Search

Accessible Summary: What is known on the subject?: This paper acknowledges the profound and lasting impact of childhood abuse on substance use and homelessness. What this paper adds to existing knowledge?: It underscores the inherent value and humanity of every individual, regardless of their struggles.That a comprehensive approach to mental health care, encompassing medication, therapy and a secure environment, is imperative. What are the implications for mental health nursing?: Early intervention and recognising individuals who suffer in silence are paramount. Mental health nurses must have the courage to ask uncomfortable questions and truly hear the unspoken words.Mental health nurses should never underestimate the power of simply being present with someone during their darkest moments. This simple act can wield significant influence. [ABSTRACT FROM AUTHOR]

Traumatic experiences can impact individuals' oral health and how they experience dental treatment in ways patients and their dental providers may or may not initially anticipate. As approximately half of children and two-thirds of adults in the United States have experienced some type of traumatic event, it is critically important for providers to be aware of patients' trauma histories and to appropriately provide trauma-informed care to their patients when needed. Individuals with a trauma history may experience significant anxiety and distress in the dental setting, even for treatment many providers and patients consider to be "simple," such as a brief intraoral examination, radiographs, or prophylaxis. Such aspects of the dental setting may trigger memories and emotions related to the original trauma and may re-traumatize patients. This short report introduces links between traumatic history, poor oral health, and dental care-related fear and anxiety. Additionally, this paper briefly describes how dental hygienists can provide compassionate trauma-informed care to their patients with the goal of providing whole-person care that considers patients' comfort, health goals, and prior experiences. Specific recommendations for providing trauma-informed care to children and adults within the scope of dental hygiene practice are provided, as is suggested wording for acknowledging a patient's prior trauma and tailoring dental care to accommodate patient experiences and concerns. As dental hygienists are often the oral health providers spending the most time with patients, they are uniquely positioned to provide compassionate effective trauma-informed care to patients with past traumatic experiences. [ABSTRACT FROM AUTHOR]

Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) is a frontline intervention for posttraumatic stress disorder (PTSD) symptoms among maltreated children. Research suggests that active caregiver participation predicts positive treatment outcomes, but these studies are often based on the perception of the caregiver. Youth perceptions of the caregiver as a source of support who might help confront distressing memories (i.e., attachment security) and how they relate to TF-CBT treatment are unexplored. This paper uses data from a small randomized controlled feasibility trial of TF-CBT to conduct a pilot examination of whether (a) attachment security may improve through the course of TF-CBT, and (b) pre-treatment attachment security predicts response to TF-CBT for the amelioration of posttraumatic stress. Results favored the conclusion that those beginning treatment with attachment insecurity may demonstrate improvement for this outcome by the end of treatment (n = 8; t = 3.3, p =.013, Cohen's d = 1.17). However, although significant improvements were found over the course of treatment for PTSD, there was no evidence that pre-treatment attachment security predicted PTSD outcome (n = 29; ∆ R 2 <.01, ∆ F (1,26) =.001, p =.969). The limitations of the current pilot study are discussed, as well as directions for future research. [ABSTRACT FROM AUTHOR]

Abstract For many local authority children and family services in the UK faced with the task of responding to children and families facing difficulties and with declining budgets, there is an increasing imperative on how services can respond more effectively to the diverse needs of families on the edge of care. At the same time policy and paradigm shifts have affected the way in which social workers engage with families. This paper is rooted in research commissioned by one local authority that used an innovative visual 'river of experience' co- production approach to understand better the experiences of children and families on their journeys to the edge of care and to inform how statutory services might respond 'better', and possibly earlier, to prevent children being taken into care. The research highlights the gap between assumptions and practices of child and family services and the realities and needs of children and families. The paper discusses these disjunctions and draws out questions to challenge statutory services. In particular, the paper asks why, in spite of serial involvement of professionals, do children still end up in the care system. The paper contributes to current discourses about rethinking child protection, arguing for a different approach to responding to families facing difficulties involving human centred, holistic family support and a more reflexive and relational approach to professional practice. Highlights • The continuing gap between services and the needs of children and families • Children's voices frequently go unheard in statutory professional interventions. • Insufficient attention to emotional/psychological legacy of early neglect • Reiterates the need for re-imagining child protection as family-centred practice • Need for Children and Family services to be flexible and adaptive learning systems [ABSTRACT FROM AUTHOR]

• Learning the lessons from serious child abuse cases can prevent harm in future. • Lack of 'professional curiosity' and 'challenge' are inadequate explanations. • More productive understandings for practice would be communication and courage. • Awareness of the ambiguous policy context is also essential. • Well supported staff and properly resourced services are vital. Learning lessons from cases where children have been killed or seriously harmed from abuse or neglect is important for child protection policy and practice around the world. In England there is a long-established system of locally based, multi-agency reviews. Three recurrent themes over the years have been the poor quality of assessments, shortcomings in inter-agency working and information sharing, and not knowing the children and understanding their experiences. The reviews often identify a lack of 'professional curiosity' and insufficient 'challenge' on the part of child protection practitioners as the cause of these problems. This paper analyses these concepts, drawing on four recent studies of child safeguarding reviews conducted by the authors and their research team. It uses qualitative data from the reports and the views of local professionals in online focus groups. The reviews tend to use the perceived lack of curiosity and challenge as the explanation for poor practice without interrogating why, when and in what circumstances it becomes more difficult for professionals to remain curious and appropriately challenging. Professional curiosity and challenge are complex, multifaceted concepts, and applying them in practice is difficult and skilled work. The paper argues for a more nuanced and grounded understanding of the concepts and their application in practice. It sets them in wider frames of communication and courage, and the ambiguous policy context of a preference for cooperative engagement with families but high expectations about protecting children. It offers recommendations for future research into the review process, authorship style, practice in local agencies and national government policy. [ABSTRACT FROM AUTHOR]

Child homicides are rare occurrences, but when they occur, they often cause significant outrage. This paper examines the role of varying degrees of intimacy between victims and perpetrators in determining characteristics in child homicide cases. Focusing on 533 cases of child homicide between 1985 and 2012 in Ontario, Canada, characteristics of intrafamilial and extrafamilial cases, biological and step/foster parents, and maternal and paternal perpetrators are compared. Results show that characteristics of the child homicide vary depending on the degree of intimacy between victims and perpetrators, including: perpetrator and victim age, weapon use, suicide following the offence, sexual violence and use of excessive force. These findings provide support for developmental victimology and a routine activities theoretical perspective. Suggestions for future research and policy implications are also discussed. 'Examines the role of varying degrees of intimacy between victims and perpetrators in determining characteristics in child homicide cases' Key Practitioner Messages: Younger children are at a greater risk of homicide from family members, while older children are at a greater risk of homicide from individuals outside the family.Developmental victimology and routine activities theory can contribute to a better understanding of the dynamics between victims and perpetrators in child homicide.Collaboration should take place between researchers, child death review committees, mental health services, social services and policymakers to improve child homicide prevention and intervention initiatives. [ABSTRACT FROM AUTHOR]

