2 Questions Define the four types of maltreatment? What are features of families in which maltreatment occurs?What are consequences of maltreatment on emotion recognition?What pathway identify to social consequences of maltreatment?How might a child be “buffered” from adverse effects?Do you believe prenatal substance exposure is child abuse?What are effects of common substances and which would and would not constitute abuse?Acosta
3 Timeline of child maltreatment Harsh discipline viewed as parent’s right and responsibilityIdea of child maltreatment is gaining worldwide recognitionAbout 3 million reports made annually to child protective servicesAcosta
5 SpankingExternalizing Maguire-Jack, K., A. N. Gromoske, et al. (2012)..Maguire-Jack, K., A. N. Gromoske, et al. (2012). "Spanking and Child Development During the First 5 Years of Life." Child Development 83(6):Using data from the Fragile Families and Child Wellbeing Study (N = 3,870) and cross-lagged path analysis, the authors examined whether spanking at ages 1 and 3 is adversely associated with cognitive skills and behavior problems at ages 3 and 5. The authors found spanking at age 1 was associated with a higher level of spanking and externalizing behavior at age 3, and spanking at age 3 was associated with a higher level of internalizing and externalizing behavior at age 5. The associations between spanking at age 1 and behavioral problems at age 5 operated predominantly through ongoing spanking at age 3. The authors did not find an association between spanking at age 1 and cognitive skills at age 3 or 5.
6 Definition Child maltreatment refers to four acts Physical abuse Emotional abuseSexual abuseNeglectAcosta
7 Physical abuse World Health Organization (WHO) Acts that result in actual or potential physical harm, resulting from an interaction that is within the control of a parent or person in a position of responsibility, power or trustUNICEF: persons under 18 years of age who suffer occasional or habitual acts of violenceAcosta
8 Emotional abuseFailure to provide a developmentally appropriate, supportive environment, so that a child can establish a stable and full range of emotional and social competencies “commensurate with his or her personal potential”Acosta
9 Sexual abuseInvolvement of a child in sexual activity that he/she does not fully comprehend, is not able to give consent to, and that violates the laws or taboos of societyAcosta
10 NeglectFailure to provide for a child in all domains: physical and mental health, education, nutrition, shelter, and safe living conditions, when the resources are reasonably available to the family or caretakersAcosta
11 IncidenceNational Incidence Study of Child Abuse and Neglect (Sedlak & Broadhurst, 1995)Overall rate of child maltreatment of over 1,500,000Includes 750,000 cases of child abuse and 880,000 cases of neglectDoes not discriminate across gender, language, religion, age, ethnicity, disability, or sexual orientationAcosta
12 Results of Maltreatment Direct effects not yet fully understood, although it is a significant risk factor for psychopathologyAffects all aspects of developmentAcosta
13 Family environment Patterns seen across maltreatment types Family environment of coercion and abuse of powerLower levels of prosocial behavior and verbal communicationUndervaluing of childrenDeviant affective displaysMaternal intrusiveness and non-responsivenessAcosta
14 Cognitive adaptations Maltreated children create defensive structure in reaction to traumaCognitive distortions, dissociation, vigilanceHypervigilance: constant scanning of environment and development of ability to detect subtle variations in itDissociation: alter level of self-awareness in an effort to escape an upsetting event or feelingPsychological escapeAttempt to be alert to possible abuseAcosta
15 Social and emotional adjustments Maltreated children often suffer from low self-esteem, self-blame, and negative affect toward the selfGreater risk for peer rejectionThe longer maltreatment occurs, the greater the likelihood of rejection, perhaps because of tendency to engage in coercive, aggressive interactions with peers as result of abuse
16 Emotion regulationInvolves ability to modify, redirect, and control emotionsMaltreated children engage in efforts to avoid, control or suppress emotionModulation difficulties: extreme depressive reactions and intense angry outburstsInternalizing behavior problems
17 Anger recognition & physical abuse Physically abused children displayed a response bias for angry facial expressions.8-11-year-old abused children demonstrated increased attentional benefits on valid angry trialsdemonstrated delayed disengagement when angry faces served as invalid cues.Pollak & Tolley-Schell. Journal of Abnormal Psychology. 112(3), Aug 2003,
20 Recognizing emotion in faces Controls viewed discrete emotions discretelyNeglected children saw fewer distinctionsNeglected children had more difficulty discriminating emotional expressions than control or physically abused children.Physically abused children showed the most variance across emotions.Pollak, Cicchetti, Hornung, Reed, Developmental Psychology. 36(5), Sep 2000,
21 Neglected children don’t distinguish emotion expression pairs Mean similarity ratings by emotion pair for control (C; solid line), neglected (N; dotted line) and physically abused (PA; dashed line) children. A = angry, N = neutral, S = sad, F = fearful, D = disgusted, H = happy
