1. Child Maltreatment
Messinger

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 responsibility
Idea of child maltreatment is gaining worldwide recognition
About 3 million reports made annually to child protective services
Acosta

4. Spanking?

5. SpankingExternalizing
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 abuse
Sexual abuse
Neglect
Acosta

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 trust
UNICEF: persons under 18 years of age who suffer occasional or habitual acts of violence
Acosta

8. Emotional abuse
Failure 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 abuse
Involvement 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 society
Acosta

10. Neglect
Failure 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 caretakers
Acosta

11. Incidence
National Incidence Study of Child Abuse and Neglect (Sedlak & Broadhurst, 1995)
Overall rate of child maltreatment of over 1,500,000
Includes 750,000 cases of child abuse and 880,000 cases of neglect
Does not discriminate across gender, language, religion, age, ethnicity, disability, or sexual orientation
Acosta

12. Results of Maltreatment
Direct effects not yet fully understood, although it is a significant risk factor for psychopathology
Affects all aspects of development
Acosta

13. Family environment Patterns seen across maltreatment types
Family environment of coercion and abuse of power
Lower levels of prosocial behavior and verbal communication
Undervaluing of children
Deviant affective displays
Maternal intrusiveness and non-responsiveness
Acosta

14. Cognitive adaptations
Maltreated children create defensive structure in reaction to trauma
Cognitive distortions, dissociation, vigilance
Hypervigilance: constant scanning of environment and development of ability to detect subtle variations in it
Dissociation: alter level of self-awareness in an effort to escape an upsetting event or feeling
Psychological escape
Attempt to be alert to possible abuse
Acosta

15. Social and emotional adjustments
Maltreated children often suffer from low self-esteem, self-blame, and negative affect toward the self
Greater risk for peer rejection
The 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 regulation
Involves ability to modify, redirect, and control emotions
Maltreated children engage in efforts to avoid, control or suppress emotion
Modulation difficulties: extreme depressive reactions and intense angry outbursts
Internalizing 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 trials
demonstrated delayed disengagement when angry faces served as invalid cues.
Pollak & Tolley-Schell. Journal of Abnormal Psychology. 112(3), Aug 2003,

18. Abused see more anger
Messinger

19. At expense of sadness

20. Recognizing emotion in faces
Controls viewed discrete emotions discretely
Neglected children saw fewer distinctions
Neglected 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 children
Reflects attentional orienting response
Unresolved anger: Eventual recovery from initial deceleration
Resolution: Greater recovery for non-abused than abused children
Pollak, Vardi, Bechner, & Curtin (2005). Physically Abused  

23. Skin conductance level change scores
Active anger: Non-abused children had emotional arousal response during second half
Abused children had relatively steady decline in SCL
Unresolved anger: Abused children had increased mid-way
Non-abused children steadily declined
Resolution: 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 behaviors
Certain types of maltreatment associated with a greater number of sexual partners and heavier alcohol consumption
Adult survivors likely to engage in substance abuse, criminal and antisocial behavior, and eating disorders

26. Bolger et al., 1998
107 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 Virginia
Children grouped according to maltreatment subtype and severity

27. Bolger et al., 1998 Findings
Maltreated children reported to have less satisfactory relationships with their peers and create negative self-concepts
Physically abused children form less positive self-concepts and more likely to be viewed as unpopular
Maltreated 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 behavior
reported by peers, teachers, and children
Aggressive behavior accounted for association of maltreatment and rejection.
Socially withdrawn behavior associated with peer rejection
but did not account for the association between chronic maltreatment and peer rejection.
Results hold for both girls and boys
Bolger & Patterson, 2001

29. Maltreatment chronicity  peer rejection

30. Maltreatment  Aggression

31. Maltreatment, aggression, & rejection

32. Specificity of abuse effects
Sexual abuse predicted low self-esteem
but not peer relationship problems.
Emotional maltreatment was related to difficulties in peer relationships
but 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 adults
Maltreatment can result in significant negative consequences that continue into adulthood
Although 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 children
Children who experienced a lack of parental supervision were less likely to be accepted by peers
Tendency to engage in unskilled or aggressive behavior

35. Possible buffers
Maltreating parents may fail to produce opportunities for positive social interaction for their children
Opportunities 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 maltreatment
Aggression between parents
Community violence
Often looked at separately even though they co-occur
Bias toward large injurious events rather than smaller, more subtle violence.
Some definitional issues
Important to distinguish between levels of severity and acute vs. chronic
Almost all children experience violence (90% in Martinez's 1993 sample) Margolin & Gordis (2004)
Margolin & Gordis (2004)
Mattson

37. Short Term vs. Long Term Effects
Externalizing
Blanket but often specific to exposure (e.g., acting out of witnessed aggression, sexual acting out)
Social Learning (exposure to violence leads to aggressive behavior)
Internalizing
Emotion and mood (e.g., the world is unsafe, helplessness)
Somatization (e.g., exaggerated startle, sleep disturbances, academic problems)
Long Term
Ehrensaft et al. (2003) violence during childhood related to increased violence by and to a partner. BUT
Kaufman and Zigler (1987) 70% of children do not become violent adults
Widom (1998) "cycle of violence is not deterministic or inevitable”
Mattson

38. Biology
Dysregulation of the HPA axis (stress response)
Cortisol levels in non-stressful situations
BUT variable…
different responses in individuals
different dysregulation of HPA axis…
Leads to different behavioral problems
Growth hormone, early puberty onset
Sympathetic nervous system over-activation
Suppressed immune function, memory functioning
Mattson
Effect 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 individual
Study variation in context and delays of presentation, vulnerable time periods
Tertiary later effects for interpersonal relationships
Multiple exposure
May just be the effect of relationship to frequency and severity
or a compounding of effects
or a primary family system impact lowering the threshold for other aggression
Mattson

40. Is maternal prenatal substance exposure child abuse?
What substances would and would not constitute abuse?

41. Cocaine summary
Cocaine 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 behavior
Although cocaine caregivers less involved at 1 & 4 months, no differences in secure attachment or quality of play at 18 months
Standardized 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 general
Standardized tests of cognitive achievement, motor performance, and language development often show no significant exposure effects
Effects, when present, tend to be of small magnitude
Although Singer recently found cocaine deficits in mental performance (and motor performance), Frank did not.
There may be “sleeper” effects only apparent as kids enter school
AS A MISTAKE, IT’S A POPULAR MISTAKE.
WAS SICK OF HEARING THAT 3 STUDIES WERE SI AND 5 WERE NOT
SO I CONDUCTED A QUANTITATIVE BEST EVIDENCE SYNTHESIS - A META-ANALYSIS OF PUBLISHED STUDIES
WE 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. Timing
Engaging 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-dependent
quantity of alcohol consumed affects severity of child deficits
Less 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 births
one 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 consequences
What 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 following
Victim name, address or location, approximate age, race and sex
Signs or indications of harm or injury, including a physical description if possible
Relationship 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.