Sexual behavior problems in preteen children: developmental, ecological, and behavioral correlates

A large sample of 2-12 year old children (N = 2311) was studied to determine the relationship between three sexually intrusive behavior items (SIBs) measured by the Child Sexual Behavior Inventory (CSBI) and a range of developmental, ecological, and behavioral correlates. The variables studied included age, gender, race, family income, single parent status, maternal education, family sexual behaviors, physical abuse, sexual abuse, domestic violence, social competence of the child, and three scales from the CBCL (Internalizing, Externalizing, and PTSD). Sexual abuse was not the primary predictor of SIB, but a model incorporating family adversity, modeling of coercive behavior, child behavior, and modeling of sexuality predicted a significant amount of variance.

Emergency child mental health services in Poland

This paper describes emergency child mental health services in Poland. The paper defines common emergencies for children and adolescents, describes who responds and how services are organized. The evaluation process, interventions and treatment follow-up are outlined. The lack of consistency across Poland is highlighted. Recommendations for further training of professionals, as well as improvements in the mental health and legal systems are made.

Child and adolescent mental health emergency services in Eastern European former Iron Curtain countries

This paper describes the evolution of child and adolescent mental health emergency services in Eastern European countries over the past decade since the dissolution of the Iron Curtain. The process of helping countries to organize services, as facilitated by the authors through their training and mentoring of Eastern European mental health professionals, organized by the Children's Mental Health Alliance Foundation, with funding from the Soros Foundation, is described. This paper is a prelude to reports from six Eastern European countries which describe in more detail how child and adolescent mental health emergencies are evaluated and treated locally.

Emergency child mental health services in Latvia

This paper describes emergency child mental health services in Latvia. The paper defines child mental health emergency and outlines which professionals are involved in evaluation and where evaluations occur. The described follow-up services are only now developing, with the majority of children still receiving minimal mental health services in shelters or detention centers. Recommendations for more training of professionals, specific protocols and an integrated system of care are made.

Rationally and empirically derived dimensions of children's symptomatology: expert ratings and confirmatory factor analyses of the CBCL

Expert ratings and confirmatory factor analyses were used to develop an alternative system for scoring the Child Behavior Checklist (CBCL; T. M. Achenbach, 1991) to measure specific dimensions corresponding to current conceptualizations of child symptomatology. Data were from a nonclinic and 2 independent clinic samples. Subscales measuring Anxiety, Attention Problems/Hyperactivity, Conduct Problems, Depression, Oppositional Defiant, Social Problems/Immaturity, and Somatization were created. Logistic regressions were conducted to evaluate the diagnostic efficiency and discrimination of the new and original approaches to scoring the CBCL. Some of the new subscales demonstrated better sensitivity, positive predictive power, and discriminant validity than the original CBCL subscales; however, subscales from both approaches demonstrated low sensitivity. Results support the use of the new subscales for specific research purposes.

Multimodal assessment of dissociation in adolescents: inpatients and juvenile sex offenders

Two samples of adolescents were studied to assess the validity of several measures of dissociation. The first sample included 70 males from a residential treatment program for adolescent sex offenders (ASO). The second were 47 psychiatric inpatients. The measures included the DSM-IV field trial questionnaire for Dissociative Disorders of Childhood, Child Dissociative Checklist, Adolescent-Dissociative Experiences Schedule, Trauma Symptom Checklist for Children, and the Dissociation Research scale. Ten of the 70 adolescent sex offender subjects (14.3%) were identified as meeting DSM-IV criteria for a Dissociation-spectrum disorder diagnosis and two (4.2%) of the psychiatric patients. Between-groups analyses with the ASO revealed significant differences on the Child Dissociative Checklist and the Dissociation Research Scale. Cumulative trauma did not differ significantly between the dissociative and nondissociative groups of ASO, but physical abuse was related to a diagnosis of dissociation in this sample. The dissociation measures were highly intercorrelated for both groups, and suggest that they measure a similar construct.

