Relations between early maltreatment and mental representations of relationships assessed with projective storytelling in middle childhood

Childhood maltreatment and parenting style associated school bullying in Chinese children and adolescents: An analytical epidemiology evidence

OBJECTIVE

The independent associations among childhood maltreatment (CM), parenting style, and school bullying in children and adolescents have not been adequately discussed. Epidemiological evidence of higher quality is still scarce. We intend to investigate this topic by using a case-control study design in a large sample of Chinese children and adolescents.

METHOD

Study participants were chosen from the Mental Health Survey for Children and Adolescents in Yunnan (MHSCAY), a mega ongoing cross-sectional study. The combined database from four study sites was used. The population-based case-control study was individually matched by study site, age, sex, race, left-behind status, whether a single child, and whether a boarding student.

RESULTS

Cases were observed to have a significantly higher prevalence of CM, higher scores for parental rejection and over-protection, and lower scores for parental emotional warmth. Multiple conditional logistic regression revealed that CM, especially emotional abuse (EA) and sexual abuse (SA), were associated with a prominently increased risk of school bullying involvement, with adjusted odds ratio (OR) of 2.28 (95 % CI: 2.03, 2.57) and 1.90 (95 % CI: 1.67, 2.17). Subsequent analysis further corroborated the robustness of EA-bullying and SA-bullying associations. Although parenting style generally showed a weaker association with school bullying, a higher level of parental rejection was related to an increased risk of bullying victimization.

CONCLUSIONS

Chinese children and adolescents who are victims of EA or SA, or experienced a higher level of parental rejection, are more vulnerable to school bullying. Targeted interventions should be designed and implemented.

Development and initial validation of the Odense Child Trauma Screening: a story stem screening tool for preschool and young schoolchildren

Background:

Early identification of young children exposed to trauma who are at risk of developing post-trauma symptomatology such as posttraumatic stress disorder (PTSD) or other emotional or behavioral problems is important for allocating appropriate treatment and preventing long-term consequences. However, assessment of young children exposed to trauma is challenging because children may not be able to talk about their trauma or trauma reactions. Story stem tools combine storytelling and play to access the internal world of young children and can be used in the assessment of children exposed to trauma.

Objective:

To examine reliability and validity of a new story stem tool, the Odense Child Trauma Screening (OCTS). OCTS was developed to screen for play-based behavior and narrative representations indicative of traumatization in preschool and young schoolchildren.

Method:

Forty-nine Danish children aged 4.5–8.9 years (M = 6.6, SD = 1.2) participated in the OCTS. Participants included a risk sample of 31 children exposed to traumas and a community sample of 18 children. Caregivers were interviewed about child symptoms of PTSD, major depressive disorder (MDD), and reactive attachment disorder (RAD) and answered the Strengths and Difficulties Questionnaire (SDQ). The community sample completed OCTS test-retests.

Results:

Interrater reliability proved excellent (ICC = .96-1.00). Test-retest reliability was acceptable (ICC = .66). Significant moderate correlations were found between the OCTS total score and scales of PTSD, MDD and RAD and the SDQ Total Difficulties Scale. The ability of the OCTS to discriminate between children from the risk and community sample was good.

Conclusions:

The study provided preliminary evidence of reliability and validity of the OCTS as a screening tool for young children exposed to trauma. OCTS shows promise as a standardized, age-appropriate informant-based screening measure applicable for clinical assessment.

Exploring Attachment and Internal Representations in Looked-After Children

BACKGROUND

This article explores the Story Stem Assessment Profile (SSAP), a narrative-based measure, for the assessment of internal representations in children between the ages of 4 and 11 years old.

METHODS

The findings draw upon two samples of children comprising of a sample of looked-after children at Five Rivers Child Care (FR) (n = 42) and a community-based population (n = 42). The FR group identified were suggested to have a higher level of need, as defined by scores obtained from the Strengths and Difficulties Questionnaire (SDQ) and Relationship Problems Questionnaire (RPQ).

RESULTS

Using the SSAP, the findings indicate the instrument's discriminant validity with strong differences being displayed between the two populations. Consistently children in the FR sample displayed more disorganized, avoidant and negative representations, whilst at the same time having significantly fewer representations characteristic of 'secure' attachment.

CONCLUSION

The SSAP is successful in differentiating between 'low' and 'high' cohorts of children aged 4-11 years. The study provides strong support for the measure as a way of capturing internal and attachment representations, with further research to explore possible changes in these representations at follow-up being promising and intriguing. Continued research efforts at FR will allow for improved clinical formulations, increased understanding and therefore positive outcomes relating to the children in their care.