While it is known that young people exposed to maltreatment or abuse are at elevated risk of developing post-traumatic stress disorder (PTSD), much of our current knowledge of mechanisms that link trauma to childhood PTSD is based on single-incident, often noninterpersonal, trauma. Theoretical models highlight psychological processes of appraisals, memory, and coping as important for the development of PTSD. The aim of this review was to synthesize the literature on the role of these key psychological processes in relation to PTSD in maltreated children and teens. Studies were included if they (1) identified a sample of maltreated individuals, ≤18 years old; (2) measured (a) trauma memory, (b) appraisals, or (c) post-trauma cognitive or behavioral responses; and (3) measured PTSD symptoms. The systematic search of three electronic databases (American Psychological Association PsychNet, PubMed, and Published International Literature on Traumatic Stress) resulted in the inclusion of 36 papers, which described 31 studies and 33 unique samples. The review found cognitive behavioral models of PTSD appeared appropriate for understanding outcomes following maltreatment, but further research is needed on all processes, particularly trauma memory. Overall, there remain significant gaps in our knowledge of how psychological processes link maltreatment to PTSD. There is limited evidence concerning how maltreatment-related characteristics (e.g., chronicity, duration, and type of abuse) influence psychological processes and in turn affect outcomes. This review recommends further research in this area and suggests that, at the very least, comprehensive assessment should be conducted with all young people reporting maltreatment to identify appraisals and coping strategies that will potentially impact on their ongoing adjustment. [ABSTRACT FROM AUTHOR]

Exploring children and young people’s own understanding of experiences with abuse and maltreatment is an important part of taking their right to participation seriously. By applying a narrative theoretical framework, this paper explores and analyzes young people’s and young adults’ stories of being the target of violence and abuse as children, and their meaning making and definition of such experiences, then and now. The overall findings show the participants’ varied and nuanced perceptions of what constitutes violence were much dependent on contextual, relational, and temporal aspects. Furthermore, many participants reported psychological and emotional abuse and neglect to be the most hurtful of their experiences of maltreatment. Finally, the analysis sheds light on how responses to abuse and maltreatment change and depend on the children and young people’s definition of their situation through time and context. The paper contributes with qualitative knowledge to the social work research and practice field, on how abuse and maltreatment unfold in and affect children and young people’s lives seen from their own points of view. [ABSTRACT FROM AUTHOR]

To promote trauma-informed professional supports and services to maltreated youth, it is imperative that researchers explore foster parents’ knowledge of child trauma. However, there is a dearth in the literature related to this topic. This exploratory study utilizes a convenience sample (N = 219) of foster parents in one southeastern state. Variables of interest include actual and perceived knowledge about child trauma. After a terse review of background literature, this paper will explicate key results, discuss these findings, and identify salient practice and policy implications derived from this study. The paper will conclude by delineating apposite areas for future research. [ABSTRACT FROM AUTHOR]

Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) and International Classification of Diseases-11th Revision (ICD-11; proposed) now include criteria for clinically significant (a) intimate partner violence (IPV) and neglect and (b) child abuse and neglect. However, existing measures of IPV and child abuse do not allow for assessment of established criteria. The current study examines the convergent and response process validity of the Family Maltreatment (FM) measure of clinically significant physical and psychological IPV and child abuse. Participants (N = 126) completed the FM via computer and measures of IPV (Revised Conflict Tactics Scale; Straus, Hamby, Boney-McCoy, & Sugarman, 1996) and child abuse (Parent-Child Conflict Tactics Scale; Straus, Hamby, Finkelhor, Moore, & Runyan, 1998) via paper-and-pencil. Participants who endorsed acts of aggression on the FM completed an audio-recorded computerized interview recounting the 2 most severe incidents. Verbalized incidents (n = 138) were coded for clinically significant family maltreatment. Results largely supported the convergent validity of the FM. Agreement of acts endorsed on the FM with those endorsed on convergent measures was excellent for IPV and physical child abuse, yet poor for psychological child abuse. Further, in support of the response process validity of the FM, comparison with observer ratings of interviews indicated few "false positives" and no "false negatives" on the FM across the examined types of clinically significant IPV and child abuse. In summary, the FM is a promising measure for the assessment of clinically significant physical and psychological abuse as defined in the DSM-5 and ICD-11 (proposed). (PsycINFO Database Record (c) 2020 APA, all rights reserved). [ABSTRACT FROM AUTHOR]

The psychological assessment of parents involved in proceedings about their parental rights is often ordered by the Court in order to determine personality traits linked to potential problems in parental competences. We compared the Minnesota Multiphasic Personality Inventory (MMPI)-2 scores of this specific sample with a comparison group of parents involved in child custody litigations, considering a total of 429 individuals undergoing personality evaluations ordered by several Italian courts. The results showed moderate elevations on clinical scales 4 (Psychopathic Deviate) and 6 (Paranoia) in the first group. Results for the Diamond's Axes, supplementary scales, content scales, and PSY-5 point to other psychological concerns, which were not considered widely in the literature we reviewed. This paper creates a comparative norm set for the MMPI-2 in Italian parental assessment, comparing the MMPI-2 scores of parents in custody litigations versus those whose parental fitness was under investigation. This study compares the MMPI-2 scores of a sample of parents involved in proceedings about their parental rights with a comparison group of parents involved in child custody litigations. Results showed a clinically useful relationship between some personality characteristics and parental competency vulnerability. [ABSTRACT FROM AUTHOR]

The many adverse effects of child maltreatment make the scientific investigation of this phenomenon a matter of vital importance. Although the relationship between maltreatment and problematic emotion reactivity and regulation has been studied, the strength and specificity of these associations are not yet clear. We examine the magnitude of the maltreatment-child-emotion reactivity/regulation link. Studies with substantiated maltreatment involving children aged up to 18 were included, along with a smaller number of longitudinal studies (58 papers reviewed, encompassing more than 11,900 children). In comparison to nonmaltreated children, maltreated children experience more negative emotions, behave in a manner indicative of more negative emotion, and display emotion dysregulation. We outline several theoretical implications of our results. [ABSTRACT FROM AUTHOR]

This study is a national cross‐sectional survey, conducted in November 2014, of 366 dental hygienists and dentists who had suspected maltreatment but did not report it to Norwegian Child Welfare Services (CWS). The aims of the present paper are to identify the reasons why public dental healthcare professionals are reluctant to report suspected child maltreatment to CWS and to determine whether there are differences in the identified barriers according to socio‐demographic variables. The questionnaire was based on earlier studies and was adapted to fit the Norwegian context. The most frequently chosen reason for not reporting was "unsure of own assessment" (90.4%). Thirteen items pertaining to not reporting were factorised into three factors of barriers. These factors were "insufficient knowledge of child maltreatment and reporting", "fear of the consequences for oneself and the dental clinic", and "fear of the consequences for the patient and their family". A t test revealed that public dental healthcare personnel who had not received training on maltreatment and reporting to CWS during their professional education scored significantly higher on the barrier "insufficient knowledge of child maltreatment and reporting" than did dental personnel who had received such training. Furthermore, dental personnel with more years of experience (11+) scored higher on this barrier than did dental personnel with less experience. No other significant differences in barriers were observed. Public dental healthcare personnel have a mandatory obligation to report to CWS if they suspect child maltreatment. Despite this obligation, the present study reveals that several barriers to reporting exist. This study underscores the importance of strengthening knowledge among dental hygienists and dentists about when and how to report, both during education and in clinical practice. [ABSTRACT FROM AUTHOR]

