous reports and are associated with greater emotional impact.

Childhood maltreatment in subjects with male-to-female gender identity disorder

Childhood maltreatment (CM) is quite common and constitutes a nonspecific risk factor for a range of different psychiatric symptoms during lifespan. It has been demonstrated that sexual minorities are at higher risk of maltreatment and abuse, and a high proportion of transsexual subjects report CM. The aim of this study is to evaluate the prevalence of reported CM in a clinical sample of patients with male-to-female Gender Identity Disorder (MtF GID), and to explore the relationship between these early life events, body image and different psychopathological and clinical variables. A consecutive series of 162 patients with male genotype was evaluated from July 2008 to May 2010. A total of 109 subjects (mean age 36 ± 10 years) meeting the criteria for MtF GID and giving their informed consent were considered. The occurrence of CM experiences was evaluated through a face-to-face clinical interview. Patients were asked to complete the Body Uneasiness Test and Symptom Checklist-90 Revised. More than one-fourth of patients reported CM. Maltreated subjects reported a higher body dissatisfaction and display a worse lifetime mental health. The presence of reported CM in these patients has relevant psychopathological implications, and therefore should be carefully investigated.

Differential effects of psychological maltreatment on children of mothers exposed to intimate partner violence

OBJECTIVE

Psychological maltreatment (PM) is the most prevalent form of child abuse, and is the core component of most of what is considered as child maltreatment. The aim of this work was to explore differential adverse outcomes of the different types of PM in the mental health and functioning of children living in homes in which they are exposed to intimate partner violence (IPV).

METHOD

Participants were 168 children, aged between 4 and 17, whose mothers experienced IPV. They were assessed using different measures of psychopathology and functioning: Diagnostic Interview for Children and Adolescents-IV, Child Behavior Checklists and Child and Adolescent Functioning Assessment Scale. Furthermore, IPV was assessed with the Schedule for Assessment of Intimate Partner Violence Exposure in Children and the Index of Spouse Abuse. Statistical analyses were carried out with regression models adjusted by means of Generalized Estimating Equations.

RESULTS

Spurning was the PM subtype with the greatest global effect on the children, as it was significantly associated with internalizing and externalizing problems. Denying emotional responsiveness specifically increased the risk of internalizing psychopathology and impairment in the emotional area. Terrorizing was not significantly associated with a greater number of negative outcomes in children's psychopathology or functioning in this population.

IMPLICATIONS

The results suggest the importance of taking PM types into account in order to fully understand the problems of children exposed to IPV at home, and for the design of effective treatment and prevention programs.

Maternal rejection of the young child: present status of the clinical syndrome

This article reviews severe disorders of the mother-infant relationship involving emotional rejection of the infant in the first year of its life. Infants exposed to their mother's hatred and rage may suffer far-ranging and long-term disadvantages, and are at risk of maltreatment. Diagnosis, therapy and research have been hampered by the lack of recognition of this clinical syndrome in the classifications. The imminent revision of these classificatory systems must include them.

Distinguishing neglect from abuse and accident: analysis of the case files of a hospital child protection team in Israel

The study compares the characteristics of children assessed as neglected, physically abused, or accident victims by a hospital child protection team (CPT) and identifies the information on which the CPT based its assessments. The comparison is based on content analysis of records of 414 children examined by the CPT in a major hospital in Israel between 1991 and 2006, of whom 130 (31.4%) were neglected, 54 (13.0%) were physically abused, and 230 (55.6%) were accident victims. Findings of three hierarchical logistic regressions show that the children classified as neglected had the most early development problems, but were the least likely to have received psychological treatment, and that that their families were the most likely to be receiving state financial support and to have had prior contact with the social services. They also show that the CPT had received the least information indicative of maltreatment about these children from the community and that their medical and physical examinations aroused the least suspicion. Finally, they show that the impressions the hospital staff and CPT had of the parents during the hospital visit had greater power to distinguish between the groups than the children's characteristics or the parents' socio-demographic background. The findings attest to the ability of the CPT to differentiate between neglect victims and physical abuse or accident victims. With this, they also point to ambiguities in the classification process that should be addressed by further research and training and to the need for detailed and thorough documentation of the information and observations on which the CPT's assessments are based.

Skin conductance reactivity and respiratory sinus arrhythmia among maltreated and comparison youth: relations with aggressive behavior

OBJECTIVE

The goal of this study was to examine respiratory sinus arrhythmia (RSA), an indicator of parasympathetic nervous system-linked cardiac activity, and skin conductance level (SCL), a sympathetic indicator, as moderators of the link between child maltreatment and adolescent aggression.

METHOD

Participants were 234 maltreated (48.3% male) and 128 (57.8% male) comparison youth aged 9-16 years participating in wave 2 of a longitudinal study.

RESULTS

Regression analyses suggest that among boys, high RSA may be protective against the effects of maltreatment on aggressive behavior. Among girls, the moderating effect of RSA was further moderated by SCL reactivity such that low levels of both baseline RSA and SCL reactivity, or conversely high levels of both baseline RSA and SCL reactivity, exacerbated the link between maltreatment and aggression.

CONCLUSIONS

High RSA may protect against the effects of maltreatment on aggressive behavior, though this effect may be moderated by SCL reactivity among girls.