Child Sexual Behavior Inventory: normative, psychiatric, and sexual abuse comparisons

A normative sample of 1,114 children was contrasted with a sample of 620 sexually abused children and 577 psychiatric outpatients on the Child Sexual Behavior Inventory (CSBI), a 38-item behavior checklist assessing sexual behavior in children 2 to 12 years old. The CSBI total score and each individual item differed significantly between the three groups after controlling for age, sex, maternal education, and family income. Sexually abused children exhibited a greater frequency of sexual behaviors than either the normative or psychiatric outpatient samples. Test-retest reliability and interitem correlation were satisfactory. Sexual behavior problems were related to other generic behavior problems. This contributed to the reduced discrimination between psychiatric outpatients and sexually abused children when compared to the normative/sexually abused discrimination.

Psychometric properties of the Trauma Symptom Checklist for Children (TSCC) with psychiatrically hospitalized adolescents

A sample of 119 consecutively hospitalized adolescents, including 32 sexually abused teenagers, was assessed with the Trauma Symptom Checklist for Children (TSCC). Participants also completed the Beck Depression Inventory, Symptom Checklist-90-Revised (SCL-90-R), Adolescent-Dissociative Experience Scale, Minnesota Multiphasic Personality Inventory (MMPI), Rorschach, and the Family Environment Scale. The reliability and validity of each of the six TSCC scales and four subscales was determined. Analyses suggest that the individual scales are reliable and significantly intercorrelated. Independent measures of depression, anxiety, anger, and dissociation typically correlated significantly with the reference TSCC scales, and in fact, the Posttraumatic Stress subscale significantly discriminated the sexually abused group from the remainder of the sample. These findings suggested that with a psychiatric sample, the TSCC is a valid measure of distress.

Developing child abuse prevention, identification, and treatment systems in Eastern Europe

Although the dissolution of the Soviet Union in 1989 brought a welcome end to the Cold War, the subsequent reestablishment of independent Eastern European countries revealed a host of problems. Among these was frequent child abuse and neglect, although lack of epidemiological data precluded any accurate estimate of prevalence. In an effort to address the problem of child abuse within this rapidly changing sociopolitical environment, the Children's Mental Health Alliance and the Soros Foundation organized the Eastern European Child Abuse and Child Mental Health Project in 1995. The authors describe the development of this multidisciplinary initiative involving collaboration with professionals from 17 countries in Eastern Europe. They highlight the goals, principles, and major phases of the project, as well as some of the challenges involved in its implementation.

A case-control study of anatomic changes resulting from sexual abuse

OBJECTIVE

Our goal was to identify vulvar and hymenal characteristics associated with sexual abuse among female children between the ages of 3 and 8 years.

STUDY DESIGN

Using a case-control study design, we examined and photographed the external genitalia of 192 prepubertal children with a history of penetration and 200 children who denied prior abuse. Bivariate analyses were conducted by chi(2), the Fisher exact test, and the Student t test to assess differences in vulvar and hymenal features between groups.

RESULTS

Vaginal discharge was observed more frequently in abused children (P =.01). No difference was noted in the percentage of abused versus nonabused children with labial agglutination, increased vascularity, linea vestibularis, friability, a perineal depression, or a hymenal bump, tag, longitudinal intravaginal ridge, external ridge, band, or superficial notch. Furthermore, the mean number of each of these features per child did not differ between groups. A hymenal transection, perforation, or deep notch was observed in 4 children, all of whom were abused.

CONCLUSION

The genital examination of the abused child rarely differs from that of the nonabused child. Thus legal experts should focus on the child's history as the primary evidence of abuse.

Sexually abused girls and their Rorschach responses

Exner's scoring (1990) was used on the responses by 46 sexually abused girls (6 to 14 years old) and 46 nonsexually abused girls (6 to 14 years old). Subjects were matched for age, race, family income, and family constellation. Sexually abused children exhibited significantly more unusual content, e.g., sex and blood, in their protocols as well as more frequent coping deficits.

Normative sexual behavior in children: a contemporary sample

OBJECTIVE

Sexual behavior in children can cause uncertainty in the clinician because of the relationship between sexual abuse and sexual behavior. Consequently, it is important to understand normative childhood sexual behavior.

