Re-examining the efficacy of child sexual abuse prevention strategies: victims' and offenders' attitudes

Current sexual abuse prevention programs have been forced to rely on anecdotal clinical information to guide curriculum development. Recent evidence that suggests that sexual abuse offenders can reliably offer information regarding their modus operandi implies that sexual abuse offenders can be important sources of information about the victimization process. However, only one study to date has examined offenders' attitudes about sexual abuse prevention topics, and methodological problems limit the applicability of that study. The current study asked 16 intrafamilial victims, 16 intrafamilial perpetrators, and 15 extrafamilial perpetrators of child sexual abuse to rate the efficacy of various prevention strategies on a Likert-type scale. Results indicated that there were no differences between the three groups and that both victims and offenders appeared to have difficulty discriminating the value of 12 prevention topics, perhaps because the items were too global or because they engendered socially desirable responses. Open-ended questions that asked offenders to identify factors that would dissuade them from pursuing the abuse of particular victims indicated that different prevention skills or strategies may be effective at different stages of the victim-offender "relationship." Overall, the findings suggest that when questioning offenders or victims about the victimization process, investigators need to utilize specific (rather than global) questions and need to separately analyze each stage in the victim-offender relationship. These methodological improvements may offer greater potential for enhancing our knowledge of how to reduce child sexual abuse.

What, me worry? A survey of adolescents' concerns

Adolescence is generally regarded as a time of transition demanding considerable adaptation. Failing to successfully negotiate the developmental hurdles associated with this period can have serious physical and psychosocial consequences (e.g., teenage pregnancy, suicide, disruption of social relationships, poor school performance). Efforts to identify problems that adolescents typically experience have been useful in facilitating a better understanding of this developmental phase. However, the perceived concerns or worries of adolescents themselves have been neglected as an additional source of useful information. This study assessed the worries of 622 adolescents between the ages of 12 and 20 years on an 80-item self-report measure, the "Things That Worry Me" scale. Findings indicated consistent concerns related to terrorism, adolescents' self-esteem, parents' physical and mental health, and adolescents' dating and sexual relationships. Gender- and race-specific differences are discussed and implications for future research and clinical applications are offered.

The availability of psychosocial interventions to children with cancer and their families

Awareness of the need for and efficacy of psychosocial services for pediatric oncology patients and their families has increased greatly in the last decade. However, it is currently unknown to what extent these services are available. Therefore, a national survey of pediatric oncologists was conducted to determine the availability of the following services: psychological/psychiatric and social work consultation, support groups for patients and family members, nonpharmacological pain and anxiety management, and nonpharmacological treatment of anticipatory emesis. Results suggest that most centers offer social work consultation and support groups to parents. Fewer support groups are offered to patients and even fewer nonpharmacological services to assist patients in coping with anticipatory nausea and pain are offered. Results are discussed in terms of the pattern of service delivery and cost-effectiveness.

The hand as a target organ in child abuse

The authors reviewed the abuse reports submitted by the staff of The Children's Hospital, Columbus, Ohio, to determine the incidence and types of injuries inflicted to children's hands. The authors did not study hand injuries in children who were not reported as physically abused. The authors examined two time periods to ascertain changes injury severity. Of the 631 abuse reports submitted from 1980 to 1982, there were 52 injuries (8.2%) involving the hands. From July 1987 to July 1988 there were 42 hand injuries (13.4%) among 313 reports. In the 94 total cases, 19 (2%) children sustained injury to the hand only, including eight with burns, two with bruises, two with human bites, two with erythema, two with fractures, and one with a laceration. Children with burns to the hand alone were significantly younger than those with other types of injuries. Of the 94 children with hand and other injuries, 18 (20%) required hospital admission. Of the 19 with injuries to the hand only, five required hospital admission. A variety of instruments were used to injure these children. The hand is a delicate organ, and it is frequently the primary or incidental target of child abuse. Familiarity with the patterns and types of hand injury suffered in child abuse is essential for early recognition, reporting, and child protection.

Self-regulation treatment to reduce the aversiveness of cancer chemotherapy

In an A-B design, the effectiveness of a multicomponent intervention for reducing chemotherapy-associated nausea and emesis in an 11-year-old cancer patient was evaluated. A highly structured, time-limited, self-regulation treatment was implemented that consisted of patient and parent instruction in self-hypnotic methods, cue-controlled relaxation, and guided imagery. Practice of the self-regulation methods at home and in vivo (clinic setting) in the absence of chemotherapy infusion were emphasized to promote skill acquisition and cross-setting generalization. Dependent variables included self-reported nausea intensity and parental report of duration of the patient's sleep and vomiting frequency. Data were obtained before, during, and following chemotherapy for baseline and self-regulation treatment phases across five cycles of chemotherapy that occurred over a 5-month period. During the intervention phase, a marked and clinically significant reduction in self-reported nausea and parent-observed vomiting were noted as well as a concurrent increase in sleep duration. The integrity of patient self-report and parental observations were supported by clinic staff anecdotal data. Treatment limitations and cost-effectiveness are discussed as well as the use of this intervention with adolescent patients.

Improving the cost efficiency of services to the chronic inebriate: an unexpected paradox

An important component of evaluating any mental health or alcoholism treatment service is to examine the accessibility of the facility to individuals in need of such services. The present study examined the question of accessibility of treatment services to the chronic inebriate in terms of program location. Utilization data were compared for periods of time when a "sobering-up" facility was located in the skid row area of downtown Tampa, Florida, and when it subsequently moved to a working-class residential neighborhood 4 miles away. Results suggest that the move resulted in a decrease in inappropriate use of the facility. The potentials for services to the chronic inebriate are discussed.