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.     

Pseudoabuse--the misdiagnosis of child abuse

When a patient's problem is judged to be the result of child abuse and it is not, considerable harm may be done to the child, his parents, and the doctor-parent relationship. The case histories of 15 children who were thought to be abused are reviewed and their correct diagnoses are presented. Overdiagnosing the battered child syndrome can be as harmful as failing to consider it.     

Psychiatric aspects of sexual abuse

Sexual abuse of children and adolescents has become an increasingly publicized phenomenon. Psychiatrists and other mental health professionals are often called upon to evaluate and treat children and adolescents who may have been sexually abused, to provide counseling or treatment to the families of such children, and to provide reports and testimony for proceedings about such cases in the child protection system, the criminal justice system, and in custody disputes. Clarity regarding the medical, psychiatric, and legal aspects of sexual abuse is essential in carrying out such professional activities and in evaluating and formulating research on sexual abuse. In this paper current knowledge regarding these aspects of sexual abuse is summarized, and the role of psychiatrists in clinical and forensic work involving allegations of sexual abuse is discussed.     

Intravenous abuse of propylhexedrine.

Propylhexedrine, a local vasoconstrictor, is the active ingredient in the Benzedrex nasal inhaler. In a six-month period, the Office of the Medical Examiner of Dallas County has encountered three deaths resulting from intravenous injection of propylhexedrine. Two of these individuals showed vascular changes in the lungs, apparently from chronic intravenous injections of this drug. Body distribution of the drug was determined in all of the cases by gas chromatographic analysis. An experiment was conducted to determine "therapeutic blood concentrations" in which a normal subject inhaled propylhexedrine from the Benzedrex inhaler. The maximum blood concentration was only 1/30 of the minimum concentration encountered in the reported cases.     

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.     

The neuropathology of heroin abuse

A broad spectrum of neuropathologic changes are encountered in the brains of heroin abusers. The main findings are due to infections, either due to bacterial spread from bacterial endocarditis, mycoses, or from HIV-1 infection. Other complications include hypoxic-ischemic changes with cerebral edema, ischemic neuronal damage and neuronal loss, which are assumed to occur under conditions of prolonged heroin-induced respiratory depression, stroke due to, for example, thromboembolism, vasculitis, septic emboli, hypotension, and positional vascular compression. Myelopathy is believed to be the result of an isolated vascular accident within the spinal cord due to an as yet unknown mechanism. A distinct entity, spongiform leukoencephalopathy, has been described mainly after inhalation of pre-heated heroin. A lipophilic toxin-induced process was considered to be due to contaminants and to be induced or enhanced by cerebral hypoxia, but a definite toxin could not be identified. At the cellular level, abnormalities in signal transduction systems and changes of various receptor densities have been reported. The exact etiology of the different neuropathological alterations associated with heroin abuse is still unclear, but may also be related to additional substances used as adulterants.     

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.     

挥发性有机溶剂的危害及滥用

本文简要介绍了挥发性有机溶剂对人体的危害及其存在的可能性，分析了几类人群对此类物质形成滥用、依赖的因素及与此相关的部分规定，提醒注意此类具有隐匿性的滥用物质。     

The influence of personal history of abuse and gender on clinicians' judgments of child abuse

Two extra-legal factors were examined for their influence on professionals' decisions to report child abuse: having been abused as a child oneself, and the gender of the child, the parent, and the professional. One hundred and one men and women who worked regularly with children in mental health settings rated a series of scenarios presented as cases from a protective service agency. Participants made several judgments regarding the case including the severity of the parent's behavior, the likely effect on the child, whether the situation was abusive, and whether the case should be reported to a social service agency. Despite some interpretive limitations, the results generally support the hypothesis that extra-legal factors influence the perceptions of professionals who are mandated to report a suspected incident of abuse.     

Amitriptyline abuse and misuse

Deaths related to amitriptyline toxicity are relatively common and are typically related to suicidal overdose. A less well-recognized situation of amitriptyline intoxication occurs when the drug is abused for its euphorigenic effects. An amitriptyline-related death due to a mixed drug intoxication is presented. Death investigation revealed that the death was accidental rather than suicidal. The case serves to remind forensic investigators that not all amitriptyline overdose deaths represent suicides. A segment of the population is known to abuse amitriptyline.     

The development of a sexual abuse severity score: characteristics of childhood sexual abuse associated with trauma symptomatology, somatization, and alcohol abuse

Childhood sexual abuse (CSA) is common and is associated with both mental and physical health problems in adulthood. Using data from an age- and sex-stratified population survey of 600 Olmsted County, Minnesota, residents, a Sexual Abuse Severity Score was developed. The abuse characteristics of 156 CSA respondents were associated with self-reported trauma, somatization, and alcohol use. Characteristics included age of first sexual abuse, more than one perpetrator, degree of coercion, severity of abuse (i.e., attempted intercourse is more severe than fondling), and the number of occurrences. This is one of the few reports to develop a risk summary that quantifies the severity of CSA.     

Postmortem toxicology of drugs of abuse

Conducting toxicology on post-mortem specimens provides a number of very significant challenges to the scientist. The range of additional specimens include tissues such as decomposing blood and other tissues, hair, muscle, fat, lung, and even larvae feeding on the host require special techniques to isolate a foreign substance and allow detection without interference from the matrix. A number of drugs of abuse are unstable in the post-mortem environment that requires careful consideration when trying to interpret their significance. Heroin, morphine glucuronides, cocaine and the benzodiazepines are particularly prone to degradation. Moreover, redistributive process can significantly alter the concentration of drugs, particularly those with a higher tissue concentration than the surrounding blood. The designer amphetamines, methadone and other potent opioids will increase their concentration in blood post-mortem. These processes together with the development of tolerance means that no concentration of a drug of abuse can be interpreted in isolation without a thorough examination of the relevant circumstances and after the conduct of a post-mortem to eliminate or corroborate relevant factors that could impact on the drug concentration and the possible effect of a substance on the body. This article reviews particular toxicological issues associated with the more common drugs of abuse such as the amphetamines, cannabinoids, cocaine, opioids and the benzodiazepines.