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.     

The correlates of child physical abuse and neglect by adolescent mothers

Theoretical and empirical knowledge about the link between adolescent motherhood and child maltreatment is in an early stage of development. Research has produced contradictory findings as to a relationship between the two and has not focused on identifying correlates. To fill gaps in the knowledge base and generate hypotheses for future tests, this secondary analysis of data on a subset of 119 mothers who gave birth prior to their 18th birthday focused on identifying characteristics that discriminate among low-income adolescent mothers with maltreated children and comparable mothers whose children were not known to be maltreated. Bivariate analyses of 18 characteristics from several theoretically justified domains revealed that 11 were associated with neglect and four with abuse. Step-sise discriminant analysis identified six correlates of neglect that correctly classified 85% of the mothers and four for abuse that correctly classified 79% of the mothers. Discussion focuses on implications for future research and hypothesis generation.     

Mandatory reporting by nurses of child abuse and neglect

Most Australian jurisdictions have mandatory reporting legislation to compel members of selected professional groups, including nurses, to report suspicions that a child has been or is likely to be subjected to abuse or neglect. This article details the legal obligations of nurses in each jurisdiction, and highlights differences between jurisdictions. Problematic features of the laws are identified, including the use of ambiguous concepts like "reasonable" suspicion and "significant" harm. Literature is reviewed to identify what is known about nurses' legal knowledge, actual reporting practice, and the practical problems that arise for nurses in this context. It is concluded that empirical research needs to be conducted, because it is not known if the laws are practically effective, whether nurses have sufficient training in, and knowledge of, their reporting duties, or what factors influence sound reporting. Such research can inform both the development of sound training systems and recommendations for legal reform.     

Prior similar acts in prosecutions for rape and child sex abuse

Conclusion The final question raised by the Bush administration proposal is whether its adoption would inevitably undermine the general rule limiting the introduction of prior acts. Of course, the proposal is limited on its face to prior acts of rape and child sex abuse, and the arguments based on greater likelihood of repetition are by their nature applicable only to a limited class of offenses. However, the doctrine of chances argument is applicable to any offense, and it has the potential to override the traditional rules strictly limiting the introduction of prior acts evidence.This article was originally presented at the Society for the Reform of Criminal Law Conference on Reform of Evidence Law, Vancouver, British Columbia, Canada, August 3–7, 1992.B.A., University of Michigan 1971; J.D., University of Michigan 1974.     

Knowledge of child abuse and neglect in nursing students: Assessment and perspectives

Misdiagnosis of child abuse and neglect can delay early treatment. Some authors have pointed out that nurses can miss child abuse and neglect diagnoses due to a lack of knowledge. It is unclear whether the lack of knowledge is due to students' insufficient preparation in nursing school and/or a deficiency in continuing education. An 18-item questionnaire was administered to final-year nursing students to assess their degree of knowledge on child abuse and neglect and to evaluate if the lack of knowledge was due to insufficient teaching/training during nursing school. The students were also asked to evaluate themselves by assigning a score to their knowledge. A statistical comparison was performed to define whether sufficient/insufficient results were associated with the following variables: sex, pediatric or general nursing student, attending pediatric lectures, training in pediatric wards/ambulatories, and attending specific lectures on child abuse and neglect. The study population comprised 175 students (154 females, 20 males, 1 unknown). Exactly 66.3% of the participants had ≤9/18 correct answers. Of all students, 77.7% self-evaluated their level of knowledge as ≤5/10. The comparisons yielded statistically significant differences between the groups with sufficient objective knowledge and those unrelated to training in pediatric wards/ambulatories or pediatric nursing students. Overall, there was little objective knowledge on the subject, which may be related to insufficient teaching/training in nursing schools. Useful corrective strategies include further teaching on child abuse and neglect, preferably using a practical approach. Further, common teaching/training programs should be conducted by both pediatric and general nursing schools.     

Estimation of stress in child neglect from thymic involution.