DESIGN

Sexual behavior in 1114 2- to 12-year-old children was rated by primary female caregivers. These children were screened for the absence of sexual abuse. A 38-item scale assessing a broad range of sexual behavior (Child Sexual Behavior Inventory, Third Version) was administered along with the Child Behavior Checklist and a questionnaire assessing family stress, family sexuality, social maturity of the child, maternal attitudes regarding child sexuality, and hours in day care.

RESULTS

Sexual behavior was related to the child's age, maternal education, family sexuality, family stress, family violence, and hours/week in day care. Frequencies of sexual behaviors for 2- to 5-, 6- to 9-, and 10- to 12-year-old boys and girls are presented.

CONCLUSIONS

A broad range of sexual behaviors are exhibited by children who there is no reason to believe have been sexually abused. Their relative frequency is similar to two earlier studies, and this reinforces the validity of these results.

The evaluation of Franco-Quebec victims of child sexual abuse and their mothers: the implementation of a standard assessment protocol

OBJECTIVE

There were two aims: first, to evaluate the feasibility of applying a standard assessment protocol to Franco-Quebec victims of child sexual abuse and nonoffending mothers; and second, to compare results from an initial sample with available data from English-speaking samples.

METHOD

A standard individual case study design was used for victims and mothers; and the satisfaction of the nine participating youth workers was assessed. Four self-report instruments for victims and five for mothers were chosen on the bases of workers' priorities, sensitivity to the impact of CSA, and the availability of published norms on English-speaking samples. Results are reported on 48 confirmed victims and 40 nonoffending mothers.

RESULTS

The protocol was favorably received by the CPS workers, supervisors and all mothers and victims. Percentages of clinically distressed victims varied from highs of 68% on the externalization difficulties of the Child Behavior Checklist and 67% for 2- to 6-year-olds on the Child Sexual Behavior Inventory, to lows of 10% on hostility symptoms and 13% on the Dissociation Scale of the Trauma Symptom Check for Children. The rate of symptom-free children was lower (19%) and that of revictimization higher (30%) than most published estimates (Kendall-Tackett, Williams, & Finkelhor, 1993). Most mothers reported elevated emotional distress (depression, 59%) and symptoms of post-traumatic stress (intrusiveness, 67%). Although 87% of mothers believed the allegations, only 45% offered adequate emotional support.

CONCLUSION

The implementation phase of this research was successful, given the positive reactions of workers and clients. Results on standard instruments from this French-speaking sample were similar to profiles of English-speaking victims and their mothers but firm conclusions on appropriate norms will require larger samples, cross cultural contrasts, and the evaluation of additional variables.

Somatic symptoms in sexually abused children

Contrasted a nonabused sample of 3 to 12-year-old children (n = 847) with a sexually abused sample (n = 252) with regards to somatic symptoms assessed via parent report, including the Child Behavior Checklist. Using ANCOVA, and controlling for family income, maternal education, age, and sex, the girls 3-6 years old who were abused and the boys 7-12 years old who were abused were reported to have the greatest number of somatic symptoms. Force and number of perpetrators were abuse-specific variables directly related to the number of somatic symptoms. Results suggest that for some children sexual abuse is related to an increased report of subjective somatic complaints.

Psychological science and the use of anatomically detailed dolls in child sexual-abuse assessments

Many devices are used in child assessment and treatment as communication aids, projective tools, and symbolic means of interaction. None are as hotly debated in their application among mental health professionals as dolls with genital details. Anatomically detailed (AD) dolls are often used in sexual-abuse evaluation and treatment with children, but such applications are controversial. This article is the product of a working group formed to review AD doll research and practice. This article reviews historical use of dolls in clinical inquiry and research on sexual behaviors in children, normative use of AD dolls in nonreferred children, differences in children's play behavior and emotional reactions to AD dolls, and memory and suggestibility issues relating to AD-doll use. Recommendations for future research are provided.

Autoerotic asphyxia: the development of a paraphilia

The authors studied five adolescent male practitioners of autoerotic asphyxia to determine contributors to its etiology. Extensive histories including detailed sexual histories were obtained from each boy. Their life histories suggested an early history of choking, in combination with physical or sexual abuse, was related to the development of autoerotic asphyxia. Each boy appeared to have paired choking with sexual arousal, and autoerotic asphyxia was a persisting behavior pattern for four of five boys. This sample is the largest study of living practitioners of this behavior and suggests the heretofore unmentioned history of either choking or abuse.