Background: Young Schema Model (YSM) emphasizes Toxic Early Childhood Experiences (TECE) as vulnerability factors to depression. However, the lack of consensus on how to define and measure TECE is likely to have led to inconsistent findings in current literature. This review maps supported and unsupported pathways to depression and measures used.Methods: A scoping review was conducted in accordance with the Joanna Briggs Institute protocol to identify primary research studies that examined developmental and maintenance pathways to depression within the YSM framework. 2463 articles were identified with 49 primary research studies selected for inclusion. As a subset of the overall review, this paper focuses on the 14 studies that examined effects of TECE on depression in context of YSM.Results: The studies used 11 different measures to examine the role of TECE in depression. Effects of maltreatment (i.e., physical abuse, emotional abuse, emotional neglect,) and perceived parenting (i.e., low care, high rejection, high overprotection and/or control, maladaptive parenting styles) on depression are well supported. Effects of sexual abuse and physical neglect on depression are currently inconclusive.Conclusion: In conclusion, findings revealed the inconsistent definition and measurement of TECE (with 11 different measures) in current literature. Findings support the effects of physical abuse, emotional abuse, emotional neglect, low care, high rejection, high overprotection and/or control, and maladaptive parenting styles on depression. Limitations of existing studies include researchers' inconsistent definition and measurement of TECE, under-examined TECE sub-constructs, possible moderating relationships, predominant cross-sectional design, and homogeneous sampling. Limitations of the scoping review include its small number of studies and the absence of evaluation of the measures used. Nevertheless, this review represents the first step in the systematic examination of the empirical basis of YSM and is an important contribution to depression treatment and innovation. [ABSTRACT FROM AUTHOR]

Abstract Families involved in high conflict child custody disputes pose unique challenges for child protection services. Little is known about the struggles faced by child protection workers when responding to complaints made by acrimonious ex-partners within the context of child custody disputes. This paper reports on an exploratory cross-sectional online survey of child protection service providers (n = 208) from five child protection agencies. Results show that the majority of workers expressed feeling higher levels of stress when dealing with families involved in child custody disputes, attributed to repeat allegations and counter allegations, the ongoing acrimony between the parents, pressure from the parents and legal professionals to take sides in the dispute and a lack of protocols to work with families involved in high conflict. The lack of specialized training to work with parents stuck in high conflict and the demands placed on workers, already struggling with large caseloads, contributed to workers feeling overwhelmed and ineffective when working with families entrenched in child custody disputes. Implications are discussed including the need for early identification of high conflict cases, specialized services to address the unique needs of families involved in child custody disputes and increased collaboration between child protection services and external service agencies. Highlights • This study is the first known survey to explore child protection service providers' experiences of working with families involved in child custody disputes. • Workers expressed feeling higher levels of stress when dealing with families involved in child custody disputes. • Workers feel pressure from the parents to take sides in the custody dispute. • The lack of training and standards contribute to the challenges faced by child protection workers. [ABSTRACT FROM AUTHOR]

Children subject to parental alienation dynamics often present with psychological splitting and lack the ambivalence towards their parents which can be observed in other groups of children, even those who are emotionally abused and neglected. This paper used the Bene‐Anthony Family Relations Test to explore differences between alienated and neglected/emotionally abused children's views and feelings towards their mothers and fathers. Results confirmed that alienated children engaged in splitting, idealising their preferred parent and demonising their target parent without legitimate justification. Conversely, neglected/emotionally abused children presented with greater ambivalence, sending both positive and negative messages to their mothers and fathers; although overall in this study, they displayed a tendency to idealise their parents despite the maltreatment that they had suffered. The results highlight the importance of not taking children's expressed wishes at face value and the need for in‐depth multimodal psychological assessments to establish children's ascertainable rather than expressed wishes. 'Explore[s] differences between alienated and neglected/emotionally abused children's views and feelings towards their mothers and fathers' Key Practitioner Messages: The Bene‐Anthony Family Relations Test is an invaluable clinical tool for exploring children's feelings about their family relationships.Children's expressed wishes about their parents are paradoxical in cases of both alienation and neglect/emotional abuse.Assessments of children need to identify their ascertainable rather than expressed wishes. This requires a comprehensive multimodal psychological assessment involving all family members, cross‐referencing information from all sources from a longitudinal perspective. [ABSTRACT FROM AUTHOR]

This paper provides an overview of research about adolescent neglect funded by the Department of Children, Schools and Families (now the Department for Education) and the Department of Health. The paper examines what is known from literature about the causes of adolescent neglect, together with its potential consequences for well-being. Drawing on qualitative data, the concept of neglect is explored from the perspectives of young people themselves and the professionals who work with them. Consideration is given to examples of interventions and preventative models geared towards addressing adolescent neglect. Key findings indicate that there is a need for both a re-examination of current definitions of neglect in the light of age-related distinctions and perspectives, and a fuller understanding of the particular needs of adolescents who are experiencing neglect. Additionally, the research highlights that there is a lack of research knowledge about neglectful parenting and the behaviour of young people, as well as limited understanding of interventions with neglected adolescents. Key themes from the research are discussed in terms of their implications for future practice, policy and research in relation to working to improve the welfare of neglected young people. [ABSTRACT FROM AUTHOR]

The Their Futures Matter reform is the New South Wales (NSW) Government's coordinated approach and long‐term strategy for how we support vulnerable children and families. In 2016, funding was provided to implement two evidence‐based models – Multisystemic Therapy for Child Abuse and Neglect (MST‐CAN®) and Functional Family Therapy – Child Welfare (FFTCW®). Both models target the causes of harm and respond to trauma and other underlying causes of child abuse and neglect. They are delivered by teams of practitioners in the family home and community (a departure from the way most interventions are normally delivered), and provide intensive home‐based services aimed at keeping families together. To span the gap between science and practice in the delivery of MST‐CAN® and FFT‐CW®, implementation is supported through a partnership between government and intermediaries supporting service providers. With the guidance of a New York (NY)‐based organisation, The New York Foundling, these intermediaries apply the Community Development Team model, an implementation strategy that uses an evidence‐based implementation approach to introduce treatment models that are themselves informed by evidence, which helps increase the likelihood of sustained treatment success. Experience across the globe, however, indicates that investment in evidence‐based approaches is not enough to secure successful outcomes for families and communities. The NSW Government is also investing in other measures aimed at addressing a range of common implementation barriers such as staff training and retention, identification of suitable families, and cultural competence. The latter is critical given the over‐representation of Aboriginal children and young people in child protection and the out‐of‐home‐care system. Over a three‐year period, evidence will be collected of this investment's impact on child and family outcomes, and on implementation support. This paper will discuss how the partnership processes of working more flexibly with service providers, families, and communities can lead to enhanced outcomes. [ABSTRACT FROM AUTHOR]

The decision to substantiate child maltreatment is one of the many complex decisions workers must make daily. Utilizing data from the Ontario Incidence study 2013, this paper examines what child, family and environmental characteristics workers paid attention to when making the determination that a child had experienced maltreatment. This study adds to the Canadian body of research on factors that influence the decision to substantiate maltreatment by exploring the Ontario population. Caregiver risk factors, uncooperative parents, older children, and children with emotional or mental health concerns all increase the likelihood of substantiation. The decision to substantiate current maltreatment was strongly influenced by the workers' assessment of the future risk of maltreatment. Further research is need to explore worker and organizational factors that also influence this risk focus and how much of an influence the current risk assessment tools have on the workers' assessment of future risk and substantiation. [ABSTRACT FROM AUTHOR]