22 Heart rate change scores (bpm) Active anger: Large initial deceleration for both abused and non-abused childrenReflects attentional orienting responseUnresolved anger: Eventual recovery from initial decelerationResolution: Greater recovery for non-abused than abused childrenPollak, Vardi, Bechner, & Curtin (2005). Physically Abused
23 Skin conductance level change scores Active anger: Non-abused children had emotional arousal response during second halfAbused children had relatively steady decline in SCLUnresolved anger: Abused children had increased mid-wayNon-abused children steadily declinedResolution: No significant main effects or interactions
24 Impact on emotion recognition Influence of early adverse experience on children's selective attention to threat-related signals is a mechanism in the development of psychopathology.As children's experience varies, so will their interpretation of emotion expressions.Pollak & Tolley-Schell. Journal of Abnormal Psychology. 112(3), Aug 2003,
25 Overlap with risky behaviors Increased likelihood to engage in a greater array of risky behaviorsCertain types of maltreatment associated with a greater number of sexual partners and heavier alcohol consumptionAdult survivors likely to engage in substance abuse, criminal and antisocial behavior, and eating disorders
26 Bolger et al., 1998107 children (56 males, 52 females) from the Charlottesville Longitudinal Study, the Child Abuse and Neglect Information System, and local files from departments of social services in VirginiaChildren grouped according to maltreatment subtype and severity
27 Bolger et al., 1998 FindingsMaltreated children reported to have less satisfactory relationships with their peers and create negative self-conceptsPhysically abused children form less positive self-concepts and more likely to be viewed as unpopularMaltreated children form poor peer relationships, found to produce later adjustment problems and antisocial behavior
28 Chronically maltreated kids likely to be rejected by peers Maltreatment chronicity higher levels of children's aggressive behaviorreported by peers, teachers, and childrenAggressive behavior accounted for association of maltreatment and rejection.Socially withdrawn behavior associated with peer rejectionbut did not account for the association between chronic maltreatment and peer rejection.Results hold for both girls and boysBolger & Patterson, 2001
32 Specificity of abuse effects Sexual abuse predicted low self-esteembut not peer relationship problems.Emotional maltreatment was related to difficulties in peer relationshipsbut not to low self-esteem.For some groups of maltreated children, having a good friend was associated with improvement over time in self-esteem.Bolger et al., 1998
33 Does abuse predict malfunction? Many children and adolescents who suffer maltreatment become well-functioning adultsMaltreatment can result in significant negative consequences that continue into adulthoodAlthough many survivors function well in adulthood, others suffer serious psychological distress and disturbance
34 Why?Maltreating parents may fail to produce opportunities for positive social interaction for their childrenChildren who experienced a lack of parental supervision were less likely to be accepted by peersTendency to engage in unskilled or aggressive behavior
35 Possible buffersMaltreating parents may fail to produce opportunities for positive social interaction for their childrenOpportunities found elsewhere (i.e., other family members, friends, teachers, etc.)Maltreated children with best friends are more likely to experience increased self-esteem and self-concept than other maltreated children
36 ‘Large’ violence & ubiquitous violence How violence has been examined:Child maltreatmentAggression between parentsCommunity violenceOften looked at separately even though they co-occurBias toward large injurious events rather than smaller, more subtle violence.Some definitional issuesImportant to distinguish between levels of severity and acute vs. chronicAlmost all children experience violence (90% in Martinez's 1993 sample) Margolin & Gordis (2004)Margolin & Gordis (2004)Mattson
37 Short Term vs. Long Term Effects ExternalizingBlanket but often specific to exposure (e.g., acting out of witnessed aggression, sexual acting out)Social Learning (exposure to violence leads to aggressive behavior)InternalizingEmotion and mood (e.g., the world is unsafe, helplessness)Somatization (e.g., exaggerated startle, sleep disturbances, academic problems)Long TermEhrensaft et al. (2003) violence during childhood related to increased violence by and to a partner. BUTKaufman and Zigler (1987) 70% of children do not become violent adultsWidom (1998) "cycle of violence is not deterministic or inevitable”Mattson
38 BiologyDysregulation of the HPA axis (stress response)Cortisol levels in non-stressful situationsBUT variable…different responses in individualsdifferent dysregulation of HPA axis…Leads to different behavioral problemsGrowth hormone, early puberty onsetSympathetic nervous system over-activationSuppressed immune function, memory functioningMattsonEffect on behavior goes far above just genetics (twin studies and outcomes)
39 Response and Exposure So why do some respond poorly? Multiple exposure We have to link episodes of violence across development to specific deficits in the individualStudy variation in context and delays of presentation, vulnerable time periodsTertiary later effects for interpersonal relationshipsMultiple exposureMay just be the effect of relationship to frequency and severityor a compounding of effectsor a primary family system impact lowering the threshold for other aggressionMattson
