Concordance of Parent- and Child-Reported Physical Abuse Following Child Protective Services Investigation

Childhood maltreatment and the structural development of hippocampus across childhood and adolescence

BACKGROUND

Prior studies suggest that childhood maltreatment is associated with altered hippocampal volume. However, longitudinal studies are currently scarce, making it difficult to determine how alterations in hippocampal volume evolve over time. The current study examined the relationship between childhood maltreatment and hippocampal volumetric development across childhood and adolescence in a community sample.

METHODS

In this longitudinal study, a community sample of 795 participants underwent brain magnetic resonance imaging (MRI) in three waves spanning ages 6-21 years. Childhood maltreatment was assessed using parent-report and children´s self-report at baseline (6-12 years old). Mixed models were used to examine the relationship between childhood maltreatment and hippocampal volume across time.

RESULTS

The quadratic term of age was significantly associated with both right and left hippocampal volume development. High exposure to childhood maltreatment was associated with reduced offset of right hippocampal volume and persistent reduced volume throughout adolescence.Critically, the relationship between childhood maltreatment and reduced right hippocampal volume remained significant after adjusting for the presence of any depressive disorder during late childhood and adolescence and hippocampal volume polygenic risk scores. Time-by-CM and Sex-by-CM interactions were not statistically significant.

CONCLUSIONS

The present study showed that childhood maltreatment is associated with persistent reduction of hippocampal volume in children and adolescents, even after adjusting for the presence of major depressive disorder and genetic determinants of hippocampal structure.

Alignment of parent-proxy report and teen self-report of adverse childhood experiences among U.S. teens

PURPOSE

Data on adverse childhood experiences (ACEs) among teens is collected using a single informant, a parent-proxy, or teen self-report. Little is known about alignment between these approaches.

METHODS

Surveys were administered online to teens ages 15-17 and their parents (n = 522 dyads) using the AmeriSpeak panel. We present descriptive statistics on the prevalence and measures agreement for 18 ACEs based on teen self-report and parent-proxy report. We fit multivariable models examining associations between teen and household demographic characteristics and discordance in ACE report.

RESULTS

Based on teen-self report and parent-proxy report, cumulative and individual ACE prevalence was overall similar. However, discordance was found in individual ACE reports within teen-parent dyads (discordance ranged: 2.9-21.2 %). Lowest agreement was among ACEs related to abuse, neglect, and violence victimization and highest among household challenges. Furthermore, parent-teen dyads with LGB+ youth (vs. heterosexual) and Black, Hispanic, and multiracial or another race (vs. White) youth were more likely to have discordant responses among several ACEs.

CONCLUSIONS

Surveillance and programmatic efforts should consider the type of ACE and the reporter when using data to inform prevention strategies. Teen self-report for abuse, neglect, and violence victimization and community challenges ACEs are particularly important to capture.

The Prevalence, Predictors, and Health Consequences of Disagreement in Reports of Child Maltreatment Exposure

The purpose of this study was to examine the prevalence, predictors, and consequences of disagreement between prospective caregiver and retrospective child reports of childhood physical and emotional maltreatment. The design was a secondary analysis of data from the Avon Longitudinal Study of Parents and Children, a three-decade long UK-based birth cohort. Prospective caregiver reports were in poor to fair agreement with retrospective child reports for physical and emotional maltreatment exposure, with caregivers tending to underreport exposure. Disagreement between reporters was associated with increased risk of depressive symptoms and substance use severity, but decreased risk for mental health diagnoses. Screening measures of childhood maltreatment exposure should take caution against using measures from different reporters interchangeably (i.e., from mother versus child). Disagreement in reports may indicate unmet need for mental health evaluation.

Mother-child reporting discrepancies of child physical abuse: Associations with internalizing and externalizing symptoms

BACKGROUND

Mother-child discrepancies frequently occur in reports of child physical abuse. Such report discrepancies raise important challenges for interpreting and integrating data from multiple informants in forensic and clinical settings.

OBJECTIVES

The main goal of this study was to identify patterns of mother-child discrepancies in reporting CPA using latent profile analysis. We then tested differences between profiles on mothers' mental health problems and children's internalizing and externalizing symptoms.

