Deaths Due to Child Abuse: A 6‐Year Review of Cases in The Cook County Medical Examiner's Office

Case files from the Cook County Medical Examiner's Office from 2007 to 2012 were reviewed to analyze homicides due to physical child abuse in children <3 years old. Fatal cases mostly involved younger subjects. Intracranial injuries were the leading cause of death, while death due to extracranial injuries was uncommon. Eyes were involved in most of the cases. Spinal cord was involved in about 1/3 of the cases, mostly in the thoracic area. In some cases, previous injuries were present. There were significant differences in the pattern of injuries between age groups. Subjects showing signs of impact to the head and subjects with no evidence of an impact showed no significant difference in internal injuries. The association of multiple injuries is highly suggestive of child abuse. In suspected child abuse, a postmortem examination including neuropathological, ophthalmological, and radiological information should be always evaluated, together with investigative reports and the medical history.     

Chronic Alcohol Abuse Leads to Low Bone Mass with No General Loss of Bone Structure or Bone Mechanical Strength,

Chronic alcohol abuse (CAA) has deleterious effects on skeletal health. This study examined the impact of CAA on bone with regard to bone density, structure, and strength. Bone specimens from 42 individuals with CAA and 42 individuals without alcohol abuse were obtained at autopsy. Dual‐energy X‐ray absorptiometry (DEXA), compression testing, ashing, and bone histomorphometry were performed. Individuals with CAA had significantly lower bone mineral density (BMD) in the femoral neck and significantly lower bone volume demonstrated by thinner trabeculae, decreased extent of osteoid surfaces, and lower mean wall thickness of trabecular osteons compared to individuals without alcohol abuse. No significant difference was found for bone strength and structure. Conclusion: CAA leads to low bone mass due to a decrease in bone formation but with no destruction of bone architecture nor a decrease in bone strength. It is questionable whether this per se increases fracture risk.     

Memory Ability is Associated With Disagreement About the Most Recent Conflict in Polysubstance Abusing Couples

There is strong evidence that men and women do not agree about the occurrence of intimate partner violence (IPV). However, few studies to date have attempted to test explanatory models of violence concordance. One possible mechanism underlying disagreement is cognitive impairment, specifically, memory dysfunction. The principal goal of this study is to test whether memory ability and overall cognitive functioning is related to disagreement about the most recent occurrence of IPV within the dyad. Data were collected from both partners of cohabiting or married couples. The male partners were polysubstance abusers within their first year of abstinence. Results indicate that the men and womens memory ability, problem solving, disinhibition, and verbal ability are significantly related to disagreement about the most recent IPV episode. Thus, cognitive ability, particularly memory ability, of the participants should be considered when assessing the accuracy of measuring IPV among individuals diagnosed with polysubstance abuse. Other implications are discussed.1Portions of this paper were presented at the 128th annual meeting of the American Public Health Association (2000).     

Isolating Adult Psychological Correlates of Witnessing Parental Violence: Findings from a Predominantly Latina Sample

This study examined the relationship between childhood exposure to parental violence and adult psychological functioning in a sample of predominantly Mexican American participants. Questionnaires assessing childhood maltreatment, family environment, and current psychological symptomatology were completed by 142 female undergraduates. Findings revealed that witnessing parental violence in childhood was associated with depressive symptoms, low self-esteem, and trauma symptoms in adulthood, even after controlling for child physical and sexual abuse. However, in subsequent analyses, also controlling for levels of nonphysical family conflict, previous associations between exposure to parental violence and adult symptomatology were reduced, such that trauma-related symptoms remained the sole outcome still predicted by a history of witnessing parental violence. Implications of these findings, issues related to the use of statistical control procedures in abuse effects research, and directions for future investigation are discussed.     

An Integrated Theoretical Model of Sibling Violence and Abuse

Drawing on three theoretical perspectives (feminist, conflict, and social learning), an integrated analytical model of adolescence sibling violence and abuse is proposed. The model suggests that certain characteristics of the parents' relationship, various aspects of parent–child relations, and characteristics of the sibling relationship are major components in explaining sibling violence and abuse. These are mediated by individual sibling characteristics and sibling verbal conflict. The model should enable researchers to systematically examine, in a more holistic way, the factors related to violence and abuse, and to assess their relative importance in accounting for these phenomena.     