Child maltreatment and adult depressive symptoms: Roles of self-compassion and gratitude

Child maltreatment, including abuse (physical, emotional, and sexual) and neglect (physical and emotional), is positively associated with depressive symptoms in adulthood. However, most studies have been conducted within a psychopathological framework and focused on underlying dysfunctional processes (e.g., insecure attachment styles, maladaptive schemas, and negative attribution styles). Protective factors that affect the relationship between child maltreatment and adult depressive symptoms are underexplored. Guided by emotion regulation theory and the perspective of positive psychology, we examined the roles of self-compassion and gratitude as protective factors in the relationship between child maltreatment and adult depressive symptoms in a sample of 358 college students. Results showed that psychological maltreatment (emotional abuse and emotional neglect) was associated with adult depressive symptoms through decreased self-compassion. Neglect (emotional neglect and physical neglect) and sexual abuse were associated with adult depressive symptoms through decreased gratitude. There was no association between physical abuse and depressive symptoms through either self-compassion or gratitude. Our findings suggest that clinical practices focusing on self-compassion and gratitude might help prevent the development of adult depressive symptoms among clients with a history of maltreatment in childhood.

Child maltreatment and interpersonal relationship among Chinese children with oppositional defiant disorder

Child maltreatment negatively affects children's development and wellbeing. This study investigated the associations between child maltreatment (i.e., emotional neglect, emotional abuse, and physical abuse) and interpersonal functioning, including parent-child relationship, teacher-student relationship, and peer relationships among children with oppositional defiant disorder (ODD). A total of 256 children with ODD and their parents and class master teachers from Mainland China completed questionnaires. Results showed a negative correlation between emotional abuse (parent-reported) and children's interpersonal relationships with parents, teachers, and peers. Emotional neglect and physical abuse were related to poor parent-child relationships. Latent profile analysis revealed three profiles of child maltreatment among children with ODD. ODD children with more severe levels of one type of maltreatment were also more likely to have experienced severe levels of other types of maltreatment. Children with ODD who were in the group of high maltreatment had the poorest quality of interpersonal relationships. Our findings highlight the urgent need to prevent child maltreatment and promote more positive parenting in families with ODD children.

Physical Child Abuse and Teacher Harassment and Their Effects on Mental Health Problems Amongst Adolescent Bully-Victims in Taiwan

This study compared physical child abuse and teacher harassment of bully-victims with other groups and examined their associations with mental health problems in bully-victims. For 6,160 adolescents, experiences of physical child abuse, teacher harassment, peer bullying, and six mental health problem indicators were assessed. Adolescents that had experienced physical child abuse and teacher harassment were more likely to be bully-victims but not neutral or pure victims. Adolescents who reported physical child abuse were more likely to be bully-victims but not pure bullies. Bully-victims that had experienced teacher harassment exhibited more severe depression and insomnia than did those without teacher harassment. Gender had moderating effects on the difference in physical child abuse between bully-victims and neutrals and on the association between physical child abuse and suicidality in bully-victims. Physical child abuse and teacher harassment should be considered when preventive and intervention programs are developed for adolescents.

Emotion regulation development of children adopted from institutional care

Számtalan nemzetközi vizsgálat igazolta, hogy az intézetekből örökbefogadott gyerekek, bár sok területen jelentős fejlődést mutatnak, még évekkel családba kerülésük után is sok szocioemocionális problémával küzdenek. Nagyon keveset tudunk azonban azokról a folyamatokról, amelyeken keresztül a korai élmények ezekhez a fejlődési problémákhoz vezetnek. Az itt bemutatott vizsgálat célja az érzelemregulációs képességek fejlődésének jobb megismerése örökbefogadott gyermekeknél, mivel ezen képességek alapvető feltételei a pszichés egészségnek, a hatékony társas működésnek. A vizsgálat központi hipotézise, hogy azok a gyerekek, akik életük első (minimum) 6 hónapját intézetben töltötték, fejletlenebb érzelemregulációs képességgel rendelkeznek. A vizsgálatban 90 4 és 6 év közötti gyerek vett részt, akik a 3 vizsgálati csoport egyikébe tartoztak: 1. olyan gyerekek, akik születésükkor gyermekotthonba kerültek, és ott éltek örökbefogadásukig, de leg¬alább 6 hónapos korukig; 2. csecsemőkorban (6 hetes koruk előtt) örökbefogadott gyerekek; 3. (kontroll) vér szerinti családjukban élő gyerekek. A vizsgálat során az érzelemregulációs képességet a játék-narratívák elemzésével (MacArthur Story Stem Battery) vizsgáltuk. A három vizsgálati csoport összehasonlításának eredményeit összefoglalva elmondható, hogy igazolódott az a hipotézis, miszerint az intézeti gondozás egyik fontos következménye az elmaradás az érzelemregulációs képességekben. Ugyanakkor az eredmények arra is felhívják a figyelmet, hogy az újszülött korban örökbefogadott gyerekek bizonyos érzelemregulációs képességei is, bár jóval kevésbé, de eltérnek a vér szerinti kontrollcsoportétól. Ez az eredmény összefüggésbe hozható egyrészt pre- és perinatális tényezőkkel, másrészt pedig az örökbefogadó szülők és család jellegzetességeivel, valamint az örökbefogadottság tényéből következő vulnerabilitással.