Pediatric cancer: predicting sibling adjustment

Within the context of a coping model, the present study attempted to determine variables associated with good and poor adjustment for siblings (N = 129) of pediatric cancer patients. Family cohesion and adaptability were found to mediate the impact of pediatric cancer on the healthy sibling. Specifically, high levels of family cohesion and adaptability were associated with better adaptation for siblings. Some support also was found for Folkman, Schaefer, and Lazarus' (1979) coping model, as the following variables, proposed by the model, predicted sibling adjustment to pediatric cancer: health/energy/morale, social support, and utilitarian resources. Results from this study stress the need to examine the child in a variety of ecological contexts (e.g., parental and familial functioning; neighborhood/community support).

Assessing children for the effects of sexual victimization

In summary, the psychological assessment of sexually abused children is complicated significantly by the fact that there is no single syndrome that reflects the impact of sexual abuse (Kendall-Tackett, Williams, and Finkelhor, 1993). A number of generic measures of psychopathology in children continue to find large percentages of children relatively asymptomatic. This is due to the variability in impact of sexual abuse, but also reflects the need to develop abuse-specific outcome measures. Because we are discussing the evaluation of children, psychological assessment must be developmentally sensitive and reflect the context of the child (Stewart, Bussey, Goodman, and Saywitz, 1993). Consequently, information should be obtained not only from parents and children, but from the entire family. Unless an evaluation includes some abuse-specific measures and examines findings about the child in the context of the larger family environment, it is not likely to be valid. The interrelationship of abuse impact on parental perception and subsequent parental accuracy in reporting also must be examined in more detail. Not surprisingly, maternal reports of their sexually abused child's emotional states are strongly correlated with their own distress (Newberger, Geremy, Waternaux, and Newberger, 1993). This confound necessitates input from teachers or other objective observers of the child. The evaluation of sexually abused children should be theoretically driven. I strongly recommend assessing both the child and the parents with regard to attachment quality, difficulties with self-regulation, and an impaired sense of self. There are a number of measures pertinent to both parents and children across each of these domains. However, measures must be developed and validated that allow for parent, child, and teacher report in the areas of sexual behavior, sexual concerns, sexual meaning, body integrity, abuse-specific aspects of self (such as blame, shame, and dissociation), PTSD, abuse-specific fears, and family-related variables of rejection and role reversal. There is a developing literature that supports the need to assess each of these domains in a multimodal manner.

Cognitive abilities and lipomyelomeningocele

Ten children with lipomyelomeningocele were evaluated with the WISC--R, the Wide Range Achievement Test--Revised, the Developmental Test of Visual-motor Integration, and the Child Behavior Checklist. These children were consecutive referrals to a birth defects clinic. Unlike their meningomyelocele counterparts, as a group these children appear to be average in their intellectual, academic, and behavioral characteristics. However, they exhibited low average perceptual motor skills, a feature more commonly seen in meningomyelocele.

Sexual victimization and sexual behavior in children: a review of recent literature

Empirical research pertaining to sexual behavior in sexually abused children, including record reviews, parent ratings, psychological assessment, self-report, and behavioral observation is reviewed and discussed. Sexual behavior is reported significantly more often in sexually abused children than nonabused children. However, the consistency of this finding varies with the research method.

Health risk behaviors and medical sequelae of childhood sexual abuse

The relationship between childhood sexual abuse and subsequent health risk behaviors and medical problems was examined in 511 women who had used a family practice clinic in a rural midwestern community during a 2-year period (1988 and 1989). These women completed a questionnaire that assessed various health risk behaviors--smoking, drinking, drug abuse, number of sexual partners, and age at first intercourse--and a medical symptom checklist that assessed 38 medical problems related to major systems of body function, the somatization scale from the SCL-90, a screen for sexual abuse, and a brief measure of social support. The results indicated that sexually abused women, who represented 22.1% of the sample, reported significantly more medical problems, greater levels of somatization, and more health risk behaviors than did the nonabused women. More severe abuse (for example, penetration or multiple abusers) correlated with more severe problems. Extent of social support correlated inversely with the number of gynecologic problems reported in the sexually abused group. Fewer than 2% of the sexually abused women had discussed the abuse with a physician. To identify and assist victims of sexual abuse, physicians should become experienced with nonthreatening methods of eliciting such information when the medical history is obtained.