PARTICIPANTS AND SETTING

Participants were 159 mother-child dyads with police-documented exposure to intimate partner violence.

METHOD

Participants were recruited from Child Protective Services and shelter residences from all regions of Portugal. After obtaining informed consent, assessment protocols were administered separately to mothers and children.

RESULTS

We identified two convergent profiles (mother-child agreement on reports of both high and low exposure to CPA) and one divergent profile (the child reported significantly higher exposure to CPA than the mother). Mothers from the divergent profile reported more depressive and post-traumatic stress symptoms than mothers from the convergent profiles. Children of the divergent profile and one of the convergent profiles (mother-child agreement on high exposure to CPA) showed the highest internalizing and externalizing symptoms.

CONCLUSIONS

These results illustrate how examining informant discrepancies in the assessment of abusive parenting practices increases our understanding of children's psychological adjustment in high-risk contexts.

Child and Caregiver Reporting on Child Maltreatment and Mental Health in the Philippines Before and After an International Child Development Program (ICDP) Parenting Intervention

Child maltreatment is a serious problem affecting millions of children. Research on self-reporting of child maltreatment has shown a difference in reporting between caregivers and children. Increased understanding of this has implications for further evaluations of parenting programmes and assessment of violence and maltreatment. The purpose of this study was to explore caregiver-child reporting discrepancies on child maltreatment and emotional health before and after piloting of the International Child Development Program (ICDP) in the Philippines. Data was collected from caregivers and their children before and after caregiver participation in ICDP. Participants were selected from the Pantawid Pamilyang Pilipino Program in Leyte by Save the Children. Caregivers and children completed a questionnaire with some adapted items from the Conflict Tactics Scale Parent-Child version (CTSPC), some relevant complementary items on psychological aggression and items from the emotional problems subscale from the Strength and Difficulties Questionnaire (SDQ). Matching items, subscales and total count scores were compared using paired t-tests in STATA 14. Forty-six caregivers and 43 children aged from 5-13 years participated at baseline, and 44 caregivers and 42 children at endline. At baseline, children reported significantly more maltreatment than their caregivers. The groups reported similarly at baseline and endline on the items from the subscale on emotional problems. Both children and caregivers had lower scores on our harsh discipline scale at endline, indicating improved parenting strategies after the intervention. These results indicate a difference in reporting of child maltreatment between caregivers and children, with higher rates reported by the children before the intervention, but not after. This is important because it illustrates child and caregiver perspectives on maltreatment, and how they can differ. As such, our findings point towards a positive effect of ICDP on parenting.

Discrepancies between children's and caregivers' child maltreatment reporting and their associations with child wellbeing

BACKGROUND

Child maltreatment reporting is critical for case investigation and service disposition. However, reporting discrepancies across informants is a challenge for child welfare services.

METHODS

Using data from the Fragile Families and Child Wellbeing Study (n = 3150), the current study examined child-caregiver discrepancies in reporting the frequencies of psychological and physical maltreatment. Multivariate models were used to examine how caregivers' reports, children's reports, and discrepancies between the two were associated with child anxiety, depression, aggression, and delinquency.

RESULTS

A quarter of the children reported psychological maltreatment at a higher (25.7 %) or lower (23.8 %) frequency than their caregivers' report, respectively; 8.4 % and 8.7 % of the children did so in physical maltreatment reports, respectively. Multivariate models showed that children's maltreatment reports were more closely associated with children's anxiety, depression, and delinquency than caregivers' reports, while caregivers' reports were more closely associated with children's aggression. After accounting for caregivers' reporting and other covariates, children who reported more frequent psychological maltreatment than their caregivers' report had a higher level of anxiety, depression, and delinquency (b = 0.17 to 0.25, p < 0.001), and the opposite was true (b = -0.36 to -0.13, p < 0.001). Similarly, children who reported more frequent physical maltreatment than their caregivers' report had a higher level of all negative outcomes (b = 0.04 to 0.44; p = 0.04 to <0.00), and the opposite was true for aggression (b = -0.08, p = 0.004).

CONCLUSIONS

The findings suggest that in addition to other reporting barriers, children and caregivers may perceive maltreatment differently, and such discrepancies are related to children's wellbeing.