Although the association between childhood maltreatment and the subsequent development of offending behavior is well documented, the association does not necessarily reflect a causal relationship. This paper provides a systematic review of prospective and longitudinal studies using official records of maltreatment to gain insights into the extent to which methodological variations are likely to influence the conclusions drawn about the likely relationship between maltreatment and offending. Sixty-two original studies met the inclusion criteria. These studies were assessed according to a set of seven methodological criteria: (1) inclusion of comparison groups, (2) the use of statistical controls, (3) valid outcome measures, (4) operationalization of maltreatment, (5) proper temporal order of associations, (6) data relating to unsubstantiated maltreatment, and (7) consideration of mediating and moderating factors. The strength of evidence in support of the maltreatment–offending association was influenced by a number of methodological factors. Despite the increasing sophistication of studies, there is a need to be mindful of how these factors are taken into account in future research in order to gain a deeper understanding of the adverse consequences of maltreatment and how this might influence outcomes and inform interventions. [ABSTRACT FROM AUTHOR]

There are few studies on didactogenicity at the global level (Cukier, 2004; Davitz & Ball, 1978; Nelsen et al., 1997; Hyman & Snook, 1999) and even fewer at the level of our country (Sava, 2001; Sava in Boncu & Ceobanu, 2013). Our paper aims at rendering the concept of didactogenicity more visible in relation to the Romanian educational system, as well as at promoting awareness of the impact of teacher behaviour upon children. This article represents the theoretical background for a research study we shall conduct in the second semester of the 2014-2015 school year that will involve applying a questionnaire to a relevant number of students from several schools in the county of Bacau. The findings of the respective study shall be revealed in a future paper. Our hypothesis is that didactogenicity is a more or less recognized issue of the Romanian educational system and that more thorough work should be conducted to diminish and control its occurrence in Romanian schools and impact upon the students' development. [ABSTRACT FROM AUTHOR]

This paper reports results of mixed methods, population survey of housing instability, and homelessness. Child welfare personnel conducted the Quick Risks and Assets for Family Triage ( QRAFT), a three-question screening tool intended to identify housing instability and homelessness. The QRAFT requires users to assess family housing history, current housing arrangement, and current housing condition, on a four-point scale from 'asset/not a risk' to 'severe risk.' The QRAFT was completed among 6828 families undergoing new child maltreatment investigations. Approximately 5.4% of families demonstrated significant to severe housing problems; approximately one-third exhibited moderate housing risk. Housing problems and homelessness were significantly associated with the outcome of child welfare investigations; among families with substantiated child welfare determinations, 21% demonstrated significant to severe housing risk, a significantly higher proportion than among families where the investigation outcome was unsubstantiated or differential response (i.e., voluntary services). Of significant to severe housing risk families, 15.7% later met eligibility criteria for a supportive housing intervention, suggesting that housing concerns combined with substantial parent and child functional difficulties. Qualitative data indicated the QRAFT was perceived as easy to administer, effective as a screening tool, and useful to 'apply the housing lens' early in child welfare involvement. [ABSTRACT FROM AUTHOR]

This paper reports the first large-sample investigation of the maltreatment-related correlates of low-income adolescents’ narratives about their childhood experiences with primary caregivers, as assessed with a modified version of the Adult Attachment Interview (AAI) and based on official reports of abuse and neglect (maltreated n = 214, nonmaltreated n = 140; M age = 16.7 years). Drawing on factor-analytic and taxometric evidence indicating that AAI narratives vary along two state of mind (i.e., dismissing and preoccupied) and two inferred childhood experience (i.e., maternal and paternal) dimensions, here we demonstrate that the experience of maltreatment, particularly when chronic, is associated with increased risk for dismissing and preoccupied states of mind and more negative inferred childhood experiences. Although such maltreatment-related associations were generally not specific to any of the four AAI dimensions, the experience of physical and/or sexual abuse was uniquely associated with preoccupied states of mind and negative inferred paternal experiences even after controlling for the other AAI dimensions. More extensive paternal perpetration of maltreatment also was uniquely related to more negative inferred paternal experiences. [ABSTRACT FROM PUBLISHER]

This paper tests the hypothesis that the association between childhood maltreatment and adult personality dysfunction is at least partially attributable to insecure attachment, that is that attachment style mediates the relationship between childhood maltreatment and adult personality dysfunction. Associations between childhood trauma, as measured by the Childhood Trauma Questionnaire (CTQ), anxious and avoidant attachment in romantic relationships, as measured by the Experiences in Close Relationships-Revised (ECR-R), and five personality domains, as measured by the Severity Indices of Personality Problems (SIPP-118), were examined in a sample of 72 psychiatric inpatients. The SIPP-118 domains included relational capacities, identity integration, self-control, responsibility, and social concordance. The direct effect of childhood trauma on all SIPP-118 domains was not significant after controlling for the indirect effect of attachment. In regression modeling, a significant indirect effect of childhood trauma via adult attachment style was found for SIPP-118 relational capacities, identity integration, self-control, and social concordance. Specifically, anxious attachment was a significant mediator of the effect of childhood trauma on self-control, identity integration, and relational domains. These results suggest that childhood trauma impacts a broad range of personality domains and does so in large part through the pathway of anxious romantic attachment style. [ABSTRACT FROM PUBLISHER]

The neoliberal direction of social policy under New Zealand’s fifth National government (2008–) is demonstrated in its 2012White Paper for Vulnerable Children. This document advocates increased monitoring and policing of welfare populations and the downgrading of child protection policy to a technical administrative system for managing ‘risky’ families. TheWhite Paper’srelease came soon after the coroner’s report into the deaths of the ‘Kahui twins’, which were treated by the media as a shocking case of child abuse, and exemplified the media’s use of a fantasy of a ‘savage’ Maori welfare underclass in reporting cases of child abuse. Drawing on Isin’s analysis of ‘governing through neurosis’, this article explores how these media and policy discourses reinforce normative patterns of neoliberal citizen subjectivity by offering compelling pathways out of anxiety that re-route citizens’ anxiety over child abuse in support of neoliberal modes of citizen subjectivity. [ABSTRACT FROM AUTHOR]

This paper reports the results of a scoping study that reviewed research about child abuse, child protection and disabled children published in academic journals between 1996 and 2009. The review was conducted using a five stage method for scoping studies. Several studies have revealed a strong association between disability and child maltreatment, indicating that disabled children are significantly more likely to experience abuse than their non-disabled peers. Those with particular impairments are at increased risk. There is evidence that the interaction of age, gender and/or socio-cultural factors with impairment results in different patterns of abuse to those found among non-disabled children although the reasons for this require further examination. It appears that therapeutic services and criminal justice systems often fail to take account of disabled children's needs and heightened vulnerability. In Britain, little is known about what happens to disabled children who have been abused and how well safeguarding services address their needs. Very few studies have sought disabled children's own accounts of abuse or safeguarding. Considerable development is required, at both policy and practice level, to ensure that disabled children's right to protection is upheld. The paper concludes by identifying a number of aspects of the topic requiring further investigation. Copyright © 2010 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This paper focuses on the challenges and complexities of caring for front-line child protection workers. It is organised in four main sections. After a brief explanation of the background, the paper reviews the silencing of children as a form of defensive denial. The second section presents research on the problems faced by child protection workers and the defences used in response to actual and threatened violence. The third section reflects on the resulting complexities of supervision in the face of organisational defensiveness. In the final section, examples of good staff support from outside social work are summarised. The paper draws on theoretical material and the primary author's experiences of undertaking research in a range of organisations. [ABSTRACT FROM AUTHOR]

