Lecture 14: Child Maltreatment

Front 1

definition: Any recent act or failure to act on the part of a parent or caretaker, which results in death, serious physical or emotional harm, sexual abuse, or exploitation, or an act or failure to act, which presents an imminent risk of serious harm.

Back 1

...

Front 2

-Punching, beating, kicking, burning, shaking, or otherwise physically harming a child
-Often unintentional and resulting from severe physical punishment

Back 2

physical abuse

Front 3

Child’s basic needs are not being met

Back 3

neglect

Front 4

3 types of negelect

Back 4

physical
educational
emotional

Front 5

Touching genitals, intercourse, exhibitionism, production of pornographic photos

Back 5

Sexual abuse

Front 6

Repeated acts by parents or caregivers that could or have caused serious behavioral, cogntive, emotional or mental disorders

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emotional abuse

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T or F all abuse will cause emotional harm

Back 7

T

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epidemiology of child maltreatment

Back 8

there are challenges of studying incidence/prevalence of child abuse due to
-reporting bias (people may not be willing to report this)
-retrospective report

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incidence=

Back 9

new cases in a given time frame

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epidemiology:
in USA
in Canada

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12.1/1000
9.7/1000

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reason for higher USA incidence

Back 11

higher rates of poverty, and it is much harder to get access to health care

Front 12

Responding anonymously, ___% of parents report using forms of physical punishment that constitute child abuse (anything leaving a mark)

Back 12

10

Front 13

Studies and treatment have focused on _____(2) abuse

Back 13

physical and sexual

Front 14

T or F older children are more likely to be neglected

Back 14

F
younger children are

Front 15

older or younger children:
who's more likely to be sexually abused

Back 15

older

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male or female:
who's more likely to be sexually abused

Back 16

female
*abused by male family members

Front 17

poverty is it a risk factor for abuse?
if so why?

Back 17

-yes
-crowded unsafe housing, restricted childcare opportunities

Front 18

see higher rates of (2) in single parent families

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physical abuse
neglect

Front 19

Maltreated children must learn to cope with challenges in environment, these adaptations may cause problems in other contexts discuss 2

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-Long term changes in physiological reactivity to stress
-Understanding of emotion

Front 20

explain why understanding emotion is affected in maltreated children

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-Being abused or neglected by a parent exposes you to different emotional experiences
-May change your understanding & experience of emotions
-E.g. If you're constantly exposed to anger from a parent, & if recognizing that anger was adaptive, would that change your perception of emotion?

Front 21

Pollak et al. 2000
-->Reading Emotional Expressions and Child Maltreatment study
emotion recognition task:
--> looked at sensitivity to differences between facial expressions, results?
--> looked at bias towards labeling a particular stimulus as a particular emotion, results?

Back 21

-neglected children were less sensitive to differences between facial expressions
-Physically abused children show a bias for angry faces & Neglected children show a bias for sad faces

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two possible reasons for pollak findings

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-Visually, children cannot discriminate between the faces
-They have different understanding of the emotional displays

Front 23

pollak et al 2000
emotion discrimination task-->Shown two photographs of models showing emotions and asked “same or different”
results?

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No differences between three groups on this task
It is not that physically abused and neglected children cannot see the differences

Front 24

pollak et al 2000
emotion differentiation task-->Children shown photographs of two models and asked to rate the similarity of the facial expressions
results

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-Neglected children perceived less distinction between angry, sad, fearful facial expressions
-Physical abused children and control children perceived more distinction between anger and other negative emotions

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pollak et al 2000
final conclusion

Back 25

Experience of abuse changes understanding of emotion

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pollak and sinha 2002 study:
-Presented children with photos displaying angry, sad, fearful, and happy facial images
-Images are slowly filled in randomly, so that the expression gradually appears
-what was the dependent variable
-results

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-how early the child can identify the photo
1) physically abused children needed less information to accurately identify angry faces than controls
2) Physically abused children needed more information than control children to identify sad faces
3) No difference for fearful and happy faces

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developmental course

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-Early experience of maltreatment fundamentally changes how children perceive emotions
-Children who have been physically abused show a bias for identifying angry faces, and they need less information to identify angry faces

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diathesis stress models:
you can have __________ interacting with maltreatment to lead to later psychopathology

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genetic predispositions

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Caspi et al. 2002 study on CD results

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MAOA activity interacting with maltreatment
Low MAOA activity and maltreatment predicting conduct disorder

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Diathesis-Stress Models:
caspi et al. 2003 study of depression

Back 30

-Serotonin transporter gene 5-HTTLPR ( short alleles and long alleles)
-In adults, short allele is associated with increased depression, but only for those who experience significant life stress
-Diathesis – short allele
-Stress – life stress
*Note that this finding has been called into question recently

Front 31

in caspi et al 2003
is there a main effect of genotype

Back 31

no
*kids severely maltreated more likely to experience depressive episode independent of genotype

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in caspi et al 2003
is there interaction between maltreatment status and genotype

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yes
*maltreatment and risk of depressive episode is more likely when u have the genotype

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another study found that
-social support played a ____role
-maltreated children with a short allele and poor social support had rates of depression ___ higher than maltreated children with a short allele and social support

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protective
2x

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T or F theres a main effect of maltreatment

Back 34

T
ie) regardless of genotype maltreatment associated with elevated rates of psychopathology

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Post-Traumatic Stress Disorder=

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-Anxiety after an extremely traumatic experience
-Direct experience
-Witness it in person
-Learns that it happened to a close family member or friend
-Experiences repeated exposure to details of event (not through media)

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Four core features of PTSD

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symptoms must persist for at least one month
Intrusion (1 required)
Avoidance (1 required)
extreme arousal (two required)
negative cognitions and mood (two required)

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PTSD in Children under 6 years of age (6)

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-More behaviorally anchored
-Young children may not show distressed affect
-Only one symptom required for avoidance and negative cognitions/mood (compared to 3)
-Feelings of detachment = social withdrawal
-Loss of interest = restricted play
-Irritable/aggressive behavior expanded to include temper tantrums

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Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) (5)

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Psychoeducation
Cognitive techniques
Relaxation skills
Safety skills
Graded EXPOSURE

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Child centered therapy

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Focuses on establishing a trusting relationship with the therapist
Encourages parents and children to structure treatment

Front 40

TF-CBT for Child Sexual Abuse Cohen et al., 2004
results

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Child effects
– Less PTSD sx
– Less shame
– Less depression
– Fewer total problems
– Greater trust
Parent effects
– Less parent depression
– Less self-blame
– More support of child
– Better parenting in general