Building Infrastructure for Surveillance of Adverse and Positive Childhood Experiences: Integrated, Multimethod Approaches to Generate Data for Prevention Action

Adverse and positive childhood experiences have a profound impact on lifespan health and well-being. However, their incorporation into ongoing population-based surveillance systems has been limited. This paper outlines critical steps in building a comprehensive approach to adverse and positive childhood experiences surveillance, provides examples from the Preventing Adverse Childhood Experiences: Data to Action cooperative agreement, and describes improvements needed to optimize surveillance data for action. Components of a comprehensive approach to adverse and positive childhood experiences surveillance include revisiting definitions and measurement, including generating and using uniform definitions for adverse and positive childhood experiences across data collection efforts; conducting youth-based surveillance of adverse and positive childhood experiences; using innovative methods to gather and analyze near real-time data; leveraging available data, including from administrative sources; and integrating data on community- and societal-level risk and protective factors for adverse childhood experiences, including social and health inequities such as racism and poverty, as well as policies and conditions that create healthy environments for children and families. Comprehensive surveillance data on adverse and positive childhood experiences can inform data-driven prevention and intervention efforts, including focusing prevention programming and services to populations in greatest need. Data can be used to evaluate progress in reducing the occurrence of adverse childhood experiences and bolstering the occurrence of positive childhood experiences. Through expansion and improvement in adverse and positive childhood experiences surveillance-including at federal, state, territorial, tribal, and local levels-data-driven action can reduce children's exposure to violence and other adversities and improve lifelong health and well-being.

Association of Housing Stress With Child Maltreatment: A Systematic Review

Child maltreatment is a significant public health issue in the United States. Understanding key risk factors for child maltreatment is critical to informing effective prevention. Poverty is an established risk factor for child maltreatment. However, recent research indicates that material hardship (i.e., difficulties meeting basic needs) may serve as a more direct measure of the way in which poverty affects daily life. One form of material hardship that is common among families is housing stress. Previous reviews have summarized the existing literature regarding the association of economic insecurity with child maltreatment, but no reviews have synthesized and critically evaluated the literature specific to the association of various types of housing stress with child maltreatment. We conducted a systematic search of multiple electronic databases to identify peer-reviewed studies conducted in the U.S. regarding the association of housing stress with child maltreatment. We identified 21 articles that used nine distinct measures of housing stress including homelessness or eviction, homeless or emergency shelter stays, foreclosure filing, housing instability, inadequate housing, physical housing risk, living doubled-up, housing unaffordability, and composite housing stress indicators. Overall, results from this body of literature indicate that housing stress is associated with an increased likelihood of caregiver or child self-reported maltreatment, child protective services (CPS) reports, investigated and substantiated CPS reports, out-of-home placements, and maltreatment death. Additional theory-driven research is needed to further our understanding of the contribution of specific types of housing stress to risk for specific types of maltreatment.

The long arm of adversity: Children's kindergarten math skills are associated with maternal childhood adversity

BACKGROUND

Childhood adversity is associated with poorer health and lower academic achievement later in life. Poor math skills in particular place individuals at higher risk for physical and mental illness, unemployment, and incarceration, suggesting math achievement may be one explanatory mechanism linking adversity to later functioning. While it is well documented that children's adversity is associated with lower academic achievement, it is also plausible that adversity mothers experience across their lifetime may affect the child's academic achievement.

OBJECTIVE

Determine whether adversity children directly experience and adversity mothers experience in their own childhood and/or adulthood is related to children's kindergarten math skills.

PARTICIPANTS AND METHODS

91 Mothers completed the Assessment of Parent and Child Adversity questionnaire, and their kindergartners completed the KeyMath-3 Diagnostic Assessment.

RESULTS

Maternal childhood adversity, but not adulthood adversity, was negatively related to children's numeration (β = -0.27, 95% CI [-0.48, -0.05], p = .015) and addition/subtraction abilities in kindergarten (β = -0.25, 95% CI [-0.46, -0.04], p = .023). Maternal childhood maltreatment and other adversity were together related to their child's numeration only (R² = 0.08, 95% CI [0.02, 0.23], p = .026). Prevalence of children's direct adversity was low and not related to their kindergarten math skills.