Spouse abuse: An integrative-interactional model

Although spouse abuse is a psychosocial problem and needs to be addressed from an ecological perspective, many clinicians confront this family issue daily. Outlined are some practical suggestions on how to deal with the abuser and the couple when one or both are clients. This work emphasizes the importance of contracts that are related to the level of work being done. Suggestions are made regarding the important considerations in the first few meetings when working with groups of men in the community. Interventions are derived from a broadly conceived cognitive-behavioral-systems perspective.     

Partner Abuse and HIV Infection: Implications for Psychosocial Adjustment in African American Women

A prospective study of the effects of partner abuse among HIV-infected and noninfected African American women (N = 137) revealed that there were both concurrent and longitudinal effects of abuse on several indices of psychosocial adjustment. Specifically, higher levels of both verbal and physical abuse were found among the HIV-infected group. In addition, the effects of abuse on suicidal ideation were significantly stronger among the HIV-infected group (n = 53) than among their demographically similar noninfected counterparts (n = 84), resulting in significant HIV status by partner abuse interactions. The findings of this study advance our understanding of intimate relationships with regard to partner abuse by examining a group of women at high-risk for abuse, yet understudied in both the HIV/AIDS and relationship literatures.     

Acts of Childhood Sexual Abuse: An Empirically Derived Typology

A clinical sample of 165 women survivors in outpatient therapy was surveyed about whether their childhood sexual abuse (CSA) included each of 17 sexual acts. Factor analysis of these acts was conducted. A typology of CSA acts consisting of three factors emerged. Inspection of the acts loading on each factor suggested that they differed primarily in terms of the type of abuse of power implied by them rather than in the nature of the sexual behavior involved. The three factors were named Coerced Complicance (Coercion), Subjugation and Humiliation (Subjugation) and Invasive Objectification (Objectification). Implications for research, theory, and clinical practice, and the need for evaluating the generalizability of the typology to other subpopulations of survivors, are discussed.     

Group Treatment for Spouse Abuse: Are Women with PTSD Appropriate Participants?

Eighty four abused women seeking therapy with their husbands were accepted into a group treatment program for spouse abuse. In the current study, we evaluated the treatment outcome of those women (n = 27) diagnosed with Posttraumatic Stress Disorder (PTSD). PTSD diagnosis, itself, did not differentiate those women who dropped out of treatment. Results indicated, however, that across all women, avoidance symptomatology significantly differentiated treatment completers from dropouts. Although women with PTSD began treatment in worse condition (lower marital satisfaction, higher depressive symptomatology, greater fear of spouse), post-assessment revealed they achieved positive treatment gains parallel to those of women without PTSD. Women with PTSD improved on each outcome variable measured, including a reduction in fear of spouse. Women with PTSD also did not differentially drop out of either treatment condition (men's/women's versus conjoint groups) which lends support to the appropriateness of conjoint treatment for spouse abuse.     

Maltreatment of handicapped children: A critical review

Despite increased interest in child abuse and neglect in the past decade, little research attention has been focused on maltreatment in handicapped populations. This is surprising given that many handicapped children display characteristics (e.g., chronic and pervasive behavioral disturbances, decreased social initiations with caregivers) that are associated with high risk for assault and neglect in nonhandicapped children. Numerous investigations have found an overrepresentation of handicapped children in maltreated samples, and results of more recent efforts reveal a high incidence of abuse and neglect in handicapped populations. Although these data underscore the high risk for maltreatment in handicapped children, a number of important issues warrant further empirical examination. Moreover, generalizations and interpretations of findings from previous research have been obfuscated by methodological shortcomings. The present paper reviews the literature concerning abuse and neglect of handicapped children. Research strategies and issues are delineated and current problems in this field are discussed. Suggestions for directions future research might take are offered.