This paper draws upon the findings of a study that looked at women's experiences of mothering in the context of co-occurrence of domestic violence and child abuse, and considers the issue of women's violence towards children – while acknowledging the fact that men are the main perpetrators of violence towards women and children in these families. The paper first explores the relationship between women's victimization and women's violence, and suggests that women's abuse of their children can be seen as a consequence of their own experiences of domestic violence. The findings nonetheless suggest that abused women have agency, and therefore have responsibilities when they chose to use violence towards their children. The paper also considers the feelings of guilt and blame that tend to arise in these circumstances. Implications for research, policy and practice are identified. [ABSTRACT FROM AUTHOR]

Children of affluence are generally presumed to be at low risk. However, recent studies have suggested problems in several domains--notably, substance use, anxiety, and depression--and 2 sets of potential causes: pressures to achieve and isolation from parents. Recognizing the limited awareness of these issues, the objectives in this paper are to collate evidence on the nature of problems among the wealthy and their likely causes. The first half of the paper is focused on disturbances among affluent children and the second half is focused on characteristics of their families and neighborhoods. Widespread negative sentiments toward the rich are then discussed, and the paper concludes with suggestions for future work with families at the upper end of the socioeconomic spectrum. [ABSTRACT FROM AUTHOR]

In this paper we describe research using narrative techniques to examine the effects of past abuse, and the process of subsequent recovery, in children aged 4-8. The paper examines the impact of abuse upon children's inner representations of self, others, and relationships, the role of defensive processes, and indicators of change as the child settles in a new family. The use of the narrative technique as part of a clinical assessment is also described. This study is ongoing, and is based at the Anna Freud Centre, Great Ormond Street Hospital and the Thomas Coram Adoption Service. [ABSTRACT FROM AUTHOR]

This paper explores paranoid and depressive trends in a patient who was abused as a child. It discusses how each parent affected the patient's way of coping with life's challenges. In this context, paranoia is described as a set of defenses against the father's shocking intrusions, while the mother's impact shows itself in the patient's depressive tendencies. [ABSTRACT FROM AUTHOR]

It is widely recognized that children in the child welfare system are particularly vulnerable to the adverse health and mental effects associated with exposure to abuse and neglect, making it imperative to have broad-based availability of evidence-based practices (EBPs) that can prevent child maltreatment and reduce the negative mental health outcomes for youth who are victims. A variety of EBPs exist for reducing child maltreatment risk and addressing the associated negative mental health outcomes, but the reach of these practices is limited. An emerging literature documents factors that can enhance or inhibit the success of EBP implementation in community service agencies, including how the selection of a theory-driven conceptual framework, or model, might facilitate implementation planning by providing guidance for best practices during implementation phases. However, limited research is available to guide decision makers in the selection of implementation frameworks that can boost implementation success for EBPs that focus on preventing child welfare recidivism and serving the mental health needs of maltreated youth. The aims of this conceptual paper are to (1) provide an overview of existing implementation frameworks, beginning with a discussion of definitional issues and the selection criteria for frameworks included in the review; and (2) offer recommendations for practice and policy as applicable for professionals and systems serving victims of child maltreatment and their families. [ABSTRACT FROM AUTHOR]

This paper examines the potential contribution of forgiveness therapy to social workers who may often encounter clients who have experienced severe interpersonal injury, or who have inflicted significant harm upon themselves or others. Basic theoretical and empirical perspectives on the processes and dynamics of forgiveness, as well as an introduction to forgiveness therapy, are provided. A case example demonstrating the application of forgiveness therapy in a social work setting is utilized to underscore points of convergence and potential divergence between this innovative therapeutic approach and important social work values and practice concepts. Research directions that may promote the further incorporation of forgiveness and forgiveness therapy into social work are indicated. [ABSTRACT FROM PUBLISHER]

A large amount of research has been completed on the impact of abuse and neglect on children's brain development, attachment and behaviour (Malinosky-Rummell & Hansen, 1993, ‘Long-term consequences of childhood physical abuse’,Psychological Bulletin, vol. 114, pp. 68–79; Margolin & Gordis, 2000, ‘The effect of family and community violence on children’,Annual Review of Psychology, vol. 51, pp. 445–479; Perry, 2002, ‘Childhood experiences and the expression of genetic potential: what childhood neglect tells us about nature and nurture’,Brain and Mind, vol. 3, pp. 79–100; van der Kolk, 2005, ‘Developmental trauma disorder’,Psychiatric Annuals, vol. 35, no. 5, pp. 401–408). Research has also begun to address the impact on the professional's and carer's psychological well-being, as a result of working with children who have experienced abuse and neglect (Cunningham, 1999, ‘The impact of sexual abuse treatment on the social work clinician’,Child and Adolescent Social Work Journal, vol. 16, pp. 277–290; Trippany, Kress and Wilcoxon, 2004, ‘Preventing vicarious trauma: what counsellors should know when working with trauma survivors’,Journal of Counselling and Development, vol. 82, pp. 31–37; Conrad & Kellar-Guenther, 2006, ‘Compassion fatigue, burnout and compassion satisfaction among Colorado child protection workers’,Child Abuse and Neglect, vol. 30, pp. 1071–1080). Psycho-dynamic concepts such as projection and splitting have begun to be explored in how children who have experienced abuse communicate their experience to their carers and the professionals involved with them. Some authors (Daleet al., 1986,Dangerous Families: Assessment and Treatment of Child Abuse, Tavistock Publications, London) have also explored the impact of the psycho-dynamics on the treatment team and the ‘splitting’ that can occur among professionals involved with the child. This paper aims to extend this reflection to also consider the impact of the professional's attachment history, early childhood experiences and current personal relationships on the child and caregiver's systems. Therefore, concepts such as counter-transference and adult attachment styles within the therapeutic relationship are explored and examples provided from my own practice. [ABSTRACT FROM PUBLISHER]

