Week 8 L14 C Maltreat Flashcards

0
Q

Physical abuse includes

A

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

Often by moms under distress and about of control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

U.S. Child Abuse Prevention and Treatment Act:

Child maltreatment definition

A

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.
Neglect, pushy usual abuse, sexual abuse, educational neglect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Neglect
Includes?

A

 Child’s basic needs are not being met 
Physical neglect
 Food, refusal of health care, inadequate supervision
 Educational neglect
 Not putting a child of manadatory age in school, not attending to special education needs

 Emotional neglect
 Failure to attend to child’s emotional needs, refusal or failure to provide needed psychological care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Sexual and emotional (harder to study) abuse

A

Sexual abuse
 Touching genitals, intercourse, exhibitionism, production of
pornographic photos

 Emotional abuse
 Repeated acts by parents or caregivers that could or have caused serious behavioral, cogntive, emotional or mental disorders
 Note that all abuse will cause emotional harm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Epidemiology of child abuse

A

 Challenges of studying incidence and prevalence of
 Reporting bias
 People may not be willing to report this
 Retrospective report
 A lot of studies are completed by asking adults to report what they experienced as children, memories shaped hanged innacuracy? detail?

Use proxy, but poor estimates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

One-year incidence rates for child abuse

A

 Recall that incidence is new cases in a given time frame
 In the U.S., 12.1/1000 children (more poverty, harder to get access to ehalthcRe)
 In Canada, 9.7/1000 children
 U.S. has higher rates of poverty, and it is much harder to get access to health care
 Responding anonymously, 10% of parents report using forms of physical punishment that constitute child abuse (e.g., hitting the child with an object) not an infrequent experience

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Most common type of maltreatment is

A

Neglect

Followed by:
Physical abuse
Sexual
Emo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Demographic characteristics of child dev.

Younger harder to manage, risk losing job late

A

 Age
Younger children are more likely to be neglected
Older children (> 12 years) are more likely to be sexualy abused
, can be left lone for longe but not overnight

 Gender
 Girls are more likely to be sexually abused
 Abused by male family members

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Younger children are more likely to be

A

neglected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Sociological and financial aspects to child abuse?

A

Poverty
 Crowded unsafe housing, restricted childcare opportunities

 Single-parent families
 Higher rates of physical abuse and neglect, due to stress and not being able to do it all. Mom is not supermom alone!

Parents have to make difficult choices, need money, leave baby alone overnight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Older children (> 12 years) are more likely to be

A

sexualy abused

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Developmental Course of child abuse

Adaptation made, cause difficulties in other contexts.

A

 Maltreated children must learn to cope with challenges in environment
 These adaptations may cause problems in other contexts
1) Long term changes in physiological reactivity to stress, more or less reactive, not useful in older newer enviro
2) Understanding of emotion: anger association to being hit, less positive input,

 Being abused or neglected by a parent exposes you to different emotional experiences

 May change your understanding and experience of emotions
 E.g., If you are constantly exposed to anger from a parent, and if recognizing that anger was adaptive, would that change your perception of emotion?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Study using emotion on faces

Reading Emotional Expressions and Child Maltreatment
 Pollak et al. 2000
 Participants
 15 physically abused children
 13 physically neglected children  11 children with no abuse history  Between 3 and 5 years of age

A

Emotion recognition task
 Children presented with 25 vignettes describing a protagonist experiencing one of 5 emotions: happiness, sadness, disgust, fear, anger

After each story, child shown three photographs of facial expressions (correct one and two distractors) and asked to point to the face appropriate for the stories protagonist

Emotion recognition task
(1) Sensitivity to differences between facial expressions
 How accurate is the child?
 Number of times a child says “angry” correctly
 Remember that some of these will be lucky guesses
 So subtract the number of times child days “angry” incorrectly

 In general, neglected children were less sensitive to differences between facial expressions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

 In general, neglected children were less sensitive to differences between facial expressions than control.
Get less emo inout, and less able to identify faces!

A

Shows that emotional understanding has changed for abused hildren.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Bias towards labeling a particular stimulus as a particular emotion Ccording to the same study showing neglected children ls sensitive to faces recognition,

A

 Extent to which a particular label may be more likely than others
 Physically abused children show a bias for angry faces
 Neglected children show a bias for sad faces

Specificity confident to expect abuse as not in neglect group! So good study

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Two reasons for those findings: from study cannot distinguish faces regarding neglected children.

A

 (1) Visually, children cannot discriminate between
the faces

 (2) They have different understanding of the emotional displays

16
Q

Follow up studies to tease apart why inability to discriminate?
Emotion discrimination task
 Shown two photographs of models showing emotions and
asked “same or different”
 No differences between three groups on this task
 It is not that physically abused and neglected children cannot see the differences

Second task?

A

Emotion differentiation task
 Children shown photographs of two models and asked to rate
the similarity of the facial expressions
 Six shelfs lined up horizontally
 One photograph placed on the far right
 Child indicated similarity by placing the other photo

 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

See diference, but not as different.

17
Q

Expeof abuse studies taken togethor

A

Change experience/understanding of emotion.

Something imp. For, interpersonal relations and acting on world!

Note also! not born who emotions! Expeerience in world shapes understanding!