Mothers of sexually abused children: an MMPI study

Thirty-seven mothers of sexually abused children were contrasted with 41 mothers who were receiving outpatient psychotherapy and with 76 women with no history of psychiatric disturbance on the MMPI. The groups were matched on age and socioeconomic status, and significant between-group differences were noted. Outpatients and mothers of sexually abused children were significantly more elevated than the normal comparison group on the majority of the scales. Mothers of sexually abused children differed from psychiatric outpatient mothers on several scales. The 4-3 and spike 4 MMPI code-types were significantly more common in mothers of sexually abused children than in outpatient mothers. Differences in the child's sexual abuse characteristics were related to MMPI scales of the mother.

Normative sexual behavior in children

A large-scale, community-based survey was done to assess the frequency of a wide variety of sexual behaviors in normal preadolescent children and to measure the relationship of these behaviors to age, gender, and socioeconomic and family variables. A sample of 880 2- through 12-year-old children screened to exclude those with a history of sexual abuse were rated by their mothers using several questionnaire measures. The frequency of different behaviors varied widely, with more aggressive sexual behaviors and behaviors imitative of adults being rare. Older children (both boys and girls) were less sexual than younger children. Sexuality was found to be related to the level of general behavior problems, as measured by the Achenbach Internalizing and Externalizing T scores and to a measure of family nudity. It was not related to socioeconomic variables.

Cognitive abilities and achievement status of children with myelomeningocele: a contemporary sample

Designed study as a conceptual replication of Shaffer, Friedrich, Shurtleff, and Wolf (1985). Intelligence, school achievement, and perceptual motor skill data from 73 children with uncomplicated myelomeningocele were examined to determine their deviation from test norms. The respective impact of shunting and functional motor level was also assessed. The sample as a whole functioned below WISC-R and VMI norms. On the WRAT, deviation from the norms was evident only for the Arithmetic subtest. Partial replication of the Shunt X Motor level interaction reported by Shaffer et al. (1985) was obtained. Limitations of small-sample studies are discussed.

Hypnotherapy with traumatized children

The psychological impact of trauma can include cognitive, affective, and behavioral components. The degree to which a child is either overwhelmed by or unable to access the traumatic event can make the working through of the event in therapy difficult. Hypnotherapy is a useful modality not only for alleviating symptoms but also for uncovering the traumatic event(s) with associated affects, integrating and making sense of the experience. 4 case studies are reported to illustrate the utility of hypnotherapy with young, traumatized children.

Psychological functioning and behavior of sexually abused girls

The psychological functioning and behavior of 46 sexually abused girls (ages 6-14) was compared with that of 46 nonabused girls who were matched on age, race, family income, and family constellation. Sexually abused children demonstrated heightened sexual preoccupation and behavior problems, lower cognitive abilities and school achievement, and more stressful past histories.

Psychological functioning and behavior of sexually abused girls

The psychological functioning and behavior of 46 sexually abused girls (ages 6-14) was compared with that of 46 nonabused girls who were matched on age, race, family income, and family constellation. Sexually abused children demonstrated heightened sexual preoccupation and behavior problems, lower cognitive abilities and school achievement, and more stressful past histories.

Sex differences in depression in early adolescents

This study examined sex differences in the self-report of depression in early adolecents. A sample of 269 junior high adolescents completed a biographical data sheet, short forms of the Beck Depression Inventory, the Family Environment Scale, a Social Support Index, and a Life Stress Inventory. A subset of 61 mothers completed a Beck inventory, and a Family Environment Scale on their children. Sex differences were demonstrated in the relation of depression to the family and individual variables. Depression in boys was correlated with life stress and lower grades, while for girls, depression was correlated with several types of social support and lower grades.

