Psychosocial dynamics of child abuse

The problem of child abuse warrants steadfast social concern and attentive study by social scientists, forensic scientists, and mental health professionals. What moves adults to physically abuse children entrusted to their care? In the present inquiry, an overview of a substantial body of the literature is organized by exploring three dimensions of abuse: the parental relationship, the psychopathology of abusive parents, and the psychodynamics of motivation. None of these dimensions taken alone provides a satisfactory understanding of the phenomenon of abuse. An integrative model is offered wherein child abuse is regarded as a function of three general factors: stresses on the parent, ego weaknesses of the parent, and vectors that direct the parent's violent impulses against the child.     

Childhood history of abuse and adult child abuse potential

The experience of aversive interactions within the family of origin is believed to increase the probability of parental physical child abuse. To test this hypothesis, 375 subjects were given a Childhood History Questionnaire (CHQ) and the Child Abuse Potential (CAP) Inventory. The CHQ contained a series of questions about the presence and frequency of various abusive behaviors and associated sequelae that were received and/or observed before and/or after puberty. The CAP Inventory was used to measure adult physical child abuse potential. As expected, a childhood history of physical abuse was significantly related to adult physical child abuse potential; and, as chronicity increased, so did abuse potential. The experience of physical abuse prior to puberty produced higher abuse scores than the experience of physical abuse after puberty. The study provides preliminary data indicating the childhood experience of a caring adult and / or caring friend moderates adult child abuse potential.     

Intergenerational child abuse and coping

Many studies have investigated the consequences of child sexual abuse (CSA) but few have examined the intergenerational effects of poly- victimization and maladaptive coping. The purpose of this investigation was to examine patterns of maltreatment and maladaptive coping among second-generation CSA survivors. It is hypothesized that: (a) maternal CSA history would be associated with a higher incidence of poly-victimization and maladaptive coping and (b) experiencing more forms of abuse would mediate the relation between maternal CSA history and maladaptive coping behaviors. The method used was a chart review of 139 sexually abused females aged 12 to 17, examining maternal abuse history, maladaptive coping behaviors, and child maltreatment. The results showed that poly-victimization differed as a function of maternal CSA history but maladaptive coping did not. Experiencing more types of abuse was associated with both self-injurious behaviors and substance use. In conclusion, results support the hypothesis that second generation CSA survivors are more likely to experience poly-victimization. Future research should address how intergenerational patterns of abuse might affect presenting symptomatology and treatment outcome.     

Subgaleal hematoma in child abuse

The mother brought her 31/2-year-old son to a paediatric clinic as his forehead was swollen and bluish in appearance. She was unable to give any explanation for this lesion. Clinically it was noted that a very visible and also palpable, doughy swelling was present both in the forehead as well as the hard skull areas. Some hours later, a massive bilateral periocular haematoma appeared. Whilst X-rays were unable to provide any diagnostic help, the sonographic examination of the skull carried out on the same day revealed an extensive subgaleal haematoma. This phenomenon is described in radiological literature as "scalping" and is caused by the use of considerable, blunt violence against the head (shear stresses, e.g. by pulling at the hair). The mother's boyfriend later confessed forceful pulling of the hair.     

School-based child sexual abuse prevention programs

Early prevention education training has been advocated by scholars and practitioners to intervene with children and youth who have been or are being sexually abused as well as to prevent sexual abuse from occurring. This study identified and surveyed major school-based child sexual abuse prevention programs in the country. Results obtained from 126 prevention programs indicated that most programs are conducted at a local level; that together they reach hundreds of thousands of students, parents, teachers, and other school staff; and that they offer a prescribed curriculum and resource materials. Nearly two-thirds receive state funding assistance, with less than a third charging the schools. Most were established in the early and mid 1980s and have well-educated staff. Further, most work to meet the needs of disabled students and provide means for disclosure of sexual abuse. Training format, duration, and materials vary.This study was supported by Grant #5083B80014, Womens Educational Equity Act Program, U.S. Department of Education.     

