Perceived social support and competence in abused children: A longitudinal perspective

The stress-social support-psychological well-being model and the social network theory of child development were used to examine the impact of child abuse and maternal perceptions of social support and competence on child perceptions of social support and competence at two points in time. The influence of child social support on child competence was also assessed. The sample consisted of 165 abused children and their mothers and a matched comparison group of 169 nonabused children and their mothers. As a source of stress, abuse had no significant independent effects on children's perceptions of social support and competence at either time period. The strongest predictors of children's views of their competence were perceived support from mothers, peers, and teachers. The findings underscore the importance of social support for the psychological well-being of children.     

Homicides of abused children prematurely returned home

Five homicides of abused children are reviewed. These children had been removed from the parents because of physical abuse, then later returned to the home where they were subsequently killed. In each case, certain factors were present either during the interval of removal or after the return of the child, which could have alerted individuals, agencies or the court and, if heeded, could have prevented the deaths. Premature return occurred because of administrative inadequacies, including abbreviated investigations, violation of routine procedures because of heavy caseloads, and inadequate or absent psychotherapy of parents or caretakers. Court dates are not extended to compensate for these failings. The factors which operate in the home after the return of the child are essentially the same as those which prompted the removal: physical abuse. In these circumstances, more frequent follow-up visits by the agency or social worker are necessary and for a longer period of time. There should be a heightened awareness that in children who are returned home after removal for physical abuse, further physical abuse is a signal for immediate removal before a fatality occurs.     

Thymus of abused/neglected children.

Forty-six cases of child abuse/neglect autopsied during the period of 1967 to 1990 were investigated. The weight and histological findings of the thymus were compared with those of control children. In most abused and/or neglected children, the weight of the thymus decreased conspicuously. Involution correlated well to the degree and period of maltreatment. In cases without weight loss of the thymus, i.e. spasmodic abuse by a mentally deranged parent or foster parent, a short history of maltreatment was noted. On the other hand, marked involution was observed in cases of prolonged physical abuse and/or neglect. Microscopically, a decrease in the number and pyknosis of lymphocytes were observed in the involuted thymus. Atrophy of the thymus was more conspicuous in the cortex than in medulla. Immunohistochemically, CD-1a positive cells (immature thymocytes) decreased in cases with thymic involution. This involution appears to be an important index of the degree and duration of child abuse/neglect. Furthermore, thymic involution in the early stage of childhood may also be related to insufficiency of the immune system.     

受虐儿童及青少年法医学鉴定92例分析

本文对92例不满18周岁家庭暴力受虐儿童和青少年法医学鉴定案例进行回顾性研究。结果表明：虐待行为多发生于下午5时前后，受虐者以女性居多（63．04％），损伤部位以头面部最多见（36．98％）。损伤类型以软组织挫伤最常见（51．13％），损伤具有多部位、广泛性、新旧不一等特点；发生场所以家中及家居周围附近为多，受虐者家庭情感生活环境差等.同时，作者还对虐待行为产生的社会根源、受虐儿童及青少年法医学鉴定及法律保护等问题进行了探讨。     

Medical examination of sexually abused children: medico-legal value

The Department of Forensic Medicine (forensic pathology and clinical forensic medicine), Aarhus, Jutland, Denmark, performs examinations of children suspected to have been sexually abused when reported to and requested by the police in Jutland, Denmark. Jutland covers an area of 210,000 km2 with about 300,000 inhabitants in Aarhus. A colposcope initially equipped with an Olympus camera, but now with a video camera attached has been used since 1994. Since 1994 the department has performed more than 100 examinations of children suspected of having been sexually abused. A preliminary study was taken to evaluate all cases from 1995 including the legal outcome. RESULTS: The material included 34 cases with three boys, mean age 11 years, and 31 girls, mean age 8 years, at the time of the examination. The sexual abuse events were fondling including penetration of the vagina, vaginal (14), anal (7), and oral (5) intercourse as well as cunnilingus and nontouching abuses. The medical examination was most often performed more than a week after the abuse. The examination revealed normal findings in 23 cases, nonspecific findings including erytherma in 13 cases, and in only one child was a traumatic lesion with rupture of the hymen seen. The perpetrators were above 25 years of ane and were family members or someone known to the child. Nine perpetrators were convicted at court, of whom three admitted having abused the child. CONCLUSION: A medical examination in cases of sexual child abuse seldom provides a legal proof of sexual abuse. The most important is the story told by the child. Therefore, the examination is a supplement which may support or remain neutral to the story told by the child.     