Family relations and marital quality when a mentally handicapped child is present

The quality of both family relations and marital satisfaction was assessed in 131 two-parent families who had a mentally retarded child. Both family relations and marital satisfaction were seen as outcome variables reflecting how families cope with the chronic strain of a special child. Social desirability was controlled, and family relations and marital satisfaction were related to a variety of psychosocial and child-specific variables.

MMPI study of identical twins: cancer patients and bone marrow donors

23 identical twin pairs, one with a hematologic malignancy, the other a bone marrow donor, completed the MMPI while in the hospital. The validity, clinical, and Repression-Sensitization scales were scored. Paired t tests for the entire group (aged 16 to 67 yr., M = 44 yr.) showed significant differences on Hs, D, and Hy. Males ( n = 12 pairs) had no significant differences, while females ( n = 11 pairs) had significant differences on Hs, D, Hy, Pa, and R-S. Female patients scored higher on Hs, D, Hy, lower on Pa and were repressors. These findings are congruent with previous research that has yielded psychological differences in people who develop malignancies and those who do not.

Coping resources and parenting mentally retarded children

Four broad dimensions of coping resources (utilitarian resources, energy/morale, general and specific beliefs, and social support) were assessed with a sample of 140 mothers of mentally retarded children. The dimensions were related to a measure of the adequacy of parental coping, i.e., Questionnaire on Resources and Stress-Friedrich Factor 1, Parent and Family Problems. Three of the four categories of coping resources were significant contributors in a regression analysis and contributed additional variance beyond that of behavioral and physical problems of the child. For validational purposes, 104 of these mothers were reexamined 10 months later. The original analysis was supported, and changes in marital satisfaction were related to an increase in parent and family problems over the elapsed time span.

Personality and psychophysiological variables in abusive, neglectful, and low-income control mothers

This study was designed to systematically investigate personality, psychophysiological, and cognitive appraisal variables in three groups of mothers, i.e., abusive (N = 14), neglectful (N = 13), and low-income control (N = 15). All subjects completed a Mini-Mult, the Repression-Sensitization Scale, the Group Embedded Figures Test, the Multiple Affect Adjective Checklist, and the Socialization scale of the California Psychological Inventory. They listened to an audiotape sequence of white noise, tone, and infant's cry sounds while cardiovascular and skin resistance measures were recorded. The mothers also rated six dimensions of the infant's cry on a semantic differential. The three groups of mothers differed on a variety of personality variables, e.g., on F, Depression (D), Psychopathic Deviate (Pd), Psychasthenia (Pt), and Schizophrenia (Sc) from the Mini-Mult, on their cognitive appraisal of the infant's cry, and on skin resistance measures. A combination of personality, psychophysiological, and cry rating variables was entered in a discriminant analysis that was successful in discriminating 80% of the subjects. The two significant discriminant functions were defined primarily by the Pd scale and a cognitive appraisal measure.

Adaptation of families with mentally retarded children: a model of stress, coping, and family ecology

Research concerned with families of mentally retarded children has often yielded inconsistent, and at times, contradictory findings. This inconsistency is partly due to methodological inadequacies and a narrow focus on unidimensional variables with unimodal measurements. In addition, no succinct model has been presented to explain family adaptation and the range of possible outcomes. In this paper a critical review focused on parents, siblings, parent-child interactions, and family systems was presented. A comprehensive conceptual model was proposed that accounts for (a) the range of possible familial adaptations, both positive and negative, involving the impact of perceived stress associated with the presence of a retarded child; and (b) the family's coping resources and ecological environments as interactive systems that serve to mediate the family's response to stress.

A short-form of the Questionnaire on Resources and Stress

The measurement of stress in families of developmentally delayed or mentally retarded children has been a difficult task. The Questionnaire on Resources and Stress (QRS, Holroyd, 1974) was designed to answer this need, but the length and psychometric weaknesses of this instrument have interfered with more widespread usage. In the present investigation, data from 289 QRSs were item analyzed, and 52 items emerged as most reliable, forming a short form of the QRS. These items were factor analyzed, and four distinct factors were found: Parent and Family Problems, Pessimism, Child Characteristics, and Physical Incapacitation. The correlation between the total scores of the QRS and this short form was .997. In Study 2 initial efforts at concurrent validation of this short form were reported.

