Home treatment for two infants who witnessed their mother's murder

Forgiveness, and other themes, in women whose fathers killed their mothers

The purpose of this article is to describe the experiences of adult women who, when they were children, experienced the homicide of their mother by their father. Two qualitative interviews were conducted with a convenience sample of 31 women survivors of uxoricide to create a qualitative description of the phenomenon. A number of themes have emerged including descriptions of the daughter "seeking understanding," "forgiving the father" (or not), and descriptions of the father in terms of his being her father or in terms of his behavior and the homicide.

Preschooler witnesses of marital violence: Predictors and mediators of child behavior problems

This paper describes a conceptual approach to understanding the impact of marital violence on preschoolers, examines the predictors and mediators of child behavioral problems in a clinical sample of multiethnic preschoolers who witnessed their mothers' battering by their father figure, and presents empirical evidence supporting the use of relationship-based therapeutic modalities in treating preschoolers exposed to violence. We find that exposure to violence and maternal life stress are each predictive of child behavior problems, and that the impact of maternal life stress on child behavior problems is mediated by maternal psychopathology and the quality of the mother-child relationship.

Heart period and variability findings in preschool children with posttraumatic stress symptoms

BACKGROUND

Traumatic experiences for young children might result in profound neurodevelopmental changes, compared with adults. Our aim was to examine autonomic control of heart rate in traumatized young children.

METHODS

Sixty-two children who had suffered traumas and 62 nontraumatized control children, aged 20 months to 6 years, were assessed for posttraumatic stress disorder (PTSD) symptoms, interbeat interval, respiratory sinus arrhythmia (RSA), family rehearsal of the trauma, and parent-child relationship quality.

RESULTS

Traumatized children with PTSD and traumatized children without PTSD both had decreased heart period in response to a trauma stimulus relative to the nontraumatized group (both p < .0167). there was no main effect for RSA change scores, however, there was a significant interaction effect between parental positive discipline with PTSD symptoms and RSA. The most sympathetic children had decreased RSA during the trauma stimulus when they had caregivers with less positive discipline during a clean-up nd family rehearsal with PTSD symptoms.

CONCLUSIONS

These findings underscore that psychopathology in young children ought to be assessed in the context of psychophysiology and parent-child relationship to optimally understand the mechanisms of maladaptation during this complex developmental period.

Uxoricide: a phenomenological study of adult survivors

The effect on children of the murder of a parent by the other parent, uxoricide, is immediate and devastating. Usually in a single act, the child loses both parents, one to death and the other to the criminal justice system. This is a report on a qualitative study, with a sample of seven adults, designed to explore the experiences of these children as they grow to adulthood. The major themes developed in the data analysis include (1) a surprising lack of anger regarding the perpetrator, (2) intimate abuse in later personal relationships, and (3) a beginning description of paths to recovery.

A relational perspective on PTSD in early childhood

This paper describes the clinical and research evidence for the importance of the relational context of posttraumatic stress disorder in young children. We review 17 studies that simultaneously assessed parental and child functioning following trauma. In many studies, despite limitations, an association between undesirable parental/family variables and maladaptive child outcomes has been consistently found. We present a model of the parental/family variables as moderators and vicarious traumatic agents for symptoms in young children. Also, a Compound Model is proposed, with three distinctive patterns of the parent-child relationship that impact on posttraumatic symptomatology in young children. Implications for clinical practice and research directions are discussed.

Psychopathology in infancy

The first three years of life present unique challenges to the study of psychopathology. We highlight four of the issues in a selective review of the developmental psychopathology of early childhood, including lack of specificity of risk and outcome variables, measurement difficulties, rapid developmental changes and the centrality of the relationship context in early childhood. We also highlight issues relevant to conceptualizations of disorders of infancy, emphasizing especially the need for efforts to validate clinical disorders. We consider two major domains of infant development that we believe are especially relevant to a discussion of psychopathology, namely, regulation of emotion and infant-caregiver attachment. Discussions of these two domains of infant development and their psychopathological extremes allow us to consider conceptualizations of psychopathology from the dual perspectives of developmental psychopathology and clinical disorders. We conclude by suggesting a number of strategies to build upon previous research.

Two approaches to the diagnosis of posttraumatic stress disorder in infancy and early childhood

OBJECTIVE

The reliability and validity of DSM-IV criteria and an alternative set of criteria for posttraumatic stress disorder (PTSD) are assessed in infants and young children (younger than 4 years of age).

METHOD

This study was conducted in three phases. Phase 1 applied DSM-IV criteria for PTSD to 20 case reports of severely traumatized infants from the literature. Phase 2 used an expanded checklist of symptoms that were developmentally sensitive and behaviorally anchored to create an alternative set of criteria for PTSD in infants. Phase 3 compared the DSM-IV criteria to the alternative criteria on 12 new cases of traumatized infants.

RESULTS

Infants and young children who have experienced severe traumas show many symptoms of impairment, similar to posttraumatic symptoms in older children and adults. The alternative criteria were more reliable and more valid for diagnosing PTSD in infancy than DSM-IV criteria.

CONCLUSIONS

Clinicians ought to be aware that infants and young children can develop posttraumatic disorders after traumatic events. Criteria for diagnosing these disorders in standard nosologies may need revision for use with children younger than 48 months of age.

Homicide as a risk factor for PTSD among surviving family members

In this National Institute of Justice-funded study, random digit dialing telephone survey methodology was used to screen a large, nationally representative sample (N = 12,500) of the noninstitutionalized U.S. adult population to identify surviving family members and friends of victims of criminal homicide and alcohol-related vehicular homicide. A total of 9.3% of the national sample had lost a family member or friend to homicide. Immediate family survivors (n = 206) completed an interview assessing demographic characteristics and DSM-III-R criteria for homicide-related post-traumatic stress disorder (PTSD). The interview participation rate was 84%. Among immediate family survivors, 23.3% developed PTSD at some point in their lifetimes, and 4.8% met full diagnostic criteria for PTSD during the preceding 6 months. Survivors of criminal and vehicular homicide victims were equally likely to develop PTSD. Survivors who experienced the homicide during their childhood, adolescence, or adulthood also showed equal likelihood of PTSD. Clinical implications of findings are discussed.

Father kills mother. Issues and problems encountered by a child psychiatric team

The child whose mother is killed by his or her father has to cope with the trauma of violence, the grief associated with the loss of both parents simultaneously, dislocation and insecurity regarding where and with whom they will live, stigma, secrecy, and often massive conflicts of loyalty. These issues and how they affected the 28 children of 14 families in which the father had killed the mother are examined. Recommendations for practice based on this clinical experience are proposed.