CONCLUSIONS

Our findings suggest that adversity impacts children's math skills as early as kindergarten via the intergenerational transmission of maternal adversity. Mothers that experienced early-life adversity and their children may benefit from early intervention to level the playing field at school entry.

Informant Discrepancies in Child Maltreatment Reporting: A Systematic Review

Potential informants on child maltreatment include the youth who has experienced the alleged maltreatment, and the youth's caregivers, social workers and case files. When multiple informants are compared, they often disagree about whether or not a youth has experienced maltreatment. Such determinations are critical as endorsement-or lack of endorsement-of maltreatment can have significant consequences on the child's safety, future living arrangements and referral for treatment and services. The current study provides a systematic review of the literature on informant discrepancies in child maltreatment. Three databases-PsychINFO, Web of Science, and PubMed-were used to identify studies for the review and 13 articles met inclusion criteria. Results showed that more youth tend to report physical, sexual and emotional abuse than seen in case files. By contrast, more case files include neglect than reported by youth. Implications and future directions are discussed.

A Systematic Review Evaluating Psychometric Properties of Parent or Caregiver Report Instruments on Child Maltreatment: Part 2: Internal Consistency, Reliability, Measurement Error, Structural Validity, Hypothesis Testing, Cross-Cultural Validity, and Criterion Validity

AIMS

Child maltreatment (CM) is global public health issue with devastating lifelong consequences. Global organizations have endeavored to eliminate CM; however, there is lack of consensus on what instruments are most suitable for the investigation and prevention of CM. This systematic review aimed to appraise the psychometric properties (other than content validity) of all current parent- or caregiver-reported CM instruments and recommend the most suitable for use.

METHOD

A systematic search of the CINAHL, Embase, ERIC, PsycINFO, PubMed, and Sociological Abstracts databases was performed. The evaluation of psychometric properties was conducted according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines for systematic reviews of patient-report outcome measures. Responsiveness was beyond the scope of this systematic review, and content validity has been reported on in a companion paper (Part 1). Only instruments developed and published in English were included.

RESULTS

Twenty-five studies reported on selected psychometric properties of 15 identified instruments. The methodological quality of the studies was overall adequate. The psychometric properties of the instruments were generally indeterminate or not reported due to incomplete or missing psychometric data; high-quality evidence on the psychometric properties was limited.

CONCLUSIONS

No instruments could be recommended as most suitable for use in clinic and research. Nine instruments were identified as promising based on current psychometric data but would need further psychometric evidence for them to be recommended.

Parent and Child Reports of Parenting Behaviors: Agreement Among a Longitudinal Study of Drug Court Participants

Identifying ways to support children of parents with substance use disorder is a critical public health issue. This study focused on the parent-child relationship as a critical catalyst in child resilience. Using data from a longitudinal cohort study, the aims of this study were to: (1 ) examine the agreement between parent and child reports of parenting behaviors and (2 ) describe the association between agreement and child mental health. Participants were 50 parent-child dyads that included parents enrolled in an adult drug court and their children, aged 8-18. Overall, agreement (i.e., concordance) between parent and child reports of parenting was slight to fair. Parents reported their parenting behaviors to be slightly more positive than how children rated the same behaviors in the areas of: involvement, 0.53 (SD = 0.80); positive parenting, 0.66 (SD = 0.87), and monitoring behaviors, 0.46 (SD = 0.90). Parents also rated themselves, in comparison to their children's reports, as using less inconsistent discipline, -0.33 (SD = 1.00), and less corporal punishment, 0.13 (SD = 1.01). Agreement was related to some, but not all, child mental health outcomes. When parents rating their parenting as more positive than their child reported, that had a negative effect on child self-esteem and personal adjustment. Contrary to hypotheses, we did not find a significant relationship between positive parenting and internalizing problems. Findings have implications for obtaining parent and child reports of parenting within the drug court system, and for identifying children at higher risk for externalizing problems.