Decision-making in child abuse and neglect

Social attachment theory can be of value in examining the wide variety of abuse and neglect situations that come to the attention of authorities. We consider evaluation of the parent-child relationship as a crucial part of the judicial process. We have suggested parameters that can be used to evaluate the relationship. We have outlined some of the more common distortions in this relationship that have, in our experience, been associated with the mistreatment of children. The use of social attachment theory has been of great help in understanding the emotional reactions of the many children we have seen for evaluation and treatment. The theory also serves as a potential guide for improvements in social policy. If we are more sensitive to the psychological world of these children, we will be better able to truly protect them.     

Containing the secret of child sexual abuse

This study reports a grounded theory study of the process of how children tell of their experiences of child sexual abuse from the perspectives of young people and their parents. Individual interviews were conducted with 22 young people aged 8 to 18, and 14 parents. A theoretical model was developed that conceptualises the process of disclosure as one of containing the secret of child sexual abuse. Three key dynamics were identified: the active withholding of the secret on the part of the child, the experience of a 'pressure cooker effect' reflecting a conflict between the wish to tell and the wish to keep the secret, and the confiding itself which often occurs in the context of an intimacy being shared. Children's experiences of disclosure were multidetermined and suggest the need for multifaceted and multisystemic approaches to prevention and intervention. The need for the secret to be contained, individually and interpersonally in appropriate safeguarding and therapeutic contexts needs to be respected in helping children tell.     

Undetected and detected child sexual abuse and child pornography offenders

Current knowledge about risk factors for child sexual abuse and child pornography offenses is based on samples of convicted offenders, i.e., detected offenders. Only few studies focus on offenders not detected by the criminal justice system. In this study, a sample of 345 self-referred pedophiles and hebephiles was recruited from the community. All participants met DSM-IV-TR criteria for pedophilia or hebephilia (paraphilia not otherwise specified), were assured of confidentiality, and self-reported lifetime sexual offending against prepubescent and/or pubescent children. Two sets of group comparisons were conducted on self-report data of risk factors for sexual reoffending. Measures of risk factors address the following dimensions identified in samples of convicted offenders: sexual preferences (i.e. co-occurring paraphilias), sexual self-regulation problems, offense-supportive cognitions, diverse socio-affective deficits, and indicators of social functioning (e.g., education, employment). Men who admitted current or previous investigation or conviction by legal authorities (detected offenders) were compared with those who denied any detection for their sexual offenses against children (undetected offenders). Group comparisons (detected vs. undetected) were further conducted for each offense type separately (child pornography only offenders, child sexual abuse only offenders, mixed offenders). Although there were more similarities between undetected and detected offenders, selected measures of sexual-self regulation problems, socio-affective deficits, and social functioning data demonstrated group differences.     

Expert testimony in child sexual abuse cases

We presented participants with syndromal, witness credibility, or anatomically detailed doll evidence to determine (a) whether these different types of expert evidence exert differential influence on participants' judgments and (b) whether the influence of this evidence could be better explained by the relative scientific status or the probabilistic qualities of the research presented. Additionally, we investigated whether a strong or weak cross-examination of the expert would be more successful in discrediting the information provided in the expert's testimony. Findings suggest that participants are less influenced by expert testimony based on probability data (i.e., syndromal evidence) than by expert testimony based on case history data (i.e., credibility of anatomically detailed doll evidence). Participant responses did not differ as a function of the strength of the cross-examination of the expert. As expected, women were more likely to respond in a pro-prosecution direction than were men. Implications for the use of expert evidence in child sexual abuse cases are discussed.     

The associations between abuse characteristics in child sexual abuse: a meta-analysis

Child sexual abuse (CSA) is a general term describing a wide range of events that vary in characteristics such as the victim’s age of onset, relationship to the perpetrator, abuse quantity, degree of contact, and use of force. To investigate correlations and provide information on the clustering of these characteristics, the present meta-analysis included data from 14,494 sexually abused individuals from 62 empirical peer-reviewed studies and doctoral theses. The results showed that victims of intrafamilial abuse were younger than victims of extrafamilial abuse. More force was used in abuse including higher degrees of physical contact. Intrafamilial abuse and early onset of abuse showed no statistically significant associations with either use of force or closer physical contact. Abuse was more frequent and/or committed over a longer time period when it (a) featured more contact or force, (b) involved a relative as a perpetrator, or (c) commenced when the child was younger. The associations were weak to moderate in strength.