Children classified as controlling at age six: Evidence of disorganized representational strategies and aggression at home and at school

The purpose of this study was to determine whether children classified as controlling in attachment differ from children classified into the traditional Ainsworth attachment categories in their symbolic representations of attachment and level of behavior problems. Sixty-nine middle-class kindergarten children and their mothers participated in a laboratory separation and reunion. Children enacted doll-play stories about attachment-related themes. A four-group representation classification scheme was developed from the doll-play transcripts of 27 children. Mothers (n = 44) completed Achenbach's Child Behavior Checklist and teachers (n = 40) completed a 30-item inventory of classroom behavior. Results showed significant agreement between the representational system and Main and Cassidy's classification system (1988) for children's reunion behavior. The doll-play of controlling children was characterized by themes of catastrophe and helplessness or by complete inhibition of play and suggested disorganization of representational processes. Controlling children also were described by mothers and teachers as significantly more aggressive than other children. The results validate the distinction between the controlling and traditional classification groups and suggest that controlling children are at risk for behavioral maladaptation at home and at school.

The impact of foster care on development

Foster care is a protective intervention designed to provide out of home placement to children living in at-risk home environments. This study employs prospective longitudinal data (N = 189) to investigate the effects of foster care on the development of child behavior and psychological functioning taking into account baseline adaptation prior to placement and socioeconomic status at the time of placement. Comparisons were made among three groups: children who experienced foster care, those who were maltreated but remained in the home, and children who had not experienced foster care or maltreatment despite their similarly at-risk demographic characteristics. In the current sample, children placed in out of home care exhibited significant behavior problems in comparison to children who received adequate care, and using the same pre- and postplacement measure of adaptation, foster care children showed elevated levels of behavior problems following release from care. Similarly, children placed into unfamiliar foster care showed higher levels of internalizing problems compared with children reared by maltreating caregivers, children in familiar care, and children who received adequate caregiving. Findings suggest that outcomes related to foster care may vary with type of care and beyond the effects associated with maltreatment history, baseline adaptation, and socioeconomic status.

Social perspective-taking skills in maltreated children and adolescents

The primary goal of this study was to assess the ability of maltreated school-age children and adolescents to understand the thoughts, feelings, and points of view of others. Level of egocentrism and social perspective-taking coordination were assessed in a group of 49 maltreated and 49 demographically matched nonmaltreated children. Twenty-six elementary and 23 high school students in each group were individually interviewed and their responses to hypothetical interpersonal situations coded for egocentricity and level of perspective-taking ability. The findings revealed that maltreated children and adolescents were more egocentric and delayed in their social perspective-taking development than their nonmaltreated peers and that they reported lower levels of global self-worth. However, differences within the group of maltreated children and adolescents emerged with regard to negotiating novel relationships, as those with fewer internalizing or externalizing symptoms exhibited better skills in this area than their peers who displayed more symptoms.

Child neglect: developmental issues and outcomes

OBJECTIVE

This article highlights the manner in which child neglect, the most common form of maltreatment, affects children's development.

METHOD

The review is organized according to three developmental periods (i.e., infancy/preschool, school-aged and younger adolescents, and older adolescents and adults) and major developmental processes (cognitive, social-emotional, and behavioral). Although the focus is on specific and unique effects of various forms of child neglect, particular attention is paid to studies that allow comparisons of neglect and abuse that clarify their similarities and differences.

RESULTS

Past as well as very recent findings converge on the conclusion that child neglect can have severe, deleterious short- and long-term effects on children's cognitive, socio-emotional, and behavioral development. Consistent with attachment and related theories, neglect occurring early in life is particularly detrimental to subsequent development. Moreover, neglect is associated with effects that are, in many areas, unique from physical abuse, especially throughout childhood and early adolescence. Relative to physically abused children, neglected children have more severe cognitive and academic deficits, social withdrawal and limited peer interactions, and internalizing (as opposed to externalizing) problems.

CONCLUSIONS

The current review offers further support for the long-standing conclusion that child neglect poses a significant challenge to children's development and well-being. Limitations with regard to the state of the knowledge are discussed and directions for future research are outlined.