Cultural differences in groups of parents of children with cancer: English- and Spanish-speaking

Therapeutic groups of parents of children with cancer have been seen as potentially helpful to those parents who utilize the groups. The authors report on a study of the differing content raised in two parent groups, one English-speaking and one Spanish-speaking.

The abusing parent revisited: a decade of psychological research

In 1972, a major review paper by Spinetta and Rigler (Spinetta, J. J., and Rigler, D. The child abusing parent: A psychological review. Psychol. Bull., 77; 296-304, 1972) was published. This paper examined the largely clinical literature that existed up to that time on the psychological characteristics of the abusing parent. The authors concluded that abusive parents were abused as children, lacked accurate parenting knowledge, and were characterologically impulsive, and that socioeconomic stressors were neither necessary nor sufficient causal factors in the abuse cycle. In the last decade, a considerable number of controlled empirical studies on the abusive parent have been published. This paper critically investigates these studies with respect to the four conclusions offered by Spinetta and Rigler and suggests future areas of research needed.

Psychosocial assets of parents of handicapped and nonhandicapped children

Parents of 34 handicapped children were compared to a control sample of parents of nonhandicapped children on a variety of measures, including marital satisfaction, social support, religiosity, psychological well being, and a measure of resources and stress. Significant differences were found between groups along a number of these dimensions.

Job satisfaction and perception of social climate in a mental health facility

21 members of a staff process group at a mental health treatment and research center were administered the Job Descriptive Index and the Work Environmental Scale once a month for a 3-mo. period. A two-day analysis of variance (job satisfaction x time) was computed for each of the 10 subscales. The three administrations did not significantly vary on any of the dimensions, nor were significant interaction effects found. Subjects high in satisfaction significantly differed from those who scored low on the dimensions of involvement and peer cohesion, staff support, autonomy, and innovation. However, no significant differences were found on the dimensions of task orientation, work pressure, clarity, control, or physical comfort. Results were discussed in terms of the importance of the variables, relationship and responsibility, to job satisfaction in a mental health setting.

A comparison of the MacAndrew Alcoholism Scale and the Michigan Alcoholism Screening Test in a sample of problem drinkers

In a sample of problem drinkers, the Michigan Alcoholism Screening Test performed best with subjects who identified themselves as alcoholics, whereas the MacAndrew Alcoholism Scale worked best with patients in the more advanced stages of alcoholism.

Comparison of two alcoholism scales with alcoholics and their wives

Both partners in 36 alcoholic marriages responded to two different alcoholism scales, the Michigan Alcoholism Screening Test and the MacAndrew Alcoholism Scale. Multiple regression analysis determined that each scale was predicted differentially, but that characteristics of the wives accounted for considerable variance of the husbands' test scores and vice versa.

A factor analytic study of the Michigan Alcoholism Screening Test

Six interpretable and nonorthogonal factors were derived from the Michigan Alcoholism Screening Test which had been administered to 512 individuals arrested and convicted of driving while intoxicated. Three of the six factors contained items which tapped diagnostic areas suggested by the National Council on Alcoholism. All 24 items loaded moderately to highly on the six factors, which were: Diagnostic I and II, Self-identification with Alcoholism, Early Effects of Alcoholism, and Warning Signs I and II.

Primary prevention of child abuse: focus on the special child

The authors review the literature on child abuse and present evidence demonstrating that children who are born prematurely or who are sickly or handicapped are at high risk for child abuse. The authors describe ways to identify such children and suggest a number of primary prevention techniques that can reduce parental stress and help prevent child abuse. The techniques include day-care programs for handicapped children, mothers' social clubs, and lay health visitors to give support and impart proper maternal attitudes.

Evaluation of a media campaign's effect on reporting patterns of child abuse

In an effort to determine what effect a media campaign had on child-abuse reporting patterns, pre-campaign measures were contrasted with post-campaign measures. The mean number of reports/day increased significantly. Reports from one of the three major reporting groups, i.e., professionals, increased significantly. Five basic types of abuse were also examined, and the number of reports in two of the categories, i.e., soft tissue and abuse with neglect, also increased significantly.