Assessment and training of social competence in dangerous psychiatric patients

Traditional approaches to the assessment and treatment of individuals who have demonstrated dangerous behavior have been based upon a trait model of personality. The social competence model differs from the trait model by assuming that much behavior is situationally determined, that new socially competent behavior patterns can be acquired through observation of models and practice, and that the frequency of undesirable behaviors can be reduced by increasing the frequency of incompatible, desirable behaviors. This paper reports the applications of the social competence model to the assessment and treatment of men in a security hospital, including individuals confined because of specific offenses, such as sex crimes, arson, and institutional assault, as well as those with high overcontrolled-hostility scores, low overall social skill ratings, and low popularity ratings from their peers. The social skills training approach that we have employed has been most successful with sex offenders and arsonists. The results suggest that the most withdrawn and shy individuals derive the greatest benefit from our social skills training approach while overassertive individuals benefit least. It is hypothesized that staff may reward unassertive patient behavior and punish assertive behavior and that future research must focus on changing this pattern in order to foster socially competent behavior by institutional residents. While many problems remain to be answered, our preliminary results suggest the usefulness of the social competence approach in the assessment and treatment of dangerous psychiatric patients and offer the possibility that the approach may lead to better control of violent behavior in the future.     

Autopsy findings in the eyes of fourteen fatally abused children

The eyes of fourteen fatally abused children and sixteen control cases were examined histopathologically. Ten of the abused children showed intraocular change. The most common ocular changes were subdural hemorrhage of the optic nerve and retinal hemorrhage which involved all the layers of the retina, but most commonly the nerve fiber layer, ganglion cell layer and inner nuclear layer. The presence of blood cavities within the retina partially supported the hypothesis of traumatic retinoschisis. The control cases of non-abused children rarely showed intraocular hemorrhage.     

Behavior at school and social maladjustment

School maladjustment is one of the first symptoms to appear in response to alterations in the child's development and maturation. The aim of this paper is to study school maladjustment in minors confined in juvenile court center and its associations with sociofamiliar, psychobiographical, and social maladjustment variables among others, given the fact that school is one of the earliest agents of socialization. The results point to the influence of family conflict on the subject's behavior in association with the anxiety trait and extroversion. We believe that an accurate diagnosis of school maladjustment is essential as it is in this setting where the treatment of social maladjustment can be initiated with a minimum of delay.     

Group therapy for women sexually abused as children: mental health before and after group therapy

Forty-five female outpatients sexually abused in childhood were offered a 2-year phase-divided group therapy. Before and after treatment and at 12 months follow-up, they answered questionnaires designed to elicit responses concerning psychological symptoms (Symptom Checklist; SCL-90) and sense of coherence (SOC). Symptoms for posttraumatic stress disorder (PTSD) were assessed before and after treatment. Inpatient days and sick listing days were assessed during 2 years before and 2 years after treatment. The psychological and PTSD symptoms were significantly reduced after treatment, and the SOC was increased as well. Inpatient days were decreased, and sick listing days increased but not significantly. Compared to a similar short-term focused therapy group and a waiting-list group there were no significant differences between the groups. Trauma-focused group therapy for women who were sexually abused in childhood seems to have promising effects on mental health, both concerning long-term and short-term approaches.     

Child Medical Evaluation Program: a statewide system for the medical and mental health evaluation of abused and neglected children

The Child Medical Evaluation Program examines 1500 children per year suspected by county social service departments of having subtle physical evidence of abuse or neglect. The program utilizes private practitioners, primarily pediatricians, in a systematic manner and provides consultation, direction, and quality control. The system is a unique, cooperative effort between private practitioners and county departments of social service. It is administered from a state university department of pediatrics. The cost is low, government involvement minimal, and the service extensive. The system is recommended to other states.     