Parental maltreatment and emotion dysregulation as risk factors for bullying and victimization in middle childhood

Examined whether children who were maltreated by caregivers were more likely to bully others and to be at risk for victimization by peers. An additional focus was to investigate emotion's role in bullying and victimization among children at risk. Participants were 169 maltreated and 98 nonmaltreated boys and girls attending a summer day camp for inner-city children. As predicted, maltreated children were more likely than nonmaltreated children to bully other children. Bullying was especially prevalent among abused children who experienced maltreating acts of commission (physical or sexual abuse). Maltreatment also placed children at risk for victimization by peers. Gender did not moderate these findings, in that maltreated boys and girls appeared to be at similar risk for bullying and victimization. As expected, both bullies and victims evidenced problems with emotion regulation. Furthermore, logistic regression analyses suggested that emotion dysregulation made a unique contribution toward differentiating bullies and victims from children who did not evidence bully-victim problems. In addition, maltreatment's effects on children's risk for bullying and victimization were mediated by emotion dysregulation.

Friendship quality and sociometric status: between-group differences and links to loneliness in severely abused and nonabused children

OBJECTIVE

There were two main aims: first, to illuminate the difference between abused children's general popularity with classmates and success in close friendships; second, to examine the specific interactional qualities of abused children's friendships and their links to loneliness.

METHOD

Thirty-five severely abused children and 43 matched, nonabused children were compared on peer-rated sociometric status, self-reported loneliness, and observed and self-reported friendship quality.

RESULTS

Abused children were not rated significantly lower sociometrically, nor did they differ significantly from control children on several measures of friendship quality, such as resolving conflicts and helping each other. However, abused children were observed to be more negative and less proactive in their interactions. They also reported their friendships as being more conflictual, and as higher on betrayal and lower on caring. Only observational friendship variables predicted loneliness.

CONCLUSIONS

The results challenge the assumption that abused children's peer relationships are uniformly more maladaptive than nonabused children's, and point to the possible benefits of structured interventions for "normalizing" their friendship interactions. The pattern of difficulties exhibited by abused children (e.g., conflict) provides foci for more specific interventions. Multi-method assessments are necessary and the multi-dimensional nature of children's social adjustment is important to understand.

Narrative representations of caregivers and emotion dysregulation as predictors of maltreated children's rejection by peers

This study examined whether maltreated children were more likely than nonmaltreated children to develop poor-quality representations of caregivers and whether these representations predicted children's rejection by peers. A narrative task assessing representations of mothers and fathers was administered to 76 maltreated and 45 nonmaltreated boys and girls (8-12 years old). Maltreated children's representations were more negative/constricted and less positive/coherent than those of nonmaltreated children. Maladaptive representations were associated with emotion dysregulation, aggression, and peer rejection, whereas positive/coherent representations were related to prosocial behavior and peer preference. Representations mediated maltreatment's effects on peer rejection in part by undermining emotion regulation. Findings suggest that representations of caregivers serve an important regulatory function in the peer relationships of at-risk children.

Narrative representations of caregivers and self in maltreated pre-schoolers

This study examined narrative representations of parents and of self, as well as child behavior during the assessment, in maltreated (N = 56) and demographically comparable non-maltreated (N = 37) pre-school-aged children in a one-year longitudinal study. Maltreated children evidenced more negative representations of parents and of self at Time 2, including the juxta-position of both a negative and a grandiose self. Over time there was a marginal interaction such that maltreated children portrayed fewer disciplining parent representations and nonmaltreated children portrayed more. Also over time, maltreated children portrayed marginally more grandiose self-representations and nonmaltreated children fewer. Furthermore, maltreated children demonstrated less responsivity to the examiner over time and nonmaltreated children demonstrated more. The deleterious effects of maltreatment on representations of self and of others, especially as development proceeds, are discussed, and the importance of providing attachment-informed intervention prior to the consolidation of these negative representations is highlighted.

Initial development of the expectations test for children: a tool to investigate social information processing

This research describes the initial development of a new measure to assess the expectations of children for social situations. Responses are provided to 16 ambiguous photographs of children. Answers identify expectations for how the child will feel and what will happen to the child in each picture. The value of expectations in identifying and understanding psychopathology was investigated. The effects of child abuse and the parent-child relationship on expectations were studied. Results begin to demonstrate the potential for clinical use, interrater reliability, internal consistency, and validity. Future development is discussed with the caution that limited variance is explained by the Expectations Test at this point.

Narrative representations of moral-affiliative and conflictual themes and behavioral problems in maltreated preschoolers

Examined whether maltreated preschoolers are more likely than nonmaltreated preschoolers to have fewer moral-affiliative and more conflictual narrative representations and whether these representations mediate child behavior problems. A structured narrative story-telling task was administered to assess representations, and independent ratings of behavior problems were obtained from teachers. The narratives of maltreated children contained more conflictual and fewer moral-affiliative themes. Maltreated children also exhibited more internalizing and externalizing behavior problems. A partial mediation effect of conflictual representations on the relation between child maltreatment and externalizing behavior problems was found. The results demonstrate the relation between child maltreatment and children's organization of their life experiences and their behavioral symptomatology.

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.