18
Q

Another study facial recognition
Pollak & Sinha, 2002
 Participants
 24 physically abused children  23 non-maltreated children
 Presented children with photos displaying angry, sad, fearful, and happy facial images
 Images are slowly filled in randomly, so that the expression gradually appears, (degraded photos)
 Dependent variable is how early the child can identify the photo

A

At 3.3 second intervals, more of photo filled in
 At each interval, children were prompted to identify
the emotion
 Had to rate their confidence in their choice from (1) Guess to (5) Certainty
 Only correct responses with a rating of 4 or 5 were used

Results:
Physical abused vs control
At no point are control children identifying happy faces more reliably than abused
But for anger
Physical abused children identify anger more reliably earlier, than control children, and then the control get to be just as good later.
Quicker and better at working with lees info.

Fear also had no difference like happiness.

Abused were worse at sad! Control were more reliable. Identify more accurately.

19
Q

Conclusion for another study of faces, identification of degraded images

A

No systematic error.

Found that physically abused children needed less information to accurately identify angry faces than control children

 Physically abused children needed more information than control children to identify sad faces

 No difference for fearful and happy faces

20
Q

Developmental Course
Summary of child abuse

A

 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
 Implications for their behavior and emotional response

21
Q

Diathesis-Stress Models

Why mLtreatment leads to psychopathology

A

 Genetic predispositions interacting with maltreatment to lead to later psychopathology
 Conduct disorder  Caspi et al. 2002
 MAOA activity interacting with maltreatment
 Low MAOA activity and maltreatment predicting conduct disorder

Short allele and significant life stress, like child abuse lead to depression. Social support though plays a protective fold!
Less social support meant deprsion 2x higher!
5http, meta analysis controversy.

22
Q

Caspi et al. found an interaction between maltreatment status and genotype

A

A second study replicated the Caspi et al. finding
 Social support played a protective role
 Maltreated children with a short allele and poor social support had rates of depression 2x higher than maltreated children with a short allele and social support

23
Q

Diathesis-Stress Models
 There is a main effect of maltreatment
 Some individuals may be particular vulnerable 

A

Multifinality

Classic interactions

24
Q

Post-Traumatic Stress Disorder
Can occur with child abuse
Diagnostic protocol (no movies cannot do it)

A

 Anxiety after an extremely traumatic experience  Actual or threatened death, serious injury, sexual violation
 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)

25
Q

Core features in dsm v

Need to experi trauma! And 4 of

A

Four core features (change from DSM-IV)
 Symptoms must persist for at least one month

 Intrusion (1 required)
 Recurrent, involuntary, memories (may see this in children as play episodes); flashbacks, nightmares, intense physical distress to reminders of the events, marked physiological reactivity to stressor

 Avoidance (1 required)
 Avoiding thoughts or feelings related to the trauma; avoiding stimuli related to the trauma

 Extreme arousal (two required)
 Difficulty falling or staying asleep, irritable/aggressive behavior, hypervigiliance, easily startled, difficulty concentrating, self-destructive behavior

 Negative cognitions and mood (two required)
 Inability to recall key features of the event, persistent negative beliefs about self or world; distorted blame of self or others; persistent negative trauma related emotions (e.g., horror, shame); diminished in activities; alienation from others; inability to experience positive emotions

26
Q

Intrusion and avoidance ?in PTSD

A

 Intrusion (1 required)
 Recurrent, involuntary, memories (may see this in children as play episodes); flashbacks, nightmares, intense physical distress to reminders of the events, marked physiological reactivity to stressor

 Avoidance (1 required)
 Avoiding thoughts or feelings related to the trauma; avoiding stimuli related to the trauma

27
Q

Negative cognitions and mood (two required)

A

 Inability to recall key features of the event, persistent negative beliefs about self or world; distorted blame of self or others; persistent negative trauma related emotions (e.g., horror, shame); diminished in activities; alienation from others; inability to experience positive emotions

28
Q

Extreme arousal (two required)

A

 Difficulty falling or staying asleep, irritable/aggressive behavior, hypervigiliance, easily startled, difficulty concentrating, self-destructive behavior

29
Q

PTSD in Children under 6 years of age, special diagnostic criteria
Complx cognitive things like for adults just not possible.

A

 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

30
Q

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

A

 Psychoeducation
 Prevalence rates of trauma
 Typical reactions to stress
 Many children have transient symptoms
 Cognitive techniques Relaxation skills
 Safety skills Graded EXPOSURE
Create a “trauma narrative”
Very detailed and graphic
Gradually read and shared
May also need to do exposure around trauma cues

Video

31
Q

TF-CBT for Child Sexual Abuse Cohen et al., 2004
 Participants
– 2 sites
– 229 youths enrolled
– age 8 to 14
– 79% female
– PTSD symptoms (89% diagnosed)
– 90% experienced many traumas
 Design
– Random assignment

Cbt or control

A

TF-CBT for Child Sexual Abuse Cohen et al., 2004
 Treated for 12 weeks
 Mean number of sessions completed was same for
each group (approximately 10)
 Seven therapists were trained in both treatment modalities and administered both
 Kept raters blind
 Potential bias of having one particularly effective therapist mnimsized

TF-CBT
 Child centered therapy
 Focuses on establishing a trusting relationship with the therapist
 Encourages parents and children to structure treatment
 Both have strong theoretical basis and are widely used cct

32
Q

Outcomes of TF-CBT

A

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