Background: International epidemiological research into violence against children is increasing in scope and frequency, but little has been written about practical management of the ethical aspects of conducting such research in low and middle-income countries. In this paper, we describe our study procedures and reflect on our experiences conducting a survey of more than 3,700 primary school children in Uganda as part of the Good Schools Study, a cluster randomised controlled trial of a school-based violence prevention intervention. Children were questioned extensively about their experiences of physical, sexual, and emotional violence from a range of different perpetrators. We describe our sensitisation and consent procedures, developed based on our previous research experience and requirements for our study setting. To respond to disclosures of abuse that occurred during our survey, we describe a referral algorithm developed in conjunction with local services. We then describe our experience of actually implementing these procedures in our 2012 survey, based on reflections of the research team. Drawing on 40 qualitative interviews, we describe children's experiences of participating in the survey and of being referred to local child protection services.Results: Although we were able to implement much of our protocol in a straightforward manner, we also encountered major challenges in relation to the response of local services to children's disclosures of violence. The research team had to intervene to ensure that children were provided with appropriate support and that our ethical obligations were met.Conclusions: In resource poor settings, finding local services that can provide appropriate support for children may be challenging, and researchers need to have concrete plans and back-up plans in place to ensure that obligations can be met. The merits of mandatory reporting of children's disclosures to local services need to be considered on a case by case basis-in some places this has the potential to do harm. Research teams also must agree on what level of ancillary care will be provided, and budget accordingly. Further practical examples of how to address the challenges encountered in this work are needed, in order to build a consensus on best practices.Trial Registration: NCT01678846 (clinicaltrials.gov), August 24, 2012. [ABSTRACT FROM AUTHOR]

Understanding the association between children's behaviors and their perceptions regarding the quality of school friendships is useful for intervention strategies focusing on the interpersonal networks of children involved with the child welfare system. Rarely are measures of the strength of peer relationships assessed as a protective factor for maltreated children in the context of understanding their behaviors. This research investigates the link between these youth's expressed relational experiences and nonproblematic behavior. Analyses were conducted on 1,054 children (ages 11-17) from the National Survey of Child and Adolescent Well-Being II (NSCAW II) dataset. Utilizing a factored measure of perceived school friend connectedness, children's behaviors were predicted using Generalized Ordered Logistic regression analyses. Results demonstrated stronger school friend connectedness is a protective factor in that, children who perceive strong peer connections at school are more likely to classify below the problem behavior threshold than those with weaker peer connections. Further, children with increased social skills; fewer deviant peer affiliations; and those who take responsibility in part-time jobs and chores are more likely to display normative behaviors. Compared with all other types of maltreatment, physically abused children are significantly less likely to display behaviors below the problem range. Moreover, physical abuse has a negative impact on the protective nature of strong peer connections. Attention should be given to supporting children's perceived positive friendships, developing social skills, and encouraging participation in part-time jobs (e.g., babysitting, paper routes) as protective factors associated with nonproblematic behaviors, rather than problematic behaviors. Implications for service delivery are discussed. [ABSTRACT FROM AUTHOR]

The relationship between childhood adversity and adult depression is well-established but less is known about the association between childhood adversity and adult depression among the incarcerated. In this paper, we examine differential exposure and vulnerability to childhood adversity by race/ethnicity and gender on adult depression among the incarcerated in the United States. We address three research questions: does exposure to childhood adverse experiences vary by race/ethnicity and gender? Is there an association between these childhood adverse events and depression and does the strength of the association vary by the specific adverse experiences? And does vulnerability to childhood adversity vary by gender and race/ethnicity? Using the 2004 Survey of Inmates in State and Federal Correctional Facilities (SI-SFCF), we measure four key childhood adverse events - parental/caretaker substance abuse, physical assault, having been placed in foster care, and sexual assault. We use ordinary least squares regression and a series of interaction effect analyses to examine differential exposure and vulnerability to the four childhood adverse experiences by race/ethnicity and gender. Incarcerated women are more likely to report parental substance abuse, but all inmates/prisoners are similarly vulnerable to this experience. For the other three adverse experiences measured, we find that there are important racial/ethnic and gender differences in both exposure and vulnerability. African American men and women are more vulnerable to the effects of physical and sexual victimization than White and Hispanic men and women. Women are much more likely to be exposed to sexual victimization, but men who report this experience are significantly more depressed. Hispanic women and White men and women are more likely to report foster care, but all inmates/prisoners who report foster care experiences are significantly more depressed than other inmates/prisoners, with the exception of white men. The findings indicate that there are significant differences in exposure and vulnerability to childhood adversity by race/ethnicity and gender. We conclude that in order to effectively design and implement programs to decrease the probability that childhood adversity is a risk factor for adult depression interventions must be targeted toward specific, vulnerable groups according to race/ethnicity and gender. [ABSTRACT FROM AUTHOR]

This paper offers research case studies of four severely maltreated children who had received a diagnosis of autistic spectrum disorder. A range of measures were employed to explore the children’s psychological and emotional functioning, including Theory of Mind assessment (Sally–Anne Test), attachment measures (Story Stems Assessment Profile and Relationship Problems Questionnaire), along with measures to assess general psychological and emotional well-being. Contrary to the diagnosis, the children did not reveal a theory of mind deficit. However, they did indicate a profile of difficulties in mentalisation on the Story Stems. The findings are discussed in terms of the extent to which mentalisation and theory of mind are influenced by situational factors, especially the anxiety evoked by the Story Stem attachment scenarios. Clinical implications regarding mentalisation as a state vs. trait phenomenon are discussed. [ABSTRACT FROM PUBLISHER]

With the anticipated publication of the DSM-5 in May 2013, much reflection and work has been done on reviewing existing psychiatric nomenclature including, but not limited to the field of traumatic exposure. Traditionally, understanding of the psychiatric and psychological effects of trauma have been developed from studies with adults and then applied to trauma-exposed children with some modifications. While this is an important step to understanding the sequelae of trauma in children and adolescents, the adverse developmental effects of traumatic exposures on the rapidly evolving neurological, physical, social and psychological capacities of children calls for a developmentally sensitive framework for understanding, assessing and treating trauma-exposed children. The importance of early attachment relationships in infancy and childhood means that severely disrupted early caregiving relationships may have far-reaching and lifelong developmental consequences and can therefore be considered traumatic. Given the high rates of violence and trauma exposure of South African children and adolescents, the need for a developmentally based understanding of the effects of trauma on child and adolescent mental health becomes even more pronounced. In this paper, we draw on theoretical perspectives to provide a practical, clinically driven approach to the management of developmental trauma. [ABSTRACT FROM PUBLISHER]

Young offenders have a high prevalence of mental illness and a large proportion report experiencing a number of traumatic events during childhood, but there is little research exploring this association. This study describes the prevalence of, and association between, child maltreatment and post-traumatic stress disorder (PTSD) among young offenders. The study uses data collected as part of the 2009 NSW Young People in Custody Health Survey which was conducted in nine juvenile detention centers. This paper reports on findings from the baseline questionnaires and 18-months of re-offending data. The analysis included 291 participants who were assessed for PTSD and child maltreatment. The sample was 88% male, 48% Aboriginal, with an average age of 17 years (range 13–21 years). One in five (20%) participants were diagnosed with PTSD, with females significantly more likely to have PTSD than males (40% vs. 17%, p <0.05). Over half (60%) of young offenders reported any child abuse or neglect, with females nearly 10 times more likely to report three or more kinds of severe child maltreatment than males. The main correlate for a diagnosis of PTSD was having three or more kinds of severe child maltreatment (OR=6.73, 95% CI: 1.06–42.92). This study provides evidence for the need to comprehensively assess child abuse and neglect among young offenders in order to provide appropriate treatment in custody and post-release. [Copyright &y& Elsevier]