The Impact of Maltreatment on Internalizing Symptoms for Foster Youth: an Examination of Spirituality and Appraisals as Moderators

Research shows that exposure to child maltreatment increases the risk of internalizing symptoms for youth, and that youth in foster care are at a particularly high risk of symptoms. However, not all youth who experience maltreatment evidence maladjustment, making the link between exposure and mental health outcomes unclear and creating a need to examine what factors buffer against symptomatology. A sample of youth in foster care was used to provide a new examination of the relation between child maltreatment exposure and internalizing symptoms, to test the possible moderating effects of both appraisals and spirituality, and examine differences between children and adolescents. Participants were 486 youth in foster care (M age = 13; 204 children; 282 adolescents). Youth completed self-report measures through the SPARK project (Studying Pathways to Adjustment and Resilience in Kids). Although appraisals and spirituality were not significant moderators, significant main effects emerged. For children, regression analyses showed that maltreatment exposure and lower scores on spiritual prosocial attitudes accounted for the majority of the 21% of the variance in internalizing symptoms. For adolescents 28% of the variance in internalizing symptoms was accounted for by greater maltreatment exposure, lower scores on spiritual prosocial attitudes, higher scores on relationship with a God/Higher Power, and more negative appraisals of stressful life events. The current study provides support for cognitive-based interventions for adolescents aimed at increasing appraisal flexibility and suggests that both children and adolescents could benefit from the development of prosocial attitudes often tied to spirituality but could be reinforced in additional settings.

Discordance in Reporting of Maternal Aggression: Exploring Differences by Characteristics of Children, Mothers, and Their Environments

This study investigated discordant reports of maternal aggression using the Fragile Families and Child Wellbeing Study (N = 1,606). Multinomial logistic regression models predicted discordant reports of hitting and shouting from child, mother, and environmental characteristics. Compared to dyads in which both mothers and children reported aggression, mothers with a college degree had higher child-only and mother-only reports of both hitting and shouting versus mothers with less than a high school diploma. High-income mothers had higher child-only reports of hitting, while families with past Child Protective Services involvement had higher child-only and mother-only reports of hitting. Additionally, children with lower reading test scores and whose fathers had history of incarceration had higher child-only reports of hitting. Families residing in neighborhoods for which mothers were scared to let children play outside also had higher child-only and mother-only reports of hitting and shouting.

Sustained Impact on Parenting Practices: Year 7 Findings from the Healthy Families New York Randomized Controlled Trial

Prevention of maltreatment and harsh parenting are the primary goals of evidence-based home visiting programs, but rigorous studies demonstrating long-term outcomes are limited despite widespread implementation. The current study examines data from a 7-year follow-up study of a randomized controlled trial of Healthy Family New York (HFNY). Specifically, the study examines whether HFNY participation predicts lower rates of harsh and abusive parenting 7 years after enrollment. The data include both maternal self-report of parenting behaviors as well as the target child's report of harsh parenting. The year 7 sample included 942 mother interviews (83.5% retention from baseline) and 800 child interviews. At the 7-year follow-up, maternal-reported behaviors measured by CTS-PC showed a significantly increased use of positive parenting strategies and lower levels of serious physical abuse in the HFNY group compared with the control group. Significant group differences were observed for the frequency with which mothers engaged in severe or very severe physical assault (control group = .16, compared with .03 in the intervention group, p < .001). In addition, fewer children reported that their parents used minor physical assault. There was no intervention impact on indicated child protective service records. The current study indicates that home visiting participation reduces harsh and abusive parenting and promotes positive parenting behaviors that endure and may strengthen later development.

Intergenerational transmission of child maltreatment using a multi-informant multi-generation family design

In the current study a three-generational design was used to investigate intergenerational transmission of child maltreatment (ITCM) using multiple sources of information on child maltreatment: mothers, fathers and children. A total of 395 individuals from 63 families reported on maltreatment. Principal Component Analysis (PCA) was used to combine data from mother, father and child about maltreatment that the child had experienced. This established components reflecting the convergent as well as the unique reports of father, mother and child on the occurrence of maltreatment. Next, we tested ITCM using the multi-informant approach and compared the results to those of two more common approaches: ITCM based on one reporter and ITCM based on different reporters from each generation. Results of our multi-informant approach showed that a component reflecting convergence between mother, father, and child reports explained most of the variance in experienced maltreatment. For abuse, intergenerational transmission was consistently found across approaches. In contrast, intergenerational transmission of neglect was only found using the perspective of a single reporter, indicating that transmission of neglect might be driven by reporter effects. In conclusion, the present results suggest that including multiple informants may be necessary to obtain more valid estimates of ITCM.