The effect of a judicial declaration of competence on the perceived credibility of children and defendants

Purpose. Three studies were conducted to determine the effect of a judicial declaration of competence on perceptions of credibility towards a child witness and an adult defendant. Methods. Undergraduates read vignettes about a 5‐ or a 13‐year‐old child witness or an adult involved in either a sexual assault case or a motor vehicle accident case. In the child conditions, the case was either preceded by a declaration of the child's competence to testify (either specific or general declaration) or there was no mention of the competence of the child. Participants then rated the perceived credibility of both the complainant/witness and the defendant. Results. A judicial declaration of competence that was targeted at the particular child sometimes increased the credibility ratings of the child and decreased those of the defendant, sometimes to levels beyond those observed in the adult conditions. These effects on credibility were not replicated when a general declaration of all children's competence was used. In fact, the general declaration sometimes resulted in more positive ratings of the defendant. Conclusions. These results are discussed in the context of recommendations for the use of competence evaluations and declarations of competence in court.     

The effects of adult and peer social initiations on the social behavior of withdrawn and aggressive maltreated preschool children

The effects of programmed peer- and adult-mediated play initiations were compared for socially dysfunctional, maltreated preschool children. An N = 1, alternating treatments design was used to compare these strategies. Two withdrawn nonmaltreated (control), two withdrawn maltreated, and three aggressive maltreated children served as subjects. Dyadic play sessions were videotaped and rated at the completion of the study by naive raters according to an 18-category observation system. Overall, the control children showed no difference in levels of interaction between peer and adult conditions. The withdrawn maltreated children showed a clear preference for interaction with the peer over the adult. The aggressive maltreated children showed a clear preference for interaction with the peer over the adult. The aggressive maltreated children showed a clear preference for interaction with the adult. They also demonstrated a decrease of positive behavior and increase in negative behavior in response to the programmed initiations. Implications of these differential responses were discussed.     

Perceived helpfulness and use of professional services by abused women

Many abused women use professional and community services and begin to talk to professionals about the abuse they have endured. This article presents and discusses results of a study of 270 abused women who used the services of professionals and service agencies. The article presents information on the frequency of contact and the perceived helpfulness of different professions. Also presented are the types of responses which were considered to be useful and ineffective. This study revealed that the most frequently contacted professions were not necessarily perceived to be the most helpful. Further, certain responses of the service providers were more frequently reported to have value.     

Partner's stake in conformity and abused wives' psychological trauma

This study investigates the potential buffering effect of help-seeking in the association between intimate partner assault and women's psychological trauma, and how this, in turn, may depend on the partner's stake in conformity. The sample consists of 374 women reporting the experience of domestic violence from a current intimate partner, drawn from the larger survey Violence and Threats of Violence Against Women and Men in the United States, 1994-1996. Help-seeking did not appear to buffer the impact of assault severity, contrary to expectation. However, the partner's stake in conformity did condition the effect of his or her having been arrested. Victims had higher levels of posttraumatic stress disorder (PTSD) when police arrested partners of average or below-average stake in conformity. But victims of partners characterized by higher than average stake in conformity did not show elevated PTSD due to their partners having been arrested. On the other hand, PTSD was higher among women experiencing more emotional abuse from the partner.     

Psychosocial adjustment and psychopathology of men sexually abused during childhood

The purpose of this study was to evaluate psychosocial adjustment and psychopathology among men sexually abused during their childhood and arrive at a better understanding of the reasons for which, following such sexual experiences, some adult males manifest greater distress than others. In total, 64 participants were interviewed and completed eight questionnaires covering various aspects of childhood and adult life. Results suggest the existence of three types of sexual abuse scenarios. Participants in each of these three groups presented with an adult-specific adjustment. However, the methodology and multivariate analyses used in this study suggest that some of these problems were not only associated with the sexual contacts but also with other childhood experiences and with the participant's cognitive, affective, and psychological resources.