This article evaluates the published empirical findings on childhood emotional abuse and its proposed relationship with psychotic symptoms. Research and governmental policy indicates that emotional abuse is present in all forms of abuse and neglect, suggesting it is the form of abuse most frequently linked to mental health problems. Literature searches were conducted in 3 peer-reviewed electronic databases and relevant papers were reviewed. Results suggest childhood emotional abuse is statistically related to psychosis in adulthood. This adds tentative support to the hypothesis that emotional abuse is related to psychotic experiences; in particular to hallucinations and persecutory delusions. A number of studies also provide tentative support to the dose–response effect proposed between cumulative trauma and a greater risk of positive psychotic symptoms. [ABSTRACT FROM AUTHOR]

This systematic review sought to assess the impact of child maltreatment on cognitive functioning. Seventeen papers from Medline, PsycINFO, Embase and Amed (1995-2011) databases were analyzed based on inclusion/exclusion criteria. The studies have shown that maltreatment during childhood has deleterious effects on cognitive functioning. Overall, adults or children/teenagers exposed to abuse during childhood performed poorly on tasks meant to assess verbal episodic memory, working memory, attention, and executive functions. We conclude that child maltreatment is a risk factor for short and long-term development due to potential adverse effects on cognitive functioning. [ABSTRACT FROM AUTHOR]

This paper aims to highlight the importance of the study of the dysfunctional patterns of personality from the beginning to the end of childhood and early adolescence. It will review the empirical evidence on the risk factors of future dysfunctional styles of personality in adulthood and the possibility of these disorders as such from very early stages. It will present the vision of personality disorders from current diagnostic manuals and some peculiarities of the future DSM-V. It also, presents an analysis of the origin and development of these dysfunctional patterns of infant-juvenile personality from a functional-contextual view including the role of language or the verbal regulation and the self. Finally, there are some perspectives to be considered for future research. [ABSTRACT FROM AUTHOR]

Daruy-Filho L, Brietzke E, Lafer B, Grassi-Oliveira R. Childhood maltreatment and clinical outcomes of bipolar disorder. Objective: Adverse life events, especially early trauma, play a major role in the course and expression of bipolar disorder (BD). The aim of this article is to present a systematic review about the impact of childhood trauma on the clinical course of BD. Method: A computer-aided search was performed in Medline, ISI database, EMBASE, PsychInfo, Centre for Reviews and Dissemination, and Databases of Thomson Reuters at April 2011, supplemented by works identified from the reference lists of the first selected papers. Two investigators systematically and independently examined all articles, selecting those according inclusion and exclusion criteria. Results: Four hundred fifteen articles were identified, of which 19 remained in the review after exclusion criteria were applied. In general, childhood maltreatment predicted worsening clinical course of BD. After assessing the quality of the data and of the measurements, childhood maltreatment can be strongly associated to early onset of disorder, suicidality, and substance abuse disorder in patients with BD. Conclusion: Data suggest that childhood abuse and neglect are risk factors associated with worsening clinical course of BD. The conclusions should be interpreted with caution because all the studies included are cross-sectional and the majority are showing inconsistencies regarding childhood trauma as independent variable and how it is assessed. [ABSTRACT FROM AUTHOR]

The aim of this paper was to provide a description of the trauma experiences, trauma-related sequels, and resilience features of a sample of Canadian youth in residential care facilities, as well as to explore the impact of gender and of the number of different traumas experienced on trauma-related sequels and resilience features. A convenience sample of 53 youth aged 14 to 17 recruited from six child protection residential care units agreed to voluntarily participate in the study. They were administered the Childhood Trauma Questionnaire, the Trauma Symptom Checklist for Children, and the Child and Youth Resilience Measure. Results revealed high rates of abusive and neglectful experiences in the lives of these youth. Most have experienced multiple forms of trauma. Girls were more likely to report sexual abuse and to display clinical levels of sexual concerns, as well as posttraumatic stress and dissociation symptoms. Multiple forms of trauma were related to higher clinical levels of depression, anger, posttraumatic stress, and dissociation, as well as to lower individual, relational, and community resilience features. [ABSTRACT FROM AUTHOR]

After questioning the practical significance of evidence that parenting influences brain development - while highlighting the scientific importance of such work for understanding how family experience shapes human development - this paper reviews evidence suggesting that brain structure and function are 'chiselled' by parenting. Although the generalisability of most findings is limited due to a disproportionate, but understandable focus on clinical samples (e.g., maltreated children with post-traumatic stress disorder (PTSD)) and causal inferences are difficult to draw because of the observational nature of most of the evidence, it is noteworthy that some work with community samples and very new experimental work (e.g., parent training) suggests that tentative conclusions regarding effects of parenting on the developing brain may well be substantiated in future research. Such efforts should focus on parenting in the normal range, experimental manipulations of parenting, differential susceptibility to parenting effects and pathway models linking parenting to brain development and, thereby, to behavioural development. Research on parenting and children's brain development may be regarded as at 'the end of the beginning'. [ABSTRACT FROM AUTHOR]

Abstract: Child maltreatment is a pervasive problem in our society that has long-term detrimental consequences to the development of the affected child such as future brain growth and functioning. In this paper, we surveyed empirical evidence on the neuropsychological effects of child maltreatment, with a special emphasis on emotional, behavioral, and cognitive process–response difficulties experienced by maltreated children. The alteration of the biochemical stress response system in the brain that changes an individual''s ability to respond efficiently and efficaciously to future stressors is conceptualized as the traumatic stress response. Vulnerable brain regions include the hypothalamic–pituitary–adrenal axis, the amygdala, the hippocampus, and prefrontal cortex and are linked to children''s compromised ability to process both emotionally-laden and neutral stimuli in the future. It is suggested that information must be garnered from varied literatures to conceptualize a research framework for the traumatic stress response in maltreated children. This research framework suggests an altered developmental trajectory of information processing and emotional dysregulation, though much debate still exists surrounding the correlational nature of empirical studies, the potential of resiliency following childhood trauma, and the extent to which early interventions may facilitate recovery. [Copyright &y& Elsevier]

Previous research has documented a relationship between child sexual abuse and alcohol dependence. This paper extends that work by providing a comprehensive description of past year and lifetime alcohol consumption patterns, consequences, and dependence among women reporting either physical and sexual abuse in a national sample. This study used survey data from 3,680 women who participated in the 2005 U.S. National Alcohol Survey. Information on physical and sexual child abuse and its characteristics were assessed in relation to 8 past year and lifetime alcohol consumption measures. Child physical or sexual abuse was significantly associated with past year and lifetime alcohol consumption measures. In multivariate analyses, controlling for age, marital status, employment status, education, ethnicity, and parental alcoholism or problem drinking, women reporting child sexual abuse vs. no abuse were more likely to report past year heavy episodic drinking (OR = 1.7; 95% CI 1.0 to 2.9), alcohol dependence (OR = 7.2; 95% CI 3.2 to 16.5), and alcohol consequences (OR = 3.6; 95% CI 1.8 to 7.3). Sexual abuse (vs. no abuse) was associated with a greater number of past year drinks (124 vs. 74 drinks, respectively, p = 0.002). Sexual child abuse was also associated with lifetime alcohol-related consequences (OR = 3.5; 95% CI 2.6 to 4.8) and dependence (OR = 3.7; 95% CI 2.6 to 5.3). Physical child abuse was associated with 4 of 8 alcohol measures in multivariate models. Both physical and sexual child abuse were associated with getting into fights, health, legal, work, and family alcohol-related consequences. Alcohol-related consequences and dependence were more common for women reporting sexual abuse compared to physical abuse, 2 or more physical abuse perpetrators, nonparental and nonfamily physical abuse perpetrators, and women reporting injury related to the abuse. Both child physical and sexual abuse were associated with many alcohol outcomes in adult women, even when controlling for parental alcohol problems. The study results point to the need to screen for and treat underlying issues related to child abuse, particularly in an alcohol treatment setting. [ABSTRACT FROM AUTHOR]

