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This study proposes a model explaining the association between physical abuse of children and children's social and affective status as one in which children's social expectations and behavior, developed within the context of abusive parenting, mediate current functioning in these two outcome domains. Subjects included one hundred 9 to 12-year-old physically abused children recruited from consecutive entries onto the New York State Register for Child Abuse for New York City and 100 case-matched classmate nonabused comparison children. Sociometric assessments were carried out in classrooms, interviews were conducted with the children and their parents, and teachers, parents, and classmates rated the children's behavior. Path analysis was utilized to test the conceptually derived models. Children's social expectations regarding peers, and two social behaviors--aggressive behavior and prosocial behavior--were found to mediate between abuse and positive and negative social status, as well as between abuse and positive and negative reciprocity. Social expectations and withdrawn behavior mediated between abuse and positive social status, but only where withdrawn behavior was a function of social expectations. Social expectations were generally found to mediate between abuse and internalizing problems. Negative social status (peer rejection) added to social expectations in producing internalizing problems. Identification of these mediating pathways can serve to guide secondary preventive intervention efforts so that they best address the problems abused children face in the absence of adequate parental and peer support as the children enter adolescence.

Objectives: The feasibility and effectiveness of treating homeless mentally ill chemical abusers in community residences compared with a therapeutic community were evaluated., Methods: A total of 694 homeless mentally ill chemical abusers were randomly referred to two community residences or a therapeutic community. All programs were enhanced to treat persons with dual diagnoses. Subjects' attrition, substance use, and psychopathology were measured at two, six, and 12 months., Results: Forty-two percent of the 694 referred subjects were admitted to their assigned program and showed up for treatment, and 13 percent completed 12 months or more. Clients retained at both types of program showed reductions in substance use and psychopathology, but reductions were greater at the therapeutic community. Compared with subjects in the community residences, those in the therapeutic community were more likely to be drug free, as measured by urine analysis and self-reports, and showed greater improvement in psychiatric symptoms, as measured by the Center for Epidemiological Studies--Depression Scale and the Brief Psychiatric Rating Scale. Their functioning also improved, as measured by the Global Assessment of Functioning scale., Conclusions: Homeless mentally ill chemical abusers who are retained in community-based residential programs, especially in therapeutic communities, can be successfully treated.

Aims: To assess the magnitude and psychopathologic predictors of attrition among homeless, mentally ill chemical abusers (MICAs) referred to residential treatment programs in New York City., Design: Homeless, MICAs were randomly referred to a therapeutic community (TC) or community residence (CR) and monitored with regard to pre- and post-admission attrition., Settings: Community based treatment facilities modified to treat both substance abuse and major mental illness., Participants: Homeless individuals with a major mental illness (DSM-III-R) and a history of abusing alcohol or other drugs., Measurements: Attrition rates and selected scales of psychopathology., Findings: From an initial pool of 694 treatment candidates, 147 (22%) were rejected for admission at their assigned facility; 247 (36%) failed to show up for treatment; and 212 (31%) dropped out of treatment at some point during the first 12 months. Contrary to expectation, those with severe levels of psychotic ideation, depressive symptoms and hostility were admitted to treatment more frequently and stayed in treatment longer at the TC, a high demand approach, than the CR, a low demand approach., Conclusion: Clinicians should consider the TC as a viable treatment option for MICAs.