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Fifty-nine physically abused children demonstrated a significantly higher incidence of self-destructive behavior than two control groups of nonabused children, one neglected and one normal. The self-destructive behavior, including suicide attempts and self-mutilation, was potentiated by interrelated variables operating in the abused child and his environment. Often enhanced by the ego deficits and impaired impulse control of the abused children, this behavior seemed to represent a learned pattern originating in early traumatic experiences with hostile primary objects. VioLit summary: OBJECTIVE: The purpose of this study by Green was to test the hypothesis that a child's experience of repeated physical abuse potentiates his or her development of self-destructive behavior. METHODOLOGY: An quasi-experimental design was employed. The study included an experimental group of 60 abused children and control groups of 30 "neglected" and 30 "normal" children who were not maltreated. The children ranged in age between 5 years and 12 years. The number of boys and girls were proportional and the groups were comparable with respect to the mean age of the children. The children were predominantly black and Hispanic and all were from low-income families. This sample was judged by the author to be representative of the ghetto areas from which it was drawn. The abused children were referred by the Bureau of Child Welfare and the Family Court of New York City. Abuse meant specifically that it was continuing or recurrent and confirmed; the majority of abused children lived at home. The sample of neglected was obtained from the Family Court. The criterion for neglect consisted of the court finding that the parent(s) failed to provide adequate physical care including food, clothing, medical care, and supervision. A neglected control group was included to control for the background of physical deprivation and neglect that often accompanies physical abuse in this ghetto population. The normal control group children were randomly referred volunteers from the pediatric out-patient clinic at Kings County Hospital. Detailed interviews, 1 to 1 1/2 hours, were conducted with the mother or maternal guardian by a psychiatrist or psychiatric social worker to determine the presence of self-destructive behavior among the children. Questions indicating child self-destructive behavior concerned possible forms of self-mutilation and self-destructive activity such as self-biting, self-cutting, self-burning, hair pulling, and suicide attempts, threats, or gestures. The presence or absence of self-destructive behavior and/or suicidal ideation was determined for each child and then summed into each group. Chi-square was used to analyze the differences between the 3 groups. Final analysis was done on 59 abused and 29 neglected children because of missing data. FINDINGS/DISCUSSION: A significantly higher incidence of self-destructive behavior was reported in the abused children. Of 59 abused children, 24 (40.6%) exhibited self-destructive behavior, and only 5 of the 29 neglected children (17.2%) and 2 of 30 normal controls (6.7%) were self destructive (p EVALUATION: This study reports yet more of the damaging effects of parental abuse on children. The sample size was large for a study of this sort. The selection of the sample was biased in that only those children who had been actually referred to official authorities were included, and Blacks and Hispanics were oversampled. Collection of data from interviews with mothers could have been supplemented with other data. The findings would have been more convincing if controls for such variables as SES, gender, and other potential antecedents had been included. This research points to another area in the phenomenon of child abuse that needs study. (CSPV Abstract - Copyright © 1992-2007 by the Center for the Study and Prevention of Violence, Institute of Behavioral Science, Regents of the University of Colorado) KW - New York KW - Child Development KW - Child Victim KW - Child Abuse Effects KW - Child Abuse-Behavior Link KW - Child Abuse Victim KW - Child Physical Abuse Effects KW - Child Physical Abuse Victim KW - Child Behavior KW - Self Destructive Behavior KW - Self Mutilation KW - Psychological Victimization Effects KW - Domestic Violence Effects KW - Domestic Violence Victim Language: en

While seeking research subjects to test the effect of hemodialysis on schizophrenia, the authors noted that the relatives of schizophrenic patients tried to involve themselves excessively in the selection process. Of 27 patients referrals meeting diagnostic criteria for schizophrenia, only one contact was initiated by the patient; the rest were initiated by family members. In more than half of the family-initiated contacts relatives attempted to become excessively involved in the patient's decision making. The authors discuss these observations in light of family theories of schizophrenia. They urge caution in selecting subjects for research that attempts to test other researchers' earlier claims which may have stimulated premature hope of improvement.

The authors observed patterns of family interaction frequently encountered in 60 cases of child abuse. The maltreatment syndrome is described as the end result of three potentiating factors: the abuse-prone personality of the parent; characteristics of the child that make him vulnerable for scapegoating; and current environmental stress. Role reversal was a prominent feature in the psychodynamic makeup of these families. The parents tended to endow the child with negative characteristics derived from their own experience with rejecting parents.

The authors describe a useful teaching tool in a psychiatric residency, an ongoing group process seminar. In it residents learn to recognize and deal with the forces of competition, scapegoating, dependency, and helpless rage at the administration. Studying these forces makes it possible to understand and effectively counter similar processes in other groups such as inpatient wards.