40 Is maternal prenatal substance exposure child abuse? What substances would and would not constitute abuse?
41 Cocaine summaryCocaine exposed neonates are born slightly earlier & smaller than non-exposed infants.Slight, scattered decrements in self-regulation at 1 month but not detectable in infant feeding behaviorAlthough cocaine caregivers less involved at 1 & 4 months, no differences in secure attachment or quality of play at 18 monthsStandardized measures of development?To summarize the early assessments, C/O exposed neonates were of lower weight, and head circumference than were non-exposed neonates.Rates of irritable characteristics were also higher among exposed neonates, but characterized fewer than one in five exposed neonates.There were no exposure differences on comparable irritable or other behavioral characteristics at one month corrected age.
42 In generalStandardized tests of cognitive achievement, motor performance, and language development often show no significant exposure effectsEffects, when present, tend to be of small magnitudeAlthough Singer recently found cocaine deficits in mental performance (and motor performance), Frank did not.There may be “sleeper” effects only apparent as kids enter schoolAS A MISTAKE, IT’S A POPULAR MISTAKE.WAS SICK OF HEARING THAT 3 STUDIES WERE SI AND 5 WERE NOTSO I CONDUCTED A QUANTITATIVE BEST EVIDENCE SYNTHESIS - A META-ANALYSIS OF PUBLISHED STUDIESWE REPLICATED THIS COMBINED EFFECT W A SAMPLE AS LARGE AS THE REST OF THE SAMPLES COMBINED.HAVING DETERMINED THAT COCAINE IS A RISK.19
43 TimingEngaging in such behavior during the third trimester places the unborn child at risk for lowered intelligence and lifelong behavioral problems.Attention problems, memory deficits, and motor skills problems have been associated with habitual social drinking by the expectant mother throughout the pregnancy.
44 Alcohol impairs prenatal development of brain structures Extensive alcohol use during pregnancy altered facial characteristics, reduced growth, and severe cognitive deficits (Fetal Alcohol Syndrome).Alcohol effects are dose-dependentquantity of alcohol consumed affects severity of child deficitsLess obvious effects of alcohol exposure include reductions in general intelligence, verbal learning, social competence.Attention problems, memory deficits, and motor skills problems have been associated with habitual social drinking by the expectant mother throughout the pregnancy.
45 Is alcohol use child maltreatment? Prenatal exposure to alcohol affects one in four birthsone in twelve mothers reporting binge drinking during the pregnancy
46 Individual Differences It has been observed that although children have undergone similar high levels of prenatal alcohol exposure, some will manifest severe FAS symptomatology, some will manifest mild effects, and some children will appear unaffected (Able & Sokol, 1986; Phelps & Grabowski, 1992).Genetic factors?
47 One in five women reports using tobacco while pregnant Prenatal exposure to cigarettes associated with premature birth, low birth weight, and irritability in the newborn.Tobacco exposure is associated with lower intelligence scores and higher risk for attention deficit disorder in school age children.
48 Current issues Improved identification of occurrence of maltreatment Examination of its consequencesWhat determines effect of abuse?Establishing adequate services and supports for families and children to protect from exploitation and harm
49 How to make a report 1 - 800 - 96ABUSE (1-800-962-2873) Provide the followingVictim name, address or location, approximate age, race and sexSigns or indications of harm or injury, including a physical description if possibleRelationship of the alleged possible responsible person to the victim. If the relationship is unknown, a report will still be taken if other reporting criteria are met.