It is difficult to evaluate the extent of stress in cases of suspected child abuse/neglect in a medico-legal autopsy. We have previously reported that stress due to abuse/neglect was found to have led to thymic involution. To elucidate the influence upon thymocytes differentiation, we compared the proportion of the thymocyte subpopulation in the thymus of a neglected child with one in an age-matched control obtained from cardiac surgery. We found that the relative number of CD4+ CD8+ double positive (DP) thymocytes decreased in the neglected child. It was presumed that the selective decrease in the number of the immature DP thymocytes with CD3- to low bcl-2low caused the thymic involution in the neglected child. It was suggested that an alteration in the proportion of thymocytes subpopulation might be used as an index of stress in cases of child abuse/neglect.     

Family and social factors associated with substantiation of child abuse and neglect reports

One hundred fifty-nine families who were reported for child abuse or neglect to a country social services agency in a single fiscal year were studied empirically to test the ecological model of child abuse and neglect. Several family and social factors were studied. Only two, size of family and stage in family developmental cycle, were significantly associated with an increased risk of substantiation of the report. Two potential sources of social support, the use of regular child care and the presence of an extended family member, were tested for their effect on substantiation in those cases where risk factors such as the two mentioned above and combinations of risk factors such as single parenthood and unemployed head of household were associated with higher rates of substantiation. In every case, these two examples of social support reduced the substantiation rate. The influence of the use of regular child care was especially strong in mitigating the effect of the family and social risk factors.     

The impact of stress on cognitive components of child abuse potential

The purpose of the present research was to test the effects of situational stress on the components of the cognitive behavioral model, including expectations, interpretations, and behavioral responses to child behaviors (Twentyman et al., 1985). It was predicted that parental abuse potential would be positively related to inappropriate expectations, to negative and internally caused interpretations of child behavior, and to negative parental responses. Second, it was expected that interpretations and responses would be more negative as child abuse potential increased. Sixteen mothers from a child abuse prevention and treatment program completed the Child Abuse Potential Inventory (Milner and Wimberly, 1980) and provided interpretations, evaluations, and responses to a set of vignettes depicting normal child behaviors. The data supported the hypotheses. As abuse potential increased, parent responses were judged as more controlling, punishing, rejecting, and aroused. High stress strengthened the magnitude of these responses. These findings were interpreted within the context of a cognitive behavioral model.     

The role of clinical forensic medicine in cases of sexual child abuse

The work of specialists in forensic medicine in those cases of child abuse that result in the killing of a child is defined and well known. It is less well defined in cases of (suspected) sexual abuse. The cases presented show the difficulties that arise if medical doctors and prosecutors are uncertain about the procedures that have to be followed or do not appreciate the value of objective findings. It is concluded that knowledge about necessary examinations by physicians, police officers and prosecutors has to be promoted in order to improve handling and (legal) outcome of these cases.     

An integrated understanding of elder abuse and neglect

In the past three decades, society has developed interest in what has come to be called elder abuse. Since interest initially appeared, concern about elder abuse has gone through different cycles regarding the conceptualization of the problem, appropriate responses, and explanations. A recent trend has witnessed a call for an interdisciplinary and integrated understanding of, and response to, elder abuse. This article describes what is meant by an integrated response to elder abuse. Ways to promote a broader response to the problem are suggested.     

The incidence of child abuse in serial killers

Fifty serial killers who murdered for the primary goal of attaining sexual gratification, termed lust killers, were studied to determine the prevalence of childhood abuse. Information regarding the childhood abuse sustained by each killer was obtained primarily from biographical books, newspaper articles, and online sites. Abuse was categorized into physical abuse, sexual abuse, psychological abuse, and neglect and was then compared to societal norms from 2001. Abuse of all types excluding neglect was significantly higher in the serial killer population. For serial killers, the prevalence of physical abuse was 36%; sexual abuse was 26%; and psychological abuse was 50%. Neglect was equally prevalent in the serial killer (18%) and societal norm populations.     

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.     

Using recidivism data to evaluate project 12-ways: An ecobehavioral approach to the treatment and prevention of child abuse and neglect

Many programs and projects have been remiss at looking at outcome variables such as recidivistic child abuse and neglect. Presented here are program evaluation data which examine recidivism data over 5 years across more than 700 families. Families receiving services from Project 12-Ways, a multifaceted in-home ecobehavioral approach, were compared with families indicated in the same region who received child protective services other than those offered by Project 12-Ways. Families who receive services from Project 12-Ways are less likely to reinjure or neglect their children again.     

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.