This paper reviews the Window of Tolerance model of the long-term effects of the severe emotional trauma associated with childhood abuse, a model which can also be applied to adult trauma of sufficient severity to cause post-traumatic stress disorder, chronic dysthymic disorders and chronic anxiety disorders. Dysfunctional behaviours such as deliberate self-harm and substance abuse are seen as efforts to regulate an autonomic nervous system which is readily triggered into extreme states by reminders of the original traumatic events. While midbrain areas such as the periaqueductal gray mediate instant defence responses to traumatic events and their memory triggers it is proposed that ascending monoaminergic tracts are implicated in longer-term changes in mood and arousal. An imbalance of ascending dopaminergic tracts may drive rapid fluctuations in level of arousal and in the associated mood, drive and motivation. Animal models of depression frequently use traumatic experiences of pain, isolation or social defeat to induce changes in mesolimbic and mesocortical dopamine systems which may alter prefrontal cortical control of midbrain defence responses. A focus on the pharmacology of the Window of Tolerance could provide advances in drug treatments for promoting emotional regulation in those who are suffering from the chronic sequelae of traumatic experiences. [ABSTRACT FROM PUBLISHER]

The family, as the basic social environment, should attend to the affective and educational needs of the child. The family should be a stable and secure place for people to live together, where the child should receive care, protection, respect and social support. The family provides the environment for the child to develop and for the parents to adjust and readjust their expectations and practices concerning each child and each different circumstance within a continuity and style. The role of the family is not simply to satisfy the basic, fundamental needs, but to facilitate an interaction between the processes of physiological maturing and daily experiences in order to achieve the child's biopsychological plenitude. When the educational style is not the appropriate one, there are likely to be psychological problems in childhood and adolescence. Some experiences the child is exposed to can be the cause of maladjusted reactions. Such maladjusted response may vary according to the intensity of the experience, the meaning it has for the child, the developmental moment in which he/she finds him/herself (the degree of maturity) and the circumstances following the event. The attachment consolidates through the interaction between the child and the people around him/her. When children are exposed to aggression and rejection from their parents or when they are not given the affection and support that they need, they are more likely to develop emotional and behavioural problems. The communicative interaction established between the child and the important adults in his/her environment is essential for language developmental acquisition. Language accompanies us in almost all the activities we participate in. The absence of stimulation in the first years, so frequent in abused children, can result in delays in the acquisition and development of language. A great part of a child's activity in the first years of life is social and communicative. Although the early interaction between parents and children does not generate language understood as syntactical, phonological or semantic rules, it is essential as it provides the child with the necessary instruments to pass on to formal language. In the disorganised form of attachment, the most usual in cases of abuse, that sensitivity towards the child's needs is distorted, so the interaction with the child does not lead to a correct attribution of the intentional and communicative meaning of the child's action. The interaction in the family environment is essential as it reinforces and redirects the spontaneous use the child makes of language, progressively leading her/him to its correct use. The child learns to refer to the same things and in the same way as others do. Yet the use of language implies the consideration of the other as a thinking being, with beliefs and intentions that should be taken into account in order to be able to establish communication and the form it should take. Several papers researching this issue have stressed the effects of child abuse and neglect on language development. This research analyses pragmatic competence and psychosocial adaptation in children in protective care. Most of the studies do not provide data concerning how each individual linguistic component is affected in such children. Important deficiencies in language development are pointed out, but nothing is said in detail about where exactly such difficulties lie. The pragmatic function determines what type of language must be used in a certain context. This underlines the importance of such psycholinguistic skill. The child, beside learning the formal aspects of the language, learns to use them in a social context. The use of language implies something more than the form or the meaning. It also involves our desires, intentions, beliefs, decisions, to plan the action, etc. Our methodological proposal was carried out within the framework of the Child Care Centres in the Region of Extremadura (Spain). The sample is made up of 74 children living in four different Centres. There were 41 boys and 33 girls between the ages of 6 and 18. We feel we should point out, as strength of the research, the fact that the sample analysed represents the total number of children in residential care over the age of 6 at the time of the evaluation. Pragmatics determines what type of language should be used in a particular context. Children, apart from learning the formal aspects of the language, learn to use it in a social context. Thus there is a difference between the literal meaning of a phrase and its intention. It is necessary for the listener to recognise the speaker's intention over and above the literal meaning of what is said. To achieve this, children must be able to adapt the linguistic forms to the communicative act. We must draw attention to such important aspects as intentionality in communication and the context in which the children's language is developed. In a conversation, the children should be able to manage such skills as: taking turns to speak, expressing intention and recognising the intentions of others, attracting the other's attention, offering an appropriate amount of information, replying in an adequate way with relevant information, adopting the speaker's point of view, the capacity to modify their discourse according to the situation, etc. Our research shows that children in protective care have difficulties in knowing how people they are speaking to will react, especially when it comes to adults. They have clear limitations when using language as a resource to adequately demand attention, so that the person whose attention is required actually does so. They are also limited when directly or indirectly demanding action (the adequate formulation of a specific demand or suggestion); when making a request, especially in those situations in which a request has to be made to an important adult or figure of affection, they often have trouble maintaining continuity in discourse, jumping from one subject to another. They also have difficulties when asking for more information or explanations about some particular event; they express dislike or displeasure inadequately; they show a lack of ability in expressing disagreement before an authority figure (parents and teachers); they show limitations when demanding action, whether it be through commands or suggestions and they have problems formulating demands for specific information including the use of interrogative pronouns. They have difficulties answering when the question or affirmation is too long, and they have problems when using the interrogative adverbs of place «where» and of time «when», as well as with the use of «whose», «for whom» and «to whom», «why» and «how». Pragmatics is related to the early development of social interaction. We emphasize the importance of the social and interactive context in infancy. In both the language and the emotional and/or social development, the family can play a positive or negative role. It is in the family where we start to learn how to interact with others and the use of concrete expressions, when to use language, what to communicate, etc. Affective dialogue with figures of affection goes from the expression of satisfaction or dissatisfaction to the function of asking for attention, replying to the speech of others, and the attempt to modify the behaviour of others. The children present personal and social failure to adapt in several of the analyzed factors. The children demonstrate dissociative disruption, negative self-concept and poor self-esteem. As for the school failure to adapt there is demonstrated lack of motivation, laboriousness and interest by the learning, school external failure to adapt, indiscipline and distaste to the teacher and school dissatisfaction. We hope this research will encourage the study of this phenomenon. We must emphasize the intrinsic complexity of this measure of protection, in which multiple factors belonging to different systems (biological family, child, residential care and professionals) play a role, making it extremely difficult to elucidate what factors play a significant role in the explanation of the adjustment and the well-being of the children under care. [ABSTRACT FROM AUTHOR]